Understanding the Millennial Learner .................. 1

AHME Salary Survey – How Does My Compensation Stack Up? ... 3 Understanding the Changes to the Common Program Requirements ......................... 4

Growing a Gritty Educational Culture for GME: Developing a Growth Mindset to Build Passion and Perseverance in Our Learners ................................. 6

American Medical Association’s FREIDA – Better than Ever! ...... 7

Matching Program Resources: Building Better Connections with the Graduate Medical Education Community ............................. 8

Health Systems Science: Building the Third Pillar of Medical Education ............................... 9

Council Spotlight .................. 10

2019 AHME Institute ............. 11

Educational Opportunities ...... 12

AHME Connects Through LinkedIn .............................. 13

Message Board Corner .......... 14

Valli Annamalai, MD - Associate Professor and Clerkship Director, Department of Pediatrics at Dell Medical School of the University of Texas at Austin

A positive learning environment necessitates understanding the needs of learners. This understanding includes knowing the learners’ backgrounds, educational goals, learning styles, expectations, values, and motivation. Effective teachers recognize when the learners’ educational needs vary from their own, leading to adaptation of their teaching styles. One approach to this adaptation is to consider the learners’ generation in the healthcare education arena.

A generation is a group of people who were born and live contemporaneously, sharing the same parental and educational upbringing, values, and have lived through similar societal events. There may be at least 4 generations in the current healthcare education arena – Traditionalists, Baby Boomers, Generation X, and Millennials. Most of our learners are Millennials, while the educators are non-Millennials, although there are Millennial educators entering the workforce. It is understandable how non-Millennial generations may have a different philosophy regarding professionalism, work expectations, and teaching and learning styles than their Millennial counterparts. This difference may lead to conflict in the healthcare education environment due to differences in expectations between educators and learners.

There are a few key tips to remember and practice when

educating Millennial learners: set clear expectations, establish transparency, foster a nurturing mentoring relationship, provide frequent feedback, and explain the relevance behind all expectations.

Millennials appreciate clear, well-defined learning objectives and are generally uncomfortable with non-structured or “hidden” expectations. They desire transparency and fairness. During their upbringing, they are used to having very structured activities with schedules being set from activity to activity per parental or teacher expectations. These expectations include very clearly outlined consequences when protocol is not followed. Being a technologically- driven generation, they are used to immediate consequences. This translates to faculty needing to be transparent with rules, policies, and grading. This also requires consistency. Millennials are very uncomfortable with rules being changed halfway through a process, appreciating “black and white,” although the clinical world is not always this clear.

Millennials want to be involved in their own education in terms of setting goals for themselves. They have been raised being told that they “can be anything they want to be,” and may have been rewarded for participation only. They are used to having close relationships with their parents, teachers, and coaches, so may not have the same regard for the traditional hierarchy sometimes seen in the healthcare environment. Millennials believe their experiences should be good, as well as relevant. They appreciate being mentored and being a part of their

Understanding the Millennial LearnerI N T H I S I S S U E

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Tips for Educa�ng Millennials(Beck, G; Eldridge, D; Annamalai, V; Mind the Gap)

(Beck, G; Eldridge, D; Annamalai, V; Mind the Gap )

Encourage Collabora�on/Avoid Rigid Hierarchy

- Ensure student feels engaged- Acknolwedge their par�cipa�on on teams

- Work products need to be recognized in a �mely mannerly manner

Learning Environment Fairness

- Clear learning objec�ves that are easy to find

- Useful and meaningful feedback given in a �mely mannerly manner

- Grading needs to be transparent

Clear Expecta�ons

- Never assume they should know- Be specific and don't modifymidstream

- Overarching generali�es should beavoided

Provide Reasons for Rules

- Clearly explain why dress codes, duty hours, etc. are in place

- Note Millennials are commi�ed to &invest in tasks perceived relevant

Encourage Curiosity & Explora�on

-

-

Provide clinical challenges not easy to find in quick online searches Allow flexibilty on how the task iscompleted

- Expect applica�on of knowledge using cri�cal thinking

Clear Feedback

- Students accept help & guidancewithout s�gma

- Students want direct observa�on of skills

- Students expect immediate detailedfeedback

Mentoring

- Share your philosophy andexperiences

Acceptance

- Avoid making assump�ons aboutlearners' mo�va�on

own education by setting goals and discussing what is important to them. They also emphasize the outcome, not necessarily the process. For example, they may question authority if the rule is to stay at work until a specified time when they believe the goal can be achieved at home or can be achieved earlier than the specified time. Another example is that they may memorize facts or know how to find information quickly, rather than spend time reading. The job must be meaningful to them. This leads non-Millennial generations to believe that Millennials

Millennials are respectful but expect to have a mutual mentoring relationship with faculty. They are comfortable questioning authority, not always accepting the status quo. Faculty can approach this knowing where their learners are coming from and explain the relevance of something very clearly to demonstrate why it is important. This may put the Millennial learners at ease, knowing that they are being asked to do something for a purpose, and not just to follow routine.

If faculty and learners develop an understanding of other generations and adapt to new methods of teaching and learning, this practice can promote a positive learning environment.

Contact: Valli R. Annamalai, MD Valli.annamalai@austin.utexas.edu

References:1. Talmon GA, Beck Dallaghan GL. Mind the

Gap. Generational Differences in Medical Education. Alliance for Clinical Education.

North Syracuse, NY: Gegensatz Press, 2017.

Association for Hospital Medical Education — SPRING 2019

EDITORVenice VanHuse, MPA

Northwell Health

ASSOCIATE EDITORTia O. Drake

Washington University School of Medicine

EXECUTIVE COMMITTEE President & Board Chair

Tia O. DrakeWashington University School of Medicine

President-ElectFrederick Schiavone, MD, FACEPHCA Healthcare - West Florida

SecretaryVenice VanHuse, MPA

Northwell Health

TreasurerAlyson P. Riddick, MHA, C-TAGME

Vidant Medical Center

Immediate Past-PresidentQuinn Turner, MS, C-TAGME

HCA Healthcare - West Florida

Executive Committee Member-at-Large

Trevor Burt, EdD, MSHouston Methodist Hospital

Executive DirectorKimball Mohn, MD

NATIONAL STAFF(724) 864-7321

Director of Association & Meeting ServicesSandi Parsons

Member Services / WebsiteKaren Zagar

AccountantTricia Gallagher

are “entitled,” lacking a sense of personal responsibility and professionalism. To reach the Millennials, faculty may need to explain why something is important, how it helps society, or how it helps them. They are motivated if they know the relevance of a task, but not if they don’t understand the meaning behind an expectation.

When Millennials are in an unstructured environment, such as the clinical arena, they desire frequent and immediate feedback based on direct observation. Faculty should provide feedback in a mentoring role: observe the learner, ask the learner what went well or not well, then provide their own feedback. Then, the faculty and learner should establish an improvement plan together, rather than in a prescriptive manner, and then follow up to see how this plan worked. Millennials desire this feedback within a parental, nurturing relationship to establish a safe, nonthreatening learning environment.

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number of years of GME experience, educational level achieved, job title and whether TAGME-certified or not. Geographic/institutional characteristics were also collected, including geographical location, type/size of institution, number of GME programs and number of trainees in GME. The average salary was calculated for each of these metrics. For example, the average for those institutional representatives with a Master’s degree is $95,014. The average for those program representatives with TAGME certification is $58,637. But the real story is revealed when each of us averages all 8 of the cohorts into which we fall. In other words, taking all 8 characteristics into account – what is the national average for someone with my exact background? A few examples can be found in the tables in the next column:

Who am I? Average of my peers

Residency Coordinator, by title $52,008Bachelor’s Degree $53,673TAGME certified $58,6375.5 years’ med education experience $54,260100 trainees in my hospital $61,0685 programs in my hospital $59,944369 beds in my hospital $55,100In South Carolina $55,070OVERALL AVERAGE: $56,220

Who am I? Average of my peersGME Director, by title $93,747Master’s Degree $95,014Not TAGME certified $108,25430 years’ med education experience $115,937380 trainees in my hospital $88,40935 programs in my hospital $89,065600 beds in my hospital $97,044In New York $92,456OVERALL AVERAGE: $97,491

Carrie Eckart, MBA – Assistant Vice President, GME Accreditation at HCA Healthcare - West Florida; Caroline Diez, BA, C-TAGME - GME Transitional Year Program Coordinator at Grand Strand Medical Center

Looking back on several decades of AHME membership, one finds countless examples of members helping members with resources, tools and data that have originated from within AHME. One of the data collections that always garners a lot of attention is our AHME Salary Survey. Once again, starting in October and concluding in December 2018, COIL and COPAC collaborated to survey our members regarding compensation information. Characteristics that help to support program and institutional GME offices were identified to stratify the salary data collected. Personal characteristics were collected as follows from each respondent:

AHME Salary Survey – How Does My Compensation Stack Up?

(cont. pg 4)

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Please make sure to attend the COPAC and COIL business meetings and hot topics sessions at the Institute in Savannah where all the data will be explained and shared. In the meantime, if you want to learn your own unique average, please jot down your 8-characteristic profile and bring it with you to the AHME Institute.

A. First, please identify whether you have an institutional or program-specific role

B. Job TitleC. Level of education you’ve completed

D. Number of years you’ve worked in Medical Education

E. TAGME-certified? Yes____ No______

F. Location (state)G. Type of sponsoring institution

(community practice OR number of beds in your sponsoring institution’s hospital(s)

H. Number of programs in your sponsoring institution

I. Number of residents in your sponsoring institution

So What’s New?

The Common Program Requirements provide a framework for all residency and fellowship programs, serving as the basis for the specialty/subspecialty-specific requirements to which programs are accountable. Significant changes in the requirements include:

• Nearly all Common Program Requirements (Sections I-V) are now categorized as “Core,” (“Core” categorization applies to statements that define structure, resource, or process elements essential to every graduate medical educational program.)

• Increased alignment with the Institutional Requirements

• New definition of “core faculty,” based on role in education and supervision, and not tied to number of hours devoted to the program

• Program director and faculty member qualification requirements now specify ABMS Member Board or AOA Certifying Board certification (or other qualifications acceptable to the Review Committee)

• A requirement for a program coordinator

• Emphasis on program mission and aims

• In the fellowship and one-year versions: Elimination of sub-competency requirements related to Professionalism, Interpersonal and Communication Skills, Practice-based Learning and Improvement, and Systems-based Practice

• Broadened definition of scholarly activity, measured at the program, rather than individual faculty member, level

Understanding the Changes to the Common Program RequirementsKathy Malloy - Vice President, Accreditation Standards at the ACGME

The ACGME Common Program Requirements are a basic set of standards for programs educating and training resident and fellow physicians. They set the context for development of the skills, knowledge, and attitudes necessary to take personal responsibility for care of patients, and they facilitate an environment where residents and fellows can interact with patients under the guidance and supervision of qualified faculty members who give value, context, and meaning to those interactions. The Common Program Requirements are embedded in each set of specialty- and subspecialty-specific Program Requirements, serving as the foundation on which the educational program is built.

The ACGME is committed to regularly reviewing its requirements, and in January 2016, began revising the Common Program Requirements, including collection of input from the GME community before any language was drafted. Section VI, which focuses on the learning and working environment and includes requirements for patient safety, physician well-being, clinical work and education hours, and related areas, was finalized first and was implemented July 1, 2017. In June 2018 the ACGME Board of Directors approved Sections I-V, as well as a new fellowship-specific version of the Common Program Requirements, both of which are effective July 1, 2019. Additionally, a new set of One-Year Common Program Requirements, closely aligned with the fellowship-specific version, is under development.

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• Standardized approach to board pass rates

• Additional clarifications to Section VI are:

- Expanded to clarify the need for programs to work in partnership with the Sponsoring Institution, and to address discrimination, and sexual and other forms of harassment

- The introduction to the Well-Being section has been expanded to emphasize the responsibility of the physician to support other members of the health care team

- Inclusion of parental leave

Review Committees also chose between two options in the following areas:

• Fellowship Eligibility

A listing of fellow eligibility decisions by specialty can be found here.

• Dissemination of Scholarly Activity

Information regarding which methods of scholarly activity dissemination are acceptable is available here.

We know these may be significant changes for some programs. To support programs implementing changes to comply with certain new requirements, implementation guides (residency and fellowship) identify requirements that won’t be cited for an additional year.

What Are the Next Steps?

These changes of course impact the specialty- and subspecialty-specific requirements, so over the course of the next year Review Committees will propose focused revisions as needed for their respective specialty and subspecialty requirements addressing the areas listed below. (Revisions will be subject to a 45-day public comment period before they are finalized and approved by the ACGME Board.)

• Program Director Support: Review Committees must define a minimum level of program director support for program administration in the fellowship and one-year versions.

• Curriculum Structure: Review Committees will develop specialty- and subspecialty-specific requirements addressing curriculum structure, length of experiences, and supervisory continuity.

• Independent Practice Option: The fellowship and one-year versions allow Review Committees to permit programs to assign independent practice to a maximum of 20% of fellows’ time per week, or 10 weeks per year. Review Committees that allow this option will gather input from the community through the focused revision process. We’ll share information on committees permitting the independent practice option in the ACGME’s e-Communication and on the ACGME website as it becomes available.

How Can You Stay Updated?

Revisions to the specialty- and subspecialty-specific Program Requirements, with the new Common Program Requirements, will be on the ACGME website this spring. We’ll announce their availability in the ACGME’s e-Communication. For anyone not currently receiving these weekly (and occasional other) e-mails, which are sent to all designated institutional officials (DIOs), program

directors, and institutional and program coordinators, simply e-mail ACGMECommunications@acgme.org and request to be added to the distribution list.

FAQs are being updated to reflect the revisions and will be available this summer. The application for new programs, the Accreditation Data System Annual Update, and the Resident and Faculty Surveys are also being revised to conform to the updated requirements.

Further announcements related to these changes will be shared publicly, and in addition to the ACGME website, our Twitter and LinkedIn accounts are key communication channels. As always, check in with the Executive Director of your specialty Review Committee if you have any questions.

We appreciate the input of the GME community and the expertise and time of the many volunteers who worked on these revisions. We look forward to continuing to partner with the community in pursuit of our mission to improve health care and population health by assessing and advancing the quality of resident physicians’ education through accreditation.

mistakes and be flexible in the face of failures has been part of being a medical educator since the time of Hippocrates. Duckworth’s characterization of “grit” as perseverance multiplied by passion has recently encapsulated the work of many other scholars who have identified the lessons that our mistakes can teach us. The secret ingredient in grit is the determination to persist, to be in it for the long game. Such focus and flexibility are clearly attributes that we as medical educators and GME program directors would like to nurture. But should we attempt to select for them?

In her book, Grit: the power of passion and perseverance, Duckworth notes that individuals can foster their own grit by identifying their passion and committing to the tedium of practicing their skill rather than relying on inborn talent, but such practice

must force them to always be pushing to improve, not remaining at the same level of competency. An oft-forgotten nuance of the concept of 10,000 hours of practice to attain mastery credited to Ericsson is that the practice must be deliberate practice to reach higher skill levels, driven by honest feedback or coaching, and received with the mindset that you must learn from your mistakes.2 This “gritty” frame of mind is strengthened when individuals identify a higher purpose to acquiring this skill and maintains hope that they will one day reach their goals.1 Thus you can feed your own grittiness when you commit to the long game and see defeats and mistakes along the way as lessons to learn from.

Duckworth also describes how grit can be nurtured by the educational environment built by a teacher or a

Growing a Gritty Educational Culture for GME: Developing a Growth Mindset to Build Passion and Perseverance in Our LearnersRebecca P. McAlister, MD – Designated Institutional Official at Washington University/Barnes Jewish Hospital/St. Louis Children’s Hospital Consortium

What do the Seattle Seahawks, championship spellers and plebes (first year students) who make it through “the Beast” boot camp at West Point have in common? According to Angela Duckworth, PhD, it is a quality she calls “grit.”1 It is what motivates people to persist in their efforts to perfect their chosen skill, whether that is competing in the national spelling bee, winning the Super Bowl or gradu-ating from West Point. Duckworth has made the study of such determination the focus of her career and the concept has begun to capture the imagination of many in medical education. Encouraging learners to stay focused on their goals, learn from their

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parent. Duckworth draws heavily on the prior work of educational psychologist Carol Dweck, PhD whose book, Mindset, describes the concept of a “growth mindset” as opposed to a “fixed mindset.”3 Learners with a growth mindset believe that they CAN improve and utilize negative feedback and failure to challenge themselves to improve. People with a fixed mindset believe themselves to have been born with a fixed level of talent or intelligence and view failure or negative feedback as a challenge to their self-concept. This makes them risk averse and defensive when given honest but negative feedback. Teachers who promote a growth mindset can influence learners by such simple methods as praising a learner’s efforts even when they make an error vs. praising a learner’s talent which feeds into the belief of talent rather than hard work as the key to success. Growth minded teachers must set clear expectations and give honest feedback. They must send the message that they have high expectations but they believe their student can meet them.3

The works of Dweck and Duckworth have long been fundamental in early childhood education and have been successfully applied in higher education up through college level. These concepts are finding their way into medical education in recent years, often by encouraging an autonomy-supportive learning environment where learners are taught to acknowledge their mistakes and build on them to improve.4 Grit particularly has begun to appear in the medical education literature. Authors have found that high scores on the Duckworth’s grit screening tool are associated with resident well-being and successful completion of surgical residencies.5,6

These findings must be interpreted with caution however, as association is not causation. Some have prematurely urged the use of grit scores to screen applicants in both UME and GME.7,8 This use however has no validation in the literature. A better use of the concepts of grit and growth mindset is for medical educators to build a learning environment that encourages all learners to see their training through

these lenses. Educators must be careful to give feedback that is honest yet supportive with the clear message that, through hard work and perseverance, the learner is capable of learning from mistakes and attaining their goals.

The lens of growth vs. fixed mindset can also help educators to understand the underlying issues when medical students, residents and even faculty are struggling and not responding to faculty efforts to coach. The painfully shy medical student who knows the correct answers but doesn’t volunteer them may suffer from fear of making a mistake and viewing him/herself as a failure. The overwhelmed intern who seemed strong and confident in July but had some highly challenging rotations later in the fall, may be in your office to change specialties to a more “lifestyle friendly” field if he/she doesn’t combine perseverance with his/her passion. The new subspecialty faculty member may reject negative resident teaching evaluations by denigrating the quality of the house staff because negative feedback challenges his/her own concept as a teacher. Thoughtful support of learning from challenges may be pivotal in one’s medical career.

I strongly encourage you to delve into the works of both Duckworth and Dweck, which also have multiple examples on YouTube.9, 10 The adaptation of educational science to the medical environment is an exciting new area in medical education.

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Helping each other to accept that growth comes from our mistakes and building an environment where it is safe to own our errors and learn from them will build a stronger environment for medical education and a safer clinical environment as well.4

References1. Duckworth, Angela. Grit: the power of

passion and perseverance. New York: Scribner, 2016.

2. Pool R, Ericsson A. Peak: secrets from the new science of expertise. Eamon Dolan/Houghton Mifflin Harcourt. 2016

3. Dweck, Carol S. Mindset: the new psychology of success. New York: Ballantine, 2006.

4. Klein J et al. A growth mindset approach to preparing trainees for medical error. BMJ Qual Saf 2017. 26:771-774.

5. Salles A, Cohen GL, Mueller CM. The relationship between grit and resident well-being. Am J Surg 2014. 207:251-254.

6. Burkhart RA, Tholey RM, Guinto D, Yeo CH, Chojnacki KA. Grit: a marker of residents at risk for attrition? Surgery 2014. 155(6):1014-1022.

7. Shih AF, Maroongroge S. Importance of grit in medical training. JGME 2017. 9(3):399.

8. Kelly AM, Townsend KW, Davis S, Nouryan L, Bostrum MPG, Felix KJ. Comparative assessment of grit, conscientiousness, and self-control in applicants interviewing for residency and current orthopedic surgery residents. J Surg Ed 2017. 75(3):557-563.

9. https://ed.ted.com/on/1xgK6Cat#watch, accessed January 31, 2019.

10. https://www.ted.com/talks/carol_dweck_the_power_of_believing_that_you_can_improve/discussion, accessed January 31, 2019.

Sarah Brotherton, PhD - Director, Data Acquisition Services at the American Medical Association; Jessica Jones - Senior Project Manager at the American Medical Association

If you’ve been working in GME for a while, you’ve probably heard of the American Medical Association’s FREIDA Online. You may have even looked at your program’s listing once or twice. What you may not know is that the AMA has dropped the “Online” and made FREIDA even easier to use—no more login!

In July of 2018, the AMA completed a major enhancement of FREIDA. In addition to providing information on all Accreditation Council for Graduate Medical Education (ACGME)-accredited residency and fellowship programs, FREIDA now has a new look and feel, offering students and residents who are researching programs a more streamlined experience. Since the enhancement, FREIDA has been more popular than ever—with over 180,000 users looking at nearly 12 million pages in the second half of 2018 alone.

American Medical Association’s FREIDA – Better than Ever!

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Laurie S. Curtin, PhD - Chief Policy Officer at NRMP

For more than 65 years, the National Resident Matching Program (NRMP) has matched U.S. and international medical school students and graduates to graduate medical education (GME) programs in United States teaching institutions. The quality of the services provided by the NRMP has earned high regard among medical educators. NRMP is viewed as an organization that provides a fair, transparent, and reliable matching process and delivers informative, meaningful data to the GME community. NRMP’s importance in the lives of young physicians is immeasurable.

Over the past several years, NRMP also has focused on ways to strengthen its partnership with the GME community through the creation of high-quality resources designed to enhance the Match experience of designated institutional officials, residency program directors and coordinators, and other GME faculty. Among those resources are:

• Match Topic Videos and Support Guides: In 2017, NRMP launched a series of short learning videos and support guides that highlight distinct tasks in the NRMP’s web-based Registration, Ranking, and Results (R3) system and explore key features of NRMP policy. Although some videos and guides are specific to applicants, topics for programs and institutions range from how to navigate the R3 system to withdrawing and reinstating programs, adding program coordinators and institutional administrators as registered users of the R3 system, and entering and certifying rank order lists. The purpose of the program-based videos and guides is to provide clinical training staff with the tools they need to better understand and engage in the matching process. Response to the resources from applicants and programs alike has been overwhelmingly positive: long-standing videos like “The

Match Process” and “How the Matching Algorithm Works” have been downloaded more than 135,000 times and the more recently published “Policy Pitfalls” videos more than 4,800 times. The popularity of the learning videos led NRMP to create its own YouTube Channel, and in the year since its inception more than 1,600 individuals have subscribed. Program directors and staff as well as institutional officials are encouraged to subscribe to the NRMP YouTube Channel and access www.nrmp.org to view the videos and guides available on the ‘Support’ pages for residency and fellowship Matches.

• Webinars: In addition to creating Match-related videos and support guides, NRMP has developed a series of interactive webinars for new program directors and staff. The first in the series entitled, “Introduction to the 2019 Main Residency Match,” was designed to assist program staff in

Matching Program Resources: Building Better Connections with the Graduate Medical Education Community

in a search result. For example, in the last quarter of 2018, there were over 5,000 FREIDA pageviews that were part of a search that included “salary” in the filter and nearly 3,000 that included “work hours.” The new program survey opens May 15. Mark your calendar!

Does your program have an unexpected vacancy? You can advertise your vacant position on FREIDA as well. While this comes in especially handy after the main Match or a specialty match—searches do indeed spike on the site after a match has occurred—you can advertise a vacant position whenever it happens. The Program Director resource page has information on posting a position, as well as instructions for modifying your program’s FREIDA listing.

Additionally, FREIDA now has a video gallery with short, fun and informative videos that help demystify

the residency program application process. There is also a series of videos called “Ask the Experts” where physicians in various specialties provide insight into the culture, personality and ugly truths of their chosen specialty. FREIDA’s specialty guide has over 40 specialty overviews to support the specialty selection process as well.

FREIDA’s exciting digital transformation continues in 2019 with a technology platform upgrade, new features, content and categories to help students/residents quickly find the residency/fellowship program that’s right for them. Program coordinators/directors will be pleased to hear that the program management tool is under redesign as well. With ongoing user research and a customer-centric design approach, the AMA will continue to evolve FREIDA to meet our profession’s changing needs.

One of the best new benefits of FREIDA is its enhanced search filters. There are now more than 35 filters that allow users to sort programs by location (via Google Maps), program type, application information, demographics, benefits, Osteopathic Recognition, special tracks and more. Users can look for programs in a particular salary range, programs that offer child care assistance, programs with a certain number of first-year positions, and so on. FREIDA’s AMA members-only dashboard helps users save, rank and keep notes on each program, and download select program information into a text file.

How can your program maximize FREIDA to ensure applicants find the information they need? Begin by fully completing the program survey on GME Track (www.aamc.org/gmetrack). Your answers become part of FREIDA’s filters—a missing answer may keep your program from appearing

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administering their programs in the Main Residency Match. The webinar, which was attended online in fall 2018 by nearly 500 program staff, highlighted program set-up options, Match policies, and support resources. The second webinar in the series, “Ranking Applicants in the 2019 Main Residency Match”, was designed to provide program staff with information about quota changes and withdrawals, how to set the Match Week Supplemental Offer and Acceptance Program (SOAP) indicator in the R3 system, and tips for creating and certifying a rank order list. More than 300 individuals participated in winter 2019. In both instances, attendees were able to post questions to NRMP and receive real-time responses. These efforts by NRMP built on its already successful partnership with the Association of American Medical Colleges and the Educational Commission for Foreign Medical Graduates to provide quality webinars for applicants that focus on ranking strategies and SOAP participation all contain a wealth of helpful information and can be found on the NRMP YouTube Channel.

• Stakeholder Conference: As helpful and instructive as NRMP’s Match-related resources are, nothing is quite as effective as a venue where program staff and hospital administrators can meet with each other and medical school officials to learn more about the Match and discuss critical issues related to the transition from undergraduate to graduate medical education. In 2015, NRMP launched its national stakeholder conference, Transition to Residency: Conversations Across the Medical Education Continuum, to bring together undergraduate and graduate medical education stakeholders to generate ideas about – and solutions for – issues facing young physicians. At prior meetings, plenary and breakout

session topics included the following:

- real vs perceived need for more GME training slots;

- revised Medical School Performance Evaluation (MSPE) and its effect on recruitment;

- data analytics as a guide to the residency selection process;

- professionalism and its relationship to applicant success in residency;

- structured interviews and their role in recruitment.

October 2019 marks the third Transition to Residency conference, and attendees will consider the impact of the single accreditation system on the Match, ways to improve transparency during recruitment for both applicants and programs, and current trends and innovation at the intersection of medicine and technology. The NRMP stakeholder conference is a great place for program, hospital, and medical

school staff to share their ideas and work collaboratively on ways to make the transition process better for students. New this year is a pre-conference workshop for residency program directors and GME office staff who are new to the Match. More information about the conference and preconference is available at www.nrmpconference.org.

NRMP prides itself on being a trusted global provider of matching services and for building and sustaining connections with the GME community that result in an improved Match experience for all. Share the online resources with colleagues and consider attending the stakeholder conference in October. We welcome your input and participation!

Victoria Stagg Elliott, MA – Technical Writer at the American Medical Association

When the American Medical Association (AMA) launched the Accelerating Change in Medical Education initiative in 2013 with 11 $1million five-year grants funding transformative projects at medical schools, one of the earliest critical innovations to emerge was the need for medical students to learn health systems science along with the basic and clinical sciences. This “third pillar” of medical education is the fundamental understanding of how health care is delivered, how health care professionals work together to deliver that care, and how the health system can improve patient care and health care delivery.

The AMA has been working diligently to create tools and resources that support the increased incorporation

of health systems science into medical education at all levels ever since.

The AMA’s Accelerating Change in Medical Education Consortium, which brings together medical schools that received grants from the AMA in the initial round in 2013 as well as subsequent rounds (including several AHME members), convened an interest group to create a health systems science framework and determine the domains that fell under the health systems science umbrella. The core domains identified included health care structure and processes; health care policy and economics; clinical informatics; population and public health; value-based care; and health system improvement. Cross-cutting domains included teamwork and inter-professional education; leadership and change agency; and professionalism and ethics. Systems thinking is the domain that links all domains together.

Health Systems Science: Building the Third Pillar of Medical Education

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In December 2016, the AMA released Health Systems Science. This textbook was written by experts from member schools of the consortium and published by Elsevier. It is the first comprehensive health systems science resource designed for health professions students and other learners across the continuum of education and practice. This book includes chapters on value in health care, patient safety, leadership, population health, socio-ecological determinants of health, quality improvement, teamwork, clinical informatics, health care economics, and health care policy. It has sold over 4,400 copies and been adopted by at least 30 institutions, including medical

schools (both consortium and consortium members), graduate level health care business programs, nursing courses, physician assistant programs, residency programs, and health care business incubators.

A second edition is being written and will be available in 2020. In recognition of the need for a student guide on the subject, the Health Systems Science Review book, a study tool with case-based questions followed by discussions of answers and suggested readings, will be published by Elsevier in April 2019. This will be a valuable review resource for medical students and instructors, as well as medical residents; nursing,

allied health, and public health students; and hospital administrators.

The AMA is also creating the Health Systems Science Learning Series. These modules are designed for medical students studying health systems science and will be released in 2019. A Health Systems Science Faculty Academy that will teach medical school faculty how to teach health systems science is under development.

To learn more about any health systems science resources highlighted in this article, please contact Victoria Stagg Elliott via email at Victoria.Elliott@ama-assn.org.

Council SpotlightCOIL – Your Council, Your PrioritiesCarrie Eckart – Chair, AHME Council of Institutional Leaders

Happy end of winter to all of you! Writing this article as the coldest temperatures imaginable grip most of the country, it seemed like it wouldn’t end. Even Tampa Florida had “cold” days and nights in the 30s and 40s. As we prepare for yet another new academic year, we see many changes ahead. This year brings new common program requirements, the last full year of AOA accreditation of GME programs and we still see no end to the physician shortage. COIL (the Council of Institutional Leaders) was formed after our Institute in Charleston to enable all of those who support central GME offices to gather in a forum that focused on their particular roles. What we believed is that we frequently manage the same issues and whether you’re a DIO, a GME director or anyone else managing sponsoring institution issues, you may not have had a place to gather as a community.

How can we best help each other? Partnering COIL members with each other – to teach and to learn – is one of the most desirable outcomes of our connections with each other. At our 2018 Institute in Phoenix, we utilized our COIL business meeting to conduct a “needs assessment”. What did our

members need to learn? And who among our members could teach these topics? Using the issues that were prioritized in this process, we created a consensus list. According to our members’ priorities, we have used this list to create resources and continue to offer AHME Institute sessions, AHME Academy topics, COIL webinar pre-sentations, COIL LinkedIn posts and tools in the Digital Resource Library. The most efficient way to access COIL members, of course, remains the AHME Message Board.

Every one of us is expert at something, and every one of us stays committed to GME because there is so much more to learn. Add something to the list. Teach us something, or, better yet, ask for some help. We are all here for each other.

Below you will find the topics that have directed and will continue to direct our educational efforts. Let us know if you have anything to add.

GME Operations Culture change and adaptation, Strategic planning, Managing data, Resident recruitment, Leadership and managing people, Optimizing resident orientation, How to teach new PDs and PCs without overwhelming them, ERAS, Communicating with HR/Legal, Diversity/inclusion and LGBT training, Immigration issues

Program Coordinators and GME Staff Staffing GME office for efficiency, Team-based integrated models/ collaborative care, PC job description/ standardization and mentorship, Professional development, Advocacy for coordinators, Managing DIO/GME Director and PD/PC relationships, GME staff burnout, Motivating people

Faculty Faculty development, New PD and faculty orientation, Scholarly activity, Faculty recruitment and engagement, Getting faculty to own and teach professionalism, Protected time for faculty/PD

Accreditation, including well-being AIR, Effective GMECs and subcommittees, Accreditation details, Making CCCs successful, AOA transition and osteopathic recognition, Resident engagement, Wellness assessment in GME, Patient Safety/Quality Improvement initiatives, Special Reviews, New program development, Self-Study (Aims Statement Development), New templates for APE

GME Finance Value added of GME and financial justification, GME budget management, CMS details (caps, fiscal intermediaries, cost reporting, etc.), Rightsizing GME, Debt burden for young MDs

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SPRING 2019 — Association for Hospital Medical Education

The Association for Hospital Medical Education has put together an outstanding program for its 2019 AHME Institute! Sessions will include GME, CME and UME topics that are current, relevant, and important to medical education professionals. The presenters will feature some new faces as well as popular, seasoned conference speakers. All will be providing critical medical education updates.

Slated for May 15-17 in Savannah, the 2019 AHME Institute will be one you won’t want to miss. Located directly on River Front Plaza in historic Savannah, the Hyatt Regency boasts stunning riverfront and city views and offers true southern hospitality in a plush setting. Many attractions are within walking distance, including charming shops, a variety of eateries, riverboat cruises, nightlife to suit all ages, stunning architecture, and Savannah’s famous squares.

The Institute provides a large number and wide variety of educational sessions that will give you information and tools you can take back to your office and use right away. Below is the list of plenary session titles. Keep in mind that there are 42 other possible sessions you can attend! You’ll want to send multiple people from your office to maximize the learning.

ACGME Update

CLER: Continuing the Conversation

One-Minute Poster Presentations

AAMC Update: The End of an Era, the Continuation of the Journey

Harassment and Medical Education: Zero Tolerance

The Institute is your one-stop opportunity to hear from the most influential people in key medical education organizations. Representatives will be on hand to present the most up-to-date topics from their organizations. AHME members and other experts in the medical education continuum fields will be well represented in the speaker roster as well.

Some of the other features of the 2019 AHME Institute include:

• Extensive programming with multiple breakout sessions

• Other experts in the field of medical education to provide you with the most up-to-date, nuts-and-bolts, take-and-use-today information

• Networking opportunities through meals and fun events...including a Tuesday evening riverboat dinner cruise (see below)

• An on-site poster session to present what you and your peers in other institutions are doing to improve and advance your programs

• Exhibitors with practical products and services to help you do your job

• Sessions expressly for Program Administrator & Coordinator learning

• Specific programming for Transitional Year professionals

• Dedicated sessions focused on topics specific to professional and faculty development

• Sessions geared to the work of your Institutional Leadership

• Information relevant to the Osteopathic educators community

At the Hyatt Regency, you will find an atmosphere of comfort and luxury along the riverbank. And the educational program will be just as great: presenters from across the country who are bringing their expertise on a slate of topics designed to help you be better informed and better able to do your job.

As if all of the above isn’t enticement enough, AHME has booked a riverboat dinner cruise for Tuesday evening! Self-pay tickets are $75 each, which includes two hours of cruising, a buffet meal, and entertainment. The dock is located right outside the Hyatt Regency Savannah so you can walk to the boat and have a wonderfully relaxing evening. Advance purchase is required using the link on the Events tab of the AHME website.

The full 2019 AHME Institute brochure and other information is available on the AHME website (www.ahme.org).

Hyatt Regency – Savannah, Georgia – May 15-17, 2019

2019 AHME INSTITUTE

Details on AHME’s educational sessions are posted at www.ahme.org when registrations open. Notification is made via email so be sure to keep an eye on your inbox for upcoming events.

EDUCATIONAL OPPORTUNITIES

12 13

Association for Hospital Medical Education — SPRING 2019

AHME WebinarsAHME conducts six webinars per year on topics relevant to the field of medical education. Hosted by a specific Council each time, the webinars are one hour in length and feature experts from around the country. And you don’t have to leave your desk to participate!

REMEMBER AHME MEMBERS: Information about AHME happenings are communicated to the membership via Constant Contact, an email marketing provider.

When you opt out of those mailings, you no longer receive information from AHME staff or leadership – including announcements about upcoming webinars and other educational opportunities. Don’t miss out! Stay connected by keeping your contact information current with AHME staff.

Best Practices from Our Members

AHME News likes to feature

articles that highlight members’

best practices. We invite you

to submit your institution’s

best practices in any area of

medical education to Venice

VanHuse, Editor, at

vvanhuse@northwell.edu

AHME AcademyThe AHME Academy is a one-day primer for new residency program administrators to gain an overview of their duties and for experienced administrators to learn some fresh approaches to their responsibilities. Its format allows for great networking and opportunities to learn the latest and greatest happenings in medical education. They typically occur two times per year and are often hosted by a member hospital in easily accessible locations.

Contact the AHME office at 724-864-7321 or info@ahme.org for more information.

Schedule: Sponsoring Council

June 4, 2019 CPFD (Council on Professional and Faculty Development)August 6, 2019 COIL (Council of Institutional Leaders)October 1, 2019 CTYPD (Council of Transitional Year Program Directors)

Upcoming Webinar Schedule!

13

SPRING 2019 — Association for Hospital Medical Education

Benefits of the LinkedIn group •Exchangebestpractices •Cultivateasocialnetwork •Promoteevents •Sharepresentations •Postvideos •Gettoknowyourcolleagues •Research/emailmembers

directlythroughLinkedIn

AHME Connects Through LinkedIn

Visit AHME’s Members Only LinkedIn Private Group Page Today! Send in a request to join! Not an AHME member? Contact Karen Zagar at karen@AHME.org.

Marie Padilla - GME Institutional Program Coordinator III at the Medical College of Wisconsin Affiliated Hospitals, Inc.

TheAHMELinkedIngrouppagewascreatedinthespringof2018tosatisfytheneedforasocialmediapresencethatprovidesallmembersavirtualspacetoengage,learn,andnetworkwithoneanotherinamorespontaneousanddirectway.Individualsshareexpertiseandopinionsthat leadtouniquefeedbackandcollaboration amongstpeers.

Currently,thegrouphas100AHMEmembersnationallyandcontinuestogrow.AHME’sfiveinterestgroups:CouncilofInstitutionalLeaders(COIL),CouncilofOsteopathicEducators(COE),CouncilofProgramAdministratorsandCoordinators(COPAC),CouncilonProfessionalandFacultyDevelopment(CPFD)andtheCouncilofTransitionalYearProgramDirectors(CTYPD)havecommittedtoprovidingexcellentanddiversemonthlycontentcontributions.Thecreationandcommitmenttoapostingschedulehasbeeninstrumentalinkeepingmomentum.ThenewlycombinedContentReviewandSocialMediaSubcommitteehasbeenleadingtheeffort,withengagementasthegoal.

Network in the MomentWeaskthatmemberscometothegroup

open-minded,withthewillingnesstolearnnew bestpracticesandadesireforcontinuousprofessionaldevelopment.Takeamomenttopostaquestion,aninfograph,arecentslidefromapresentation,oreventfeedback.Thisisaboutcreativecommunicationandcollaborationinthemomentandbeyond.Thereisabenefitforbothseasonedmemberstotrysomething“outofthebox”andnewmemberstofindinspirationandexpertisefromsharedresources.

Manyoftheitemsaredownloadableandcanbesharedwithcolleagues.ToaccessthegrouppageonLinkedin,searchfortheAHMEgroupinthesearchbaronyourprofilehomepage,thenrequesttojoin.Foradditionalquestions,pleasecontactContentReviewandSocialMediaCo-Chairs-MariePadilla,mpadilla@mcw.eduorVeniceVanhuse,Vvanhuse@northwell.edu.SeeyouattheAHMEInstituteinSavannah.Wewouldbehappyto connectanddiscussatlength.

Exciting/Informational Content is just a click away……….View articles/topics/ presentations/announcements on:

•Stressmanagement •TheroleofMedical EducationManager

•Emotionalintelligence •Upcomingevents

•Therelationshipof •Certificationchanges doctors

•GMEFinance •Surveys–information gatheringandsharing

Association for Hospital Medical Education — SPRING 2019

MESSAGE BOARD CORNER

Welcome to the AHME MESSAGE BOARD CORNER.

In this section we highlight recent active

Message Board threads which may be of

special interest to you.

These threads are linked in the pdf version

of the newsletter on the AHME website

(https://www.ahme.org/publications/) so you

can go directly to the conversation and read

the current content. If you are a member of

the Message Board you can join in the

conversation. Remember the AHME Message

Board is open to all medical education

professionals; not just AHME members.

Feel free to register yourself or send this

link to others who may be interested:

AHME Message Board Registration Site

Or if you prefer, contact Quinn Turner,

the Message Board Administrator at

Quinn.Turner@hcahealthcare.com and

he will get you activated.

Here are several recent threads:

• DIO Salary/Stipend?

• Fellowship initial PGY level assignment

• Recruitment Practices and Diversity

• Evaluation Distribution Question

THE MESSAGE BOARD has the following topic areas for medical education professionals to post questions and seek information from others:

• Undergraduate Medical Education • Graduate Medical Education • CME, CPD, and Faculty Development • Miscellaneous Topics • Program Administrator Forum • Transitional Year Program ForumIf you haven’t done so already, please sign up and start sharing with the medical education community.

14

AHME News FeedbackPlease give us feedback on the AHME News content and coverage by sending an email to sandi@ahme.org. If you have ideas and suggestions for topics or questions you would like to see covered in the News, let us know. Counterpoint opinions on content and issues are always welcome and appreciated.

SPRING 2019 — Association for Hospital Medical Education

15

• ISBN 978-0-692-67254-9

• 8.5x11; 650 pages; paperback

• Published in November 2016

• Chapters from AAMC, ABMS, ACCME, ACGME, ECFMG, FSMB

• Available through Amazon and Barnes & Noble

• For more information, www.AHME.org

FIFTH EDITION

Guide to MedicalEducation in theTeaching Hospital

Route to:

_____ Program Director_____ Colleague_____ GME_____ CME

Want more information about AHME? Contact Karen Zagar, Member Services, at 724-864-7321 or Karen@ahme.org.

PRSRT. STD.U.S. POSTAGE

PAIDGreensburg, PAPermit No. 88

109 Brush Creek RoadIrwin, PA 15642

I N T H I S I S S U E

A S S O C I A T I O N F O R H O S P I T A L M E D I C A L E D U C A T I O N

Understanding the Millennial Learner

AHME Salary Survey – How Does My Compensation Stack Up?

Understanding the Changes to the Common Program Requirements

Growing a Gritty Educational Culture for GME: Developing a Growth Mindset to Build Passion and Perseverance in Our Learners

American Medical Association’s FREIDA – Better than Ever!

Matching Program Resources: Building Better Connections with the Graduate Medical Education Community

Health Systems Science: Building the Third Pillar of Medical Education

Council Spotlight

2019 AHME Institute

Educational Opportunities

AHME Connects Through LinkedIn

Message Board Corner