New EM Residency Program

[Arctic Char]

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i have recently had several conversatins with public policy gurus (i just happen to know them personally) who are interested in establishing an emergency medicine program in alaska. but they don't know where to start. there is a modern hospital, adjacent to an excellent university . . .. what could i suggest for them?

i would love it if they could pull this off in two years in time for my graduation. but i don't see it coming. nonetheless, i would like to see this happen.

anyone have experience or insight into what they'll be up against, or some first considerations i can pass along?

thanks all

 

[Haemr Head]

The best first step in starting a program is to see if there are the minimum criteria in place :

1. A base ED with at least 30,000 ED visits/year and a reasonable admission rate.​

2. A chair of a department of emergency medicine (at least at the base hospital if not a medical school) who is board certified in emergency medicine with some experience in both education and research.​

3. Enough EM attendings or the committment and ability of a qualified chairman to recruit enough attendings to act as core faculty to the residents. These folks need to bring enough research to the table to be credible with the RRC.​

The second (optional) step is to reach out to SAEM and find a team for a site visit to assess what more is needed.

The third step is to recruit a future program director. The first task given to this person is to create the RRC application. The RRC has rather explicit rules about the credentials of both the head of the program (the chairman) and the program director so choose, but choose wisely.

If you want to discuss this more fully, feel free to IM me. I've been down this pathway before.

 

[deleted77919]

According to the Alaska Native Medical Center website they receive 56,000 ED visits annually and are the 2nd busiest in AK. This suggests to me the first busiest is Providence Alaska Medical Center in Anchorage, but didn't find hard numbers on annual volume.

P.S. I would be the first to jump on board with this as either a resident or attending depending on how long this takes to set up. (If it happens that is).

 

[deleted77919]

Double post.

 

[BKN]

The best first step in starting a program is to see if there are the minimum criteria in place :

1. A base ED with at least 30,000 ED visits/year and a reasonable admission rate.​

2. A chair of a department of emergency medicine (at least at the base hospital if not a medical school) who is board certified in emergency medicine with some experience in both education and research.​

3. Enough EM attendings or the committment and ability of a qualified chairman to recruit enough attendings to act as core faculty to the residents. These folks need to bring enough research to the table to be credible with the RRC.​

The second (optional) step is to reach out to SAEM and find a team for a site visit to assess what more is needed.

The third step is to recruit a future program director. The first task given to this person is to create the RRC application. The RRC has rather explicit rules about the credentials of both the head of the program (the chairman) and the program director so choose, but choose wisely.

If you want to discuss this more fully, feel free to IM me. I've been down this pathway before.

This is good advice, but I would add that the hospital must have other teaching programs usually at least the 6 pack. There must be major institutional support (read money and desire), a GME program and director. Best first pass advice is to go to www.acgme.org and select the EM residency review committee. Read the specialty requirements carefully, also read the general requirements carefully.

In general, this is not a quick or casual process.

 

[deleted77919]

Well, at the moment all that's there is FM. No other residencies. Hmm . . .

I can also imagine problems related to the ED already being fully staffed. Do you just fire people because they don't have enough research to make room for new faculty?

 

[Miami_med]

Well, at the moment all that's there is FM. No other residencies. Hmm . . .

I can also imagine problems related to the ED already being fully staffed. Do you just fire people because they don't have enough research to make room for new faculty?

If you read the requirements, it doesn't actually say that you have to have any other residencies, just educational experience in the core competencies. In actuality, having the FM program probably provides enough services to cover this, if the EM residents actually get to do similar rotations.. Just a thought.

 

[GeneralVeers]

Two years is optimistic for starting a new residency. I'm at a brand new program myself, and in my talks with the PD and faculty, it was a long, complicated ordeal to get a residency. From the time the decision was made at the hospital/GME level to apply for approval, it took five years of work before they could match their first interns.

 

[deleted109597]

Yeah, the guys at Charleston acted like they were very surprised by the amount of time it took for their accredidation. They thought it would be much longer, but it went through on the first try.

 

[lucky_deadman]

Yeah, I spoke with some of the newer programs and have heard an average of 7 years to get things done from starting the planning until the first class enters.

 

[Arctic Char]

thanks for the advice. i'll pass it along.

as it stands, you're right providence does have a FM residency. and providence is directly adjacent to the university of alaska campus, which also supports the University of Washington WWAMI program. there are clinical faculty there, but i'm not sure about their fields or numbers.

these folks said they are looking for ways to retain more physicians in alaska. they mentioned increasing the number of positions in the WWAMI program for students, and some are arguing that increasing residencies might be a better way to recruit more docs. i agree with the latter approach, for many reasons. and i especially envision EM in alaska being attractive to many future EP's.

and i'd also like going home ; )

anyway, thanks again for the information. we'll see what goes down . . .

 

[ryng]

The University of Washington School of Medicine maintains a Deans office in Alaska as part of the WWAMI program. Maybe they could help. Here in Seattle were looking at the possibility of having a program in 10 years. I would love to move up to Alaska and help start a program on the administrative end.

-

 

[Haemr Head]

Two years is optimistic for starting a new residency. I'm at a brand new program myself, and in my talks with the PD and faculty, it was a long, complicated ordeal to get a residency. From the time the decision was made at the hospital/GME level to apply for approval, it took five years of work before they could match their first interns.

I've helped get two programs get started in less than 2 years from soup to nuts, but it requires that you have all the right things in place before you start and really understand the RRC process. If you are including the work needed to obtain full institutional support including a minimum of 18 residency positions, building a faculty with a sufficient academic track record, recruting a chairman and a PD with the right credentials, then I agree it is a whole different ballgame. Approval by the institution to submit should really only happen when all those prelminary things are in place.

 

[Haemr Head]

The University of Washington School of Medicine maintains a Deans office in Alaska as part of the WWAMI program. Maybe they could help. Here in Seattle were looking at the possibility of having a program in 10 years. I would love to move up to Alaska and help start a program on the administrative end.

-

Is 10 years Michael Copass' life expectancy?

Step 1 in starting a program in Seattle - retire the ED director at Harborview
Step 2 Recruit a PD from the existing pool of PDs and associate PDs.
Step 3 Sit back and in 5 years you will have one of the top programs in the country.

 

[SolidGold]

Is 10 years Michael Copass' life expectancy?

Step 1 in starting a program in Seattle - retire the ED director at Harborview
Step 2 Recruit a PD from the existing pool of PDs and associate PDs.
Step 3 Sit back and in 5 years you will have one of the top programs in the country.

How old is the director there? Any chances he will retire anytime soon? 😀

I know that his idea of EM is quite outdated...

 

[EM_Rebuilder]

Alaska... My g/f is there right now, up in Prudhoe Bay. I am in Houston, TX for the CS exam....so we are essentially almost as far apart from each other as possible while still being in the US.....

She sent me a picture of a vistor outside her hotel in Anchorage last night:

or here if the pic is not showing up

Dont see that in Texas...

 

[Dr. Will]

Alaska... My g/f is there right now, up in Prudhoe Bay. I am in Houston, TX for the CS exam....so we are essentially almost as far apart from each other as possible while still being in the US.....

She sent me a picture of a vistor outside her hotel in Anchorage last night:

Dont see that in Texas...

Apparently we don't see it on SDN, either.

 

[deleted109597]

Heh heh.

Moose.

 

[Jeff698]

Dont see that in Texas...

Nope. We have many wonderful things in Texas.

That certainly ain't one of 'em.

Yet another reason I'll continue making frequent trips up north.

Sweet picture.

Take care,
Jeff

 

[Mr. Freeze]

My school has started a new one, taking prelim folks this year. The way it was described to us, the crux (surprise!) was money. The RRC wants to know how the program is funded. Apparently legislation was put in place to make ours a line-item in the state budget, due in no small part I'm sure to the lobby of MD's (we have a few DO residencies here...)

I used to live in a basement apartment in Fairbanks, so it didn't have any windows you could really see out of. I went upstairs one day to start my car and when I opened the door there was a ****ing moose RIGHT THERE! HUGE! He freaked out, I freaked out, he ran back into the yard, I tripped and went down the stairs.

 

[trkd]

Alaska... My g/f is there right now, up in Prudhoe Bay. I am in Houston, TX for the CS exam....so we are essentially almost as far apart from each other as possible while still being in the US.....

She sent me a picture of a vistor outside her hotel in Anchorage last night:

or here if the pic is not showing up

Dont see that in Texas...

AHHHHHH!!!! I love him!!!!! I want him!!!!!

 

[trkd]

Two years is optimistic for starting a new residency. I'm at a brand new program myself, and in my talks with the PD and faculty, it was a long, complicated ordeal to get a residency. From the time the decision was made at the hospital/GME level to apply for approval, it took five years of work before they could match their first interns.

I met the UF-Gainesville PD when he first came to Gainesville in 2002. He was apparently recruited specifically to start up the program. They took their first class in 2006 so I guess that was 4 years or so. However, not sure how much planning came before that.

 

[Arctic Char]

good stuff . . . thanks for all the input.

yeah, i miss my moose friends. guess i'll have to settle for camels these days . . . but they're much less charming. man, i can't believe i live in the middle east right now . . . what a world

 

[trkd]

good stuff . . . thanks for all the input.

yeah, i miss my moose friends. guess i'll have to settle for camels these days . . . but they're much less charming. man, i can't believe i live in the middle east right now . . . what a world

AHHHHH!!!! I love camels too!!!! I want one!!!!!

 

[Arctic Char]

enh . . they're big, they're dumb, and after a mere 10 minutes atop a camel, your tush will ache for hours. but, i must say, at the onset when you're waiting there for your ride . . . and you see this big goofy looking beast drunkenly trotting toward you, growling like chewbacca, with an 8 year-old stable-boy on top smacking it with a stick . . . it is so freakin funny . . . and thats when you know you'rr travelling ; )
; )

 

[wook]

Alaska... My g/f is there right now, up in Prudhoe Bay. I am in Houston, TX for the CS exam....so we are essentially almost as far apart from each other as possible while still being in the US.....

She sent me a picture of a vistor outside her hotel in Anchorage last night:

or here if the pic is not showing up

Dont see that in Texas...

Pretty moosive animal.



Wook

 

[Arctic Char]

oh dear . . .