1. APDIM Survey Committee
Fall 2009
Furman S McDonald, MD MPH
Chair, APDIM Survey Committee

2. APDIM Survey Committee
Maria Lucarelli, MD
Furman McDonald, MD MPH, Chair
Susan Sefcik, MD
Debbie Stevens
Lisa Willett, MD
Ex Officio
Eric Holmboe, MD
APDIM Support
Nicole Baptista
Jessica O’Hara
Michael Adams, MD
Betty Aman
Vineet Arora, MD
Brent Beasley, MD
Joanne Connaughton, MD
Stephanie Call, MD, Vice-Chair
Karen Chacko, MD
Saima Chaudhry, MD
Kevin Hinchey, MD
Robert Hopkins, MD

3. Goals Answer Questions Important to APDIM
Consolidate (i.e. decrease) Surveys
Longitudinal Database
Research Network

7. Comments ARE NOT included to protect anonymity of respondents.

9. Publications in Press
Pharmaceutical Industry Support and Residency Education. Loertscher, Halvorsen, Beasley, Holmboe, Kolars, McDonald
Ambulatory Training Since Work-hour Regulations. Zebrack, Fletcher, Beasley, Whittle
Demographic and Work-Life Study of Chief Residents. Singh, McDonald, Beasley
Hospitalists Involvement in Internal Medicine Residencies. Beasley, McBride, McDonald

10. Survey Development Shorter Better Timing
Core Section repeated year to year
Variable Sections based on:
APDIM Membership
Previous Surveys
Listserve/Discussion board calls for input
APDIM Council
Investigator initiated proposals

11. 2008 Survey Core Section Variable Sections
Program Director Characteristics
Program Characteristics
Questions only if data not obtainable elsewhere
ACGME, ABIM, FREIDA, US Census
Variable Sections
GME Funding
Remediation
Duty Hours / Work Intensity

12. 2008 Survey Facts 268 programs responded
72.0% of all 372 APDIM members
APDIM members represent 97.1% of all 383 ACGME accredited internal medicine residency programs*
*ACGME web site, December 1, 2008
responder=1, APDIM_member=1

13. 14%
22%
38%
25%

14. Program Description (source: FREIDA)
Community-based,
university hospital affiliated
Program_Desc

15. 2006-2008 Rolling Pass Rates (source: ABIM)
Mean = 92.2% Median = 93%
Percent
abim_06_08

16. Accreditation Cycle Length (source: ACGME)
Mean = 4.2 years Median = 4.5 years
Percent
Cycle_Length

17. Program Director Tenure (source: ACGME, as of 12/1/08)
Percent
Median = 6 years
Mean = 7.4 years
12/1/ Program_Director_Appointment_Date, (percent)

18. Gender
1995 – 18%
Question 11 – can we make this pink and blue?

19. Career Designation
Question 16

20. Academic Ranks
Question 15

21. Total Annual Salary Percent
Question 19 – show as bar graph distribution

22. Average Annual Salary http://www.bls.gov/data/inflation_calculator.htm
Question 19 – show as bar graph distribution

23. Would like to have input in how DME is disbursed?
Hospital(s) → Residency
Agree
80%
Have input?
Hospital(s) → Department
Department → Residency
14%
33%
Question 118

24. Which systems of GME funding should APDIM support?
All Payer
Modify Current
Private Insurance
No Opinion
Discretionary
Questions 132 a-f
Other

25. REMEDIATION Residents with Problems
Program Prevalence 74%
Resident Prevalence 5%
Question 27, 43, 28, Total_Number_of_Filled_Positions, 82

26. 77% Struggle in Multiple Competencies
Questions 52-58

27. Successfully Remediated Competencies
Questions 73-80

28. Highest Level of Intervention
Questions 29-40

29. Do You Have Any Duty Hour Problems?
“yes” to any of Questions 139, 141, 143, 145

30. Duty Hour Rules: If So, Which?
Questions 139, 141, 143, 145

31. What have you done to better meet duty hour requirements?
Increased Staffing
Question 147 a-e, g-n

32. What have you done to better meet duty hour requirements?
Increased Workloads
Question 147 a-e, j-n

33. What have you done to better meet duty hour requirements?
Modified Schedules
Question 147 r, s, u-x

34. What have you done to better meet duty hour requirements?
Decreased Resident Responsibility
Question 147 f, o-q, t, y

35. Non-direct Patient Care Tasks
“Routinely” Performed by Residents
Decreased duty hours and resident time with patients without decreasing non-patient care tasks.

36. PLEASE COMPLETE 2009 Survey
Core Section
Program Director Characteristics
Program Characteristics
Questions only if data not obtainable elsewhere
Variable Sections
Recruitment
Global Health
Night-Time Supervision
IOM Duty Hour Recommendations

37. Thank You

39. Transparency in the way DME money is flowing?
Medicare → Hospital(s)
Hospital(s) → Department
Department → Residency
Agree
15%
14%
27%
Questions – Can you follow the Money?

40. Direct Medical Education (DME)
Attempted to find 59%
Successful finding 31%
Regularly in Budget %
Questions 111, 102, 104 – Discuss who was contacted and why they didn’t try

41. The number of residents with problems has:
Question 71

42. Application Materials Helpful? (of 35% who identified “red flags”)
Questions 44-49

43. How Were They Identified?
Question 51a-r, those who indicated “other” and said Chief Resident were moved to the “Supervising resident” category

44. Contributing Personal Factors
Questions 61-69

45. Intervention Effectiveness
Questions 83-99, the denominator for each percent is 268-# with no experience

46. Intervention Effectiveness
continued...
Questions 83-99, the denominator for each percent is 268-# with no experience

47. How Do You Track Duty Hours?
Question 135

48. Frequency of Duty Hour Monitoring?
Question 133