September PD Meeting and Birthday Party

Hi everyone,

We had an excellent PD Meeting/Birthday Party on Friday. The cake looked delicious (I’m watching my diet). Here are the minutes (tell me if they need edits, subtractions, or additions):

1. Surge Update: The YNHH census remains high, outstripping the capacity of the hospitalist team. To ensure patient safety and help our colleagues, we’re temporarily open to taking more patients on the teaching teams while more hospitalists are recruited. To date, the Surge has only modestly impacted resident teams with ~10-15 patients total coming to our services, mostly on Cooney and Peters. We haven’t taken non-geographic admissions and we’ve stayed within ACGME admitting rules and caps. As it’s been explained to me, the plan is for the Surge to be temporary, ending as new hospitalists are hired. We will continue monitoring the impact of the Surge on housestaff census, work hours, and education, recognizing that our core mission is to provide exceptional clinical training and education.
2. PCC Numbers: We reviewed the rationale for increasing the number of patients scheduled for half-day clinics in the PCC, which was based on numbers showing that residents saw an average of only 2-3 patients per half day- largely because of frequent no shows. The new template was intended to increase by one the number of patients each resident sees per half-day. A couple of issues have come to our attention. First, there has been a suggestion that residents were already seeing more patients before templates were changed, so we need to ensure the new system is not creating unmanageable expectations. Second, we know of at least a few cases where the patient load made it impossible for residents to eat lunch and attend educational conferences, and also led to late nights writing notes. PCC leadership is actively examining the numbers. A question was also raised about whether we could avoid scheduling residents for two clinics on the same day, particularly because of the impact on the ability to eat lunch and the large volume of notes that need to be written. It may not be possible to change clinic days in the short term, but Dr. Gielissen will investigate (one potential option might be to end morning clinic earlier or start afternoon clinic later when two clinics are scheduled for the same day). We will continue to monitor the impact of the new system on resident workload, wellness, and education; we are committed to ensuring reasonable schedules that optimize patient care, education, and resident well-being. The move to Long Wharf, scheduled for later this academic year, should help significantly by increasing administrative resources. Finally, we referenced a recent article by a Primary Care physician and educator, which beautifully describes the benefits of schedules that best meet the needs of patients and physicians.
3. Review of work climate and petition: We discussed concerns that were raised recently about a faculty member credibly accused of sexual harassment as well as a related petition. Those interested in learning more can read this account in the New York Times and the Yale Daily News as well as the university’s response. The faculty member in question has had no contact with trainees for several years. We reiterated that the Department of Medicine and our Residency Program have zero tolerance when it comes to harassment. Our fundamental goal is to ensure a safe and respectful work climate in our hospitals and clinics. In the weeks ahead, we will be sponsoring bystander training during ambulatory education sessions. Our Women’s Interest Group welcomes participation. We encourage anyone with concerns about inappropriate behavior to contact Program leadership, Department leadership, or the GME office. All concerns will handled promptly and confidentially.
4. Special resources for residents: We reviewed counseling resources available for residents (included in all Chief-on-call announcements) as well as educational support available through the GME office with our education specialist, Jack Contessa.
5. Annual Program Retreat: We briefly reviewed the discussion led by the PEC at our Annual Program Retreat in August. Overall, the program is performing well. We are accomplishing our core missions: our board pass rate is nearly 100% and we continue to provide second-to-none clinical training, extracurricular activities, mentorship, and scholarship opportunities. Recruitment, fellowship matches, and job opportunities have been consistently fantastic. This year, we will be focusing on ways to ensure excellent resident morale throughout the year as well as opportunities to give real time feedback to program leadership, including Chiefs and Program Directors.
6. Early Year Review: Preliminary feedback on the 2018-19 academic year has been excellent. Highlights have included exceptional morning reports, fun social events, excellent noon conferences, and a renewed focus on wellness by the Wellness Committee and Chiefs.
7. Preparation for recruitment: Applications for next year’s interns will start coming in next week. If this year is similar to the past, we will get ~3000 applications for 42 categorical/PST positions and ~800 applications for 14 preliminary positions. Given our past success, we won’t be changing our overall recruitment strategy. Most importantly, we will continue maximizing opportunities for applicants to meet residents at interview dinners, lunches, tours, and end-of-the day coffee sessions. Your intelligence, kindness, and commitment are contagious and our most effective recruitment tool. Please reach out to friends from your medical schools and encourage them to apply. If you’d like to get involved even more deeply with recruitment—and we encourage you to do so—please reach out to Nicolette Rodriguez and join the Welcoming Committee.

As always, we welcome (we NEED) your feedback and suggestions. Please send me comments as well as agenda items for our next PD Meeting/Birthday Party on Friday, October 5.

Happy birthday to all the September babies.

Finally, on this eve of Rosh Hashana, we wish everyone a healthy, safe, happy, and sweet New Year,

Mark