"The TL;DR: A lot of care and consideration is put into the curriculum and overall running of the residency program: 4+4 X+Y promotes wellness, research, mentorship, professional development in preparation for fellowship application PGY-2; resident-led rounds promote early autonomy and time with attending; TEACHING is promoted in many ways including faculty are paid, residents have retreats, electives, people more likely to speak up during resident-led rounds; TRACKS - they have many, Global health track really strong with rotation in Arizona res, Birmingham strong clinic, anyone can attend any of the lectures, POCUS; RESEARCH: structured system for research oppos "LEAD", speed dating for interns interested in research; Things that make sense: buddy coverage system. General: lots of UPMC lifers. Less segregation of care as there is no county hospital so everyone comes to Montefiore/Presbyterian. The night before had a fun social with the residents, given $15 grubhub card lots of upmc lifers history of transformative science huge txp center - first liver transplant - pre peri post txp spectrum salk - polio vaxx Social Justice: “Rewarding place to learn and to serve” Vulnerable pops: high opioid epidemic, aging population UPMC provides more care to the region’s poor and underserved than any other health system in PA. charity care provided by largest nonprofit health systems in PA Less segregation of care no separate county hospital, everyone comes to Montefiore/Presby Birmingham – 50% spanish speaking, fully uninsured patients often the care is o different at the hospital-based clinic because the institution has a huge commitment to care of the underserved GH and underserved track have CC here Residents volunteer at free clinic weekends off EO month VA PGH access to mental health – wait time is shorter access to tx for substance use, housing instability, affordable or free meds Diversity, Equity, Inclusion: “Diversity that you can see and that you can’t” – religion, career goals, financial; “we have to give it as a drip” White Coats against racism and injustice kneel Bystander and upstander training for interns – what to do with microaggressions from patients Longitudinal anti-racism curric “Anything given as a bolus does not stick, we have to give it as a drip” Financial investment in diversity training All faculty get bias reduction in medicine BRIM training - evidence-based, effective and strategies to reduce 3-hour synchronous training, was billed as if they were seeing patients. Female leadership three female division chiefs of 11, 3 of 5 department vice-chairs are female better recruitment, retention, morale, productivity, mortality Current state of hospital: staffing shortage: “we have hit the nadir” nursing tuition will be paid in july for starting work Residency Tracks! 40% of residents. “Commitment to individualizing training” professional development and personal growth residency goes really really fast 4 + 4 ambulatory: “educational rigor” 4 ward, 1-2 ICU, 4 consults/electives 28 hour call ~6x yearly Wellness and professional development “Spinning wheels does not facilitate curiosity and empathy. What is more important than this? Not a whole lot” Ambulatory curriculum buddy coverage sys buddy is on oppo x + y pattern so if your patient needs to be seen team-based care - patient-centered medical home, VA PACT ACGME requires more and more time in outpatient the better you are in outpatient the more you understand the logistics, medicine, barriers challenges – can’t just repeat the sodium every 4h, can’t admit everyone Inpatient resident-led bedside rounds – “we’ve been doing this for 20 years” resident is decision-maker in eyes of patients, interns, students studied by MGH – no diff in error late, interns feel less efficient, autonomous, speak less when attg present, no impact on round length “if you are not deliberate, autonomy gets undermined” really in-depth walking rounds with teaching takes 4 hours not optimal for patient care or teaching dedicated attending teaching rounds, not at the expense of resident autonomy Innovations Teaching: “core competency” Clinical reasoning curriculum Teaching to teach elective certificate monthly book club – thanks for the feedback, radical candor retreats – cover so everyone can come “Not an hour learning the socratic method to reproduce hyponatremia algorithm” walk and talk, think out loud – your nurse calls saying your pt has SOB – give you the framework breaking down steps in thinking, why patients are receiving the treatment they are Health policy initiatives POCUS Elective and interest group Research world-class science – NIH Funding 9 resident scholarship LEAD program - infrastructure to support scholarly activities dynamic list of shovel-ready projects Intern speed dating retreat to recruit research great fellowship match Conferences Bank - 1500 for 3 years, scholarship and fellowship IV Opportunity to present 30-40 residents at SGIM many places teaching is unfunded mandate. grants, patient care prioritized. here it is mandated, paid, carve out time. "

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