1. Surgery RRC Thomas V. Whalen, MD, Chair

2. RRC—Surgery Members ■ Thomas V. Whalen, MD, Chair ■ ■ J. Patrick O’Leary, MD, Vice Chair ■ Adeline Deladisma, MD, Resident ■ Timothy R. Billiar, MD ■ G. Patrick Clagett, MD ■ Peter J. Fabri, MD ■ Linda M. Harris, MD ■ George W. Holcomb, MD ■ James C. Hebert, MD ■ Mark A. Malangoni, MD ■ Marshall Z. Schwartz, MD ■ Charles W. Van Way III, MD ■ Marc K. Wallack, MD ■ Frank Lewis, MD, Ex- Officio ABS ■ Patrice Blair, MPH, Ex- Officio ACS

3. Surgery RRC--Members ■ 3 AMA-CME nominees ■ 3 ACS nominees ■ 3 ABS nominees ■ 1 resident ■ Ex-Officio Liaisons (ABS, ACS)

4. RRC—Surgery Leadership ■ Chair ■ Vice-Chair ■ Chair-Elect (Chosen during Chair’s 3 rd year) ■ Executive Committee (Chair, VC, Chair-Elect) –Interim Administrative Decisions (Participating Site, Temporary Increases in Complement) –Review and approve meeting agenda, newsletters, etc. –Meet with ED and Administrator prior to each RRC meeting ■ Vice-Chair mentors new members

5. Surgery—Program Data 2010 Total Programs Cont. Accred. Initial Accred. Other Surgery24523447 Pediatric Surgery383170 Critical Care9582130 Vascular-Independent1009091 Vascular-Integrated212190 Hand1100 TOTAL500440528

6. Surgery—Resident Data 2010 Approved Positions Filled Positions % filled vs approved Surgery8255741089.7% Pediatric Surgery767294.7% Critical Care21115874.8% Vascular-Independent26224693.8% Vascular-Integrated1154034.8% Hand88100% TOTAL8927793488.9%

7. Site Visit Results 2008-2009 ■ 124 programs were surveyed –110 administrative requests at meetings –283 administrative interim decisions ■ 237 citations issued by RRC –(1.91 citations per program) ■ Average cycle length: 3.43 yrs. ■ Common Citations –Education Program – Procedural Experience –Evaluation– Residents, Faculty, Program

8. 2009 RRC Activity ■ 152 programs reviewed (post site-visit) ■ 3.68 year average cycle length ■ 261 citations ■ 3.43 citations per program review ■ 72 administrative requests ■ 328 interim requests (PD changes, participating site change, temporary increases)

9. Surgery RRC Innovation ■ Collaboration with SCORE ■ Milestones ■ Use of Reviewer Templates ■ Use of Citation Glossary (core only) ■ Adoption of Grovesite –Program workups (excluding PIF) –Submission of Reviewer Notes

10. RRC Meetings ■ Meet 3 times annually (1.5 days) ■ Chair uses ED’s reconciliation sheet to alert members to widely discordant recommendations prior to meeting.

11. RRC Meetings (cont.) ■ Order of program review –Adverse action rebuttal responses –Consent Agenda (PRs, permanent increases) Items recommended by RRC team, members are asked to pull any items they would like discussed. –Full Program Reviews –Duty Hour Reports

12. Communication ■ Stakeholders –ACGME Education Conference—Chair/ED –APDS (2x/yr)—Chair/ED –APDVS (1x/yr)—Member/ED –Pediatric Surgery PDs (1x/yr—Chair or ED –Surgical Critical Care PDs—Member –Coordinator Groups (1x/yr)—ED, OpLog Staff

13. Communication (cont.) ■ Attendance at RRC meetings –3 attended in 2009-10 –Use of Evaluations ■ Newsletters –3 times per year (after each RRC meeting)

14. Committee QI ■ Member Evaluation ■ Program Reviews ■ New Member mentoring ■ Process monitoring at conclusion of each meeting

15. Strategic Planning Process ■ Retreats –February 2007 Retreat Topics –Communication with stakeholders –Process improvements –Consistency among Core and sub PRs –Next Retreat ??????????? ■ Use of Subcommittees –PR revisions –Op Log Revisions

16. Requirements ■ ECA Experience at Integrated Sites ■ PD Appointment ■ NDP and DP Residents ■ Formal Transplant Rotation ■ Definition of Resident as “Surgeon” –Operative minimums to be reset ■ “New Patient” definition ■ No 88 hour exemptions ■ ECA Experience at Integrated Sites ■ PD Appointment ■ NDP and DP Residents ■ Formal Transplant Rotation ■ Definition of Resident as “Surgeon” –Operative minimums to be reset ■ “New Patient” definition ■ No 88 hour exemptions

17. Future Opportunities ■ Development of new sub-specialty –Advanced Surgical Oncology ■ Additional RRC member –Number of total programs has grown from 457 in 2003 to 500 in 2009 (9%) ■ International Rotations ■ Residency Training Restructuring Committee