SAHM FELLOWSHIP DIRECTORS ANNUAL LUNCHEON March 19, 2015

Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve apparent conflicts of interest. In addition, presenters are asked to disclose when any discussion of unapproved use of pharmaceuticals and devices is being discussed. Lea Widdice has no commercial relationships to disclose. Karen Soren is the recipient of an investigator-initiated grant form Merck to examine cytology outcomes after HPV vaccine No discussion of off-label pharmaceuticals or devises. Disclosures:

Agenda Self-introduction of program directors (verify contact information) Review of ERAS statistics Review of NRMP statistics Report from AAP Committee on Pediatric Education (content specs, ACGME recommendations) Overview of EPAs, Sub-competencies, Milestones Discussion – Clinical Competency Committees- did they work? – Sharing of resources (curriculum and evaluation)

Number of Fellowship Applicants (ERAS) Adolescent Medicine – 2012: 25 applicants (19 US/Can, 6 IMG) – 2013: 20 applicants (15 US/Can, 5 IMG) – 2014: 27 applicants (22 US/Can, 5 IMG) 34 – 2015: 34 applicants (25 US/Can, 9 IMG) Peds Rheumatology 2015: 30 total (15/15) Peds Nephrology 2015: 26 total (11/15) Peds Infectious Disease 2015: 45 total (28/17) Peds Endocrinology 2014: 77 total (49/28)

NRMP Match n%n% Programs enrolled25 withdrawn20 participating in Match23 25 filled1148%1872% unfilled1252%728% Positions open35 36 filled2160%2878% unfilled1440%822% Applicants enrolled2632 enrolled and entered a rank list22 31 matched2195%2890% unmatched15%310%

Report from COPE (Committee on Pediatric Education) of the AAP Main lesson- ACGME is trying to issue fewer dictates about content – will leave it up to the sub-boards Of 35 page program requirements, only 5 pages outline content areas that should be covered Push for programs to create new and innovative curricula to teach content; make sure trainees leave competent with for unsupervised practice

EPAs DOMAINS OF COMPETENCE COMPETENCIES MILESTONES Patient Care Medical Knowledge Systems-Based Practice PBL&I Professionalism IP&C Skills Modified from the original version created by Dr. Ann Burke 7 Common 4 Adol Med

Common EPAs EPAs that cross the generalist to subspecialist role Apply public health principles and improvement methodology to improve care for populations, communities, and systems Provide for and obtain consultation from other health care providers caring for children Contribute to the fiscally sound and ethical management of a practice (e.g., through billing, scheduling, coding, and record keeping practices). Facilitate handovers to another healthcare provider Lead and work within interprofessional health care teams EPAs that are common to all subspecialties Engage in scholarly activities through the discovery, application, and dissemination of new knowledge (broadly defined) Lead within the subspecialty profession

Adolescent Medicine Specific EPAs Provide care for adolescent and young adult patients with acute physical and mental health issues. Provide continuity of care for adolescent and young adult patients with chronic medical problems and complex health conditions Provide preventive health care that includes the conditions specific to the adolescent and young adult population. Transition care of the adolescent and young adult patient to adult health care settings

What are milestones? Competency-based developmental outcomes (e.g., knowledge, skills, attitudes, and performance) that can be demonstrated progressively by residents and fellows from the beginning of their education through graduation to the unsupervised practice of their specialties One significant point in trainee's development

Example of one milestone continuum for Medical Knowledge

Discussion Did you have difficulty or encounter problems entering data to ACGME website? EPA study – results pending Clinical Competency Committees – Did they work? – What lessons did you learn from facilitating committees? Evaluation tools – Did you develop or already have evaluation tools developed that worked?