issues facing large programs oxentenko (1)

GI-Face Off:GI-Face Off:Issues Facing Small, Medium Issues Facing Small, Medium

and Large Programsand Large Programs

Amy S. Oxentenko, MD, FACP, FACGAmy S. Oxentenko, MD, FACP, FACGAssociate Professor of MedicineAssociate Professor of Medicine

Fellowship Director, Mayo Clinic-RochesterFellowship Director, Mayo Clinic-Rochester

Our Core Program SizeOur Core Program Size

Tracks # Per Year # Currently

In Match 7

NIH 1-2 6

Clinical Scholar 5-6 16

Not in Match*

Clinical Investigator 0-3 6 (+2)

Total 7-10 28

Approved by ACGME 30

*Match into fellowship at time of residency match

Our Advanced Program SizeOur Advanced Program Size

Advanced Programs # Per Year Accredited?

Transplant Hepatology 3 Yes

Advanced Endoscopy 1 No

Inflammatory Bowel Disease 1 No

Pancreas 1 No

Motility 1 No

Esophageal 1 No

GI Neoplasia 1 No

TOTAL 9

The Big IssuesThe Big Issues• Many fellows (39) and staff (~78)Many fellows (39) and staff (~78)– Repeat contact for adequate teaching and feedbackRepeat contact for adequate teaching and feedback– # to educate on requirements/faculty development# to educate on requirements/faculty development

• Overall time (PD and EPC)Overall time (PD and EPC)– Schedules, semi-annual reviews, interview season, Schedules, semi-annual reviews, interview season,

letters for jobs/advanced training/awards/etcletters for jobs/advanced training/awards/etc

– Worse w/milestones and competency committeesWorse w/milestones and competency committees

• Trainee issuesTrainee issues– Absences, personal issues, behavioral issuesAbsences, personal issues, behavioral issues

• Advanced trainingAdvanced training– Additional interviews, separate program goals and Additional interviews, separate program goals and

measures, same internal review workload, 2 PDs measures, same internal review workload, 2 PDs