Residency weekly conferences and morning report

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Aesculapius

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Three questions for those still in residency:

1. What is the duration and structure of your weekly conferences?
2. Does everyone in the residency class attend conference, or are there some who skip due to working the overnight shift the previous night, off-service rotations, etc.?
3. How often do you hold morning report, and how long does it take? Does everyone working that day attend?

Thank you very much; I'm hoping to use this information to improve our own residency program.

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Three questions for those still in residency:

1. What is the duration and structure of your weekly conferences?
2. Does everyone in the residency class attend conference, or are there some who skip due to working the overnight shift the previous night, off-service rotations, etc.?
3. How often do you hold morning report, and how long does it take? Does everyone working that day attend?

Thank you very much; I'm hoping to use this information to improve our own residency program.


I don't know why you're only soliciting advice from people still in residency. A few of us graduated only recently and still remember the set up.

1. Five hours, held once a week. Conference consisted of going over Tintinalli readings, lectures on topics that were related to whatever we were reading, resident-led presentations on everything from pediatric cases, to tox stuff, to "Here's what I learned on my away elective." We had one hour of grand rounds every week included in conference.

2. Everyone attends conference every week. No one works overnight the night before---both in the ED and on off-service rotations. There is also no leaving conference early.

3. Morning report was typically 4 times a week, attended only by residents that were scheduled to work the morning shift.
 
Apologies. Anyone who would like to chime in, of course, would be welcome to do so.
 
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1. Five hours once a week.
2. No. People on ICU services are excused. They try to minimize overnights the night before, but it doesn't always happen (so those folks are excused).
3. 2 mornings a week, 30 minutes, only interns working the day shift are required to attend. Others attend as volume permits and if they want to stay post-overnight.
 
1. What is the duration and structure of your weekly conferences?
RRC requires 5 hours a week. On average. Individualized (asynchronous) can only be 1 hour of that.
2. Does everyone in the residency class attend conference, or are there some who skip due to working the overnight shift the previous night, off-service rotations, etc.?
You have to attend 70% of them as an RRC requirement. Offservice months still count, and I bet you spend more than 30% of your residency on other services. So you're going to have to go to them. Some places make 100% attendance mandatory except special situations, others allow the residents to attend 70% of their choosing (ie, not coming in on days off). The comical thing about places without mandatory attendance above 70%, is the last couple of months usually ends up with ridiculous attendance as everyone already has their numbers. Also, the 7am slot usually ends up poorly attended.
3. How often do you hold morning report, and how long does it take? Does everyone working that day attend?
Again, program dependent. Trained at a program that never had it. Have seen others that do it every day that isn't conference. It is more training, and only required attendance for the people working during that hour, so I can't see the harm.

Thank you very much; I'm hoping to use this information to improve our own residency program.
Improve? By reducing the limited amount of education you receive during 3-4 years?
I love the people who say that they don't learn after working overnight. While you may be tired, so are the people who got up at 7 and weren't working that day. And even if you do 12 hour shifts, you are still only at the hospital 17 hours if you go to conference after a shift.
If you're going to increase the required attendance, then by all means go for it.
 
5 hours once a week. Excused on ICU months, vacation. Not excused on other off-service rotations.

We do 5-10 minute "rounds" every shift change except weekends where we go over a pearl.
 
I was actually looking to improve attendance by seeing if we could arrange the schedule for all residents to attend conference, not reduce hours... Thanks to all who responded.
 
5 hours a week, protected. All residents expected to attend, even post-call and post-night (though exceptions made).

Usually a core topic lecture, practice pearls, guest lecture, M&M, and grand rounds. Often usurp this, too, for theme days - sim, tox, inservice review, ultrasound - that focus entirely on one aspect.

Echo the above - you need 70% attendance to graduate, so very important to make the effort.
 
I was actually looking to improve attendance by seeing if we could arrange the schedule for all residents to attend conference, not reduce hours... Thanks to all who responded.
Glad you're not trying to reduce hours. Many are, so that's why I included both options. Protected time is the way to go. They should get off of everything. We would miss trauma, MICU, PICU, you name it. Most places I know of go 7-12, on either Wed or Thursday.
 
We had 5 hours a week, split 2.5 hours twice a week.

Nobody was excused, RRC requires 70%, our program required 80% to moonlight.

Stay after night shifts, come in on offer service, days off, whatever.. just get 80%. You could be scheduled to work at conference time, but were excused to go to conference. If the ED got crazy, the senior most resident would occasionally get called out.
 
Ours was pretty loose. 5h all on Wednesdays. Only 4h on nights after once monthly journal club, so you got to sleep in an extra hour. Interns got the night off prior but others did not. Suggested to stay after overnights which, after intern year, usually wasn't too bad since our Tuesday nights are 8h shifts. Required to attend 3 of 4 while on off-service months. My senior year attendance got pretty crappy so they had us all signing in for each hour, not just for the day like we used to. There was some talk about asynchronous learning but no implementation prior to my graduation.
 
This is going to come off like someone who forgets what it's like to be a resident.
I don't. It wasn't that long ago.

You should attend every conference possible. If you are excused from conflicting work duties, your attendance should be close to 100%.
I also don't think that you need to get the night off before to attend a morning conference.
Go to work, go to conference and go home to sleep.

Does this suck.
Yes it does.
But you need to take advantage of all your educational opportunities.

Now if conference sucks and is not worth attending, than that is another problem that needs to get fixed.

My training program was tough.
Borderline malignant at times.

Looking back from the attending side, I'm glad they were that tough on me.
 
1. What is the duration and structure of your weekly conferences?
5 hours, as mandated by the ACGME.
1 hour traditional plenary session, 1 hour of sim cases, 1 hour of a mix of US/ECG/Procedure/Board review lectures, and 2 hours of the core content of EM, taught using the flipped classroom model of education

2. Does everyone in the residency class attend conference, or are there some who skip due to working the overnight shift the previous night, off-service rotations, etc.?
Residents are required to attend unless they are excused (vacation, overnight in ED).

3. How often do you hold morning report, and how long does it take? Does everyone working that day attend?
No morning report. Shift work is bad enough but trying to coordinating everyone getting together in the morning on a daily basis would be tough. I'm not sure how programs do this. As a night shift guy, one conference day a week already kills my circadian rhythms.
 
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Agree with above that morning report is not appropriate for most EM programs.
 
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Structure: 5 hrs total- 3-ish of traditional lecture and 2-ish of stuff to get you up and moving like US or Sim etc.

Attendance: Considered protected time. Optional if overnight on an off service rotation (no EM resident works overnight the night before). Must attend 90% over the course of the year. An average of 1hr per week can be done as "asynchronous learning" as long as it's the second time you've been through the curriculum (aka late second and all of third year).
 
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