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Message from the Council of Pediatric Subspecialties
(CoPS) Chair
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Welcome to CoPS Communications! Our hope is that this
inaugural edition of our newsletter will be the beginning of even
more communication to and from our constituents about the activities
of the CoPS.
Victoria
F. Norwood, MD
CoPS
Mission and Vision
Our mission is to integrate approaches to subspecialty
education, research and patient care by providing a forum for members
and other organizations and by serving as the common voice for the
pediatric subspecialties. Our vision is for all pediatric subspecialties
to work together to ensure excellence in pediatric subspecialty
medicine by valuing compassion,
diversity, communication, career
development and satisfaction, and the highest quality
education, training and research.
Who Are We?
CoPS is comprised of two representatives from those
subspecialties in which the American Board of Pediatrics offers a
certificate of special qualifications plus others as chosen by the
council. (For a listing of the current representatives, click
here). One representative from each subspecialty must be a
training program director. There are also liaison members from the American
Academy of Pediatrics (AAP), American Board of Pediatrics (ABP),
Association of Medical School Pediatric Department Chairs (AMSPDC),
Association of Pediatric Program Directors (APPD), Pediatric Academic
Societies (PAS) and Federation of Pediatric Organizations (FOPO).
How Does
CoPS Operate?
There is a five member Executive Committee that guides task
forces and addresses issues facing and raised by the pediatric
subspecialty community (see
http://www.pedsubs.org/issues/index.cfm).
CoPS has two meetings, one in the fall, in conjunction with APPD, and
one in the spring with PAS. CoPS also has general and subspecialty
web-based discussion boards at http://www.pedsubs.org/discussion/index.cfm.
How is CoPS Funded?
Since its inception, CoPS has been funded through the generous
support of the APPD and AMSPDC. Individual representatives are
currently self-supporting or supported by their nominating societies.
A dues structure for subspecialty organizations is planned to begin in
2009.
Why Do We
Need CoPS?
Two years ago, when the Council of Pediatric Subspecialties
was founded, we envisioned an organization dedicated to ensuring
excellence in pediatric subspecialty medicine by providing an
integrated forum for members and other organizations to address
common issues of education, research and patient care. We have
an ambitious agenda, with identified issues
across the breadth of our missions, but in a short period of time we
have made significant strides in defining communication lines,
establishing ourselves as a "go to group" for other
organizations desiring input, opinions and assistance from pediatric
subspecialties, and initiating action into complex concerns.
I cannot complete these thoughts without expressing my gratitude to
our liaison organizations, ABP, AAP, APPD, AMSPDC, FOPO, and
PAS. They have been continuously supportive of our missions and
provide many of our connections to the breadth of pediatric
medicine. To the subspecialty pediatricians and their
representatives, CoPS is yours. I encourage you to utilize our
strengths and assist our efforts. To Laura Degnon, our Executive
Director, we owe our focus and our organized, yet creative,
style. Welcome to the adventure!
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Update on CoPS Task Forces
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Fellowship Core Curriculum
This group is
to examine and then share curricula with the CoPS members. Co-Chaired
by B. Li, MD and Josef Neu, MD, The goal is to link with the APPD
Share Warehouse and develop toolkits for subspecialty program
directors.
Communications
This task
force, led by Richard Mink, MD, is working to develop an effective
inter-subspecialty communications network. Since CoPS' initial issues
focused on fellowship programs, efforts have first been directed at
creating a pediatric subspecialty program directors e-mail directory.
Thanks to the categorical programs and the ABP, this is very nearly
completed. The task force is now in the process of developing an
e-mail listing of the leaders of the organizations that represent
each subspecialty. Ultimately, the goal is to generate a method to
contact all pediatric subspecialists. The task force has also been
working on creating a newsletter and updating the website. This
newsletter is the first large-scale communications effort of the task
force with additional ones planned for twice per year.
Relationships with Regulatory Agencies
Charged with
forming pro-active and interactive partnerships to enhance
subspecialty training and practice, this task force, led by Chris
Kennedy, MD, is utilizing a request from the ABP to structure a
working group to address these issues. The ABP has requested
that CoPS assist in the development of a subspecialty program
director's guidebook to improve the understanding, efficiency, and
accuracy of processes required of training directors. Meant to
complement information supplied by the ACGME, this guidebook will
build on the success of the document developed for core pediatric
directors and will include information regarding timelines,
differentiating certification from accreditation, definition and
evaluation of competencies, links to available ABP materials, forms
and documents, and FAQ's. If you are interested in helping, or
know of a capable team member willing to assist, please contact Chris
Kennedy at ckennedy@cmh.edu.
Advocacy
and Workforce Task Forces
The Advocacy
(interim chair Bill Schnaper, MD) and Workforce (chair Christopher
Harris, MD) Task Forces are working together to address related
recruitment and quality-of-life issues that appear to be of paramount
importance for most pediatric subspecialties. Two main goals
have been identified. First, we should seek in the long run
"right-size" the subspecialties by identifying what
clinical and academic needs are now, and will be in the future.
The immediate tasks are to find out what kind of data we need to
define the problem, and then devise the means to obtain the
data. Only after this process will we are able to develop
targeted approaches. Since this effort will take some time, our
life-style issues (and our ability to recruit trainees into the subspecialties)
will be enhanced by our second, more short-term goal of
"increasing the denominator" by finding ways to
collaboratively lessen the workload for subspecialists. An important
part of this effort will be finding subspecialists advocates! We
need the help of any interested CoPS members who might be interested,
please let us know.
Additional
information about the CoPS Task Forces can be found on the CoPS
website.
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Streamlining the Fellowship Application Process
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The
random nature of the processes for pediatric subspecialty fellowship
application and acceptance was one of the initial issues that
stimulated the formation of CoPS. Happily, this has undergone a rapid
transformation. In January 2008, CoPS recommended that all
subspecialties utilize the Electronic Residency Application Service
(ERAS) to standardize fellowship applications. At that time,
only 4 of 19 CoPS-represented subspecialties utilized this
process. Since then, 5 more subspecialties have agreed to use ERAS. Similarly,
in January of 2008, only 10 of 19 pediatric subspecialties utilized a
match and there were eight different match dates. Since the CoPS
report, 2 additional subspecialties (nephrology and pulmonology) will
initiate matches for the 2010 appointment year. In addition,
most of the subspecialties using the match have agreed to use one of
two match dates, a Pediatric Specialties Spring Match that will occur
13 months prior to the start of training and a Pediatric Specialties
Fall Match that will occur 8 months prior to the start of training.
The NRMP calendar of events is listed below. Child Neurology holds
its match annually each January through the San Francisco Matching
Program. CoPS will continue its support to streamline the fellowship
application process and assist in reporting the effects of these
charges.
Click
On Image For Larger View
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CoPS and the Association of Pediatric Program
Directors (APPD): Working Together for Pediatric Education
By Susan
Guralnick, MD, APPD President
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The
APPD is proud to have played a part in the formation of CoPS. It has
been exciting for us to watch this organization grow, define its
goals, and work toward those goals. We know that CoPS has a great
future as an organization that will support the pediatric
subspecialty arena. It is also clear that our missions of the two
organizations are similar:
APPD Mission: The Association of Pediatric Program Directors
is committed to excellence in pediatric graduate medical education to
ensure the health and well-being of children.
APPD Vision: Exemplary pediatric education.
APPD Values: · Innovation · Collaboration ·
Communication · Scholarship
The APPD has over 2000 members, including Categorical Program
Directors, Associate Program Directors, Program Coordinators, Chairs,
Medical Education Specialists, and Chief Residents. We have 482
Subspecialty Program Director members and 10 Fellowship Program
"Super" Directors. The APPD membership dues year is from July
1-June 30. Annual dues are $1400 per accredited pediatric program,
which includes the program director, one associate program director,
the department chair, one pediatric residency program coordinator and
all chief residents. We also invite individuals from programs such as
Pediatric Emergency Medicine, Medicine Pediatrics, Pediatric Child
Psychiatry, Pediatric Rehabilitation Medicine, Pediatric Genetics,
Subspecialty Training Fellowship Directors, etc. There is a $100
charge for each additional individual or programs may pay $2500 for
an unlimited number of individuals.
Possibly our greatest achievement to date is the Share Warehouse, a
member's only resource. The Share Warehouse is a virtual, web-based,
collaborative project that provides a place for pediatric graduate
medical educators, including subspecialists, to find resources to
improve their trainees' educational curriculum, evaluative processes
and their own administrative capabilities. The Share Warehouse will
soon allow pediatric educators to submit and receive academic
recognition for their work, while fostering collaboration at a real
and meaningful level.
The APPD also worked with the American Board of Pediatrics to help
program directors improve their teaching of professionalism,
culminating in the publication "Teaching and Assessing
Professionalism - A Program Directors Guide." Our Professional
Development Working Group is creating a program to develop leadership
and management skills for Program Directors.
Another current project for the APPD is LEARN (Longitudinal
Educational and Research Network), a network that will allow programs
to work collaboratively on educational research projects. This will
promote evaluation of innovations across programs and provide the
resources needed for many programs to be involved in research and
curricular change.
Recognizing the need to further develop the educational tracks for
Fellowship Directors, this year the APPD created a position for a
Fellowship Director on our Board (Debra Boyer, MD). We will continue
to seek input from Fellowship Directors as to how we can meet their
educational needs.
For more information about the APPD, please visit www.APPD.org.
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CoPS Joins the Organization of Program Directors
Associations (OPDA)
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This
past November, CoPS became the newest member of OPDA, the
Organization of Program Directors Associations. Created in 2000
by the Council of Medical Speciality Societies (CMSS), OPDA is
comprised of 28 members representing each of the medical and surgical
specialties recognized by the ACGME. Among the members are
representatives from the Association of Pediatric Program Directors
(APPD), Association of Program Directors in Internal Medicine,
Council on Residency Education in Obstetrics and Gynecology,
Association of Program Directors in Surgery and Council of Emergency
Medicine Program Directors (click
here for a listing of member
societies). OPDA facilitates peer interaction and collaborative
problem solving among program director associations. Via OPDA,
pediatric subspecialties, represented by CoPS Vice-Chair, Jim Bale,
MD, now have a link to the Council of Medical Specialty Societies, an
umbrella organization at the center of all activities of American medicine.
The importance of pediatric subspecialty representation in these
venues cannot be understated.
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CoPS to Participate in the First Pediatric Educational
Excellence Across the Continuum Conference
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Do
you educate students, residents or fellows? Are you just getting
started teaching? Are you interested in improving your
teaching expertise? If you answered
"yes," then you will be interested in a new conference to
enhance teaching. CoPS has joined with the APPD, the Council on
Medical Student Education in Pediatrics (COMSEP) and the Academic
Pediatric Association (APA) to present the first "Pediatric
Educational Excellence Across the Continuum" (PEEAC) Conference.
This conference, to be held in 2009 on September 11 and12 at The
Westin Arlington Gateway, Arlington, VA, will be the perfect venue
for educators to gain content expertise and improve teaching
skills. Faculty recognized for their teaching
expertise will direct workshops and small group sessions. For
more information, visit www.peeac.org/.
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CoPS Comments: The Timing of the Transition from
Resident to Fellow: Are Our Expectations Reasonable?
By Rob
McGregor, MD, APPD Immediate Past-President
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Pediatric residents are typically contracted through June 30th while
many fellowships require orientation prior to this date. To explore the
magnitude of this transition timing issue, fellowship directors and
categorical pediatric residency directors were surveyed. While more
than 95% of fellowship directors (113 out of 491 surveyed) take more
than 75% of their fellows directly after completing their third year
of residency, 80% state that fewer than 10% of their fellows report a
conflict with their start date. Conversely, of categorical pediatric
program directors surveyed (109 out of 182), 25% reported that at
least 1 in 4 of their residents starting fellowship experience a
conflict.
Categorical program directors manage the challenge of their
graduating residents being in two places concurrently by using
terminal vacation (although residents may find themselves under two
contracts at the same time) and just letting them leave residency
early. Fellowship directors report strategies that include having
flexible start dates, no expected clinical responsibilities until
August, late scheduled start date (range July 3rd to July
16th.) The service needs on the receiving end seem to drive
fellowship start date.
With our increased efforts to promote professionalism, the transition
challenges seem to be a set-up for residents and fellows to be placed
in a professionalism dilemma. Should
there be a uniform fellowship start date which delays fellowship
start time by seven days? 68% of fellowship directors
and 92% of categorical program directors responded positively,
recognizing that the impact on service would only be realized in the
first year of fellowship.
Do you have an opinion? Please post your comments on the CoPS General
Discussion Board.
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IOM Report About Resident Duty Hours Released
(summary provided by the AAIM)
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The
Institute of Medicine (IOM) Committee on Optimizing Graduate Medical
Trainee (Resident) Hours and Work Schedules to Improve Patient Safety
released the report, "Resident Duty Hours: Enhancing Sleep,
Supervision, and Safety," Tuesday, December 2, 2008. The
report recommends revisions to medical residents' duty hours and
workloads to "promote conditions for safe medical care, improve
the education of doctors in training, and increase the safety of
residents and the general public."
The IOM report recommends the maximum residents' work hours per
week remain at 80 hours. However, the report diverges from the
current duty hour limits to propose the maximum shift length of 30
hours should allow the admission of patients for up to 16 hours, plus
a "5-hour uninterrupted continuous sleep period" provided
between 10:00 p.m. and 8:00 a.m., with the remaining hours for
transitional and educational activities. The maximum shift
length without protected sleep time would be 16 hours.
In addition, the report recommends:
Both
internal and external moonlighting should be counted against the
80-hour weekly limit.
Night
float must not exceed four consecutive nights and must be followed by
a minimum of 48 continuous off-duty hours after three or four
consecutive nights.
The
maximum in-hospital, on-call frequency should be every third night
without averaging.
The
minimum time off between scheduled shifts should be changed to 10
hours after day shift, 12 hours after night shift, and 14 hours after
any extended duty period of 30 hours.
Mandatory
time off duty should increase to five days off per month, one day off
per week, without averaging, and one 48-hour period off per month.
While
the report focuses heavily on altering residents' work schedules, it
also notes the importance of increased supervision of residents,
limits on patient caseloads, and scheduling overlaps to improve
patient handoffs. The report also recommends that
regulatory bodies should strengthen their current monitoring
practices to ensure residency program compliance.
The committee estimates the implementation cost of these
recommendations to be approximately $1.7 billion
annually.
According to committee chair Michael M.E. Johns, MD, implementation
of the report's recommendations should begin immediately, and all
action should be taken within 24 months. In March 2009, the
Accreditation Council for Graduate Medical Education will convene a
duty hours conference to review the IOM report and discuss possible
refinements to its recommendations.
For more information on the report, please visit the National
Academies website.
CoPS is very interested in your comments about this report and its
potential impact. Please post your comments on the special IOM
Duty Hour Report Discussion Board.
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2009 Certifying Examination Dates of the American
Board of Pediatrics
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Sports Medicine
Examination Dates: July 8-11, July 13-20,
and July 22-25
Neurodevelopmental Disabilities
Examination Dates: September 21-25
Sleep Medicine
Examination Date: November 19
Child Abuse Pediatrics
Examination Date: November 16
Pediatric Endocrinology
Examination Date: November 16
Pediatric Gastroenterology
Examination Date: November 16
Pediatric Infectious Diseases
Examination Date: November 16
2009
Certifying Examination Dates of American Board of Medical
Genetics Examination Dates: August 17-21
2009
Certifying Examination Dates of the American Board of Psychiatry and
Neurology
Click here for
the examination dates for Child Neurology and Child Psychiatry
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