ACGME case logs

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donaldfaison

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I've been pretty bad at keeping up with these. How important is it to log all of your cases? I was planning on just logging enough to pass the required amount of cases.

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I've been pretty bad at keeping up with these. How important is it to log all of your cases? I was planning on just logging enough to pass the required amount of cases.

Our program made sure we kept up on it. And it helps them determine what we're deficient in so they can adjust the program accordingly to make up for any numbers problem.
 
Make sure you have your cases logged somewhere whether its the ACGME system or if your residency program's billing company keeps records. When you get credentialed for your first post residency job they will want a case log in some form or another.
 
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I do my best to just quickly log my cases if there's a chance during each case. Takes 30 seconds max. If it's a fast/rapid turnover day I do make sure to do it quickly before I leave. Plus as was said above the recent graduates of my program all said that their respective employers wanted some form of log. If all you have are the bare minimums, then they're likely just going to assume that's all you've done. They aren't likely to guess as it seems common sense for you to know what you've done.
 
I’ve been told there are some facilities out there that want your case logs for certain privileges - like blocks, TEE, and others. You are literally required to keep up an accurate log as part of residency and it’s super fast, just do it each day when you’re reviewing your cases for the next day.
 
It can be something as simple as having a pocket size moleskin and writing the date and case. If you're a cardiac fellow definitely keep track of EVERY TEE exam you personally perform. It's honestly a nice habit to get into because when you go into private practice, if you're in a production based group you want to keep track of all your cases when inevitably your accounting dept or the billing dept misses or miss tracks a case.
 
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What does everyone put in the “case ID” spot?
 
Log everything you do. Since you haven’t kept up, just spend a few hours some random weekend and retroactively document everything. It can be a pain, but many jobs, including mine, asked for a comprehensive list of everything that I did during residency.
 
I echo the idea of logging everything you do in case someone asks. I was told jobs would ask, none did, nor did they for any of my friends. But still, it’s worth logging for your own knowledge, and just in case.
 
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Make sure you have your cases logged somewhere whether its the ACGME system or if your residency program's billing company keeps records. When you get credentialed for your first post residency job they will want a case log in some form or another.

we've never asked for anyone's case log nor has any insurance company that we credential them with. The only thing I could potentially see being asked to see it for would be hospital privileges for some sort of procedure.
 
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My program director always explained these as “your transcript” from residency. I have had jobs ask for these. Doing just enough case logs to pass would almost make it seem like you came from a very borderline program.

Log everything. Seriously, everything.
 
I honestly can't overemphasize how important it is to log. I slacked off once I hit my minimums and had to go back through EMR and log another 150 or so cases before PD would sign my diploma. My understanding is ACGME mins are just a guideline and the ACGME wants to get a feel for how many cases each program is really doing.

I also had to send case logs for a locums gig and as you can imagine it looks bad if you only logged 20 cardiac cases or 50 blocks etc
 
When ACGME does a full blown site visit, or even their annual review, of a program, they look at the case logs. That is one way they figure out if a program is providing an adequate amount of cases to train you. So, for instance, if everyone in your class only logged the minimum number, then ACGME may decide that there are too many people in the program for the amount of cases, and state that there has to be a decrease. (Have heard of it happening) It is also a requirement that the PD review your case logs quarterly, to make sure that they are done and appropriate.

Also, I have been requested to supply copies of case logs (I keep a copy of the grad's) in order for a grad to be credentialed (privileged) for the most mundane things, (placement of central lines), as well as maybe more specific (blocks, etc). I give the grads a printed copy of their logs, but I know that sometimes those get lost.

And don't CT Fellows have to supply logs when they go for their special boards? I know in years past they have.

In other words, get into the habit now. It will serve you well in the future.
 
How about continuing to log cases/keep track of cases once you start as an attending?
 
How about continuing to log cases/keep track of cases once you start as an attending?


Your billing company does that for you. You can keep your own log to check to against their reports to see if they miss anything.
 
I keep an Excel file with date, case, anesthesia type, added procedures, and anything special (like pulmonary cripple, or severe AS). The record is just for my own purposes, so I can see how much of what I've been doing, and how I may change my practice over time. When asked for a case like for jobs, though, they've accepted my Excel file, so it also serves that purpose.

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