accreditation council for graduate medical education nuclear medicine review committee update snmmi...
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Accreditation Council for Graduate Medical Education
Nuclear MedicineReview Committee Update
SNMMI Winter 2015
Jon Baldwin, DOChairRC Nuclear Medicine
Disclosure
• No conflicts of interest to report
• RC structure and NM program stats• Program requirements update• Resident case logs• NAS/ ADS Updates • Questions
Session Overview
Nuclear Medicine
Medical specialty that uses the tracer
principle, most often with
radiopharmaceuticals, to evaluate
molecular, metabolic, physiologic and
pathologic conditions of the body for
purposes of diagnosis, therapy
and research
Current Committee Membership
• Jon Baldwin, DO (AMA) – Chair• David Lewis, MD (AMA) – Vice Chair• Helena Balon, MD (SNM)• Frederick Grant, MD (SNM)• Barry Shulkin, MD (ABNM)• Kirk Frey, MD (ABNM)• Erica Cohen, DO (Resident)
RC Meetings
• 2 meetings per year
• Check RC website for agenda closing dates & meeting dates• February 13-14, 2015 (closing date December 12, 2014)• May 29-30, 2015
• Meeting Length: 1 – 1 ½ days
• Program reviews & Other pertinent matters
• 43 accredited programs
• 93/159 (58%) filled vs approved residents positions
Nuclear Medicine 2014-2015
Nuclear Medicine 10-year Stats
Academic Year ProgramsResidents On
duty
2004-2005 62 149
2005-2006 61 161
2006-2007 61 160
2007-2008 57 161
2008-2009 56 149
2009-2010 56 166
2010-2011 54 155
2011-2012 54 136
2012-2013 50 120
2013-2014 47 111
2014-2015 43 93
Nuclear Medicine Programs2004-2014
Nuclear Medicine Program Requirements
Effective July 1, 2014
Major Changes
• Program Director Qualifications: • (II.A.3.b).(1) - Other acceptable qualifications are certification by
the American Board of Radiology with subspecialty certification in Nuclear Radiology. (Core)
• (II.A.3.b).(1).(a) - The program director must be an authorized user 132 for 10CFR 35.190, 290, and 390, including 392, 133 394, and 396. (Core)
• Program Director Responsibilities• (II.A.4.s) - The program director must: ensure that residents log
cases in the ACGME Case Log
System. (Core)
Major Changes
• Other learners• (III.D.2) The presence of nuclear medicine residents
must not dilute or detract from the educational opportunities available to the residents in the core diagnostic radiology residency and to the fellows in the nuclear radiology fellowship if these programs are sponsored by the same institution. (Core)
• Removed NM level specifications in ACGME Competency section
Major Changes
Major Changes
Major Changes
V. Evaluation•When averaged over the preceding five years:
• V.C.2.c).(1).(a) - at least 70 percent of residents who enter a program should graduate; (Outcome)
• V.C.2.c).(1).(b) - at least 75 percent of a program’s graduates should take the American Board of Nuclear Medicine (ABNM) certifying examination within three years of graduation; and, (Outcome)
• V.C.2.c).(1).(c) - at least 75 percent of a program’s graduates taking the ABNM certifying examination
for the first time should pass. (Outcome)
2014 NM Eligibility Changes
• III.A. Eligibility• Language referring to AOA-accredited training
has been removed
• Prerequisite criteria III.A.1.b) “Two or more years of GME and passing USMLE Step 3” has been removed
• These changes were made in anticipation of the new ACGME eligibility requirements.
Eligibility
• Exception options available 2016
• These exceptions are not available in 2014 version of NM requirements
• Until 2016, RC-NM will allow programs to use eligibility options outlined in pre-2014 requirements
• See 2014 NM FAQs
Eligibility FAQ
Question:The program requirements that become effective on July 1, 2014 limit eligibility to residents whose prior training was accredited by the ACGME or the Royal College of Physicians and Surgeons of Canada (RCPSC), but the common eligibility requirements that become effective on July 1, 2016 permit exceptions as specified in the requirements. Will I be able to appoint a resident with prior training accredited by the AOA between 2014-2016?
[Program Requirement: III.A.]
Eligibility FAQ
Answer:The revised specialty requirement revision was intended to align with the implementation of the new common program requirements related to resident eligibility, which were originally planned to become effective on July 1, 2014. The further revision of the common program requirements related to eligibility approved by the ACGME Board this year permit exceptions as detailed in the requirements and will take effect on July 1, 2016. As it was not the intent of the Review Committee to change the eligibility requirements before the new common program requirements were implemented, the Review Committee will permit programs to appoint residents to the program as specified in the pre-2014 version of the requirements in sections III.A.1 – III.A.3.a), which specifies that residents must complete (a) a prerequisite year of clinical education accredited by the ACGME, RSPSC, or American Osteopathic Association (AOA), or (b) two years or more of graduate medical education with a passing score on the United States Medical Licensing Examination (USMLE) Step 3. Effective July 1, 2016 all programs must comply with the new eligibility requirements.
Case Logs
Resident Case Logs
All programs are now required to use the ACGME Case Log System• Letter sent December 2012
Resident procedure logs make it possible to:• Track individual resident learning experiences • Identify individual/program deficiencies• Establish future training requirement
benchmarks
Resident Case Logs
• Residents should enter all specified procedures performed during their residency education into the ACGME case log system• RC-NM Case Log message on 12/18/13
Program directors are expected to ensure that:• Residents understand how to use the system• Entries are accurate and complete• Review resident case logs with residents during
semi-annual evaluations
NM Case Log Changes
“Attending” has been removed
Not required
NAS
What is NAS and when does it start?
• The Next Accreditation System (NAS) Phase II begins July 1, 2014 for Nuclear Medicine programs
• NAS Strategic Plan:• Foster innovation and improvement in the learning
environment• Increase the accreditation emphasis on educational
outcomes• Increase efficiency and reduce burden in accreditation• Improve communication and collaboration with key
internal and external stakeholders
Accreditation System Comparison
Current Accreditation System Next Accreditation System
Site visits every 5 years (or less)Scheduled self-study visits every 10
years
Programs evaluated by RRC in conjunction with site visits
Program data evaluated annually by the RRC
Large printed Program Information Form (PIF)
No PIF; data transmitted electronically to ACGME annually
Periodic evaluation Continuous, longitudinal evaluation
Process oriented (provide appropriate documentation)
Performance oriented (Outcomes based)
What are core, detail and outcome program requirements?
• Core Requirements: Statements that define structure, resource, or process elements essential to every graduate medical educational program.
• Detail Requirements: Statements that describe a specific structure, resource, or process, for achieving compliance with a Core Requirement. Programs in substantial compliance with the Outcome Requirements may utilize alternative or innovative approaches to meet Core Requirements.
• Outcome Requirements: Statements that specify expected measurable or observable attributes (knowledge, abilities, skills, or attitudes) of residents or fellows at key stages of their graduate medical education.
Core & Detail PR Examples
• There must be a formal didactic lecture schedule (Core)• The didactic lecture schedule should indicate the
specific date and time of each lecture, the topic of each lecture, the individual presenting the lecture, and the duration of the lecture (Detail – describes how to achieve core PR)
• Participation in regularly scheduled seminars, conferences and journal clubs should be documented with attendance logs. (Detail – describes how to achieve core PR)
Do I have to adhere to the “detail” program requirements?
• “Innovation” does not mean you don’t have to adhere to the requirement, it means you can do it a different way.
• Programs that have initial accreditation or are in trouble must demonstrate compliance with all “detail” program requirements as written.
• Programs that have a status of continued accreditation will be allowed to “innovate” or use alternate methods for those program requirements that are identified as “detail”.
NAS Screening Data NAS Screening Data Reviewed by RRCReviewed by RRC
Annual ADS UpdateProgram Characteristics – Structure and resourcesProgram Changes – PD / core faculty / residentsScholarly Activity – Faculty and ResidentsOmission of data
Board Pass Rate – 3-5 year rolling averages Resident Survey Faculty Survey Clinical Experience – Case logs Milestones - TBD Ten year self-study - TBD
© 2013 Accreditation Council for Graduate Medical Education (ACGME)
Click on the down arrows for more information
Look for the green checkmarks or the word “complete”
Ensure that the faculty certification information has been entered and current. A yellow flag will appear if missing data.
Scholarly activity is required to be entered in the NAS
If these 4 boxes total 15 hours or more, then this person is considered to be a core faculty member
Those identified as a “core” faculty member will be given the faculty survey and must have scholarly activity entered into ADS
Scholarly activity for faculty and residents must be entered
3200000000 – University of SamplePediatrics - Anytown, IL
Doe Jane 1 Active Full Time 7/1/2012 6/30/2015
000000 – University of Sample College of Medicine
*** - ** - xxxx
John Doe
Scholarly Activity for all residents is required.
Scholarly Activity for all residents is required.
Block Diagram Upload
Detailed on following slide
Block Diagram Upload
Detailed on following slide
All three years must be submitted, even if you currently only have NM3 residents.
Print a program summary of your updates for your records.
NM First NAS Review
• 14 programs passed with no flags
• 16% of pgms flagged for board pass rate.
• Several programs flagged for lack of data reporting: no case log data, multiple zeros reported for procedures, no faculty or resident scholarly activity
PD Responsibility: Accurate Data
• Program Director: • Must provide complete and accurate information• Review all information before “hitting” the submit button• DIO should also review before submission• Common Omissions:
• Faculty credentials (degree, certification, re-cert)• Participating sites• Updated response to citation(s)• Complete block diagram
ACGME Staff Contact List
Executive DirectorFelicia Davis, MHA 312-755-5006 [email protected]
Senior Accreditation AdministratorSara Thomas 312-755-5044 [email protected]
Nuclear Medicine ADS RepresentativeSamantha Alvarado 312-755-7118 [email protected]
Case Log questions [email protected]
Questions?Thank you
Our Answers