GRADUATE MEDICAL EDUCATION Review

Graduation/Summer 2013

Residency

Congratulations to our pediatric resident graduates: back row - Dr. Sarah Waite, Dr. Musab Al-Yahia, Dr. Peter Mangubat, Dr. Rohini Singh, and Dr. Nam Nguyen; front row - Dr. Aneidra Leysath, Dr. Sneha Taylor and Dr. Courtney Shipon.

ADVANCING KNOWLEDGE. TRANSFORMING LIVES.

1115 W Call St. | Tallahassee, FL 32306

Our 2013 Pediatric Resident Graduates

Obstetrics & Gynecology Graduation Day

Congratulations to graduates Dr. Lisa Bean, Dr. Raina Ferenchick and Dr. Barbrette Baldwin.

Program Director Dr. Julie DeCesare presenting Dr. Lisa Bean with a special resident award in Minimally Invasive Gynecology.

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Hosting MS-1 students for Summer Practicum & MS-4 students for Ad-vanced Family Medicine Clerkship

We thoroughly enjoyed having Julia Comer and Loren Farley in the first session and Louis Gerena in the sec-

ond session of the FSU College of Medicine Sum-mer Clinical Practicum. These students gave us some very positive feedback on their experience. During each session we hosted two social events at the homes of Drs. Christy Cavanagh and Gary Goforth that were also attended by the students doing their Summer Clinical Practicum at the Im-mokalee Health Education Site. We are also en-joying having fourth year students Lorenzo Her-nandez and Kevin Carnevale, our first students participating in the Advanced Family Medicine Clerkship. They are having a great experience in our program, and they cite the ability to work with several faculty members, obtaining experience in inpatient and outpatient settings at the Family Medicine Center and Lee Memory Center, and the opportunity for one-on-one teaching as positive attributes. These students represent the future of our residency program, so we are excited to have the opportunity to host them as we build it.

We were very pleased to hear that our program was fully accredited by the Accreditation Council for Graduate Medical Education for the maximum interval of three years after the Review Committee for Fam-ily Medicine met in May 2013. Our expanded Family Medicine Center is now under construction and will be completed by April 2014. The residency practice has grown rapidly since the initial Family Medicine Center opened on July 16, 2012, and we now have an operational in-patient medicine and OB service for the residency program. Dr. Gary Goforth, Founding Program Director, and the faculty are excited about recruiting six residents to serve in the inaugural class beginning in July 2014 and expect to fill many positions in the PGY-2 class. The ultimate goal of the program is to reduce the shortage of primary care physi-cians created by a more than 40 percent growth in Lee County between

Family Medicine Residency Program Receives Full Accreditation

At Dr. Christy Cavanagh’s House

Recruiting for the 2013-14 YearNow that we are fully accredited, recruitment for new residents may begin in earnest! Dr. Julia Fashner has developed a template for a recruiting video and the FSU College of Medicine sent a pho-tographer to take photos in May. We will be attending the AAFP National Conference in Kansas City early in August, and Dr. Gary Goforth plans to visit all of the FSU College of Medicine regional campuses in the coming months. We also plan to attend recruiting fairs at the FSU College of Medicine and other medical schools in the Southeast. The Electronic Residency Application Service (ERAS) will open on Sept. 15, and we expect to receive many applications based on feedback from students calling and writing our program. We have the tools to bring outstanding residents into the program and help supply primary care physicians for Southwest Florida for many years to come.

Tommy Mattis (family) & Luke Stowers, MS-1

Loren Farley, MS-1, Shalom Chege (family) & M. Figueroa-Sierra, MS-1

2000 and 2010. History has taught us that more than half of the physicians trained in a residency program tend to stay in the same area where they trained. Our new residency program is off to a great start!

As we approach our first anniversary as an up-and-running program, joining TMH's well-established Family Medicine Residency Program, we celebrate our triumphs and work on our goals. We started the program with 10 interns (eight cat-egorical and two preliminary) and five second-year residents. Triumphs: nWard Team We started our inpatient ward service last year and have covered the service for the entire year. In addition we have started a critical care service. Our goal is to expand to two ward teams (Garnet & Gold Teams) starting this July and structure the critical care rotation to be staffed by an intern and resident each block.nScholarly Activity Two of our residents participated in the Florida ACP Resident Poster competition this year. Vinay Wayal, MD and Neelima Ravi, MD, both presented posters this fall with Dr. Shashaty cheering them on. nThe Match Our first participation in the match was a success. We reviewed over 1,500 electronic applications and interviewed over 100. We filled all of our eight categorical positions in the match. We had two preliminary positions, one of which was filled in the supplemental match. Our entering class represents two U.S. medical schools – both of our preliminary residents are from the FSU College of Medicine. We also have one Osteopathic gradu-ate, two from St. George, three from Ross and one from the American University of Antigua.nContinuity Clinic We started our continuity clinic on Sept. 11. We have slowly been building our patient base. In addition, we are par-ticipating in a mammogram study pursuant to a grant. Goals: nExpanding our ambulatory electives We have been working to expand our available am-bulatory electives. We have added Rheumatology, Dermatol-ogy, and Radiology electives and we are working to add an Orthopedic and ENT ambulatory elective.nMarketing our Continuity Clinic We are working with TMH and the College of Medi-cine to develop a comprehensive marketing strategy for our continuity clinic to increase patient population while focus-ing on the demographics and the resources we have avail-able. nExpanding our full-time faculty We have been actively recruiting for two full-time faculty positions to assist us in the continuity clinic and with the ward coverage. We hope to have good news soon! We are off to a great start and look forward to the opportunities and challenges offered by the upcoming aca-demic year.

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Our New IM Residency Program

Above Internal Medicine Resident, Dr. Vinay Wayal, and be-low, Dr. Neelima Ravi presenting their research project at the Florida ACP conference this year. Good work!

Page 4A Message from the DIO

Dr. Joan Younger Meek

As we come to the close of an-other academic year for the residency programs, I want to

wish all of our graduating residents the best in the next phase of their careers, whether that means additional fellow-ship training or making the transition to private practice. We know that they will serve their communities well and be great representatives of our FSU College of Medicine programs. We are in the process of welcoming and orient-ing our new group of residents that be-gin training in July. We are excited to have them on board and look forward to working with them throughout their training. The last six months have been busy for our GME programs and staff. Faculty and residents from the FSU College of Medicine residency programs participated in the College of Medicine’s annual research fair in February. A contingent from the main campus also had the opportunity to attend the resident research presenta-tions at Sacred Heart Hospital, as the pediatric and obstetrics-gynecology residents presented their work. Dr. Fogarty served as a judge for this event. The quality of resident faculty research projects improves with each academic year. Our entire GME office attend-ed the annual education conference of the Accreditation Council for Gradu-ate Medical Education (ACGME) in Orlando Feb. 28-March 3. Several of our residency directors also attended. There was a major focus on the AC-GME’s Next Accreditation System and the Clinical Learning Environment Re-views (CLER), which will take place at our clinical partner sites. The CLER fo-cus is to evaluate resident engagement within the hospital system in the areas of patient safety, quality improvement, disparities in health care delivery, and institutional oversight of resident su-pervision, transitions in care, resident duty hour monitoring and fatigue miti-

gation. The academic year 2013-2014 will be a major transition in graduate medical education as accreditation standards and processes continue to be revised. In May, I also completed the third and final segment of the AAMC Leadership Development Course, de-signed to help GME academic lead-ership and designated institutional officials become more prepared to nav-igate the every changing landscape of GME. In May, the GME Office was very pleased to get the news that the FSU College of Medicine Family Medi-cine Residency Program at Lee Me-morial Health System (LMHS) in Fort Myers received initial accreditation for three years. Dr. Goforth and his team at Lee Memorial continue to work on recruiting the best class of interns in the match in 2014. There is a great clini-cal partnership between the College of Medicine and the administration and staff at LMHS. The Internal Medicine Pro-gram at Tallahassee Memorial Health-Care will complete its first year of training for five PGY-2 residents and 10 PGY-1 residents in July. A subcommit-tee of the College of Medicine Gradu-ate Medical Education Committee re-cently conducted an internal review of this program at mid-cycle and found that it has made great progress in its first year of operation. TMH’s support for the program is great. The College of Medicine of-ficially begins sponsorship of the Pro-cedural Dermatology Fellowship effec-tive July 1, at Dermatology Associates of Tallahassee. The fellowship is di-rected by Dr. Armand Cognetta. We recently held our annual spring meeting of all program direc-tors and coordinators at the College of Medicine in Tallahassee and found this to be a productive time to share re-sources, problem-solve, and strategize for the future. Our program directors appreciated the opportunity to partici-pate again in Dr. Romrell’s anatomy lab for the new first-year students: “In-troduction to the First Patient.” Our program coordinators spent time with Connie Donohoe, Program Manager, and Jessee Graham, Program Asso-ciate, discussing time management, customer service, and other important topics, as Dr. Mulrooney, Associate

Dean, GME, led the program directors in a leadership development session. Since we are spread throughout the state, we appreciate the opportunity to get everyone together in person. Finally, I want to recognize Connie Donohoe on attaining her MPH degree from FSU in May. Congratula-tions on a job well done!

Simulation training is an integral part to any well rounded residency program. These FSU Obstetric and Gynecology residents and students are learning in-vasive ultrasound procedures, as well as practicing state of the art hystero-scopic fibroid resection. These simula-tion machines allow learning to occur in a safe, supervised environment.

Hysteroscopic and Simulation Training

Above OB/GYN Resident Dr. Poe is trying her hand at these techniques and below Drs. Collins, Spencer, Tidwell & Joseph are being instructed through the use of simulation.

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Dr. Chris Mulrooney

tices. For the most part, we believe this is best accomplished by affiliating with existing community clinical sites rather than creating our own. Needless to say, this “matrix management” is no mean feat! Every clinical training opportunity that a resi-dent or fellow experiences is made pos-sible because of a complex web of legal affiliations, contracts, billing systems, IT protocols, employment processes, etc., that guide the (hopefully) effective partnership of FSU and clinical sites to create the best environment pos-sible to achieve excellent educational outcomes. The FSU College of Medi-cine team that I have the privilege of leading, in concert with a peer team at our partner clinical institutions, works with this goal in mind. As with any goal, there are often obstacles that get in the way. Whether those are IT snafus caused by sometimes competing educational vs. clinical operating systems; or payroll and benefit challenges that arise from a complex mix of employment relation-ships; or decisions made without re-membering to include the perspective of the other partner; or any number of other day-to-day issues, the operations teams behind the GME programs seek to avert the obstacles as much as pos-sible before those obstacles interrupt the clinical environment. I love to hear when that is going well, such as when I recently witnessed Connie Donohoe receiving an award from the pediat-ric residents in Pensacola for her out-standing customer service. However, I also appreciate knowing when things aren’t going so well, so that we can con-tinuously improve the matrix relation-ships that govern our clinical training environments. Please do not hesitate to email me with feedback whenever you’d like, at chris.mulrooney@med.fsu.edu. Best wishes to all our residents, fellows, faculty, and staff on starting a new program year!

Christopher P. Mulrooney, M.P.S., Ph.D., has spent 30-plus years in direct service, adminis-trative, consulting, and executive roles in health care and aging services, from CNA to CEO. His educational background is in gerontology, health services administration, and organiza-tional psychology, and he is on the faculty of the College of Medicine’s Department of Geriatrics.

As As-s i s t a n t D e a n

for Graduate Medical Educa-tion (GME) and Chief Operating Officer of the College of Medi-cine’s Faculty Practice Plan, much of my

work is behind-the-scenes as I lead a great team of professionals to oversee the operations of our residency pro-grams and other clinical affiliations. That team includes Connie Donohoe, MPH, GME Program Manager; Dawn Snyder, CPA, Chief Financial Officer for the practice plan; David Welling, CPA, Business Analyst for the practice plan; Jessee Graham, GME Program Associate; Heather Smith, Accounting Associate; Carlisha Jenkins, Adminis-trative Assistant; and several other as-sociates and contractors who provide the expertise necessary to keep our ser-vice and clinical care partnership op-erations…well, in a word…operating! As most readers know, nearly all student, resident, and fellow train-ing, as well as all faculty clinical practice overseen by the College of Medicine, is conducted at affiliated institutions and medical practices not operated by FSU. This naturally creates an invigorating, but also challenging, dynamic tension in operating a program with a distinct FSU identity, while acknowledging and appreciating the unique culture and systems of a distinct clinical orga-nization. Many academic medical cen-ters are, at least to some degree, more vertically integrated than this – mean-ing that educational, clinical, and fi-nancial services are often provided un-der the same organizational structure. The FSU College of Medicine was es-tablished with a primary care mission and under a different paradigm, as it seeks to more effectively link clinical learners as “apprentices” with senior attending physicians already practic-ing in health systems and private prac-

A Few Words from As-sistant Dean for GME,

We’d like to congratulate Dr. Yong-Zing Zhou and Dr. Cui Yang for successful completion of Graduate Medical Education as a First Year Pre-liminary Resident in Internal Medicine at Tallahassee Memorial HealthCare from July 2012 to June 2013. We wish them all the best in their chosen spe-cialties.

Internal Medicine Preliminary Residents finish year

Program Director Dr. Greg Todd, center, presented Drs. Yong-Zing Zhou and Cui Yang certificates.

Congratulations!We’d like to congratulate Dr. Prerna Satyanarayana for receiving the Resi-dent of the Year Award from the Flor-ida Chapter, Internal Medicine, of the American College of Physicians.

Dr. Todd presented Dr. Satyanarayana with the ACP Resident of the Year award.

Dr. Chris Mulrooney

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2013 Research Night held at Sacred Heart HospitalOn April 26 our pediatric and obstetrics and gynecology senior residents presented their research projects. All of the resi-dents did an outstanding job. The Best Research Project Award was a tie this year and was presented to Dr. Sneha Taylor, pediatrics, for her presentation ‘Proximety of major bodies of water and Kawasaki Disease’ - faculty mentor Dr. James Burns, and Dr. Ashley Poe, obstetrics and gynecology, for a research project titled ‘Advancing Endometriosis Stage is As-sociated with a Decline in Anti-Mullerian Hormone Independent of Age and Tobacco’ - faculty mentor Dr. Barry Ripps.

Pediatric residents having fun at Research Night. Sitting on the carousel horse is Dr. Sneha Taylor, co-winner of the Best Research Project.

Dr. Julie DeCesare, OB/GYN Program Director, presenting Dr. Poe with the Best Research Project award.

Above, pediatric faculty, Drs. Amy Lee and Ryan Hahn, anxiously await the evening to begin in anticipation that the pediatric residents will perform well. (The table toppers in the background are favorites as door prizes!).

Distinguished judges for the evening were Anthony Okafor, PhD, U. of W FL, Gary Cumberland, MD, Sacred Heart, John Fogarty, MD, Dean, FSU College of Medicine, and John Tyson, MD, Assistant Profes-sor, Surgery, FSU

At left, Dr. Dawn Hannah is presenting her research project on Postpartum Contraception Rates in CenteringPregnancy® Versus Traditional Obstetrical Care - mentor Dr. Julie DeCesare.

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Patient Quotes

A patient’s family member thanks Dr. Broge for calling in a prescription to the patient’s pharmacy. Many thanks to Dr. Broge!!! - PEDS

“The FSU resident that is a little, bitty Indian lady was my favorite. She was so caring and easy to talk to. She was like talking to another Mama. She explained everything so clearly. She was just so sweet.” - PEDS (Dr. Neemuchwala!)

Dr. Gail Joseph, PGY-2 OB/GYN-Resident was ac-cepted for rotation at the prestigious Rutledge Fellowship in Gyn Oncology at the MD Anderson

OB-GYN Resident Dr. Natasha Spencer was selected by the Con-gress District Chair to attend the 2013 Ameri-can College of Obste-tricians and Gynecolo-

Kudos:

PEDS Resident Dr. Sneha Taylor had a case report, ‘Use of naloxone for clonidine intoxication in pediat-ric age group,’ accept-ed for publication in

Cancer Center in Texas. This month long, competitive program is awarded to residents at the PGY-3 level to foster career growth, research and experience in the field of Gyn Oncology.

OB-GYN

http://www.facebook.com/fsu.gme

Excerpts from SNIPS

the American Journal of Therapeutics.

Happy Birthday, Dr. Poe!

Death by White Chocolate - her FAV!

Special Events

Internal Medicine Residency Program’s recent Team Building Bowling Event.

During the conference, Julie DeCesare, MD and Donna Maxwell, DNP, CNM presented CenteringPregnancy, and Suzanne Bush, MD and resident phy-sician Raina Ferenchick also helped lead roundtable discussions in a small group setting, ranging from programs with no previous knowledge of Cen-teringPregnancy to groups currently practicing CenteringPregnancy within their program.

Enjoying the sights while at the APGO

CREOG Spring Conference!

Below: D. Maxwell, R. Ferenchick, S. Bush, J.

DeCesare and Coordinator Julie Floyd

Family Medicine As-sociate Program Direc-tror Dr. Julia Fashner provided the Capsule Comment, Eye Dis-ease and Women, for

gists’ Annual Clinical Meeting, OB-GYN Reporter Program.

the Florida Academy of Family Physicians eBYTES. The Capsule contained many components including Refractive Errors, Age-Related Macular Degeneration, Cata-ract, Diabetic Retinopathy, and Glaucoma.

Thanks Deb Danforth, MS, ARNP, (below right with OB/GYN Resident Lakeema Bruce) for bringing OSCE’s to us!

Suggestions? Contact the *Editor

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Joan Meek, MD | Associate Dean / Designated Institutional Official | joan.meek@med.fsu.edu | 407.835.4103Chris Mulrooney, PhD | Assistant Dean | chris.mulrooney@med.fsu.edu | 850.645.9646

Connie Donohoe, MPH | Program Manager (*Residency Review editor) | connie.donohoe@med.fsu.edu | 850.645.6867Jessee Graham | Program Associate | jessee.graham@med.fsu.edu | 850.645.9977

Reading ROCKS

GME Office Staff

The “Reading Rocks” event held recently at the Pediatrics Clinic was organized by resident physician, Dr. Tri-cia Pinto. Many books that had been collected throughout the Hospital were donated to Loaves and Fishes. The Blue Wahoo Mascot (Kazoo) was also present and read to children in the clinic. This event was sponsored by the American Academy of Pediatrics to raise awareness of childhood literacy.

The FSU Pediatric Residents had a great time promoting early childhood literacy with a week-long series of events!

Pediatric Residents, Dr. Stephanie Gorman, Dr. Sarah Waite, Dr. Courtney Shi-pon, Dr. Tangra Broge, Dr. Aneidra Leysath and Dr. Talal Sekkik donating books for the Reading Rocks event.

Kazoo and event organizer Dr.Tricia Pinto

Pediatric Faculty, Dr. Diane Wilkinson

Dr. Peter Mangubat, PGY-3 Resident

Photos from Sacred Heart Children's Hospital Facebook page