RadOnc & ACGME (Interesting/funny observations)

[Gfunk6]

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First off, the source of the info I'm about to write about is located here.

It is basically a residency FAQ for RadOnc from the ACGME. Some interesting points:

1. When requesting a permanent increase in the resident complement what will the RRC consider an adequate ‘educational justification’?

"Growth in patient numbers alone will not be deemed sufficient justification for an increase in resident complement, as this will raise concerns that residents are being utilized for service."

On the interview trail, if I wasn't so scared of not matching I would've thrown this curveball to PDs who didn't want to give more than a few months of research. "Well, I'm concerned Dr. X, that you are simply using residents to run your clinics."

2. Is a resident permitted to use PGY-1 year experience in pathology, hematology/oncology or diagnostic imaging to fulfill the radiation oncology clinical experience requirements in these areas?

"For those radiation oncology program directors who do not provide direct oversight of thePG-1 year, and accordingly, do not control the content or curriculum components of these initial 12 months, the Committee’s response would be ‘no’."

This is a good argument for going to an integrated program I suppose. However, the FAQ does go on to say that ALL of these requirements may be met by attendance at multidisciplinary tumor boards.

3. How should patients be counted in resident logs?

"1) Patients should be counted as simulated by a resident if:
a The resident was present and participated throughout the initial simulation and treatment planning process;
b The resident simulates and plans treatment of a new area on an established patient (for example a new metastasis, new primary, or new recurrence)."

Interestingly you don't have to actually interact with the patient in any capacity to log a "sim." This was alluded to @ some of my interviews but I guess I'm kind of surprised to see it in writing.

4. How many pediatric patients must be treated to satisfy minimum requirements?

"The RRC reviews diversity as well as number. In general, however, residents should simulate a minimum of 12 children (of whom at least 9 have solid tumors) during their residency to satisfy minimum standards."

This is a lot lower than I would've thought since a lot of programs send their residents to St. Jude's for a month or so.

5. What is considered an adequate level of scholarly activity on the part of faculty in a training program?

"All of the faculty must demonstrate participation in national meetings. In addition, the majority of the faculty should demonstrate active participation in effective independent research. The most commonly used benchmark for this work is publication in peer-reviewed journals. [Successful grant applications and participation in the development of clinical research trials are also considered]."

Interesting benchmark. Though publishing clinical trial results clearly is a scholarly activity, "development of clinical research trials" seems like a garbage term w/o your name on a publication.

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Feel free to comment, but these are just some musings of a bored MS-IV who has yet to start internship.

 

[medgator]

First off, the source of the info I'm about to write about is located here.

It is basically a residency FAQ for RadOnc from the ACGME. Some interesting points:

1. When requesting a permanent increase in the resident complement what will the RRC consider an adequate ‘educational justification’?

"Growth in patient numbers alone will not be deemed sufficient justification for an increase in resident complement, as this will raise concerns that residents are being utilized for service."


I wonder what would be "sufficient justification." Do they want to see how the job market pans out in 5 years before making any massive changes, given the scares of the past?

 

[Gfunk6]

Well here's the full answer to the question though I don't think the job market is listed as an "official" answer.

When requesting a permanent increase in the resident complement what will the RRC consider an adequate ‘educational justification’?

• Growth in patient numbers alone will not be deemed sufficient justification for an increase in resident complement, as this will raise concerns that residents are being utilized for service.
• The program must be in good standing (full or continued full accreditation) with no significant areas of noncompliance from the last RRC review.
• Documentation of adequate faculty (a) as well as patient resources (b), including external beam, pediatric, and brachytherapy cases, to support the increase must be provided.
• A description of improved resident-resident interactions facilitated by the increase will be considered.
• Ample opportunities for clinical research as well as opportunities to utilize state-of-the-art technology would provide support to such requests.
• Facilities (office space) must be adequate to support the increase in resident numbers.
• To apply for a permanent increase the Program Director must submit:
a. An explanation of the reasons a permanent increase is being requested;
b. Medical data for the most recent calendar year. Data should be submitted for all institutions and should be in the format of Section 8 of the Program Information Form (PIF is accessible from the ACGME website: www.ACGME.org);
c. Resident logs for the most recent program graduates (4 years of experience must be included for each of the graduating residents);
d. An explanation of how the program is addressing or has addressed areas of noncompliance identified in the ACGME notification letter following the most recent survey review by the Residency Review Committee.