Scholarly Activity in the Internal Medicine Residency

1. Scholarly Activity in the Internal Medicine Residency Emily George, MD Michael Oravec, MPH June 28, 2019

2. Introduction • We actually enjoy doing this stuff! • We realized that there will be varying degrees of interest in scholarly activity • You probably fall on a scale between “I’d rather swim with piranhas” to “how many NIH grants can I apply for this year?” • We aim to accommodate those who are motivated and make it less painful for those that hate it • ACGME has some minimum requirements for resident and faculty scholarly activity • ACGME broadly defines “scholarly activity” • Research/QI • Case reports/case series • Grand rounds lectures • Teaching formal courses

3. Research/QI faculty • Emily George, MD (Assoc. Dir. IMC/IM Core Faculty) • Project ideas, study design, frame clinical question, presentation • Mike Oravec, MPH (Research Program Director - IM) • Research/QI methodology, study design, statistics, abstracts/posters, nagging • Rose Penix, MPH (QI Program Coordinator, DOM) • Study design, data acquisition and management, CarePATH issues • Joe Myers, MD (Associate PD, Dept. Chair/VPMA Emeritus) • Project ideas, poster/abstract/manuscript guru, expert mentorship • You can work with any faculty on a project, but we need to know what project you are doing so we can track everything appropriately

4. Starting a project • We are your resources! • Please let us know what you are thinking about • Helps to ensure that there are not duplicate projects • We can help refine your clinical question • We help to ensure that you are plugged in with the right people and determine whether you need IRB approval • Some QI projects will need an IRB certificate to proceed if you want to publish or present your project – QI projects are most definitely publishable! • Summa Health Scholarly Activity Handbook available on Summa@Work

5. Starting a project • Please, please, please don’t wait until the last minute to talk to us • It may take 8-12 weeks to get a project full IRB approval • It may take a week or more to get a QI certificate • Please, please, please don’t ask Kathleen Walker (library) for help with a lit review you need in 3 days; give her several weeks at least • Please, please, please don’t ask Steve Getch (media services) for a poster you need printed in 3 days; give him two weeks at least

6. IM Residency Scholarly Activity Requirements/Timeline • PGY1 • Journal Club: 30 min presentation any time during the academic year during noon conference • PGY2 • Case Vignette/Research/QI project presentation (30 min presentation) • Takes place Aug-Oct of PGY2 year • Accompanied by an abstract HANDED OUT AT THE PRESENTATION • This abstract MUST be submitted to a conference (local, regional, or national) • Clinical Pathology Case (30 min presentation) • April-May of PGY2 year • Identify case and a pathology colleague to help you in Feb-March • PGY3 • Morbidity & Mortality (M&M) Conference (30 min presentation) • Takes place Nov-Jan of PGY3 year • Attend Education Committee meeting (ECM) 1-2wks after presentation • Implement project and report back to ECM with completed project charter • Anytime: ongoing research/QI project or elective research month (optional) • Detailed instructions for these available on imsumma.org (eventually summalearner.com)

7. Transitional/Preliminary Residency Scholarly Activity Requirements • All TY and PM residents are required to work on a QI project as part of their ambulatory (IMC) month • Residents will attend QI methodology didactic during this month • TY/PM residents have the opportunity to work on an ongoing longitudinal group project • Last year: improved colorectal cancer screening • This year (potentially): improved use of advanced directives in the IMC • 6-8 half days dedicated time during IMC month to work on project • Transitional/Prelims can do elective research month as well (please note the instructions for planning one!)

8. Research Elective Requirements • You MUST work on one of the following during the month. You CANNOT only write up a case report or a manuscript of previously completed work during the month. • Substantial work towards completion of an original research or QI project (i.e. ~120 hours of needed dedicated time) • Manuscript for review article with faculty mentor • All details MUST be finalized 3 months in advance of your elective** • Project to be worked on • Faculty mentor • Where your research is taking place (i.e. away vs. on campus) • IRB application if required (can take 8-12 weeks) • What your deliverable is for the month (manuscript, number of articles reviewed, number of charts reviewed)- this will be on a case by case basis and Emily and/or Mike can help you ** If the above is not completed, you will be placed on a clinical elective

9. Research Elective Requirements (con’t.) • During your research elective you will be required to: • Attend noon conference daily unless you are post-call • Go to clinic, CBT, and LTC depending on your PGY (not prelims/TY’s or away rotations) • Address your/your buddy’s IMC electronic and paper boxes daily (unless away) • Be on campus with your pager ON from 8am-5pm if you are not physically with your mentor elsewhere • Meet with Emily George and/or Mike Oravec each Thursday morning at 9am unless otherwise arranged. • Approval process for research electives: • Dr. Sweet (IM/PM)/Dr. Jones (TY) must approve your plan • The REEAC Committee (meets twice per month) must then approve your plan

10. Presenting at Regional/National Conferences • You are encouraged to submit abstracts to appropriate regional/national conferences! • Let Mike and Emily know if you submit • Use all available resources (coauthors, Dr. Myers, Mike and Emily, faculty mentors) to make sure your abstract is in the best shape possible! • Please let Program Director, Chief Resident, Dr. Myers, Mike Oravec, and Mary Yanik know if you are accepted • ≈30% of graduating PGY3s have a national presentation/peer-reviewed publication • You can use you Med Ed educational funds for conference attendance • First/presenting authors only may be eligible for additional funding to attend conferences • Summa has in-house printing for posters • Start early once you know you are accepted • Use all available resources (see above) to make sure your poster is in the best shape possible! • Your poster will be reviewed by faculty for quality/accuracy prior to being sent for printing • All posters must be submitted for printing 2 weeks prior to the date you need it • Within 2 weeks, you will be responsible for having poster printed yourself, at your own expense (absent significant mitigating circumstances)

11. Criteria for Authorship on Scholarly Activities • According to the International Committee of Medical Journal Editors (ICMJE), the criteria for authorship for scholarly activities are as follows: • Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND • Drafting the work or revising it critically for important intellectual content; AND • Final approval of the version to be published; AND • Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. • Anyone who is listed as a coauthor on your project should meet the above criteria, and (perhaps more importantly) anyone who meets the above criteria should be listed as a coauthor!  • Discuss authorship early in a project to avoid conflicts at the end.

12. Questions? We’ll be available in the afternoon sessions for Q&A regarding scholarly activities