Section 4 – Standing Committees -...

Department of Internal Medicine Policy and Procedure Manual ________________________________________________________________________

Section 4 – Standing Committees

Department of Internal Medicine Committees Standing Committees and Membership Committee Terms of Reference

Executive Committee

Finance Committee

Undergraduate Medical Education Committee

Postgraduate Medical Education Committee

Core Internal Medicine Residency Training Committee

Medicine Program – Ambulatory Coordinating Committee

Department of Internal Medicine

STANDING COMMITTEES

COMMITTEE CHAIR FUNCTION

Executive Committee

Dr. Dan Roberts

Executive advisory group to Department Head.

Finance Committee

Dr. Andrew MacDiarmid

Review and approve budget. Develop and recommend policies

regarding practice plan.

Promotion and Tenure Committee

Dr. Elizabeth A. Cowden

To review applications for faculty promotions and to advise Department Head on each applicant.

Research and Faculty Development Committee

Dr. Bruce Light

Advise on career development for junior faculty and make recommendations regarding faculty development fund.

Review research performance for all faculty with research commitment greater than 25%.

Undergraduate Education

Dr. Nick Hijadiacos

Medicine responsibilities for Med III & IV of MD program including rotations, evaluation programs.

Subspecialty Postgraduate Education

Dr. Pamela Orr

Policies for all Residents training programs in the Department of Internal Medicine.

Core Internal Medicine

Dr. Ken Kasper

Planning, policies and procedures, and admissions for CORE Internal Medicine Program.

Resident Education Fund

Dr. Pamela Orr

To support Postgraduate Medical Education in the Department.

Dale Iwanoczko Award

Dr. Ken Kasper

To identify recipient of annual award.

Updated: February 11, 2008


EXECUTIVE COMMITTEE MEMBERSHIP DEPARTMENT HEAD Dr. Dan Roberts

SECTION HEADS

Clinical Allergy Dr. Richard Warrington Cardiology Dr. James Tam Critical Care Dr. Bruce Light Dermatology Dr. Jack Toole Endocrinology/Metabolism Dr. Gregoire Nyomba Gastroenterology Dr. Charles Bernstein General Internal Medicine Dr. Ken Van Ameyde Geriatric Medicine Dr. Phil St. John Hematology/Oncology Dr. Eric Bow Hepatology Dr. Gerald Minuk Infectious Diseases Dr. Ethan Rubinstein Nephrology Dr. David Rush Neurology Dr. Alan Jackson Physical Medicine & Rehabilitation Dr. Dan Roberts, Acting Proteomics & Systems Biology Dr. John Wilkins Respiratory Medicine Dr. Sat Sharma Rheumatology Dr. Hani El-Gabalawy

SITE MEDICAL DIRECTORS

Health Sciences Centre Dr. Dan Roberts St. Boniface General Hospital Dr. Karen Humphreys Grace General Hospital Dr. Elizabeth A. Cowden Victoria General Hospital Dr. Al Lipson

VIRTUAL CLINIC GROUP REPRESENTATIVE Dr. Matthias Kramer

BUSINESS MANAGER Mrs. Kathy Blair Colbert

STANDING COMMITTEE CHAIRS Finance Committee Chair Research Performance Review Committee Chair Promotions and Tenure Committee Chair Core Residency Program Director Undergraduate Medical Education Director Postgraduate Medical Education Director

Dr. Andrew MacDiarmid Dr. Bruce Light Dr. Elizabeth Cowden Dr. Ken Kasper Dr. Nick Hajidiacos Dr. Pamela Orr

GRAND ROUNDS COORDINATOR Dr. Fred Aoki

September 2008

FINANCE COMMITTEE

Dr. Andrew MacDiarmid, Chair

Dr. Charles Bernstein

Dr. Martin Karpinski

Dr. Mathias Kramer

Dr. Elizabeth A. Cowden

Dr. Karen Humphreys

Dr. Bruce Light

PROMOTIONS & TENURE COMMITTEE

Dr. Elizabeth Anne Cowden, Chair

Dr. Elizabeth Boustcha

Dr. Bill Leslie

Dr. Lindsay Nicolle

Dr. John Wilkins

Dr. Hani El-Gabalawy

Dr. Brendan MacDougall

Dr. David Rush

RESEARCH and FACULTY DEVELOPMENT COMMITTEE

Dr. Bruce Light, Chair

Dr. Charles Bernstein

Dr. Hani El-Gabalawy

Dr. Andrew Halayko

Dr. Ken Van Ameyde

Dr. Patrick Choy

Dr. John Foerster

Dr. Dan Roberts

Dr. John Wilkins

July 2008


TERMS OF REFERENCE

EXECUTIVE COMITTEE

Section: Standing Committees Page: 1 of 1

Review/Revision Dates: Sept. 2005,

Chair Head, Department of Internal Medicine Membership

Department of Internal Medicine Section Heads

Postgraduate Medical Education Director

Undergraduate Medical Education Director

Site Medical Directors for WRHA Medicine Program

Business Manager

Virtual Clinic Group Representative

Chairs of Standing Committees

Purpose of Meetings 1. To serve as a forum to discuss issues relevant to patient care, academia, education,

administration and research.

2. To receive information and approve recommendations arising from the Department of Medicine’s Standing Committees.

3. To develop strategic directions for the Department of Internal Medicine.

4. To monitor changes in the WRHA Medicine Program that will impact on

departmental activities.

Committee Meetings The Committee will meet every Second Wednesday of each month, September to June at 0730 hours – 0855 hours unless otherwise stipulated by the Chair.


TERMS OF REFERENCE

FINANCE COMMITTEE

Section: Standing Committees Page: 1 of 1 Review/Revision Dates: June 13, 2006

Membership The Committee shall consist of:

Three elected full-time members of the Department of Internal Medicine Three appointed full-time members by the University Department Head The Chair, Research and Faculty Development Committee One representative of part-time members One representative from each of the teaching hospitals The University Department Head (ex officio) The Business Manager, Department of Internal Medicine (ex officio) The Assistant Business Manager, Department of Internal Medicine (ex officio)

The Chair of the Finance Committee is appointed by the Department Head, usually but not necessarily, from the members of the Committee, based on relevant experience and willingness to serve, and sits on the University Medical Group Executive. Each term is for a three-year period, renewable once.

Reporting Relationships

The Committee will report through the Chair to the University Executive and to the

Department membership at large.

Purpose

The Committee shall: Be an advisory committee to the Department Head on matters related to finance. Review the annual budget for the Department. Review the financial status of the Department on a quarterly basis. Review terms of reference and expenditures for:

GFT Travel Fund Develop a framework for any changes in funding mechanisms for the Department. Review department investments quarterly and develop strategies for maximizing

the return on investments within limits imposed by the University of Manitoba.

Meetings

The Committee will meet quarterly during the period September – June.


TERMS OF REFERENCE

UNDERGRADUATE MEDICAL

EDUCATION COMITTEE


Review/Revision Dates: February 18, 2008 Rev. 1,

Chair Undergraduate Medical Education Clerkship Director Membership Clerkship Director and Chair – Appointed by the Head, Department of Internal Medicine ITC/CPA Director Core Internal Medicine Chair Members-at-Large (2) Site Coordinator for each site the chair is not based at Elected Postgraduate Representatives (3) 1 - RI Resident

1 - RII Resident 1 - RIII Resident

Elected Undergraduate Representatives (2) 1 - 3rd year med student 1 - 4th year med student

Reporting Structure

The Committee reports through its Chair to the Head, Department of Internal Medicine.

Purpose of Meetings The Committee shall develop, implement and evaluate educational policies relevant to

undergraduate medical education. It is the Department of Internal Medicine’s goal to ensure that medical students will acquire the

skills needed for them to develop as competent clinicians and health care providers. These skills are also to be applied and evaluated in the context of CanMEDS 2005 core competencies.

1. Medical Expert a. Cognitive: The teaching of basic medical knowledge falls outside the scope of

any one department, with a large obligation falling on the pre-clinical years. The clinical exposure afforded by the Department of Internal Medicine is designed to reinforce previously taught concepts and disease processes by placing them in a clinical context, and by stimulating the student to develop a pattern of problem-based, patient-focused self-learning. Standardized teaching (tutorials, EKG interpretation, radiological interpretation, etc.) is designed to fill the gaps between the pre-clinical years and skills required for functioning in a clinical venue.

Terms of Reference: Undergraduate Medical Education Committee

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b. Problem solving: This is seen as a graded process that is carefully supervised by the preceptor-mentor. Early sessions (Med II Clinical Skills) are primarily aimed at techniques of data collection (history and physical examination). The introduction to clerkship teaches differential diagnosis through hypothesis generation. The medical clerkship involves the application of this process in the actual care of patients. Thus, there is an expectation of graded problem solving abilities commensurate with the student’s expanding knowledge base and clinical acumen.

c. Clinical skills: As in problem solving, this is seen as a continuum in the student’s education. A stereotyped checklist approach (Med II Clinical Skills) gradually gives way to higher-order problem-oriented history and physical examination.

2. Communicator The students learn to deal with a variety of patient and family situations for the

purpose of data collection, explaining diagnosis and management, and building patient trust. It is expected that students will have the opportunity to observe and practice such communication skills as “giving bad news,” discussing resuscitation decisions, assessing patients’ knowledge of their illness, etc.

3. Collaborator The students will learn to work in a healthcare team. They will learn to

understand the roles of other healthcare professionals in the assessment, management and ultimate disposition of patients in a medical setting. The students will learn to work with and communicate with other healthcare providers in order to ensure high level patient care and to prevent conflict between members of the healthcare team.

4. Manager

The students will learn through observation and practice the role of properly managing finite healthcare resources and the skills needed to properly allocate those resources. Examples being: ordering the correct test in the correct order on a patient or reevaluating the need for frequent blood work on a patient.

5. Health Advocate

The students will learn to identify the roots of endemic health problems in the areas they serve and what resources are out there to address them. They will also learn what avenues and to who to advocate for their patients.

6. Scholar

The students will continue to learn and assimilate new information (teaching sessions, tutorials, self-directed readings). They will learn to incorporate this information into better patient care and best practice. Evidence based medicine will be the gold standard. They will learn to share newly acquired information with colleagues and other health care professionals.


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7. Professional Students are expected to demonstrate an appropriate level of professional responsibility towards their patients and colleagues. This includes but is not limited to: confidentiality, reliability, honesty, compassion, and support for patients, colleagues and the profession of medicine.

Evaluations

The Committee will develop appropriate evaluation techniques for the: Evaluation of the trainee:

a) Cognitive: assessed by the NBME and LMCC examinations, and to a lesser extent on the ITER by observing the students’ clinical performance.

b) Problem solving: Assessed as part of the ITER clinical evaluation.

c) Clinical skills: This is assessed on the ITER clinical evaluations with a final

comprehensive assessment on the CCE. d) Interpersonal skills: Assessed on the ITER clinical evaluations along with the

comprehensive assessment on the CCE. e) Professional skills: assessed on the ITER clinical evaluations.

Evaluation of Program:

a) The success of the Department of Internal Medicine program can be partially judged by the success of its candidates on external examinations (NBME, LMCC). Failures on the in-training examination (NBME) are not infrequent, but are usually passed on the subsequent attempt. Repeat failures are uncommon and undergo a formal, supervised remediation program which is usually successful in helping the student attain a passing grade.

b) Each group of students completing the Medical CTU rotation is collectively interviewed

by the Medical Clerkship Director/Coordinator for each hospital. If a consistent problem is encountered then this is brought to the attention of those responsible.

c) Each Medical CTU and Medicine Selective attending physician is evaluated by the

students using an anonymous, standardized computerized form and this information will be summarized for each attending physician on an annualized basis.

d) The students evaluate the Medical CTU and Medical Selective rotation using an

anonymous, standardized computerized form and this information will be used for continuous quality improvement of the rotations.

e) The students evaluate each Medicine tutorial series with respect to content and structure

using an anonymous, standardized, computerized form and this information will be used to improve the quality of the presentations and to evaluate the need to replace sessions/presenters.


Page: 4 of 4

Committee Meetings The committee will meet on average every six (6) weeks aiming for a minimum of six (6) meetings per year. As well, at the discretion of the chair, extra meetings will be scheduled to discuss urgent issues (ex: student failures). An agenda will be circulated prior to the meeting. Minutes will be taken. Any member may add items to the agenda or discuss them at the meeting under other business.


TERMS OF REFERENCE

POSTGRADUATE MEDICAL

EDUCATION COMITTEE


Review/Revision Dates: Aug. 29, 2005;

The University of Manitoba's Department of Internal Medicine currently sponsors 15 accredited postgraduate training programs for residents in the following medical specialties or subspecialties:

• Cardiology

• Clinical Immunology and Allergy

• Endocrinology and Metabolism

• Gastroenterology

• General Internal Medicine

• Geriatrics

• Hematology

• Infectious Diseases

• Intensive Care

• Nephrology

• Neurology

• Oncology

• Physical Medicine and Rehabilitation

• Respiratory Medicine

• Rheumatology

In compliance with the accreditation guidelines of the Royal College of Physicians and Surgeons of Canada, the day-to-day operation of each program is supervised by a designated Program Director and a Resident Training Committee. The role of the Postgraduate Medical Education Committee within the Department of Medicine is to provide direction and support for these 15 Program Directors and Resident Training Committees, to help promote the highest standards for postgraduate medical education within the resident training programs, and to help ensure the limited resources for postgraduate education within the department are used effectively.

Chair

Director, Postgraduate Medical Education, Department of Internal Medicine

Terms of Reference: Postgraduate Medical Education Committee

Page: 2 of 4

Membership The Postgraduate Medical Education Committee is made up of the Program Director from each of the 15 accredited resident training programs within the Department of Medicine, and chaired by the Director of Postgraduate Education for the Department. The Committee also includes the Departmental Representative on the Faculty Postgraduate Medical Education Committee and the Chair of the Department of Medicine. The complete make up of the Committee is summarized below:

Director, Postgraduate Medical Education, Department of Internal Medicine (Chair)

Program Director, Cardiology Program Director, Clinical Allergy and Immunology Program Director, Critical Care Program Director, Endocrinology and Metabolism Program Director, Gastroenterology Program Director, General Internal Medicine Program Director, Geriatrics Program Director, Hematology/Oncology Program Director, Hepatology Program Director, Infectious Diseases Program Director, Nephrology Program Director, Neurology Program Director, Palliative Care Program Director, Physical Medicine and Rehabilitation Program Director, Respiratory Medicine Program Director, Rheumatology Head, Department of Internal Medicine

The Program Director for any new postgraduate resident training program within the Department of Medicine, recognized by the Royal College of Physicians and Surgeons of Canada, will automatically become a member of the Committee. Other faculty members and trainees will be invited to participate in Committee activities as required.

Reporting Structure

The Committee is an advisory body to the Head of the Department of Internal Medicine through the Department's Director of Postgraduate Education and the Departmental University Executive Committee. The Committee is also an advisory to the Associate Dean, Postgraduate Medical Education through the Faculty Postgraduate Medical Education Committee.


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Specific Duties and Responsibilities The specific duties and responsibilities for the Departmental Postgraduate Medical Education Committee can be summarized as follows:

A. Program Development

The Committee is responsible for ensuring that each postgraduate resident training program within the Department of Medicine is compliant with the accreditation guidelines of the Royal College of Physicians and Surgeons of Canada, and provides the best educational and training experience possible, within the limits of the resources available. As part of the process the Committee will ensure that each resident training program:

has clearly defined and up-to-date educational goals and objectives

has adequate facilities, personnel and support services to function effectively

uses effectively the patient care and educational resources available at the

two major teaching centres

are administered effectively, efficiently and fairly. B. Resident Selection

The Committee is responsible for assigning all MATH-funded training positions allocated to the Department of Medicine, to the various resident training programs within the Department. The Committee, will also assist each of the training programs in developing more effective methods of recruiting qualified trainees.

C. Resident Evaluation

The Committee is responsible for ensuring that each resident training program within the Department of Medicine, has effective policies and procedures for evaluating the performances of trainees. In the event that a resident wishes to contest an evaluation, the Committee will also provide a formal appeal mechanism, or if necessary refer the evaluation and appeal to the Faculty PGME Committee for review. The Department will also ensure that each resident training program has effective procedures for evaluating the performance of faculty members, in accordance with the rules and regulations of the Department and Faculty of Medicine Faculty evaluation process.


Page: 4 of 4

D. Program Evaluation

The Committee will be responsible for ensuring that each resident postgraduate teaching training program has effective ongoing program evaluation procedures, as required by the Royal College of Physicians and Surgeons of Canada. As part of this responsibility, the Committee will delegate one representative to participate as a member on internal review survey teams established by the Faculty Postgraduate Training Committee to evaluate resident training programs within the Department.

D. Research

The promotion of research is a major priority for Postgraduate Training Programs within the Department of Medicine. The Committee therefore has a responsibility to assist individual programs within the Department in carrying out this mandate by encouraging broad participation in Resident Research Day.

E. Resident Counseling

The Committee will be responsible for ensuring that each Resident Training Program provides career counseling for all trainees, and that mechanisms are in place for ensuring residents have access to counseling or other support services when required.

F. Manpower Planning

The Committee will participate with individual Resident Training Programs and the Chair of the Department of Medicine in Manpower Planning to help ensure that the needs of both the trainees and the health care system are being considered in planning postgraduate medical education activities.

H. Quorum

A quorum shall consist of five Committee members. Members who are in contact by telephone shall also be included in a quorum.

Updated: August 29, 2005


TERMS OF REFERENCE

CORE INTERNAL MEDICINE

RESIDENCY TRAINING COMITTEE


Review/Revision Dates: April 29, 2005;

Chair Program Director, Core Residency Training Program Membership

• Program Director, Core Residency Training Program (Chair) • Chair, Postgraduate Medical Education, Department of Medicine • Chair, Undergraduate Medical Education Committee, Department of Medicine • Associate Program Director, Internal Medicine Residency Training • Service Chief, Health Sciences Centre (unless already represented) • Service Chief, St. Boniface General Hospital (unless already represented) • Chief Medical Resident, Health Sciences Centre • Chief Medical Resident, St. Boniface General Hospital • One Senior Medical Resident (R III/IV) • One Junior Medical Resident (R I/II) • Up to three other Faculty members, at the invitation of the Chair and with the

approval of the Committee, for assistance with a specific issue and for a two year term, renewable for another two years if they so wish.

Ex-Officio Members

• Head, Department of Internal Medicine • Department of Medicine Representative Faculty P.G.M.E. Committee

(where applicable) Reporting Structure

University Department Head through the Chair of Postgraduate Medical Education, Department of Internal Medicine

Goals

To develop, implement, and evaluate educational policies relevant to the core internal medicine training program of the Department of Internal Medicine

Terms of Reference: Core Internal Medicine Residency Training Committee

Page: 2 of 3

Scope and Function

1. The Committee will endeavour to establish an environment conducive to teaching and

learning which will encourage academic excellence. 2. The Committee will make recommendations regarding the structure and content of

the core training program based on educational principles relevant to professional training.

3. The committee will review, evaluate, and recommend modifications to the structure

of the core training program including: the resident selection process specific rotational requirements academic half day, and external elective rotations

4. The committee will work with individual sections within the Department of Internal

Medicine to develop and/or modify appropriate curriculum guidelines which meets the training requirements of core residents on individual subspecialty rotations.

5. The committee will monitor and assess the educational/service balance on all

rotations.

6. The committee will establish an evaluation system to provide residents with reliable and valid feedback on their clinical competence.

7. The committee will encourage resident participation in either clinical, basic sciences,

or educational research including the resident research day.

8. Assist and support faculty teaching evaluation system in cooperation with Specialty Postgraduate Training Committee and Department Head.

9. The committee will support and develop resident teaching skills through both

educational interventions and evaluation methodologies.

10. The committee will establish programs to enable residents to receive appropriate career and personal counseling, where appropriate.

11. The committee will hear appeals and decide on all resident appeals challenging

rotational or yearly evaluations.

Terms of Reference: Core Internal Medicine Residency Training Committee

Page: 3 of 3

Committee Meetings

Chairperson: The Chair shall call the meeting and set the agenda The Chair or delegate, shall preside at all meetings The Chair shall ensure that decisions are communicated to appropriate individuals

or sections, for implementation Quorum

A quorum shall consist of 5 members.

Number of Meetings

The committee will meet at least six (6) times per year on the First Monday of each month, at 0800 – 0900 hours unless otherwise stipulated by the Chairperson.

Notice of Meeting

The notice of the meetings, with the agenda and minutes from the prior meeting, will be sent out to all members seven days prior to each subsequent meeting.

Terms of Office

The Chair of Postgraduate Education and the Chair of the Undergraduate Medical

Education Committee will be members of the Committee for the duration of their respective terms of office.

The Director of the Core Program will be appointed by the Department Head for

three years.

Service Chief at both teaching hospitals (unless already represented) will be members of the committee for 2 years, and will be appointed upon the recommendation of the Chair of Postgraduate Education.

The two chief medical residents will be members for the term of their

appointments.

The Senior and Junior medical resident representatives will be elected to the Committee by the Resident Committee for the Department of Medicine for one year.

Updated August 29, 2005


TERMS OF REFERENCE

Medicine Program AMBULATORY COORDINATING

COMMITTEE

Section: Standing Committees Page: 1 of 1 Review/Revision Dates: Feb. 2006,

Preamble

This committee functions in keeping with the Health Sciences Centre Vision, Mission, Core Values and Code of Conduct.

Accountability/Reporting Relationship Winnipeg Regional Health Authority (WRHA) Medicine Program

Health Sciences Centre (HSC) Medicine Program

Health Sciences Centre (HSC) Clinical Programs Leadership Team

Membership

Medicine Program Ambulatory Care – Dr. Dan Roberts Director of Patient Services Medicine Medicine Managers of Patient Care – Ambulatory Care Ambulatory Care Physician – Dr. Ken Van Ameyde Quality Engineer, Medicine Program MSI Systems and Process Manager Business Manager, Department of Internal Medicine

Purposes

To provide a forum for discussion and decision-making related to ambulatory systems management within the HSC Medicine Program

To discuss and develop policy to support best-practice for Medicine Ambulatory programming

To determine prioritization of services

To progress the Medicine Programs’ goals toward timely response to consultation and services

Process for determining i8mpact and approval of new patient equipment and associated supply requirements.

To support quality, patient safety, performance evaluation and utilization initiatives Chair: TBD Meetings: A minimum of ten meetings per year

Section 4 – Standing Committees -...

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