Spring 2015
10 Questions .... Financial Aid Services Page 9
Out & About... Baseball in the Bay Area
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Out & About... Roller Skating Page 14
The Residents in this issue Mission Bay Information 1 QI Incentive Update 3 SFGH QI Incentive 4 GME Diversity Update 5 Self-Compassion 7 10 Questions 9 SFGH Update 12 Out & About: Baseball 13 Out & About: Roller Derby 14 GME Cypher 16 Sustainability Box 16
Report
Information for Residents and Clinical Fellows Regarding Mission Bay Amy Day, MBA Director, Graduate Medical Education After almost ten years of preparation, the new UCSF Mission Bay Medical Center opened on Feburary 1, 2015! Here is some information regarding services that are available for residents and fellows:
UCSF Shuttles: Shuttle service to and from Mission Bay has been enhanced to include early morning shuttles. For the shuttle schedule please go to http://campuslifeservices.ucsf.edu/ transportation/services/shuttles
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Parking: Residents and fellows may purchase monthly parking permits for $174 for use at Parnassus, Mt Zion, and Mission Bay. Parking permits can either be purchased in person from a transportation office located at Parnassus (Millberry Union, P7) or Mission Bay (Rutter Center Garage, Suite 104) or online (and picked up in person). Daily parking permits for $10.50 each are also available for purchase through the new payby-phone system. Like Parnassus, Mission Bay provides free parking for residents and fellows from 4:45pm to 9:00am, Monday through Friday and anytime on UC holidays Continued on page 2
and weekends. (A 2014-2015 sticker is required; contact your program coordinator if you do not have one). For more information please go to http://campuslifeservices.ucsf.edu/transportation/ services/parking.
Call Rooms: Programs that have residents and fellows on inhouse call have been assigned call rooms. There are also call rooms available for all other residents and fellows on an as needed basis.
Food Services: The main cafeteria is open from 7am to 7pm Monday through Friday and 7am to 3pm on the weekends. In addition, an express cafeteria with grab and go food options and Peet’s coffee is open seven days a week from 6am to 11pm. Vending machines, including fresh food options, are located near the cafeteria, and are available 24 hours a day. For information on retail dining services on the Mission Bay Campus, please visit http://campuslifeservices.ucsf.edu/retail/services/ dine.
Lounges: There are two resident and fellow lounges for the use of all UCSF residents and fellows at Mission Bay Hospital. One lounge is designed to be more of a quiet/library/napping space while the other is meant for work, socializing, and collaboration. They are located on the second floor on the southwest side near the stair well off of the Children’s Surgical Waiting Area. (The room numbers are C2933 and C2931).
If you would like to know more about UCSF at Mission Bay please check out the following: Pocket Guide: The Mission Bay Employee Pocket Guide contains maps of the new building; descriptions of amenities available; a phone directory; emergency and safety information; and other general information of interest. You can view an online version of the pocket guide on the Office of Graduate Medical Education’s website: http://meded.ucsf.edu/sites/meded.ucsf.edu/ files/documents/graduate-medical-education/ employeepocketguidemb.pdf. Hard copies of the MIssion Bay Employee Pocket Guide can can be obtained in the Office of GME.
GME Grand Rounds: At a recent GME Grand Rounds, Drs. Elena Gates and Scott Soifer presented on the transition to Mission Bay. The presentation included discussion of plans for the new hospital, including patient flow, clinical issues between services, interaction between Mission Bay and Parnassus, etc... You can view of video of this presentation at http://vimeo.com/117952359.
ATM: An ATM is located near the cafeteria.
Occupational Health: An Occupational Health satellite office is located on the first floor of the Children’s Hospital near the cafeteria, in suite C-1739.
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Panoramic view of the new Mission Bay Hospital.
UCSF Resident and Clinical Fellow Quality Improvement Incentive Program Update Glenn Rosenbluth, MD Director, Quality and Safety Programs, GME
Results:
Population % Immunized Inpatient 94% Primary Care 57% Faculty, Staff, and Residents 92%* *100% of residents and clinical fellows have received flu shots!
We are excited to share the latest results for the UCSF Medical Center Resident and Clinical Fellow QI Incentive Program, as well as details of our progress.
As of December 1st, Overall Flu Compliance has now been added to the Discharge before Noon Dashboard.
Housestaff Wide-Goals
Goal #3 – Resource Utilization: Increase percent of patients discharged before noon to >20% for 6 of 12 months.
Goal #1 - Patient Satisfaction: On the HCAHPS and CGCAHPS survey question; “would you recommend to your family & friends” achieve the following average result for the last quarter: 88% of patients rated “yes definitely.” Results: We currently have a “Yes Definitely” rating of 86%
Results: We have achieved our goal of >20% for 4 months (August, October, November, and December).
Discharges Before Noon
Rated “Yes Definitely”
Program Specific Goals Goal #2 - Patient Quality and Safety: During the FY15 influenza season, improve overall compliance with influenza vaccination at UCSF: Tactics 1. Increase inpatient vaccinations to 90% (3 of 6 months) 2. Increase Primary Care vaccinations to 51% 3. Maintain Faculty, Staff and Residents vaccinations at >95% Measurement: Achieve three of three tactics
We have 22 residency and fellowship programs that have developed program-specific goals and quality improvement programs. You can check out a complete list on our website. For more information about the UCSF Resident and Clinical Fellow Quality Improvement Incentive Program please visit http://meded.ucsf.edu/ gme/ucsf-resident-and-clinical-fellow-qualityimprovement-incentive-program.
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SFGH Housestaff Incentive Program Update Goal #1: Improving Patient-Physician Communication: To improve patient experience and communication between physicians and patients, increase the annual SFGH-wide mean score for “Always” response on the inpatient HCAHPS survey “Communication with Doctors” domain from 71.3% to 76.3% by June 2015. Goal #2: Improving Timely Discharges: To improve safe, timely flow and access for SFGH patients, increase the percentage of SFGH patients who have a discharge order entered before 10am from 15% to 25%, and/or the number of patients
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discharged from the hospital before noon from 12.7% to 17.7%, without adverse increases in length of stay or readmission rates, by June 2015. Goal #3: Reducing Length of Stay in ED: To improve safe, timely flow and access for SFGH patients, decrease the median time between ED arrival and departure for discharged patients from 275 minutes to 242 minutes, without adverse effects on the number of patients who return within 7 days of discharge (7-day bounce-back), by June 2015. For more information about the SFGH Housestaff Incentive Program, please visit: http://meded.ucsf. edu/gme/sfgh-housestaff-incentive-program.
GME Diversity Update Rene Salazar, MD
Director of Diversity, Graduate Medical Education Dean’s Diversity Event: Interim Dean Bruce Wintroub, MD hosted the annual UCSF Resident and Fellows Diversity Celebration Reception on October 21, 2014. This event brought together residents, fellows, faculty, and campus leaders to welcome new trainees to UCSF. Dr. Renee Navarro, UCSF Vice Chancellor for Diversity and Outreach presented an update on campus-wide diversity efforts, and Dr. René Salazar, GME Director of Diversity, presented an update on activities to promote diversity in GME.
Residents and Clinical Fellows at the Diversity Celebration Reception
UCSF School of Medicine Leadership Retreat: On January 8-9, 2014 the UCSF School of Medicine held the 2015 leadership retreat entitled, “Race Matters at UCSF.” The theme of the retreat was in response to recent national and local events, including the “White Coats for Black Lives” Die-in held on December 10, 2014. The retreat included panel discussions with students, trainees, and faculty as well as several other presentations. The panel discussions addressed a variety of topics including the experience of diverse medical students, mentoring for success, and strategies to address inequities in education related to race and ethnicity. SOM faculty presentations included a series of TED talks on race, ethnicity, and inequities in health care, a panel discussion on strategies to enhance faculty diversity at UCSF; and a discussion
on developing community partnerships to achieve health equity. Participants then worked together to propose innovative strategies to address existing inequities; enhance the experience of diverse students, trainees, staff, and faculty; and enhance relationships between UCSF and San Francisco’s diverse communities. Participants selected six proposals to focus on over the next year. To learn more about the SOM leadership retreat or “White Coats for Black Lives” Die-in please contact Dr. René Salazar, GME Director of Diversity. UIM Dinner Program: GME co-hosted a dinner with the UCSF School of Medicine Mentorship Program for Underrepresented in Medicine (UIM) students on January 20, 2015 entitled, “Residency and Beyond: Tips I wish I learned in Medical School.” Thank you to all the residents and fellows who attended. Special thanks to the following panelists: Willie Moses MD (General Surgery), Angela Echiverri MD (Family and Community Medicine), and Rosny Daniel MD (Emergency Medicine). GME Second Look Diversity Event: Our 8th annual Second Look Diversity Event for residency program applicants was held on Friday January 30, 2015. In addition to learning more about our training programs, the Second Look program provides applicants with the opportunity to meet campus leaders committed to promoting diversity at UCSF. A panel discussion with housestaff and fellows was held in the afternoon followed by an evening reception.
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National Meetings: Opportunities to represent UCSF at annual and regional meetings for various organizations are also available. Upcoming meetings include the SNMA Annual Medical Education Conference (AMEC) (New Orleans April 1-5, 2015) and LMSA National Conference (Cleveland April 23-26, 2015). Residents or fellows interested in attending or participating should contact Dr. RenĂŠ Salazar, GME Director of Diversity. Volunteer Opportunities: UCSF sponsors several student-run clinics in San Francisco. Volunteer preceptor opportunities for housestaff and fellows are available year-round at the following clinics: Homeless Clinic (provides care to the homeless), Hepatitis B Clinic (focuses on hepatitis B screening in Asian communities), and Clinica Martin Baro (provides free primary care services for Latino day laborers in the Mission). In addition to providing free screening and health care to underserved populations, the clinics also provide a chance to work with first and second year UCSF medical students and undergraduate students from UC Berkeley and San Francisco State University. Contact Dr. RenĂŠ Salazar, GME Director of Diversity to learn more. UCSF Unconscious Bias Education Initiative: Unconscious bias refers to the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner. A large body of compelling research has demonstrated how unconscious, automatically activated, and pervasive mental processes manifest across a variety of contexts. The impact of unconscious bias is significant. For example, unconscious bias can impact patient-provider relationships and treatment recommendations, both of which lead to health and health care disparities. The UCSF Office of Diversity and Outreach and
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Clinical and Translational Science Institute has developed an unconscious bias education initiative to educate faculty, staff, students, and trainees on unconscious bias and the impact of unconscious bias on our work. We are currently developing a website (to be launched in June), which includes a description of the current state of the science on unconscious bias; a summary of strategies to assess and address unconscious bias; and a list of resources and references for those interested in learning more. On February 26, 2015 the UCSF Multicultural Resource Center (MRC) will offer an hour-long unconscious bias training at noon. Residents and fellows are encouraged to participate.
Upcoming Events Apr. 1-5, 2015
Student National Association Annual
Medical Education Conference New Orleans, LA April 23-26, 2015 Latino Medical Student Association National Meeting Cleveland, OH April 28, 2015
UIM Resident and Fellow
Mentorship Dinner 6:30-8PM
N 417&423
May 12, 2015 Diversity Advisory Group Meeting 6-7:30PM Multicultural Resource Center
Self-Compassion as a Healthier Motivator Toni R. Galace, Psy.D. Faculty and Staff Assistance Program (FSAP) As residents you constantly juggle different roles and expectations. The amount of hours you work each week, the clinical knowledge you have to master, and maintaining a work/life balance can leave you feeling overwhelmed and prone to burnout (McCray, Cronholm, Bogner, Gallo, & Neill, 2008). With your adrenals in overdrive, you may be asking yourself, “How do I manage all of this?” when no amount of medical training has taught you how to mitigate burnout within an extremely busy schedule. When pressed for time, it can be a battle to meet even the lowest rung of Maslow’s hierarchy of needs. That is, developing a self-care routine where you can eat properly, sleep sufficiently, and/or exercise begins to feel more like a luxury than a necessity. Perhaps you have been working around these basic needs by eating sugary snacks, sleeping less, drinking coffee or energy drinks, or walking the halls of the hospital and calling that exercise. But unhealthy eating habits and working with too few hours of sleep is not sustainable; keep at it long enough and it becomes ineffective at best and damaging at worst—to yourself and potentially to your patients. Just to be clear: I am not writing to metaphorically preach to the choir of physicians who already know how to take care of the human body. I am reaching out to residents who, despite being seen by most others as Herculean, are actually stressed, tired, and also in need of care. That’s right: you are human, too, and you deserve to be treated with the same kindness, caring, and compassion you show your patients. However, is it possible to prescribe this kind of compassion to yourself? To be where you are now—at a leading university that provides world-class care—means you are an extremely intelligent, passionate, and driven
individual. By the same token, I wonder if some of your successes were fueled not only by self-sacrifice, but also perhaps by being self-critical and hard on yourself. In the medical field you live in a culture where mistakes and failures are often internalized, eliciting negative emotions such as embarrassment and shame. Additionally, perhaps in order to get through medical school and residency, cracking the whip of self-judgment at times motivated you to succeed. As a resident, however, feeling stretched thin, ever pressed for time and under constant evaluation, that tough inner critic may now be doing you more harm than good. Instead of fighting against the negative emotions or just pushing past the discomfort (Germer, 2009), it is time to consider a different and more beneficial practice to deal with your distress: self-compassion. First, compassion itself means to “suffer with” and entails the same feelings you have towards others. That is, you notice another person is suffering and then you are moved in such a way that your heart responds to the other person’s pain as a fellow human being. You consequently feel a caring and the desire to help ease their suffering (Neff, 2009). So too with self-compassion: you notice the distress you are experiencing, the pain and discomfort it causes you, and then respond in a kind way that eases the suffering. More concretely, Neff (2009) described three elements of self-compassion: selfkindness, common humanity, and mindfulness. Selfkindness involves having warmth and understanding toward yourself when you fail, feel inadequate, and suffer; these experiences are inevitable and cannot be entirely avoided or made to disappear with either denial or harsh criticism. Common humanity reminds us that we are all connected and we all suffer; rather than personalize and feel alone in facing life’s difficulties, you can remember that you are not the only one to make mistakes. Lastly, mindfulness is a non-judgmental stance of observing your emotions and thoughts, without either suppressing things or building them up so that you get caught in the negativity. Mindfulness builds on compassion and
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self-kindness, allowing you to relate your experiences to the bigger picture and remain empathic to yourself. Now, please do not make the mistake of thinking self-compassion is self-centered or selfish, as though paying a little more attention to yourself means caring for yourself at the expense of others or putting yourself above them (Germer, 2009). Nor does practicing self-compassion make you weak; on the contrary, practicing self-compassion benefits everyone. Indeed, the more empathy you have toward your own flaws and idiosyncrasies, the more empathy and patience you will have in caring for others (Germer, 2009). So let us try another path outside the usual fare of stoicism, criticism, and blame: How to change your critical self-talk (adapted from Neff, 2009) • Be cognizant of when you are self-critical. For example, when you feel bad about something, what do you say to yourself? Are there key phrases that come up again and again? Is your inner voice angry, distant, or condescending? Learn to become mindful of when your inner judge becomes active and harmful. • Address the self-critical voice with compassion, not self-judgment. For example, when you hear the inner critic say, “You’re such an idiot, what were you thinking?!” respond with something akin to, “I know you’re trying to point out and help me overcome my shortcomings, but the negative attitude causes me more pain than comfort.” Negative self-talk feeds into feelings of anger, irritability, or exhaustion; whereas compassion feeds kindness, forgiveness, and patience. • Reframe the observations your inner critic makes in a more positive and friendly way. If you are having a hard time coming up with the words, imagine what a good friend would say to you.
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Following the example above, you could say, “This has nothing to do with your intelligence. You were really pressed for time. With your quick thinking and skills you did the best you could.” Furthermore, while engaging in this positive self-talk, gently stroke your arm or pat yourself on the shoulder. Yes, it may seem silly, but the physical gestures tap into the caregiving system, releasing oxytocin and reducing stress. Therefore, if you start to act kindly toward yourself, feelings of warmth and caring will follow. Like going to the gym, this mental exercise to change your critical self-talk will take time and practice to develop. Putting in the effort will lay the groundwork for how you can relate to and take better care of yourself (Neff, 2009), and you will be particularly better equipped to take the difficulties of your rotations in stride. Additionally, if things start to feel overwhelming, reach out to your support system for help or contact the Faculty and Staff Assistance Program. Our services are free and confidential and we provide counseling for both personal and workrelated issues. We also provide referrals to mental health practitioners in the community. Please contact us at 415-476-8279 or visit our website at www.ucsfhr.ucsf.edu/assist for more information. For more exercises and to test how selfcompassionate you are, go to www.self-compassion. org. References Germer, C. K. (2009). The mindful path to selfcompassion: Freeing yourself from destructive thoughts and emotions. New York, NY: The Guilford Press. McCray, L. W., Cronholm, P. F., Bogner, H. R., Gallo, J. J., & Neill, R. A. (2008). Resident physician burnout: Is there hope? Family Medicine, 40(9), 626632. Neff, K. (2009). Self-compassion: A healthier way of relating to yourself. www.self-compassion.org
10 Questions from the Resident and Fellow Affairs Committee 2. So, what should a resident or fellow do to get on the right track?
Carole Ann Simpson, Resource Advisor for UCSF Financial Aid Services, and Aris Oates, MD, Pediatric Nephrology Fellow, answer residents and clinical fellows’ questions about managing student loans during residencies and fellowships. 1. What is the most important thing a resident or clinical fellow should know about managing student loans? Spending just a little time now making a financial plan for student loan repayment may save tens of thousands of dollars in the long run. Sometimes with everything going on in a resident or fellow’s life, it is convenient and frankly easier to be tempted to just tell the loan servicers “I’m in a residency and I want a forbearance.” This allows residents and fellows to avoid paying anything toward their loans for years. But that is a very COSTLY proposition. I’ve met many physicians who are quite shocked at the amount of interest that has been added to their loans during residency. You can find a repayment plan that will work within a resident budget and mitigate this effect. Planning now will involve a little time, but maybe a better long-term decision.
First, it’s important to get organized and make a list of who you owe and how much you owe. You could have a variety of loan sources from federal to private loans depending on what your loan profile was during medical school. Looking at www.nslds.ed.gov will give you a listing of all your Federal student loans. Health and Human Services loans such as Health Professions Loans and Loans for Disadvantaged students aren’t on this site, but are managed by the campus that disbursed the loan or a servicer that they choose. Your medical school financial aid office can help you find this information. Private loans can be found by looking at your credit report at www. annualcreditreport.com. The critical information to know about each loan is: servicer (who do you have to pay?), interest rate, amount owed, and type of loan as well as repayment options. 3. Should I start making small payments on loans during residency – especially on higher interest federal loans? Generally for residents the Income-Based repayment or Pay-As-You-Earn repayment plans can offer highly affordable payments on your Federal loans that will be manageable on your current resident/fellow salary. This does a couple of things for you; paying even some of the accruing interest each month is better than being in a forbearance, and it can have the added effect of qualifying that month as one of the 120 months involved in the Public Service Loan Forgiveness Program. 4. Why not just use forbearances during residency and not pay at all during this time? While medical residents qualify for a forbearance (no payments required) during residency, the interest
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on those loans will continue to add up. Typically these forbearances are for 12 months at a time. At the end of each forbearance, the interest that has accrued is added to the principal of the loan, and during the next forbearance, the accruing monthly interest is calculated on this new, larger, principal balance. This can really make loan balances add up quickly. The AAMC (American Association of Medical Colleges) provides some comparisons based on a resident who owes $175,000 – after a four year residency that borrower will pay nearly $40,000 more over the life of their loans even when choosing standard repayment after residency. Another way to look at it is that a borrower who owes $175,000 is generally racking up interest somewhere around $1,100 a month during residency depending on the underlying interest rates. 5. Do clinical fellowships qualify me for a deferment? Yes, many clinical fellowships may qualify you for an “education related deferment.” This allows you to defer the loans during your fellowship. However, if most of your debt is unsubsidized graduate debt, there is little difference in the way that interest will accrue during this deferment than the forbearance, above. 6. What are the “income driven” repayment plans? Two income driven repayment plans, “Income Based Repayment” and “Pay As You Earn,” allow you to make payments on Federal Direct loans solely based on your current earnings rather than based on the amount you have borrowed. The advantages of these plans are that they are affordable on a resident salary, you are paying at least part of the accruing interest keeping your loans from growing too much, and you are avoiding the ratcheting effect of capitalization of accrued interest that happens at the end of a deferment or
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forbearance. You can very quickly find out how much your payments under these plans are likely to be by signing on to www.studentloans.gov using your FAFSA pin and clicking on the “Repayment Estimator.” Be aware, since both Income Based Repayment and Pay as You Earn are based on your reported income, a servicer will generally use your previous year’s tax return or, if you didn’t file, a current paystub can be used to establish your payment for the next twelve months. Even if your income was $0 on last year’s taxes, it is often to your advantage to make small IBR or PAYE payments that will apply toward the interest that is accruing based on your current earnings. Treatment of married borrowers’ income when setting these payments depends on your filing status, the state you live in, and whether your spouse has student loans. If you are married, you will need to report your filing status, your spouse’s income, and the balance of his or her student loans as part of the application. 7. What is Public Service Loan Forgiveness? If you expect to continue to work in the public service (at a state agency, or any 501(c)3 nonprofit tax-exempt organization) for 10 years (including your residency and/or fellowship), you will want to know about this program! If after 10 years of income-driven payments on Direct Loans while working for qualifying organizations there is a remaining balance on your loans, it can be eligible for forgiveness. To learn more about this program visit www.myfedloan.org/pslf. To be sure you’ve positioned your loans so that they qualify, you’ll want to think about them NOW, not later. It may take a federal consolidation to get your loans to qualify, all your payments must be on time, and you’ll want to be sure you make payments that will count. Direct debit, available from all of the loan servicers, makes being on time every month easy, and will save you money over the long run –
you will qualify for a .25% interest reduction when making these payments.
is MORE important when you don’t have a great deal of money than when you make a larger salary.
An additional loan forgiveness program, the National Health Service Corps can offer up to $60,000 loan forgiveness to primary care physicians when they practice in health professional shortage areas http://nhsc.hrsa.gov/loanrepayment/index.html
10. Where can UCSF residents and fellows get more help?
8. Should I consolidate my loans? There are good reasons to consolidate, and there are good reasons NOT to consolidate as well. The answer to that question for you is based on your unique situation and loan portfolio. To help you make a decision, I recommend this quick fact sheet written by the AAMC specifically for the medical profession: https://www.aamc.org/ download/94404/data/consolidate.pdf. One important thing to be aware of is that there are two types of consolidation: federal and private. Federal consolidation maintains the federal benefits and programs associated with student loans, while a private consolidation of your federal debt turns that debt into something more equivalent to a consumer loan – and it will have different terms and benefits. You’ll want to compare carefully before pursuing a private consolidation of your federal debt. If you want to consolidate to make older federal FFELP loans or Health Professions or Perkins loans eligible for Public Service Loan Forgiveness, it must be a federal loan consolidation 9. Will I survive student loan repayment? Yes, you can! Medical professionals are among some of best repayers of federal student loans. If you make student loan repayment a part of your overall financial plan now and in the future, you’ll survive without paying more than necessary in interest. That success depends on starting that financial plan now. It’s ironic, but financial planning
One of the best resources I know is available online at the following link: https://www.aamc.org/ services/first/first_for_students/250460/survivalkitstudentsandresidents.html. This site can answer many of your questions and contains very specific topics such as “choosing a repayment plan,” and many other financial management topics in small, bite-sized chunks such as “getting married during residency.” While there are companies out there who will help you manage your loans for a fee, I encourage everyone in the UCSF community who has loans to visit with me before taking the step of hiring someone to do it for you – it’s not as complicated as it sounds, and usually it takes just a few minutes to accomplish the steps to effectively manage your loans each year during your residency or fellowship. As the Resource Advisor for UCSF, I am always happy to meet one-on-one with our residents and fellows to assist. Often in a one hour appointment we can form a plan and I can help you file any necessary forms. If a resident or fellow wants to meet with me to review their loans and their options, they can call 415-476-4181 to talk to the front desk of the Financial Aid Office here at UCSF. The folks who answer that number have access to my calendar and can book a phone, skype, or in-person appointment for any UCSF community member who wants to review their loan history and their options. I want our residents and fellows to worry about their patients and research, not their student loans!
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Update from SFGH Comparatively New Contract with Residents at San Francisco General Hospital (SFGH) The Memorandum of Understanding (MOU) between the City and County of San Francisco and the Committee of Interns and Residents (SEIU) has been executed effective July 1st 2014 through June 30, 2017. Full details of the MOU can be found: http://www.sfdhr.org/modules/showdocument. aspx?documentid=20615 Highlights of the MOU: • No Work Stoppages: Sympathy strikes are prohibited under the MOU • Dues deductions, once initiated, shall continue until the authorization is revoked in writing by the intern/resident • The Union shall be notified by the Hospital in writing of all grievances filed by interns and residents • Interns and residents on a rotation at SFGH shall be provided with meal cards, with a daily value of $23.00 – good for up to $5.00 for breakfast, up to $9.00 for lunch and up to $9.00 for dinner • Educational, medical, sick, maternity, jury, bereavement and personal leave will continue to follow the University of California’s leave policy. Update to the Online Tuition Reimbursement System for SFGH Interns and Residents The Educational Expense Reimbursement Program at SFGH was established to reimburse interns and residents who work three or more months at SFGH for qualifying education and training expenses up to $300 per fiscal year. Interns and residents may qualify for this reimbursement once they are scheduled to complete their three months in the fiscal year in which they are requesting the reimbursement. The procedure by which the reimbursements are
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processed have changed significantly – no more paper, it’s all completed online! Instructions of the online procedures can be found: http://www.sfdhr. org/index.aspx?page=595. Interns and residents may look up their name on the eligible list posted here: http://www.sfdhr.org/ index.aspx?page=595. The list of eligible interns and residents will be updated this academic year on January 2015 and April 2015. In future years it will be posted four times per year (July, October, January, and April). Intern and residents will be required to obtain a pre-approval request before submitting for a reimbursement. Instructions for pre-approval may be found: http://www.sfdhr.org/index.aspx?page=595. Types of Expenses that can be Reimbursed: Medical books/journals/subscriptions Exams* Computer and digital equipment (excluding accessories and/or warranties) Conference registration (excluding travel and lodging) Wearable medical equipment (For example, a stethoscope) Medical software *Exam fees will only be reimbursed when you successfully pass an examination. Therefore, you should only submit reimbursement requests for exam fees in the academic year in which you pass the exam. You may submit your pre- approval request before you pass the exam, but you will need to cancel the pre-approval request if you do not pass the exam. Non-Allowable Expenses USMLE/COMPLEX and medical board licensing. If UCSF’s historic practice of paying for USMLE / COMPLEX should discontinue, no later than April 15 of the following fiscal year either party may serve written notice to reopen the Memorandum of Understanding for the purpose of discussing possible reimbursement of USMLE / COMPLEX.
OUT & ABOUT from the Resident and Fellow Affairs Committee
Where members of the UCSF Community recommend their favorite scenes outside UCSF
Baseball in the Bay Area
League can be found at www.cactusleague.com.
Scott L. Hansen, MD Associate Professor and Residency Program Director, Plastic Surgery Consultant Surgeon, San Francisco Giants
Across the Bay, the American league Oakland Athletics are housed at O.Co Coliseum. While not gathering the attention that the SF Giants have had lately, the team has played well the past few years. Tickets to the A’s games are easier to get and less expensive. The stadium is not as aesthetically pleasing (it is shared with the Oakland Raiders), but provides a good experience and is easily accessible by public transportation. The Oakland A’s also play in the Cactus League and regularly play the SF Giants.
If you happen to be a baseball fan, then the Bay Area is a great place to be. There are a number of options to enjoy baseball, some obvious, some not so obvious. I will begin with the obvious baseball club in the Bay Area- The San Francisco Giants. The Giants have been on a run as of late with their 3rd victory in the World Series in 5 years. In 2000, after forty years, the Giants left the cold and windy Candlestick Park and moved downtown to the shoreline of China Basin. The park is currently named AT&T Park (originally named Pac Bell Park). The regular baseball season begins early in April and ends in September. There are 162 days in a season with roughly half of those games at home. While the games are generally sold out, tickets can be obtained from the SF Giants website (sanfrancisco. giants.mlb.com/) or from Stubhub. AT&T Park is widely accepted as one of the best baseball parks in the United States. Make sure you bring warm clothing for the evening games as the temperature drops significantly when the sun goes down. There are essentially no bad seats in AT&T Park. If tickets cannot be obtained, you can walk around the outside of the stadium and watch the game from the right outfield observation area for free. Another option to watch SF Giants baseball is during Spring Training in the month of March. The spring training home of the Giants is Scottsdale, Arizona. The Giants play in the Cactus League along with 14 other major league baseball teams. This is a great opportunity to see Giants baseball in a smaller, more intimate setting. Information about the Cactus
The SF Giants have a hand-full of minor league affiliates in the area. If you are interested in seeing tomorrow’s baseball stars today, then you can go to San Jose to see the San Jose Giants. The San Jose Giants are one of the minor league affiliates of the SF Giants where the likes of Buster Posey, Pablo Sandoval, Tim Lincecum, and Madison Bumgarner once played to ready themselves for the big leagues. This is great experience, especially for those of you with kids, as there are many fan activities between innings that allow kids to get on the field. After certain games, kids are allowed to run around the bases. The tickets are easy to get and run about $10-15. Information about the SJ Giants can be found at www.sjgiants.com. The other minor league affiliate that is somewhat close to home is the Triple-A Sacramento River Cats. This is a new affiliation that just begun after the team left Fresno. The Triple-A team encompasses players that are just one level below the SF Giants and oftentimes move up to the big league team during the course of the year as injuries occur. The stadiums at the Triple-A level are larger and are closer to the major league feel. Information about the Sacramento team can be found at www.milb.com.
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Lastly, if you still haven’t had enough baseball, you can visit the University of San Francisco (USF). USF is a NCAA Division 1 baseball team that historically is very competitive and plays in the West Coast Conference. USF has produced many major league baseball players. The field is right on the campus of USF at the corner of Masonic and Golden Gate Avenue (Benedetti Diamond). Tickets are cheap and you can sit right up front and watch competitive college baseball. Information can be found at www.usfdons.com.
Photo: Dr. Hansen and his sons at Spring training with a Giants rookie pitcher.
Roller Skating and Roller Derbies in the Bay Area Virginia Schuler, Fellowship Coordinator, Division of Infectious Diseases In 1974, my brother and I came to live with our Aunt Cecilia in San Francisco from Nicaragua. I was 5 years old. The first thing Aunt Cecilia did when we arrived was to buy us each a pair of roller skates. My skates were black boots with metal wheels (boy, have skates changed since then!). As a kid, my brother and I would spend hours each day rollerskating outside of our house. This continued all through high school and undergraduate school. Then, for no particular reason, I stopped rollerskating. During these non-roller-skating years I worked, went to graduate school, got married, and had two kids. Why I stopped roller-skating…I’ll never know. Fortunately for me, my daughter was invited to a “roller skating birthday party” three years ago. The birthday girl’s mom cautiously invited all the other moms to rent some skates if we felt up to it.
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I asked myself, “could I go back to skating after all these years?”…and I’m happy to report that “yes” I could. I have been roller-skating since this birthday party and have no intention of stopping! Fortunately, there are several venues in San Francisco and in the Bay Area to skate. On Sundays, in Golden Gate Park, near 6th Avenue and Kennedy Drive (not far from Fulton St.) there is an outdoor space where skaters like to show off their dancing and skating moves to beats that are jammin’ from a beat box in the center of the “rink.” You will see every level of skating at this place, from putting on roller skates for the very first time to folks that were practically born with roller skates on! Anyone is welcome to join the skaters and folks are super friendly! If you do not have your own skates, you can rent skates from several places within a block or two of this space. Even if you decide not to throw some skates on, you will have a blast watching the skaters “dancing” to the music! Nearby is a slalom course where skaters zip down hill.
At 554 Fillmore Street (and Fell Street) is the “Church of 8 Wheels” (formerly Sacred Heart Church). This place is fairly new (I first heard about it in March of this year). The building was formerly a church and the façade hasn’t changed. However, once you step inside, you will see it is now an indoor roller rink. The stained glass pictures of saints are still there. The rink is a decent size and the music is jumpin’! It is open on Tuesday, Wednesday, Thursday, and Saturday nights, with each night having a different musical theme. I happened to have gone on a Wednesday night, which is “Disco Night”! You can rent skates here: www.skategoldengate.com/ churchof8wheels.htm About 25 miles from San Francisco in Redwood City is the “Redwood City Roller Rink.” This is the roller rink that I most frequent. It is a fairly large indoor rink. If you roller skated as a kid and went to a public roller rink, this place will bring back memories. I don’t think it’s changed since it was built and that is exactly why I love this place. Different nights and days have different musical themes and I have been to the majority of them. The music is fun and they will even play “Red Light – Green Light” on some days, which is very fun to participate in as well as to watch. You can rent skates at this rink. http://www.redwoodrollerrink.com/
team. Unlike the San Francisco Bay Bombers, the Peninsula Roller Girls (PRG) is a women-only team and skate on a flat track. This team plays more like the roller derby you see on TV. These women are tough and play hard! I realized this as I saw the EMT walk in before the skating began with his emergency bag! In addition, all the women were wearing mouth guards…Yikes! I took my kids to see this team play and we all had a blast! http://www. peninsularollergirls.com/ Both roller derby events are very family friendly! The kids (and the adults) are free to move and walk around during the derby. These are also lots of fun for a group of friends hanging out on a Friday or Saturday night.
If you are into Roller Derby, there are a couple of choices to choose from in San Francisco and Redwood City. The San Francisco Roller Derby team is called the “San Francisco Bay Bombers”. This is a co-ed team that skates on a banked track. They play at Kezar Stadium (very near UCSF). A temporary track is built for the team to play in. This is truly fun to watch! The players like to “ham it up” against the other team and sometimes you can’t tell when the skaters have truly fallen or pretended to fall! Nevertheless, it’s quite the show and my kids love it! http://www.baybomber.com/ The Redwood City Roller Rink (mentioned above) is also host to the “Peninsula Roller Girls” roller derby
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Spring 2015 The Residents Report
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Editorial Staff: Robert Baron Andrea Cunningham Amy Day
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Instructions: The above is an encoded quote from a famous person. Solve the cypher by substituting letters. Send your answers to Andrea.Cunningham@ucsf.edu. Correct answers will be entered into a drawing to win a $50 gift card!
Cover Photo: Errol Bush, MD Cover Photo by: Elisabeth Fall
Congratulations to Pathology Resident Gabrielle Rizzuto, MD, PhD.
Many thanks to the following contributors: Amy Day Toni Galace Scott Hansen Christina Middleton Roger Mohamed Aris Oates Glenn Rosenbluth Rene Salazar Virginia Schuler Carole Ann Simpson Sandrijn van Schaik
GME Contacts GME Confidential Help Line: (415) 502-9400 Amy Day, MBA Director of GME (415) 514-0146 Amy.Day@ucsf.edu Robert Baron, MD, MS Associate Dean, GME (415) 476-3414 baron@medicine.ucsf.edu
The most recent Cypher Answer was: “Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.” ― Dale Carnegie
UCSF School of Medicine Graduate Medical Education 500 Parnassus Avenue, MU 250 East San Francisco CA, 94143
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