The next big thing… Anoop Agrawal, M.D. Co-chair, MPPDA Research Committee

‘Swolphin’

 Mammalian vs. Nautical  Nautical used in olden times on world maps That is one ugly dolphin…

 Dispel the myths  “Do med/peds graduates pursue careers in primary care?”  “Do med/peds graduates continue to practice both specialties?”  Demonstrate our impact and value on the primary care workforce  Generate support for greater GME funding and expansion of our programs Research to advance our field

 Now have a seat on the APDIM Survey Committee  APDIM Survey Committee Goals  Answer questions important to APDIM  Provide longitudinal database to assess trends over time  Facilitate research of importance to APDIM  Reduce burden by consolidated surveys One step forward

 It is a beast…  Anywhere from 138 (on 2014 survey) to 194 questions (on 2013 APDIM survey)!  Topics included last year:  Transitions of care  FMLA  High value care/cost-conscious care APDIM Program Director Survey

Mitesh S. Patel, MD, MBA; Darcy A. Reed, MD, MPH; Laura Loertscher, MD; Furman S. McDonald, MD, MPH; Vineet M. Arora, MD, MAPP. Teaching Residents to Provide Cost Conscious Care A National Survey of Residency Program Directors. AMA Intern Med. 2014; 174(3): Angus, Steven MD; Vu, T. Robert MD; Halvorsen, Andrew J. MS; Aiyer, Meenakshy MD; McKown, Kevin MD; Chmielewski, Amy F.; McDonald, Furman S. MD, MPH What Skills Should New Internal Medicine Interns Have in July? A National Survey of Internal Medicine Residency Program Directors. Academic Medicine: March Volume 89 - Issue 3 - p 432–435. Alissa Brummond, MD, Susan Sefcik, MD Andrew J. Halvorsen, MS Saima Chaudhry, MD, MSHS Vineet Arora, MD, MAPP Mike Adams, MD Maria Lucarelli, MD Furman S. McDonald, MD, MPH Darcy A. Reed, MD, MPH Resident Recruitment Costs: A National Survey of Internal Medicine Program Directors. Published Online: May 20, West CP, Halvorsen AJ, Swenson SL, McDonald FS. Burnout and distress among internal medicine program directors: results of a national survey. J Gen Intern Med Aug; 28(8): Adams M, Morrison TB, Call SA, Halvorsen AJ, Moore J, Lucarelli M, Angus SV, McDonald FS. Changes in the National Residency Matching Program Policy: Are Internal Medicine Program Directors “All-In”?. JGME June;4(2):

What topics do you recommend be investigated in future MPPDA Program Director Surveys?

Med-Peds Workforce questions Arch Pediatr Adolesc Med. 1999;153:

 Identified 1482 individuals who completed combined med/peds training between 1986 and  Sent paper survey of 12 questions  Board certification  Principal activity  Whom they cared for  Medical school appointment  Received 1005 responses (67.8%)! Methods of 1999 survey

 81.6% were certified in both boards  70% were primarily involved in direct patient care  Most cared for all ages  85% managed patients who require hospitization  50% had medical school appointments A few results

 109 of 122 graduates from 1987 to 2011 (89%)  73% in primary care, 27% in fellowships  87% see both adults and pediatrics  Current board certification: 86% IM, 81% Peds  56% current medical school appointment BCM’s results

 “Future research must follow the career outcomes and practice patterns of these well- qualified generalist physicians.”  “Since the interest in med/peds training has escalated during the past decade, it will be important to follow the career outcomes and practice patterns of graduates with similar surveys. By 2000, the number of individuals who completed combined training will have more than doubled. Survey questions will be developed to gather information about subspecialty training and careers, including interest in dual subspecialty training.” Some conclusions from the 1999 paper

 Following in the footsteps of Drs. Lannon and Tunnessen, we want to conduct the largest to date Med-Peds workforce survey.  We speculate that since 2000 there have been ~6000 med-peds graduates.  If looking back to 1986, then ~10,000.  WE NEED YOUR HELP! Next steps

Thoughts, suggestions, questions?