Www.musckids.com Primary Care Residency Track MUSC Residency Program Director: Mike Southgate, MD Grant Director: Bill Basco, MD, MS.

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Primary Care Residency TrackMUSC

Residency Program Director:Mike Southgate, MD

Grant Director:Bill Basco, MD, MS

www.musckids.com

What is it?

• An effort to improve entry into primary care community practice by reducing time in hospital-based training

• Increasing training time in community practices• Specifically training these residents in

interprofessional activities in order to better prepare them to function in a multi-professional PCMH

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What’s Different?

• Pediatric Residency has 36 blocks (4 wk periods)• PCT Residents will spend 9 blocks in primary care

oriented training during their 3 years in training• This more than doubles the time spent in primary

care settings compared to current residency • The PCT residency program will add the

community-based rotations by adjusting the PL2 and PL 3 years of the PCT residents

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Timeline for PCT Residents

Month 0-6 Mo. 7-12 Mo. 13-18 Mo. 19-24 Mo. 25-30 Mo. 31-36

New Experiences as part of PCT

4.5 months in Community Practice sites

4.5 months in Community Practice sites

Attend SC AAP Meeting Attend SC AAP Meeting Attend SC AAP Meeting

Complete Interprofessional Faculty Development Institute

(IFDI)

Complete Advocacy or PCMH Project in Community Practice

Didactic Component

Pediatric Department Residency Teaching sessions: Morning Report (M-Thur, 8 a.m. via teleconference if away); Noon Conference (M-Thur, 12 noon via teleconference if away); Grand Rounds (Friday 8 a.m., via teleconf. If needed).

MUSC General Pediatric Residency Program

Continuity Clinic at Pediatric Primary Care SiteIntern (PL1) Rotations Modified PL2 rotations Modified PL3 rotations

Learning QI constructs

Group Planning for

Project

Plan Project/PossiblyConduct Project

Complete Advocacy or PCMH Project in Community Practice

Attend Present Poster at SC AAP Chapter Meeting

Present PCMH or Advocacy Project at PAS

Yellow indicates experiences unique to PCT

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Required in Current

• Residency Review Committee requirements (25 required blocks): – Inpatient: 5 blocks – ER: 4 blocks– NBN Nursery: 1 block– ICU: 5 blocks (3 months NICU, 2 blocks PICU)– Adolescent : 1 block– Behavior/Development: 1 block– Subspecialty: 7 blocks (don’t have to be inpatient)– Advocacy: 1 block

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Breakdown of Blocks for PCT

• Therefore, the required blocks will take up 25 of the 36 available to PCT residents, leaving 11 for other activities.

• Nine of those blocks will occur in the PCT community training sites, with the other 2 available as electives in addition to the electives the residents have available as part of their subspecialty allotment of 7 blocks.

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What Will Potentially Be Removed?*

• 1 Subspecialty wards• 3 Inpatient General Wards• 1 Elective• 1 NICU• 2 Elective/NFF• 2 ED• 1 Pediatric Surgery

• * Note: schedule can be modified to some degree with input from trainees, so these are

proposed

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PCMH Education:

• We plan experiential PCMH learning for the PCT residents.

• PL1 and PL2 years complete directed readings about the PCMH.

• Work with Practice Manager in Georgetown to learn about– Rural Health Clinic and Federally Qualified Health Center

Designation– Learn billing and collection issues

• EBM/QI project will be completed in one of the community sites, designed to evaluate, improve, or implement a functionality of the PCMH.

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Community Preceptors and Sites

• Henry Lemon, MD, MSCR – MUSC Children’s Care, Northwoods. – 14,500 visits per year.

– 65% Hispanic, 24% black, 8% white, and 3% other.

– Insurance 93% Medicaid ,2.6% private insurance , 4.4% uninsured.

– 6 weeks here in each of Years 2 and 3 of residency

• Paul J. Hletko, MD –Georgetown Pediatric Center (GPC). – 28,000 visits per year.

– Patient population 52% Black, 40% white, 8% Hispanic.

– Insurance 67% Medicaid, 23% private insurance and 10% uninsured.

– 3 MONTHS here in each of Years 2 and 3 of residency

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Novel Benefits for PCT Trainees:

• Attend State AAP meeting yearly• Be in the forefront of our tele-education efforts• Be in the forefront of our tele-medicine efforts with subspecialists• Get to learn what it is really like to be an ambulatory physician• Get to experience increased ambulatory training while also being at a

tertiary center• Learn more about practice management than regular track residents• Planning to add additional Devel Peds and or Child Psychiatry time• Become part of a community, and learn how a physician operates in a

community

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Frequent Concerns

• You are not obligated to go into primary care, nor is there a financial penalty for not doing so

• You ARE obligated to stay in PCT (not switch to MUSC’s other track) as space may not be available in the current categorical track

• You are obligated to fulfill the community training time – this can’t be modified because of the grant obligations

• Georgetown housing paid for• Travel to-and-from Northwoods and Georgetown

reimbursed

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Questions?

• Residency Coordinator – – Becky Hasegawa: [email protected]

• Residency Program Director – – Mike Southgate: [email protected]

• Grant Director – – Bill Basco: [email protected]