Summer 2011
The Residents Report Newsletter of the Office of Graduate Medical Education I University of California, San Francisco
A New Era in Graduate Medical Education Begins emphasize supervision of all trainees: supervision that assures both the safe and effective care of the patients we care for now and the successful development of each resident and clinical fellow’s skills to ensure outstanding care for patients in the future.
in this issue GME Update 1 News from the Library 3 WarnMe System 4 Grand rounds 5 10 Tips to Improve Clinical Teaching 7 Out & About 8 Honors & Awards 10 10 Questions 12 resident/Fellow’s Council 15 CTSI Update 17 GME diversity 18 OGME Events Gallery 19 Cypher 20
UCSF School of Medicine Graduate Medical Education 500 Parnassus Avenue MU 250 East, Box 0474 San Francisco, CA 94143 tel (415) 476-4562 fax (415) 502-4166 www.medschool.ucsf.edu/gme
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Robert B. Baron, MD, MS Associate Dean for GME and CME Graduate medical education (GME) has come a long way since the days that young doctors-in-training (mostly single men) lived a majority of their lives in the hospital (as “house staff” and “resident” physicians). This July, the process of training physicians continues to evolve as we begin implementation of the Accreditation Council for Graduate Medical Education’s (ACGME) new common program requirements. These requirements apply to all residency programs and all ACGME-accredited fellowships across all specialties. Although mostly thought of as new duty hour requirements, the new common program requirements define a comprehensive set of new ideals (and new rules) for GME. One central ideal—not new but much more clearly stated—is “graded and progressive responsibility.” This principle emphasizes the need for residents and clinical fellows at each phase of training to assume more responsibility and have more autonomy. The new requirements
The new requirements emphasize shorter duty periods (16 hours) and closer supervision for first year residents. The key is to ensure that all residents are “fit for duty” at all times. The requirements, however, also create more flexibility and responsibility for senior residents and clinical fellows as they prepare for unsupervised practice of medicine. Senior residents may now stay on duty beyond the limits of duty hours in circumstances when it is necessary to do so to care for patients. To supplement care lost by more restrictive hours for residents and clinical fellows, each of our major hospitals is adding new faculty and staff. Nonetheless, we will need to be vigilant to ensure that these changes don’t have untoward effects on both patient care and clinical education. One potential area of concern is handoffs and transitions of care. With more restricted hours there will be even more handoffs between physicians. While it is not proven that shorter hours lead to better care, it is known that more transitions can result in worse care. The new requirements, and the principles of patient safety and quality of care, demand that we all master the art of sign-out. Residency and clinical fellowship leaders are working hard to develop program-specific and institutionwide principles, practices, and resources that enhance our existing sign-out systems. (continued on page 2)
A New Era in GME.... (continued from page 1)
The new requirements also emphasize that residents and clinical fellows must be directly engaged in patient safety and quality of care. Many of our programs already fully meet this requirement. Our unique resident and clinical fellow quality of care incentive program contributes to meeting these requirements. This year, in addition to our all program incentives on patient satisfaction, hand hygiene, and reduction of unnecessary lab tests, 11 of our residencies and all of the Department of Medicine (DOM) fellowships participated in program-specific incentive goals. These interventions, almost all of which have been achieved, also address issues of patient satisfaction and laboratory utilization as well as numerous improvements in care processes. For 2011-2012, 15 residencies and the DOM fellowships will participate. This is a remarkable achievement in improving patient care and enhancing competence in patient safety and quality of care. The new requirements also place even greater emphasis on evaluation and assessment to ensure the competence of each trainee. Although most of our programs do an excellent job evaluating trainees, faculty, and the program itself, this remains an area for further improvement. We will increasingly use more powerful assessment tools than the commonly used “global assessment” evaluation form, standard knowledge exams, and procedure logs. Stronger processes will include more direct observations, greater use of multi-source feedback including feedback from patients, peers, and non-physician health professionals, as well as the use of learnercentered portfolios. The next year or two will also see the implementation of training “milestones” in each specialty. Milestones will define specific skills and competence for each specialty at each level of training. Achievement of groups of milestones will define “entrustable professional activities” that will more precisely define independent practice. Other Changes in GME in 2011-2012 2011-2012 will also be the year for implementation of our new electronic health record, APeX. APeX is already in use in several UCSF clinics and many more are scheduled for early summer. The entire UCSF Medical Center (inpatient and outpatient) will use APeX by next spring. This new system will markedly enhance our ability to care for patients in an 2
integrated inpatient and outpatient manner. There will undoubtedly continue to be many challenges during this transition as we change our workflows and train everyone on this powerful but complex new system. In the end, though, we will have a safer, more efficient, and more patient-centered UCSF Medical Center. This next year will also see the further expansion and development of our innovative Pathways to Discovery program. Over 100 residents participated this year and received additional training in molecular medicine, clinical and translational medicine, global health, health professional education, and health and society. The Pathways program has resulted in a substantial explosion of resident and clinical fellow scholarship. Approximately half of all trainees had a first author presentation or paper this year! GME will also evolve this year with greater use of simulation in clinical education. The development of the state-or-the art Teaching and Learning Center in the library at Parnassus (along with ongoing programs at SFGH and the VA) has created new opportunities for procedural training, observed training in other clinical skills, and teamwork training. This fall will also see some important changes in leadership in Medical Education at UCSF. David Irby, PhD, has announced that he will step down as vice dean for education in the UCSF School of Medicine in September. In this role, Dr. Irby directs undergraduate, graduate and continuing medical education programs of the School of Medicine and leads the Office of Medical Education. As a senior scholar at the Carnegie Foundation for the Advancement of Teaching, he recently co-directed a national study on the professional preparation of physicians. In July, Dr. Irby will present GME Grand Rounds on his vision for the future of medical education. After a sabbatical starting in September, Dr. Irby will return to work on specific education initiatives. Replacing Dr. Irby as Vice Dean for Medical Education is Catherine Reinis Lucey, MD. Dr. Lucey is currently interim dean and vice dean for education at the Ohio State University (OSU) College of Medicine, and associate vice president for health sciences education for the OSU Office of Health Sciences. She is chair elect of the American Board of Internal Medicine and a member of the AAMC committee, charged with overseeing the revision of the MCAT process. She (continued on page 17)
NEWS FrOM UCSF LIBrArY Josephine Tan, MLIS Education and Information Consultant, Clinical Sciences UCSF Library
With the words, “just Google it,” resting at the tip of our tongues whenever we want to find information fast, it becomes increasingly more important to make sure you can go to key reliable resources quickly rather than just depending on what Google floats to the top. Nowhere is it more important than in medicine that we find fast and reliable information for clinical practice. Below are some resources that the Library provides as well as free resources on the web for finding clinical practice guidelines. LIBRARY RESOURCES ProceduresConsult Access this resource in the POPULAR RESOURCES section on the right side of the Library’s homepage (http://library.ucsf.edu). ● Provides pre-procedure, and post-procedure checklists ● Includes images, illustrations, and video demonstrations ● Highlights when patient “informed consent” is required ● Allows for self-testing and tracking your knowledge of procedures ● Also available for your mobile device AccessMedicine, MdConsult, & STAT!ref Access these resources in the POPULAR RESOURCES section on the right side of the Library’s homepage. These three resources are primarily medical textbooks but also provide additional content beyond purely textbooks. ● AccessMedicine & MDConsult each have a Guidelines tab in their interface that lets you directly browse the available guidelines ● STAT!Ref has a Point of Care link in the left margin of your search results page. Go there to see evidence-based practice guidelines provided by ACP PIER (American College of Physicians Physician’s Information and Education Reference) & AAFP (American Academy of Family Physicians) FREE WEB RESOURCES National Guideline Clearinghouse (http://ngc.gov) NGC is a collection of North American clinical guidelines. Keep in mind that there are guidelines presented from several different years. ● Re-sort the results by publication date (a button option at the top of a results list) to show the most recent guidelines at the top ● Check any of the boxes in the right of the results list and then select the yellow “Compare Guidelines” icon to generate a customized comparison chart between the specific guidelines you selected Agency for Healthcare research and Quality (AHrQ)’s Effective Health Care Program (http://effectivehealthcare.ahrq.gov) AHRQ is a part of the U.S. Department of Health & Human Services. The Effective Health Care Program is as they describe it, “Helping you make better treatment choices.”
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Library Update..... (continued from page 3)
● Provides Clinician Guides that are two to four-page clinical guideline summaries ● Click on the Search for Guides, Reviews, and Reports section in the gray left menu bar to get to the
search feature for these guides ● Also provides the option to listen to audio files that describe the guidelines
I don’t advocate for making your life entirely Google free when it comes to finding medical information. Google is fast, accessible, and part of our everyday lives. What I do advocate for is that you should definitely turn to some of the resources mentioned above to make sure you have the best evidence for practicing good medicine. Looking for other information searching tips? Visit the “In Plain Sight” blog at http://blogs.library.ucsf.edu/inplainsight. For more information, contact Josephine Tan at josephine.tan@ucsf.edu, 415-476-2534.
WarnMe Emergency Notification System H. Amabintu Jah Mass Notification System Coordinator UCSF Police Department
system. WarnMe information is strictly confidential and information will not be sold or shared with any other University of California programs or other public, private or government entities. As of March 1, 2011, the WarnMe system has been integrated with MyAccess authentication. Updating profiles in WarnMe no longer requires the use of a separate username and password, providing enhanced security and facilitating the login process.
UCSF provides an emergency alerting system, WarnMe, developed in the aftermath of the Virginia Tech tragedy which is intended to send warning of imminent threat to life or safety. As students, faculty, and staff are often mobile across campuses, everyone is encouraged to register personal contact information such as e-mail and cell phone. Please register as many personal means of communication as possible for reaching you in an emergency. WarnMe will only be used during life threatening situations to provide brief updates on an emergency as it’s happening, or to instruct you on where to receive aid in the aftermath of an event such as an earthquake. Occasional drills, clearly defined as such, will also be conducted to test and ensure the effectiveness of the 4
Please note: Everyone with an official UCSF ID has automatically been set up in the system with UCSF phone numbers and email addresses. To update this specific information you will need to contact your program coordinator, payroll administrator, or human resources representative to have the payroll system information changed. Once entered, the information will be automatically uploaded to WarnMe after 24 hours. For updates and information on emergency preparedness subscribe to the Emergency Management Listserv (emergency_mgt@listsrv.ucsf.edu). More information on how to subscribe can be found at http://its.ucsf.edu/main/listserv/g2/list-subscribe.html. Further information about WarnMe can be found on the FAQ page: https://warnme.ucsf.edu/faq.php
GME Grand ROUNDS
There’s an App for That: Key Smart Phone Applications for Surviving Residency Michelle Lin, MD Associate Professor of Clinical Emergency Medicine, UCSF, SFGH and Trauma Center
Apps on handheld devices and smart phones are quickly taking over our lives. Apps most commonly are used for social media communications (Twitter, Facebook), entertainment, games, and music. However, apps are definitely spreading into the medical arena. These medical apps improve the rapid access to information, optimize bedside management of diseases, and facilitate learning while on the go. Currently the iOS platform (iPhone, iPod Touch) has the most robust collection of medical apps, but the Android, Nexus, Blackberry, and other platforms are quickly catching up. Below is a collection of the top 12 apps which may be useful for residents, clinical fellows, and faculty, which cost less than $5.00 each. Most are actually free. 1. Evernote (free) This all-in-one organizational, cloud-based software automatically keeps your desktop, online account, and smart phone documents all synchronized and accessible anywhere. Evernote entries can be free text or even PDF documents. The search feature amazingly will search each entry for the word(s) you are looking for. This includes your PDF documents. Evernote also allows you to create notebooks and tags to help you organize your files. Personally, I use Evernote for everything ranging from:
• A copy of my passport when I travel out of the country • Key PDF articles of landmark emergency medicine studies for referencing and bedside teaching on shift • My notes from journal articles • My notes from conference calls • The emergency department’s monthly attending schedule • To-do list • Grocery shopping list 2. Epocrates (free) and MicroMedex (free) These two drug-prescribing apps provide an extensive list of medications and medication-related tools. Both provide standard information such as pediatric and adult drug dosings. Uniquely, Epocrates also contains a “Pill ID” tool, which allows you to identify mystery pills based on the pill shape, color, and markings. Additionally, it provides you with the cost of each medication. While, MicroMedex also provides comprehensive drug information, it includes a toxicology section for each medication in case of overdose. The rumor is that MicroMedex is slightly more reliable, especially with pediatric medication dosing. 3. Medscape (free) This web-based resource by WebMD has converted to mobile app format. It serves as a pretty comprehensive reference for physicians and other health professionals. It spans multiple specialties, contains fact sheets on various diseases, contains a drug formulary, and features medical journal articles. This is an impressive app resource, considering that it is completely free. 4. MedCalc (free) and Mediquations ($4.99) The two best medical calculator apps are MedCalc and Mediquations. They feature a very similar list of calculations. The added feature that I like in Mediquations is that it tracks the most recent calculator tools that you used, so that you can quickly access your frequently-used calculations. If this is not a major deal for you, you might consider using MedCalc, because it is free. 5. Camera (free) Smart phones typically include a Camera app as part of the standard operating system. The camera can be extremely useful in clinical practice. This may include taking a picture of an ECG to email to the Cardiology fellow or cardiac catheterization team. You can also take a picture of a patient’s face and ask him/her if the subtle (continued on page 6)
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GME Grand ROUNDS...... (continued from page 5)
facial droop is new. Another example includes taking a photo of an intoxicated patient’s scalp laceration to convince him/her that there is indeed a deep scalp laceration that requires immediate wound closure in the emergency department. A word of caution -- Be aware of violating HIPAA rules and avoid patient identifiers if at all possible. 6. Pedi Safe ($0.99) and Pedi Stat ($2.99) Both of these pediatric resuscitation reference apps are a terrific pediatric resource. They both allow users to input a patient’s weight to determine key drug doses and equipment sizes. Pedi Safe also provides the normal range of pediatric vital signs, based on the patient’s weight and age. Pedi Stat has a slightly more user-friendly interface and also allows the user to estimate weight based on length or age. Pedi Safe does not allow the latter. 7. Eye Handbook (free) and Eye Chart (free) When patients complain of blurry vision, a visual acuity should be obtained. This is the “vital sign of the eye.” Instead of carrying around a Snellen visual acuity chart, Eye Chart allows for a quick visual acuity check. The chart should be held at a distance of four feet. The Eye Handbook is an app, which works in collaboration with the American Academy of Ophthalmology, that features various vision testing tools, calculators, and patient education resources. I commonly use the Eye Handbook because it contains fun pediatric fixation targets, which are essentially simple animations featuring cartoon animals making funny sounds. There are also two free short animation movies which distract the pediatric patient long enough to perform a quick physical exam or irrigation of a laceration. 8. NEJM This Week (free) The New England Journal of Medicine just released a free app in June 2010, which highlights articles, 6
images, and videos each week. There are also weekly podcasts summarizing the current issue. This a great way to keep up with the journal. 9. iRadiology (free) and Radiology 2.0 (free) These two case-based apps focus on teaching the user how to identify common radiologic findings. The first, iRadiology, contains hundreds of plain film and CT images. When ready, the user can select to read the discussion of the findings and view the labels. The second app, “Radiology 2.0: One Night in the ED” contains 65 classic CT cases. The unique feature, which makes this app worth looking at, is the fact that the user can scroll through all of the CT slices for a single patient by sliding one’s finger up and down on the screen. The images scroll through as smoothly as on the digital PACS machine in the Radiology department. Discussions are provided for each case. 10. Diagnosaurus ($0.99) This free app contains a massive amount of medical information. Divided by organ system and symptoms, the user can look up differential diagnosis lists for a variety of presentations. The topics primarily cover the areas of internal medicine and surgery. 11. Ruler (free) Accurate documentation of length is important when evaluating lacerations, abscesses, cellulitis, and burns. A simple ruler can help the user obtain an accurate measurement. 12. Whiteboard Lite (free) With more records, charting, and order sheets going paperless, there is less quick-access to scrap paper to doodle a quick diagram to a patient, medical student, or fellow resident. Occasionally, I have witnessed people draw on the sheet of a patient’s gurney. With this app, you can quickly select a pencil color and size and immediately start doodling a picture on a blank white screen. Furthermore, two users can create pictures together over local Wi-Fi or Blutooth peer-topeer signal. Summary Medical apps are quickly becoming a staple within the medical professional community for both teaching, learning, and medical decision making. To keep up to date about new apps, be sure to visit www.iMedicalApps.com.
Every Physician is a Teacher: 10 Tips to Improve Clinical Teaching Susan B. Promes, MD Director, Curricular Affairs, GME Program Director, Emergency Medicine Residency Program
Clinical teaching is expected of us as physicians at UCSF. Our learners are very clear about what they want from their clinical teachers. In one study by Dr. Thurgur et. al. five characteristics rose to the top of learners’ minds when they were asked what they wanted from their teachers. Those items were: takes time to teach, gives appropriate feedback, tailors teaching to the learner, uses teachable moments well, and possesses a positive attitude.1 I would like to recommend the following tips as suggestions to aid in improving your clinical teaching. #1 – Diagnose Your Learner In order to be most effective as a teacher, it is important to know your learners and “diagnose” their weak areas and help them fill their knowledge gaps. It is very easy to fall into teaching the same things over and over again because it is an area we feel comfortable with or enjoy. Try to teach to your learner rather than simply your comfort zone. #2 – Take Time to Prepare We do so much teaching on the fly, but when you have the opportunity, take time to prepare for a teaching encounter. The encounter does not have to be long, but take time to plan what you want to accomplish. Go to the bedside. Let the patient know that you will be teaching at the bedside. Consider preparing a brief handout or supplying the learners with a key article on a topic that is appropriate for a patient that they are caring for that day. Consider asking the learners to prepare in advance for a discussion you plan to have the next day about a patient the team is caring for. #3 – One-Minute Preceptor Model The One Minute Preceptor Model is very popular here at UCSF thanks to the work of Dr. Irby. It is a nice framework to help get the most out of those teaching moments with special emphasis on the individual learner. The model is composed of five microskills: 1) get a commitment from the learner by asking the learner what they think is going on with the patient; 2) probe for supporting evidence by asking the learner
what lead them to the conclusion they came up with in the commitment step; 3) teach general rules about the case; 4) reinforce what was done well with positive feedback; and 5) give guidance about errors or omissions. Give this model a try if you have not already used it. #4 – Aunt Minnie Model Aunt Minnie is the name used by Sackett and coworkers to describe a process of pattern recognition; if she dresses and walks like Aunt Minnie even if you cannot see her face she is probably Aunt Minnie. This model is particularly useful when time is short and the patient has a classic or easily identifiable problem. After the learner has completed their evaluation of the patient, they are asked to present the chief complaint and their diagnosis. The teacher then gives immediate feedback to the learner based on the learner’s brief analysis of the case. This model only works if the teacher sees the patient and knows the correct diagnosis. It works best with common conditions. #5 – SNAPPS The SNAPPS model is for the self-directed learner. The learner uses the mnemonic SNAPPS to organize their presentation and direct their teaching. SNAPPS stands for Summarize case; Narrow the differential to two to three items; Analyze the differential; Probe the teacher about any uncertainties, difficulties or alternate approaches; Plan management course for the patient; and Select a case related problem for self-directed study. Note this model puts the pressure on the learner to create teaching points, not the teacher. #6 – Activated Demonstrations Many of us are asked if junior learners can shadow us in our everyday clinical setting. The activated demonstration model is a nice way to get junior learners involved in the clinical environment by giving them a specific task to observe while the teacher demonstrates. This works well for things such as observing an interview technique; having a difficult conversation with a patient or a family member; or a clinical exam or procedural skill. By giving the learner a task they then feel that they have an important role rather than simply just standing around watching an interaction. After the demonstration, a (continued on page 14)
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OUT & ABOUT from the Resident and Fellow Affairs Committee Where members of the Resident and Fellow Affairs Committee recommend their favorite scenes outside UCSF.
Urban Hikes! Liz Brown, MD, PhD Emergency Medicine Resident
Urban hikes, secret stairwells, and the best views in town: One of my favorite things about doing residency in San Francisco is that there are so many easily accessible places to go for a quick walk. You don’t have to wait for your day off to enjoy some fantastic views--you can squeeze in a breathtaking glimpse of the city, the bay, and the Golden Gate Bridge after work, or find some solitude on one of the magical hidden staircases in the city. Here are some of my favorite lesser-known spots to go for mini-hikes with my husband and our baby: 1. Tank Hill: wear your windbreaker and be prepared for a bit of a steep ascent up Stanyan Street to reach this gem of a park with views of both bridges and most of the city. 2. Corona Heights Park: not far from Buena Vista Park, in addition to a dog run area at the base, Corona Heights Park offers spectacular views from the peak of the large rocky hill. 3. Land’s End: offering views of the Marin Headlands and the Golden Gate Bridge, Land’s End is an easy walk along the cliffs overlooking the bay. San Francisco also has an abundance of hidden stairwells tucked between homes, which are highly worth a climb, as they reveal secret gardens along the way and spectacular views from the tops. My favorites are the Vulcan Stairway and the Saturn Street Steps, half a block apart on Ord Street overlooking the Castro. Another great set of San Francisco steps are the mosaic-clad steps leading up to the peak of Grand View Park in the Inner Sunset, well worth the climb for the 360o views of the city and the water (warning--I went into labor while climbing the steps of Grand View Park!). The neighborhoods surrounding Coit Tower also have numerous staicases tucked between homes and gardens. If you have an afternoon to wander in the Telegraph Hill area stop at one of the many cafes bordering Washington Square Park, then get lost in the winding streets that lead up to Coit Tower. Don’t miss the Greenwich Street stairs or the Filbert Steps! If you have a day off and want to venture a little further afield, there are some great views to be had by crossing the Golden Gate Bridge or the Bay Bridge. If you head to the East Bay, drive along Grizzly Peak Blvd, which connects Tilden Park and Sibley Park, and you will find lots of spots to wander. The views from Seaview Trail in Tilden Park are stunning, especially in the late afternoon. I highly recommend stopping for spicy Ethiopian food at Cafe Colucci on Telegraph Avenue before you head back home. If you head north to Marin, the easiest access to ocean views is from the Tennessee Valley trailhead. Exit 101-North to Highway 1, and Tennessee Valley Road will be on the left--turn at the fruit stand (where you can also stop off to pick up some provisions for your hike). The Coastal Trail offers great views of the city and the ocean, and takes you all the way down to Muir Beach, if you don’t mind the climb back up afterwards. Hope you enjoy the views!
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OUT & ABOUT...... Gone Vegan Stuart Lustig, MD, MPH Assistant Clinical Professor, Psychiatry Child & Adolescent Psychiatry Program Director
Where else but the bay area can one so lovingly and healthfully indulge one’s taste buds without contributing to the environmental decimation or devastating cruelty of the meat, poultry, or fishing industries? Here are my picks for vegan dining from simple to extravagant.
Creation at 854 Washington west of Grant (great dim sum!); Golden Era at 572 O’Farrell between Jones and Leavenworth; and Golden Buddha at 832 Clement between 9th and 10th. Among other cuisines from that corner of the world, try Saffron Grill at 1279 Fulton just east of Divisadero for northern-style Indian. Though not a vegan establishment, they have an extensive vegan menu upon request, and will make sure to bring you vegan chutneys if you specify. Entrees are around $10, and on the weekends, ask about their okra and eggplant specials. Back to more continental American, Ananda Fuara, 1298 Market St and 9th has several items with cheese (gasp!) but most are vegan. Be sure to try the succulent “neatloaf” sandwich, vegan upon request, for $8.95. Slightly trendier with a more eclectic, around-the-world menu, is Herbivore at 983 Valencia between 20th and 21st or 531 Divisadero at Fell. My two favorites from their vast selection are the roasted red beet salad and the coconut noodle soup, both just $7.50.
Our tour starts at Gracias Madre on 2211 Mission at 18th for sumptuous and elegant vegan, organic non-GMO Mexican food, which is locally sourced. The chile relleno topped with cashew cheese ($14) is worth the trip. Gracias Madre is the brainchild of the folks at Café Gratitude, located nearby at 2400 Harrison at 20th specializing And what tour of vegan dining would be in raw food. Express your complete without the sophisticated, avantfeelings when ordering the garde Millenium in the Hotel California, dishes, such as the “I am 580 Geary St at Jones. The Frugal Foodie fortified” (a quinoa vegetable Menu gets you an appetizer, entrée, and plate -$12) or the “I am nourished” (an almond paté dessert for $39 with a $12 optional wine pairing. Or and avocado sandwich - $13). Portions are not huge; what the heck – go all out for the $72 chef’s five-course they should have a dish called, “I’m still hungry.” tasting menu and $28 wine pairing. Chosen at random from their menu: roasted root vegetables, king trumpet Changing continents, but not neighborhoods, try mushrooms & braised tofu, lemongrass-caramelized Cha-ya at 762 Valencia between 18th and 19th for shallot-beer broth, spicy kumquat sambal, Asian vegan Japanese. All the usual suspects are there, aromatic & sprout salad, and chile candied cashews including tempura and “sushi” rolls. This place and that’s all just one dish ($25)! Not only will you works miracles with eggplant. More generally, San have eaten like royalty; you will have tantalized your Francisco boasts an embarrassment of riches when dinner companions with your vegan dining prowess. it comes to vegan Asian cuisine. Steps from the UCSF Parnassus campus is Loving Hut, 524 Irving Holy Gelato at the northeast corner of 9th and Judah th th between 6 and 7 and also at 1365 Stockton at boasts an entire case of twelve different non-dairy Vallejo. Among several unabashedly vegan dishes frozen desserts, some with a coconut milk base, others are concoctions for carnivores, such as the sizzling with a soy milk base. Sample to your heart’s content teriyaki chicken (with a surprisingly chicken-like and then order Charlie Brown’s Nightmare, a decadent, rendition of tofu - $9.45) or Mongolian delight at chocolate peanut butter concoction that would make $9.95 with the great imitator, soy protein, now posing Charles M. Schulz proud! Cross Judah and walk a convincingly as cow carrion. Similar faux-pho type few steps north to Arizmendi Bakery for a vegan establishments, with prices comparable to Loving chocolate mint cookie. What a way to end your vegan Hut, include: Enjoy Vegetarian at 754 Kirkham adventure...or maybe now it’s all just beginning. at 12th and 839 Kearney at Washington; Lucky 9
hONORS AND rECOGNITION FOR hOUSESTAFF ADOLESCENT MEDICINE Vice President of the Southern California Chapter of the Society for Adolescent Health and Medicine Melissa Pujazon, MD, MPH ANESTHESIA 2010 Krevans Award for Clinical Excellence Brad Cohn, MD 2010 Recipient of the Stuart C. Cullen Award Candice Tam, MD 2010 Medical Student Teaching Award (department-awarded) Michele Arnold, MD Tyken Hsieh, MD Alain Salvacion, MD Noah Stites-Hallett, MD John Turnbull, MD Brian Waldschmidt, MD 2011 CTSI Resident Research Travel Award Joshua Cohen, MD Jason Ku, MD 2011 UCSF SOM Clinical Teaching Excellence Award for Cherished Housestaff from The UCSF SOM Class of 2011 Graduation Committee Lance Retherford, MD 49th Annual Western Anesthesia Resident Conference Joshua Cohen, MD – 3rd Place Poster Presentation CARDIOLOGY Laennec Young Clinicians Award Finalists James M. McCabe, MD Brian Moyers, MD DERMATOLOGY Medical Dermatology Society 2011-2012 Mentorship Award Francisco Ramirez-Valle, MD, PhD 2010 American Society for Dermatologic Surgery Andreas Boker, MD - “Cutting Edge Research Grant” American Academy of Dermatology Leadership Program Barrett Zlotoff, MD EMERGENCY MEDICINE 2011 Back Bowls Trivia Champions at the Western Regional SAEM Meeting Bory Kea, MD Eric Silman, MD Cynthia Zamora, MD 2011 SAEM SimWars Champions Caitlin Bilotti, MD Eric Silman, MD Marianne Juarez, MD 10
Yale/Stanford Johnson & Johnson Global Health Scholars Program Hemal Kanzaria, MD 2011 CTSI Outstanding Resident Research Award Hangyul Chung-Esaki 2010 CTSI Resident Research Award Hemal Kanzaria, MD 2010 CTSI Resident Research Travel Award Bory Kea, MD 2010-2011 Department of Emergency Medicine Intern of the Year Award Daniel Repplinger, MD Mt. Zion Health Fund Margaret Salmon, MD 2011 Krevans Award for Clinical Excellence Dina Wallin, MD HEMATOLOGY/Oncology ASCO YIA Award and ACS Grant Chloe Atreya, MD, PhD ASCO YIA Award Edward Cha, MD, PhD DOD Grant Prostate Cancer Training Award Andrew Hsieh, MD RAP Grant Katherine Van Loon, MD, MPH NIH Loan Repayment Grant Alain Algazi, MD Pfizer Oncology Fellowship Award Rahul Aggarwal, MD INTERNAL MEDICINE Keith Johnson Award Nizar Mukhtar, MD Jeffrey Weingarten Award Nat Gleason, MD Community Service Award Larissa Thomas, MD Basim Khan, MD Thomas Evans Teaching Award David Dowdy, MD Reza Gandjei Humanism Award Anna Chodos, MD Professionalism Award Gabe Mannis, MD Abbi Eastburn, MD Floyd Rector Basic Science Research Award Kanako McKee, MD Floyd Rector Clinical Science Research Award Celia Yau, MD Obstetrics & Gynecology 2010 CTSI Resident Funding Program Wayne Lin, MD APGO/CREOG Resident Scholar Jocelyn Chapman, MD
hONORS AND rECOGNITION FOR hOUSESTAFF Krevans Award for Excellence Juno Obedin-Maliver, MD 2011 CTSI Resident Research Funding Program Tami Rowen, MD Special Resident in Minimally Invasive Gynecology Deirdre Lum, MD Ophthalmology Garcia/Asbury Award Daniel A. Greninger, MD Head Foundation Fellowship Charles Lin, MD Brett L. Shapiro, MD Alison Skalet, MD, PhD Starr E. Shulman Fellowship Award Jason Ruggiero, MD Hogan/Garcia Award Brett L. Shapiro, MD 2010 CTSI Resident Research Travel Grant Brett l. Shapiro, MD PATHOLOGY Stowell-Orbison Certificate of Merit Nikoletta Sidiropoulos, MD Pediatrics Resident Teaching Awards Shannon Denise Shea, MD Christina A. Acuna, MD Lawrence R. Shiow, MD Lucy S. Crain, MD Award Jason Boehme, MD Amit J. Sabnis, MD Ahmad GhaneaBassiri, MD Pediatric Intern Award Shireen F. Cama, MD Volunteer Faculty Teaching Award Mark H. Corden, MD Rudolph Award Eleanor L. Chung, MD Faculty Teaching Award Bradley J. Monash, MD Postdoctoral Fellow Teaching Award Amy Gelfand, MD Compassionate Physician Award Robert E. Goldsby, MD Brown-Coulter Award Joanna Mimi Choi, MD Grossman Award Sarah E. Libecap, MD Krevans Award for Excellence Adam D.Schickedanz, MD 2011 Chancellor’s Award for Gay, Lesbian, Bisexual, and/or Transgender Leadership Illana Sherer, MD
PSYCHIATRY Northern California Regional Vice President for CIR/SEIU Flavio Casoy, MD APA/SAMHSA Minority Fellowship Keith Hermanstyne, MD Phillip J. Resnick Scholarship Abilash Gopal, MD RADIOLOGY 2011 Gabriel H. Wilson Award Timothy M. Shepherd, MD, PhD 2010 CTSI Resident Travel Award Judong Pan, MD, PhD 2010 CTSI Resident Research Award Ania Azziz, MD American Alliance of Academic Chief Residents in Radiology Secretary Nazia Jafri, MD RADIOLOGY oncology ASCO Foundation Investigator’s Award Stephen Shiao, MD, PhD Best Physical Science and Molecular Biology Award Stephen Shiao, MD, PhD B. Leonard Holman Pathway in Radiation Oncology Tina Dasgupta, MD, PhD RSNA 2011 Roentgen Resident/Fellow Research Award Jennifer Yu, MD, PhD surgery Nusz Achievement Award Insoo Suh, MD Azakie-Chesson Award for Compassion Jong-Ping (JP) Lu, MD Haile T. Debas Resident Teaching Award Alexander Ayzengart, MD Urology 37h Annual Northern California Urological Resident Research Seminar 2nd Place: Sima Porten, MD - Clinical Science 2nd Place: Lawrence Flechner, MD - Basic Science Miley B. Wesson/Olympus Resident Essay 1st Place: Thomas Chi, MD Joseph F. McCarthy/Olympus Essay Contest 2nd Place: Maurice M. Garcia, MD 3rd Place: Jared M. Whitson, MD
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10 Questions from the Resident and Fellow Affairs Committee
Kim P. Norman, MD, Clinical Professor of Psychiatry and Director of the UCSF Young Adult & Family Center, and Russ Cucina, MD, MS, Associate Professor of Clinical Medicine and Medical Director of Information Technology at UCSF Medical Center answer resident and clinical fellow questions about social networking in a medical environment.
1) What guidelines should physicians follow when communicating with a patient semi-publicly through a social networking site to avoid HIPAA violations? It is wonderful to use social media to communicate with patients in order to educate them about general health issues and do health promotion. However, it is not appropriate to use the social media space to answer a patient’s personal medical questions or give specific medical advice. While a social networking site such as Facebook or Twitter has certain privacy controls it is a public forum with internet intermediaries and any communication on these sites constitutes a disclosure to those intermediaries. Since ancient times, it has been a physician’s ethical and professional responsibility to protect patient privacy. Any identifying information that arises from the doctor-patient relationship must be protected from public disclosure. HIPAA is quite clear that public sites cannot be used for communication and California law imposes even stricter expectations and penalties about the security of patient information in this setting and these apply to both the institution and the individual. 2) Can physicians use social networking to communicate patient information such as lab 12
results if done via a private but unencrypted interface (e.g. Gmail “chat”), if it is requested by the patient? This is by far the most common question asked and the answer is “no.” It is never appropriate. Whether or not the patient requests exchange of information in this forum is immaterial. All communication between you and your patient should be done through encrypted email. If you send the communication from your UCSF email account and you put the word SECURE or PHI in the subject line, UCSF will encrypt the email and keep the information on UCSF servers and provide the patient a way to access the information through a secure portal. Once APeX is operational, UCSF will be able to communicate all confidential information with the patient within the confines of the APeX patient portal. As physicians we are accustomed to the patient consenting to things, like a procedure, and thus making those things acceptable. Consent does not apply to protecting the patient’s privacy. The patient cannot consent to have their privacy violated and cannot excuse the physician from his or her ethical, professional, and legal duty in this regard. 3) How should physicians handle questions, concerns or comments directed to them by friends of a patient on a social networking site? Any response on a social networking site, a public forum, is a violation of HIPAA and raises ethical and legal complications. The same applies to email inquiries. A great analogy regarding sending emails is the difference between sending a letter and sending a postcard. You send a letter in an envelope which only the recipient is legally authorized to open while sending a post card opens the content for anyone to read along its journey. Aside from the issue of a social media or email site, a physician can respond to questions from a patient’s family or friends only if the patient has given written consent for release of medical information to these individuals. 4) Is it acceptable for physicians to publish patient information on a public website (e.g. blog) if HIPAA-defined identifying information has been removed? It is very risky and a bad idea. It is natural to want to
10 Questions.....from the RFA Committee your career. The permanency of the Web makes this talk about your day at work, but our work carries special impact more pressing. In addition, we have a duty as doctors to be public role models and we shouldn’t obligations. For example, a physician in Rhode Island be acting in a manner we wouldn’t encourage any of was talking about her day at work on her Facebook our patients to be doing. page. She believed she had been careful to remove identifying information about her patient. However, the 7) What are some ways that physicians can use description of the patient’s injuries contained enough social networking sites to improve patient care detail that it was possible to reconstruct the patient’s without violating privacy rules? identity from reports in the news media. The physician While improper to deliver clinical advice in a public was fired from her job at her hospital and disciplined by forum, social media is a great way to publish general the Rhode Island Medical Board. This case has set a health information and advice. UCSF has used precedent and it is clear that describing clinical events its own Facebook and Twitter presence for health or sharing feelings about patients online is dangerous promotion by announcing the availability of influenza because it is very difficult to assure the true anonymity vaccination, promoting wellness activities such as of a patient. diet and exercise, and educating the public about 5) Is it legal and/or ethical to initiate or accept a “friend request” from a patient? It is not illegal to accept a friend request, but doing this can create an ethical problem. As a physician you have the obligation to protect private information about your patient’s medical condition. During the course of friendly exchanges with a doctor, a patient may innocently reveal more about themselves than they should and include protected health information. Postings are shared with other friends and the physician becomes responsible for unwittingly leading the patient into the danger of self-revealing. It is important to keep professionally appropriate boundaries with your patients. A big difference between being a friend and being a physician is that the patient-doctor relationship is singularly focused. In the therapeutic relationship, it is the doctor’s obligation to support and treat the patient, and not the other way around. We would also add that it is never professionally appropriate to extend a friend request to a patient. It invites a personal relationship with the patient and puts them in the unacceptably difficult situation of having to accept or decline your friend request. 6) What measures should a physician with an active presence on social networking sites take to avoid unprofessionalism in their ‘private’ life? Assume everything you do on Facebook, Twitter, and other social networking sites is being published on the front page of The San Francisco Chronicle. If it would embarrass you personally and professionally, do not post it. The social media profile you maintain for your personal use is still a public forum and overstepping boundaries by showing disrespect for others or using vulgar language can impact your reputation and tarnish
current health concerns such as the absence of any threat of radiation from Japan. Public education has always been part of the social mission of being a physician; we just have new tools in which we can disseminate this information. UCSF is scheduled to go live this summer with the site “Ask an Expert@UCSF” where a member of the public can anonymously type in a question and have it reviewed and answered by a UCSF expert. It will be made very clear that the expert is not giving medical advice or creating a doctor-patient relationship and the information that is given will be limited strictly to general health information.
Psychiatry is currently piloting a secure social network called Tiatros. It creates a social network around an individual patient which will include a care team made up of all the licensed clinicians involved in the patient’s care. There can also be a community of care-givers which may include friends, family, and loved ones. The network is being developed with controls so that all communication is private and HIPAA compliant. 8) What issues arise when physicians comment on medical issues in an on-line chat room? Giving medical care on a pro bono basis does not change a physician’s medical, professional, and legal responsibilities. Whether on the radio or in a chat room, comments about medical issues in a public forum must be restricted to general advice and cannot stray into individualized therapeutic recommendations. It is prudent to realize in these settings that there is no protection to state “I am not (continued on page 14)
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10 Questions.....from the RFA Committee (continued from page 13)
your doctor” if you then assume the role of treating physician. 9) Can departments use technology such as Skype to set up dial-in support groups? Skype is not secure, not HIPPA compliant, and should not be used for any patient level communication. An alternative might be one of the several private networks that are commercially available and offer encryption and indemnification for breach of privacy violations. 10) What should you do if a colleague posts information that violates patient privacy or is otherwise inappropriate in a public forum such as Facebook? If the information violates a patient’s privacy it is your professional and ethical duty to inform your colleague that he or she needs to take the material down. You should also contact the UCSF Privacy Office at (415) 353-2750 regarding the potential breach.
Every Physician is a Teacher... (continued from page 7)
directed educational discussion can follow—making the most of the teachable moment. #7 – Bedside Case Presentations It is rare these days to see an actual case presentation at the bedside. I encourage you to try it from time to time. By having the learner present to the teacher at the bedside, the patient can engage in the discussion and fill in any missing data. It can be a very efficient use of time. In general, patients enjoy the attention and opportunity to be actively involved in the discussions about their care. #8 – Learning Prescriptions As physicians, we are used to writing prescriptions all the time. Why not consider writing a prescription for your learners? How many times have you suggested to a learner to look something up and get back to you and then forgot to follow up on your request? By giving them a learning prescription you direct them to follow up on a key educational point and report back. In the prescription you can tell them exactly what you would like them to do and when you would like them to report back to you. #9 – Teaching Procedural Skills When teaching procedural skills it is important to recognize the resources we have available to us at UCSF. The New England Journal of Medicine procedure videos are an excellent resource as is Procedure Consult. Both are available online through the UCSF library. Practice and preparation 14
prior to performing a procedure is key. Make sure to verbally walk though any procedure with a learner before going to the bedside and make sure someone is there to supervise the learner when they are performing a new procedure. I would like to recommend that prior to having a novice perform any procedure to agree on a word or key phrase that signals the learner to immediately stop what they are doing during the procedure if they are about to harm a patient or simply need redirection. #10 – Effective Feedback Feedback is critical to the learning process. As teachers we all must embrace the importance of feedback. Learners deserve to hear from their teachers in a timely manner what they are doing well and what they need to work on. It is our duty as teachers to provide constructive feedback. Feedback should be done in a timely manner, ideally in a private place and it should be based on observable behaviors. Positive feedback should be given along with discussing areas for improvement or areas of concern. Feedback should be clear and concise and the teacher should check in with the learner to make sure they understood the feedback that was provided. Teachers should suggest ways to improve if the learner has difficulty identifying a plan for improvement. Hopefully, you will find these ten tips helpful for you as a clinical teacher. If you are interested in any further information about any of the points provided, feel free to contact me at susan.promes@ucsf.edu. Thurgur L, Bandiera G, Lee S, Tiberius. What do emergency medicine learners want from their teachers? Academic Emergency Medicine. 2005; 12:856–861. 1
UCSF rESIdENT ANd FELLOW’S COUNCIL Barak Bar, MD and Angela Walker, MD Resident and Fellow’s Council Co-Chairs
Congratulations to our graduating colleagues and welcome new interns, residents and clinical fellows! For those who are new to the University, the Resident and Fellow’s Council (RFC) is a group of housestaff representing the diverse disciplines at UCSF. We work together with the Office of Graduate Medical Education and greater campus community on projects important to resident and clinical fellow life and well-being. Past accomplishments have included: salary supplementation with the housing stipend; implementation of a patient care fund; house staff lounge renovation; and cooperation with the residents at SFGH to implement a single-payer system and work towards pay parity for residents rotating among the different clinical sites.
2010-2011 RFC Members (back row l/r) Kelly Mills, MD, neurology; Joseph Martel, MD, ophthalmology; Thu Ho, MD, pediatric endocrinology fellow; Elizabeth Le, MD, internal medicine; Robin Horak, MD, pediatrics, Delphine Tuot, MD, nephrology fellow; Dana Weiss, MD, urology; (front row l/r) Barak Bar, MD, neurology; Gabe Aranovich, MD psychiatry
To review some of the year’s noteworthy projects: Efforts continue on efficiency projects to improve process procedures for busy residents. Details of a radiology image ordering algorithm are being finalized. Discussions to establish ICU central line kit carts are well underway. Spectralink phones are ready for use by senior residents as part of a pilot project to ease resident-resident communication at night. Together with the Resident Fellow Affairs committee (RFA), we have been working to make medical records among different clinical sites more transparent. Computers in the UCSF emergency department with access to the LCR system of records for patients previously seen at SFGH are highly anticipated. This is a major accomplishment to help with continuity of patient care! Also, look for UCSF shuttle changes this July. Responding to our needs to improve efficiency of shuttle transit (especially from Mt Zion to SFGH locations), RFA has arranged to have shuttle stop/routes improved. Housestaff remain committed to quality improvement projects, particularly those defined by the 2010-2011 incentive goals. Hand hygiene compliance has dramatically improved in the last six months, following implementation of teaching titled, “Just in Time.” For those unfamiliar with this campaign, please remember that all can approach or be approached by a colleague to review hand hygiene tenets. Our policy requires every provider to wash or gel upon both entry to and exit from patient rooms. Patient care satisfaction remains high, and as of late April 2011, third quarter data showed our highest ever patient satisfaction score – 91.1. We continue to work to decrease the use of aggregated lab tests and many departments are working hard to achieve program-specific quality goals. If incentive goals are met this academic term, look for your incentive bonus sometime this summer - up to $1200! And, as announcements are made for 2011-2012 goals, we encourage continued commitment to quality and safety. Resources continue to be available in the Patient Care Fund. As you rotate through services at UCSF, think of ways we can better provide for our patients and submit a proposal. Information and applications can be found on the RFC webpage (http://medschool.ucsf.edu/gme/residents/rescouncil.html) and are reviewed monthly at RFC meetings. We continue to work with the Nurse Resident Council on important patient care initiatives. In the recent (continued on page 16)
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rFC.... (continued from page 15)
year, many units have started unit-specific nurse resident councils, and most are preparing orientation materials for new housestaff to review and reference upon the start of rotations. In March, Jody Mechanic, RN, MS, Coordinator for the UCSF Magnet Recognition Program, visited our group to discuss progress on the application for this prestigious nursing recognition award. As a reminder to all housestaff, don’t forget about the group’s conflict facilitation service run in conjunction with Spiritual Care Services (415-514-6400). Communication difficulties can be resolved through this assistance program instead of the incident reporting mechanism. In April, discussions were initiated with Larry Lotenero, Chief Information Officer, and members of the information technology team to assist in IT strategic planning efforts. As the UCSF Medical Center transitions fully to the new EPIC/APeX electronic medical record system, we welcome the opportunity to work with technologists to elevate IT customer care. Truly what an exciting year! As new colleagues settle into San Francisco, we welcome you. As old faces depart, we wish you well. It’s been a pleasure serving as co-chairs this year. At the start of the new academic year, please join Robin Horak, MD (pediatrics) and Elizabeth “Lisa” Le, MD (internal medicine) as new cochairs at the RFC table. We always welcome new members. If you would like to get involved, please contact us or your department representative… or come to a meeting!!! Happy June! Angela and Barak
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A New Era in GME.... (continued from page 2)
completed her residency and chief residency in internal medicine here at UCSF. It is a pleasure to welcome her home! At OSU, Dr. Lucey has overseen undergraduate medical education, graduate medical education, and continuing medical education, as well as the schools of allied health and biomedical sciences. As interim dean, Dr. Lucey has unified the educational programs across the continuum of medical education and has advanced interprofessional collaboration in education. Dr. Lucey’s areas of expertise include professionalism, clinical problem solving, and learner remediation. She has been a passionate advocate for using education to advance the quality and safety of patient care and to prepare leaders capable of solving current problems in health care and health care delivery. Also in September, I will begin a brief sabbatical as the Robert G. Petersdorf Scholar-in-Residence at the American Association of Medical Colleges in Washington DC. I will have the opportunity to work on GME policy at a national level, with an emphasis on GME financing and accountability. I will also work on the AAMC’s programs to integrate clinical education and patient safety and quality of care. During my leave, Dr. Susan Promes will serve as Acting Chair of the GME Committee. Along with Mary McGrath, Claire Brett, Amy Day, and many other faculty and staff, our GME administrative and support systems will remain as strong as ever. This July also sees the departure of Dr. Arpana Vidyarthi. Arpana has provided outstanding leadership as our first Director, Quality and Safety Programs, GME. Dr. Vidyarthi has played a particularly important role in developing the UCSF Medical Center resident and clinical fellow incentive program, advancing the quality and safety educational opportunities on campus, integrating the quality and safety missions between the School of Medicine and clinical operations, and bringing the UCSF experiences with quality and safety education to the national arena. Dr. Vidyarthi will be taking a new position in Singapore focusing on developing and teaching programs in leadership development, change management, and quality and safety. Please join me in thanking and congratulating Arpana! A new Director will be named shortly, to begin in July.
CTSI resident research Symposium Christian Leiva, CTST Coordinator
Resident Oral Presenter Hangyul Chung-Esaki, MD, Emergency Medicine and Mentor of the Year Robert Rodriguez, MD, Emergency Medicine
On May 4, 2011 the Resident Research Training Program of UCSF’s Clinical & Translational Science Institute held its fourth annual Resident Clinical & Translational Research Symposium in Milberry Union. The symposium provided an opportunity for residents to present their work and to develop cross-departmental collaborations.
Three of the submitted abstracts were accepted for oral presentation. James Andrews, MD, internal medicine, presented “Pain and ADL Dependence in
the Elderly”; Hangyul Chung-Esaki, MD, emergency medicine, presented “Ruling Out Endocarditis in Febrile Injection Drug Users: A Validation”, and Sarah Goglin, MD, internal medicine, presented “Telomere Shortening and Mortality in Patients with Coronary Heart Disease from the Heart and Soul Study.” In all, 31 resident posters were presented, representing many programs across campus from anesthesiology to radiology. This year introduced the Mentor of the Year award. The success of residents embarking on a research project is highly influenced by the quality of their mentorship. This year’s recipient was Robert Rodriguez, MD, Professor of Clinical Medicine and Research Director, SFGH Emergency Department. If you are interested in learning more either about the Symposium or other opportunities in the Resident Research Training Program, please go to http://ctsi.ucsf.edu/training/resident. 17
GME dIVErSITY Rene Salazar, MD GME Director of Diversity
As Director of Diversity for the Office of Graduate Medical Education, I would like to welcome you to UCSF. GME is committed to promoting increased recruitment, retention and advancement of residents and clinical fellows from diverse groups including those traditionally underrepresented in medicine. We strive to promote cultural diversity across all training programs at UCSF and have several opportunities for interested trainees. Several events are planned for this year including participation in the School of Medicine’s Beth Wilson, MD, FCM and Rene Salazar, MD Underrepresented in Medicine (UIM) mentorship dinner program, which was created to provide mentorship for medical students from diverse backgrounds. GME will also host several social events including a new resident/fellow welcome dinner, a reception with the School of Medicine leadership, recruitment receptions, and a second look visit program for interested applicants. There are also opportunities to volunteer in various student-run clinics including the Homeless Clinic, Hepatitis B Clinic and Clinica Martin Baro which provides free primary care to uninsured Latino day laborers. GME also provides financial support for residents and clinical fellows to represent UCSF at national meetings, including the Student National Medical Association (SNMA), Latino Medical Student Association (LMSDA), National Hispanic Medical Association (NHMA), Association of American Indian Physicians (AAIP), and Gay and Lesbian Medical Association (GLMA). For more information please contact me via email at salazarr@medicine.ucsf.edu or telephone (415) 5148642.
UIM/GME Mentorship Dinner (l/r) Willie Moses, MS4; Kirsten Bibbens-Domingo, MD, PhD; Hyman Scott, MD; Nuriya Robinson, MD; Hobart Harris, MD SNMA Conference Indianapolis, IN (l/r) John Hollier, MD, pediatrics; Randi Smith, MD, east bay surgery; William Wood, MD, east bay surgery
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GME EVENTS GALLErY Chief Resident Orientation May 19, 2011
Incoming chiefs enjoying the day! Outgoing CRs (l/r) Leah Malhotra, MD, psychiatry; Vinil Shah, MD, radiology; Greg Tasian, MD, urology; Mercedes Paredes, MD, neurology; Matt Russell, MD, OHNS
Sumant Ranji, MD holds a discussion with incoming chiefs on improving patient safety.
Incoming Chiefs Brett Ley, MD, internal medicine and Joanna Harp, MD dermatology
Incoming Chiefs Varun Saxena, MD, internal medicine and Radhika Madhavan, MD, Ob/Gyn
Incoming Chief Aiyin Chen, MD, ophthalmology
2010-2011 Program Specific Incentive Symposium May 26, 2011
Incentive Program Champions enjoying the evening. Delphine Tuot, MD, nephrology fellow answers questions regarding DOM fellow’s incentive goal.
Annie Hiniker, MD, pathology, discusses her department’s program specific incentive goal results. Melissa Rosenstein, MD, Ob/Gyn, presents her department’s incentive goal.
Peter Chen, MD, radiation oncology presents his department’s incentive goal results.
Kara Bischoff, MD, internal medicine, discusses the success of her department’s incentive goal.
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Summer 2011
Upcoming Events
G M E
GME Grand Rounds
C yphe r
The
Robert B. Baron, MD, MS
Third Tuesday of each month from noon to 1 pm
Solve the Summer 2 0 1 0
Resident and Fellows Council Third Monday of each month from 5:30 p.m. to 7:30 p.m.
C y p h e r
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new Resident and Clinical Fellow Orientation June 17th and June 30th The Winter 2011 Cypher answer was:
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“How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving and tolerant of the weak and strong. Because someday in your life you will have been all of these. “ George Washington Carver
Residents Report
Editorial Staff: Robert Baron Amy Day Paul Day
Many Thanks The Dean’s Office of GME would like to thank the following contributors to articles
Instructions: The above is an encoded quote from a famous person. Solve the cypher by substituting letters. Send your answers to Paul Day in OGME daypw@medsch.ucsf.edu. Correct answers will be entered into a drawing to win a $50 gift certificate!
Congratulations Kristie White, MD, Pathology Fellow, PGY3!!
Have a Bright Idea to improve the welfare of our campus community?
The Office of Graduate Medical Education
Submit it online!
Welcomes New ACGME Program Directors and Program Coordinators
Program Directors Clay Johnston, MD - Vascular Neurology
Ideas that have been implemented include: • Eliminating bottled water from the Medical Center; • Installing sound signals for the visually impaired on Parnassus crosswalks;
Program Coordinators Marcela Cazares - Pulmonary and Critical Care Medicine Sharon Salapare - Geriatric Psychiatry Katharina Vester - Pediatric Rheumatology & Pediatric Allergy/Immunology
• Creating “Mark’s List,” a central depository for equipment, toner, and supplies
http://brightideas.ucsf.edu/
in this issue.
Contributors Barak Bar Robert Baron Liz Brown Russ Cucina H. Amabintu Jah Christian Leiva Michelle Lin Stuart Lustig Mary McGrath Kim Norman Susan Promes Rene Salazar Sandrijn van Schaik J o s e p h i n e Ta n A n g e l a Wa l k e r
Important GME Contact Information
Office of Graduate Medical Education
(415) 476-4562
GME Confidential Help Line
(415) 502-9400
Director, GME Associate Dean, GME UCSF Faculty & Staff Assistance Program (FSAP)
(415) 514-0146
GME Website
daya@medsch.ucsf.edu
(415) 476-3414
baron@medicine.ucsf.edu
(415) 476-8279
www.medschool.ucsf.edu/gme
UCSF School of Medicine Graduate Medical Education 500 Parnassus Avenue MU 250 East, 0474 San Francisco, CA 94143 tel (415) 476-4562 fax (415) 502-4166 www.medschool.ucsf.edu/gme
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