How to Survive a Site Visit

1. How to Survive a Site Visit Doreen J. Addrizzo-Harris MD Program Director Pulmonary Section Chief New York University School of Medicine

2. Site Visits • Who has never been through a site visit? • Who will undergo a site visit this year? • Who has been through a site visit in the last year?

3. Key points for a successful site visit • Be organized • Be truthful • Be well aware of the requirements: • Institutional Requirements • Common Program Requirements • Subspecialty Program Requirements • Subspecialty FAQ • Program Letter Requirements • www.ACGME.org

4. Key points for successful site visit • Share resources amongst other subspecialty program directors within and outside your institution. • Be sure your fellows are happy and deal with issues they may have about the program or faculty as best you can before the site visit. • Educate your faculty and fellows • Multiple faculty and fellow meetings • Fellow selection (self selection)/chief fellow • Rehearse • Mock Site visit

5. Program Files • see enclosed list

6. Program Files • Program letters of Agreement • Required for rotations of one month or longer • Required for institutions with different governing bodies • Identify the faculty • Specify teaching, supervision and formal evaluation of fellows • Duration and content (curriculum) • Policies and procedures • Not older than 5 years • Signed by program director and site director (plus DIO)

7. Pulmonary / Critical Care Medicine Fellowship Lines of Reporting IM Residents and Team Chief Resident Director of Service/Unit Pulmonary/ Critical Care Fellows Pulmonary/Critical Care Attending Program Director Pulmonary and Critical Care Medicine (Dr. Addrizzo-Harris) Program Director Internal Medicine (Dr. Ellen Pearlman) Division Chief Pulmonary/ Critical Care Medicine (Dr. William Rom) Chair of Medicine (Dr. Martin Blaser) Direction of arrow indicates reporting relationship

8. Program Files • Program Policy manual (handout) • Conference attendance record • Copies/ web-based/ print available for those who missed lecture • Duty hour policy • Mechanism for relief if over • Dates of revision and distribution • Evidence of duty hour monitoring • Including monitoring of home call and moonlighting

9. Program Files • Documentation of internal review (cover sheet only) • Annual program evaluation of faculty and curriculum • Minutes of faculty meeting addressing curriculum with fellow representation • Written curriculum with increased responsibilities for each level of fellowship • Goals and objectives • On-line resident survey and program’s response to any deficiencies

10. Program Files • Autopsy reports and distribution to fellows • Sample evaluations/schedules/conferences • Supervision guidelines • Program Improvement projects • Faculty development

11. Fellows’ Files • Usually most recent graduates and senior fellows • Credentials • If non-ACGME trained, letter of PD, prior to appointment of ABIM policies, etc • If transferring in, written verification from prior program director • Procedure log (indications/complications)

12. Fellows’ Files • Documentation of receipt of moonlighting policy, duty hour policy and curriculum/policies. • Documentation of completion of sleep module or attendance at sleep lecture. • All evaluations • Rotation, research, clinic • Final evaluation with summation statement-- practice competently and without direct supervision • 360 evaluations • Semi-annual • Conference, journal club or chart audit evaluations • Mini-CEX (handout); simulation exercises, OSCE

13. Fellows’ Files • Portfolio (printed out for one or two fellows) • Lectures • Grant applications • Abstract/publications

14. Faculty Files(KCF and PD) • All evaluations by fellows (or summation of) • CV including participation in faculty development • Checklist of receipt of policies, sleep module, curriculum • Documentation of meeting with division chief/program director with regards to faculty portfolio prior to site visit