The University of New Mexico

Graduate Medical Education - Rightsizing Committee

2 November 2006

Chair:               Gerald Charlton, MD

Present:            Charlton, Kingsley, Bocklage, Kapsner, Watt, Sparkman, Hoffman, Gateley, Pendergast (Voting Members)

                        Bankhurst, Jastzemski, Jensen, Wills, Vasef

Minutes 9/14/06

The minutes of the last GME Rightsizing Committee were distributed and reviewed by the committee members. 

Action:                        The committee accepted the minutes of the 14 September 2006 as presented.

Funding Request University Hospital 2008-09

Anesthesiology

Request:         2 FTE at UH for 2008-09

John Wills, MD, Chair of Anesthesiology made the presentation for Jim Harding, MD, Program Director.  The request is for funding of two additional positions and not an increase in the total number of trainees.  Beginning in academic year 2008-09 the RRC will make the program a full four year program which would include the intern year at the same location.  At that time, all intern positions will be trained exclusively at UNMH to ensure adequate experience and supervision.  The demand is high nationally and the need is great locally.  The program is stable and has no difficulties attracting qualified applicants.  The program needs for the interns to be at the home institution for the first year of training.  Current training sites for Anesthesiology are UNMH, VAMC, Lovelace Medical Center, and Methodists Hospital of Houston.  The department funds some rotations for specific requirements which are not available at the affiliated sites. 

ACGME Accreditation Status: Continued Full Accreditation, 5 Citations, 3 yr cycle                     

Vote:               Favorable                   Against                        Abstain

                        8                                  0                                  0

Action:                        The committee was very supportive of the department and the educational merits of the intern year being at the major participating institution (UH).  However, the program seems to have more than adequate funding from several sources for the number of positions they are approved for by the RRC.  The RSC recommended an increase of funding (for current positions without an increase in the total number of trainees) of 1 FTE at UH for 2008-09.  The increase would bring the program to seven trainees at each level of training for the four year program (total 28 FTE).

Priority:          2         

Rheumatology

Request:         1 FTE at VAMC for 2007-08; 1 FTE at UH for 2007-08

Art Bankhurst, MD, Program Director of Rheumatology presented the requested information to the committee.  Rheumatology is a two year fellowship which recently received a five year accreditation with no citations or concerns.  Nationally the population is ageing and there is a great demand for rheumatologists.  Specialty residents from medicine, family medicine, and pediatrics rotate on the service.  The educational opportunities and clinical care opportunities are adequate to accommodate the increased number of fellows.  Two additional fellows would provide instructors who could help the parent program, Medicine, resolve their citation from the RRC on inadequate opportunities to become proficient in arthrocentesis.  The RRC requires a faculty to fellow ratio of 1:1.  The program would be in compliance with the RRC requirement with an increase in trainees.  Recruitment and demand for training is good.  The program has research opportunities. 

ACGME Accreditation Status: Continued Full Accreditation, No citations, 5 yr cycle

Vote:               Favorable                   Against                        Abstain

                        8                                  0                                  0

Action:                        The Committee recommended Rheumatology increase the program size by 1 FTE at the VAMC for academic year 2007-08 and increase the program size by another 1 FTE in 2008-09 at UNMH.  Approval of actual funds are subject to the budget process at UH and Chief of Staff at the VAMC. 

Priority:          1

Departmental Funded 2007-08

Molecular Genetic Pathology (New)

Request:         1 FTE at UMNH for 2007-08 with Departmental Funds

Mohammad Vasef, MD made a presentation to the committee on the benefits of having a fellowship in Molecular Genetic Pathology.  The new fellowship at UNM HSC would be accredited by the ACGME.  Nationally there are approximately twelve ACGME accredited program at major training institutions.  The fellowship program would greatly strengthen the parent program and provide the opportunity for residents in the pathology program to continue their education in molecular genetic pathology.  The program will provide a good background for academics.  The program will require a research component.  There are adequate procedures available at UNM and TriCore Labs with approximately 16,000 molecular diagnostic, 900 molecular oncology, and 1300 in cytogenetics.  The program must have the approval of the institution and approved funding prior to an application to the RRC which would be due in January 2007.  A letter from the Chair of Pathology was included which ensured departmental funding.

Vote:               Favorable                   Against                        Abstain

                        8                                  0                                  0

Action:                        The committee recommended the approval of the program as an ACGME accredited program which will be funded with departmental funds beginning in academic year 2007-08.

Priority:          1

General Dentistry (2^nd Year Expansion)

Request:         2 FTE in Roswell for 2007-08 with Departmental/State Funds

Pete Jensen, DDS, Program Director of General Dentistry has obtained funding from the State of New Mexico which will pass through the dental department to provide two residents with the opportunity to have a second elective year of training.  The training site will be in Roswell.  The UNM program currently has five residents in the one year program.  CMS money will be available for reimbursement.  An affiliation agreement is being developed between the institution and Eastern New Mexico Medical Center.  Training sites will include Eastern New Mexico University, New Mexico Department of Health, and Eastern New Mexico Medical Center.  The dental program will help strengthen the family medicine program in Roswell, as well as provide dental care in an underserved area of the state.  A dental hygiene program is already established at Eastern New Mexico University.  A new facility is to be built in the immediate future.  The facility will have 12 examination room and 6 of those will be for resident.  The second year dental resident salary, benefits, and contract will be through UNM HSC.  The GME Office will be reimbursed by state legislative funds through the dental department with a 25% administrative fee.  The increase in the resident component will require a self study analysis to be performed by the accreditation agency for the new site.  A curriculum as well as goals and objectives have been developed.  Supervision will be provided by faculty at Eastern New Mexico Medical Center and UNM.

Vote:               Favorable                   Against                        Abstain

                        8                                  0                                  0

Action:                        The committee was impressed with the detail the program had placed into the request.  The committee recommended the increase of 2 FTE for a second year of training at the Roswell site. 

Priority:          1

VAMC Allocation 2007-08

The VAMC has received an additional 7.5 FTE for academic year 2007-08 through the VAMC national allocation process.  The committee reviewed the request which were made to the committee in June 2006 and at the last meeting.  Request for additional positions total 15 FTE.  Criteria had been developed for the committee to prioritize positions which was in addition to the criteria developed for initial request (training demand, funding, requirements, institutional impact, evaluation, training site, and number of faculty).  The criteria developed for recommendation of additional positions through the VAMC allocation were based on ACGME accreditation status, number of citations or concerns in the last RRC letter of accreditation, and the length of the accreditation cycle.  The committee received requests from the following departments for funding in 2007-08:

Anesthesiology 1 FTE, Medicine 2 FTE, Rheumatology 1 FTE, Pulmonary Critical Care 1 FTE, Neurology 3 FTE, Psychiatry 3 FTE, Addiction Psychiatry 1 FTE, Geriatric Psychiatry 1 FTE, Radiology 1 FTE, and Urology 1 FTE.  Careful consideration was given to each department requesting additional funding for trainees at the VAMC.  Committee members fully agreed upon the final recommendations for funding in 2007-08 as follows: Medicine 1 FTE, Pulmonary Critical Care 1 FTE, Rheumatology 1 FTE, Psychiatry 1 FTE, Addiction Psychiatry 1 FTE, Geriatric Psychiatric .50 FTE, Radiology 1 FTE, and Urology 1 FTE. 

Action:                        The recommendation of  the Rightsizing Committee for the above mentioned permanent funding will go to the Chief of Staff at the Albuquerque VAMC for final approval. 

Summary Chart

RSC Recommendations 2006