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CORD Meeting Agenda May 18
12:30 - 1:30 pm CORD Business Meeting
3:00 - 3:45 pm Roundtable Discussion
New Program Directors' Workshop
CORD will sponsor a new program directors orientation workshop again this year in conjunction with the SAEM meeting in May. This will be held on Monday, May 18 from 8:00 am - 12:00 noon in the and is free to all CORD members, although it is geared to those program directors who have been in their position for 3 years or less and assistant program directors. The agenda is below. Please let the CORD office know if you will be attending to ensure that there are enough handouts.
| 8:00 - 9:00 am | Living by the Program Requirements - RRC-EM |
|---|---|
| Larry Sulton, PhD and Joe Clinton, MD | |
| 9:00 - 9:30 am | The Nuts and Bolts of Resident Remediation |
| Carey Chisholm, MD | |
| 9:30 - 10:30 am | Motivating and Mentoring Residents - panel discussion |
| Glenn Hamilton, MD, Rita Cydulka, MD, Tiffany Medlin, MD | |
| 10:30 - 11:15 am | ABEM Issues and Procedures |
| Dan Danzl, MD and ABEM staff | |
| 11:15 - 12:00 noon | Conflict Negotiation and Resolution |
| Louis Binder, MD |
President's Message "Update of the Cord Task Force and Committee Activities for 1997-98"
I am taking this opportunity through the President's Message to summarize CORD committees and task forces activities for 1997-1998. Committees and task forces have been quite active this past year. First of all, I would like to thank each committee chair and member for its dedication to CORD.
Some of the committees and task forces will be carried over to 1999 to complete their objectives. Some task forces will be dissolved as their objectives have been completed. There will be some changes in membership on committees and there will possibly be the establishment of new task forces. Any CORD member interested in participating in committees and task forces, please contact me to let me know of your interest prior to or during the CORD meeting.
The Faculty Development and New Program Director Orientation Committee has an outstanding New Program Directors Workshop scheduled May 18, 8:00 a.m.-12 noon. This orientation workshop is free to CORD members and is geared to program directors 3 years or less in the position as well as assistant program directors. The Faculty Development course for 1997 did not have as many registrants as the previous years' course due to location and competing courses. Nonetheless, the course was felt to be successful and was of high quality. The board of directors decided to continue the faculty development course due to the success and quality but to look very closely at the location for the upcoming year. The location for the 1998 course will be announced after the SAEM meeting.
The SLOR Task Force revised the SLOR this past year and has received input from the membership on suggestions for revisions. SLOR continues to be viewed as a valuable tool for program directors to assess applicants.
The Program Directors Monograph Task Force has been busy and will complete their objective of producing a monograph for program directors by the SAEM meeting. The monograph will contain information regarding timelines (cyclical deadlines) commonly called upon organizations, job descriptions and other useful information for program directors. The CORD Board of Directors will review and subsequently anticipate approving the monograph project distribution to the membership. The Electronic Residency Match Task Force monitored ERAS activity this year. It has been a tremendous asset to CORD in bringing about a very successful year involvement of emergency medicine in ERAS.
The Nominating Committee fulfilled its objective of nominating CORD members for board election and they have selected the recipients for the CORD residents and faculty award. Members who are standing for election and the CORD awardees are featured in this newsletter.
The EKG Bank Subcommittee of the Curriculum Committee has developed an EKG teaching file for program directors that is electronic, interpretation linked and case linked. The proceedings of the EKG Subcommittee will be on display at the SAEM meeting.
The Bylaws Committee reviewed and recommended revisions to the Bylaws for the May, 1998 CORD meeting. Specifically, the Bylaws committee reviewed participation by non members and the process of appointment versus election to fill unexpired terms. The Bylaws Committee proposed recommendations for revisions for 1998 are outlined in this newsletter.
Dr. Joseph LaMantia, one of the two CORD CAS-AAMC representatives, attended the CAS Spring meeting. Joe reports that the consistent theme during the CAS meeting was the need to develop new structure processes in the academic medical center to meet the challenges both from within and outside academic medicine. From the perspective of the emergency medicine program director several issues have particular relevance and importance. Please see Dr. LaMantia's report in this issue of the Newsletter.
The CPC Task Force has organized the annual Regional CPC Competition which will occur on May 16 in Chicago. 50 programs will be participating and details are included in this Newsletter.
Sam Keim, MD, and Carey Chisholm, MD, served as the CORD representatives on the Core Content Task Force in the past year. They have prepared an update which is included in this Newsletter.
The Organization of Resident Representatives (ORR) have done a find job. An outstanding report submitted by Rebecca Parker appeared in the last issue of the Newsletter.
The Program Committee has done an outstanding job in arranging the 1997-98 CORD programs. An outline of the CORD Meeting which will be held on May 18 is included in this Newsletter. I look forward to seeing you in Chicago.
Marcus Martin, MD
University of Virginia
Match Update from the University of Illinois
As many of you are aware, this year's match was altered by an unfortunate chain of events which involved the University of Illinois Emergency Medicine residency program. Due to a clerical error, the residency was over booked by 18 positions. The number of positions reported to the NRMP was 36 (the size of the entire residency) instead of the correct 12 position quota. The error went undetected until Monday, March 16 (48 hours before Match Day) when the UIC Emergency Medicine residency was informed that they had matched 30 new residents with six unmatched positions. In the 20 year history of the program, this was the first time it had been listed as "unmatched." The residency program staff labored feverishly in an attempt to remedy the situation once the match officials stated they were unwilling to re-run the match.
On March 16, the NRMP placed some of the students who had listed other programs on their rank list into these programs if positions were available. The UIC residency program then worked on placing the remaining students into other EM programs which had unfilled positions or were willing to increase their quota of first year positions. Following immediate/temporary approval from the RRC, UIC expanded its EM residency to accommodate two extra positions in the straight three year program and one extra position in the combined IM/EM program to place the overmatched applicants. Obviously, the program could not take all 30 applicants.
The UIC EM residency has done everything possible to help accommodate these applicants. As of Match Day, (March 18), 17 of the 18 applicants were placed in other residency programs. The remaining student has several options and will soon be properly placed. The UIC staff extends its thanks to those programs who were willing to assist during a very trying time. We are extremely apologetic for any "ripple effect" this over booking may have caused in other residency programs. At no time was there calculated ill-will or competitive motives to "scoop" top notch applicants away from other residencies.
The lesson we learned was the necessity to tighten the lines of communication with the National Resident Matching Program. This mistake occurred and was propagated all too easily and a more advanced, "fail-safe" system is needed since repercussions of mistakes are great. The UIC EM residency hopes that we can work together to assure this never happen again, to any program.
Jackie Strange
EM Residency Coordinator
University of Illinois, Chicago
Award Recipients Announced The Nominating Committee is please to announce the recipients of the CORD Awards which will be presented during the CORD Business Meeting on Monday, May 18 between 12:30 and 1:30 pm.
CORD Resident Academic Achievement Award
CORD is pleased to announce the selection of Stephen W. Burgher, MD as this year's winner of the CORD Resident Academic Achievement Award. This award recognizes a resident who has demonstrated great potential as a future academic faculty member. Dr. Burgher is currently chief resident in the Portsmouth Naval Medical Center, Emergency Medicine Residency Program. He has been instrumental in developing and implementing two original research projects during his residency, both resulting in regional and national presentations; published abstracts; and manuscripts submitted to emergency medicine journals. He teaches Pediatric Advanced Life Support, Advanced Cardiac Life Support, Advanced Trauma Life Support, and is authoring a chapter for Emergency Medicine Clinics in North America. He also has developed the program's computer-generated residency logo which won first place at the 1997 SAEM Annual Meeting Photography Competition.
Kevin J. Knoop, MD, Program Director of the Naval Medical Center Emergency Medicine Residency, offered these comments about Dr. Burgher in his nomination letter: "Dr. Burgher has demonstrated all the facets of an outstanding future academic faculty member during his residency. He has been at the top of this class clinically and academically from day one. Formal monthly evaluations from faculty and rotating interns have consistently documented his avid teaching and superb clinical skills. Each of his emergency medicine conference lectures has been rated as outstanding by attending staff...Dr. Burgher's academic enthusiasm and productivity as a resident has truly been impressive. He has gone above and beyond in his efforts to learn and practice academic emergency medicine. His hard work and leadership have directly benefited his fellow residents and set the stage for future residents to follow in his footsteps. His accomplishments have brought great credit upon himself and upon our young program. I can think of no one more deserving to receive this prestigious award recognizing resident academic achievement."
CORD Faculty Teaching Award
CORD is pleased to announce the selection of Gregory W. Hendey, MD, as this year's winner of the CORD Faculty Teaching Award. The award recognizes the contributions of a junior faculty member to the education of emergency medicine residents. Dr. Hendey is Assistant Clinical Professor of Medicine at the University of California, San Francisco and is the Residency Director of the Emergency Medicine Residency Program at Valley Medical Center, Fresno, California. He co-directs the Department's Research Committee and is the Medical Director of the Air Ambulance Program and elective resident rotation.
Dr. Hendey completed his emergency medicine residency training at the University of California, Los Angeles Medical Center and was the Chief Resident in his final year of training. He is a graduate of the ACEP Teaching Fellowship and has served on the ACEP Educational Meeting's Committee. He serves as a reviewer for the Annals of Emergency Medicine, Journal of Emergency Medicine, and Pediatrics. He is a member of CORD and participated in the development of the standardized medical student evaluation form. He is a past recipient of Valley Medical Center's Housestaff Faculty Teacher of the Year Award.
Herbert G. Bivins, MD, Emergency Medicine Program Director at Fresno, offered these comments about Dr. Hendey and his teaching in his nomination letter: "Dr. Hendey's fairness and dedication to the residents in EM resident education is unsurpassed. His conferences, which include a wide variety of topics, are well developed, delivered and received...His enthusiasm and leadership has led to increased resident participation and interest (in research)...There has not been a junior faculty member who has had a bigger impact on resident education in our residency program."
Slate of Nominees
During the May 18 CORD meeting an election will be held for the following position: one Board member-at-large (3 year term). The Nominating Committee has selected the following slate of nominees for the position and nominations from the floor will also be accepted.
Board Member-at-Large
Susan Dufel, MD, is Program Director of the Integrated Residency in Emergency Medicine at the University of Connecticut Health Center, and an Associate Professor of Emergency Medicine in the Department of Traumatology and Emergency Medicine. She graduated from Northwestern Medical School in 1980, completed an emergency medicine residency in 1983 at St. Vincent's Medical Center/Toledo Hospital, and completed a fellowship in administration in 1984 at EMS Miami Valley Hospital. Dr. Dufel is a member of the CORD Program Committee and served as an item writer and section editor for the CORD Question and Answer Bank in 1993 and 1998. She has been an ABEM Examiner since 1987 and a reviewer for Academic Emergency Medicine (1996-1998).
Joseph LaMantia, MD, is the Director of the Emergency Medicine Residency Program at North Shore University Hospital. Dr. LaMantia graduated from the State University of New York at Brooklyn Medical School in 1979 and completed an internal medicine residency in 1982 from Johns Hopkins Bayview Medical Center. He has served as the Chair of the CORD Program Committee and as a member of the SAEM Geriatric Task Force, serving as chair of the task force (1997-1998). Dr. LaMantia served on the SAEM Education Committee (1989-1993), the Faculty Development Subcommittee of the SAEM Education Committee (1991-1993), and the SAEM National Consensus Group on Clinical Skills in Emergency Medicine Task Force (1993-1997) and served as the chair of the Task Force (1996-1997). Dr. LaMantia is an ABEM Oral Examiner and has served as a CORD Representative to the AAMC-CAS.
New Program Approved by RRC-EM
During the February meeting of the Residency Review Committee for Emergency Medicine, a 1,2,3 program was approved (8 residents per year). This brings the number of approved programs to 120. CORD congratulates this program!
Saginaw Cooperative Hospitals, Inc.
Robert W. Wolford, MD
Saginaw Cooperative Hospitals, Inc.
Emergency Medicine
1000 Houghton Avenue
Saginaw, MI 48609
Telephone: 517-771-6817
Fax: 517-754-2741
e-mail: rwolford@concentric.net
ECG Task Force Annual Report
Since our October meeting, the ECG Task Force has been busy setting-up the mechanics for ECG submission, storage and processing. An in-depth investigation and trial of the optimal search engine was the first priority. We did not want to solicit yet ECG submissions from the CORD membership. The interpretation, editing, and processing of such ECGs would have required considerable work that had a great risk of not being used due to incompatibility with the final electronic format. We have determined that the best search engine to browse optimally through the website, the links, and the Excel database, would be Cold Fusion. CORD members would be able to search quickly for specific needs that they would indicate. Cold fusion allows great flexibility accessing and filing the ECGs, scenarios, teaching points or multiple choice questions we plan to provide. Cold fusion will also allow us to keep track of users, to approve or deny access to users, and potentially to allow a user to log in and pick up where they last left off, if going through a preset series of cases.
The process we are setting up involves downloading electronic data for any specific ECG that a CORD member wishes to contribute unto a floppy. We would provide you with instructions on how to do that from heart stations at your individual institutions. Various Marquette editions are out there (over 6 we have identified so far). We have worked with Marquette and now can directly download ECG images from archives as digitized raw data. This digital data may be used to redraw the tracings at original resolution. The data for each individual ECG can be saved as 15k files onto floppies in any contributing institutions. They are then forwarded to us via e-mail as files or via post, and processed via programs secured unto an excel macro we are designing. Data would be transformed into Excel files that can be plotted using Java as an actual ECG on your screen.
The quality of the scan would be outstanding and homogeneous. No need for lengthy and faulty cleansing of ECG copies. We would also avoid the impact of grids and artifact on quality of the final product. We would no longer need to sacrifice the quality of what you view during scanning, compression and cleansing of paper ECG submissions. File size, search and downloading time would be small. CORD would then have a state-of-the-art educational program that has not been designed or conceived of by any other specialty. It would be one where quality and potential for development are tremendous. It would also be definitely easier to edit and maintain.
The links, clinical scenarios, and teaching points for each submission would be available, processed, and edited as demonstrated in October in San Francisco. The 3-frame format will still be used. Individual CORD contributors and their institution would be acknowledged on the text relevant to that ECG.
We are also working on a relational database, in Access, to store all of the ECGs and related clinical scenarios and teaching files. The database will make use of an exhaustive Excel spreadsheet of descriptions of ECG abnormalities which will be used to catalog each tracing. The access database is being designed to allow for storage of more than one set of teaching points for each ECG, so that we could have a basic set and more advanced sets to accommodate different levels of users (students, residents, paramedics).
The project could be done without Cold Fusion and the Access database, by simply coding all of the links between html pages. If we go that route, we loose a huge amount of flexibility and ease of updating and improving the collection of cases, not to mention some of the database search functions like retrieving all ECGs demonstrating a specific abnormality, heart rate, etc. We shall face two difficulties: 1) Institutions that do not utilize Marquette would be at least initially at a disadvantage in their ability to submit ECGs for the bank. 2) Many of our interesting ECGs that many of us have collected over the years would not be useful unless they can be located using [date + name and/or medical record] in our individual heart stations. On the other hand, we also found out that in theory any old ECGs can be retrieved and processed irrespective of the MUSE edition or year it was taken.Finally, we are presenting the most recent version of the project as one of the Innovation in EM Education Exhibits at the SAEM Annual Meeting in Chicago. We hope to have an actual prototype ready to demonstrate the website in Chicago - using a laptop, a modem and basic software. We will use a limited number of ECGs in that demonstration. We plan to begin soliciting ECG submissions and designing clinical scenarios and teaching points after the meeting. We thank you for your support and welcome any comments or suggestions.
Antoine Kazzi, MD
University of California, Irvine
CPC Regional Competition
The annual CPC Regional Competition will be held on Saturday, May 16 in the Ohio, Mississippi, Colorado, and Erie rooms of the Sheraton Hotel in Chicago. Sixty-seven cases were submitted and 50 selected for presentation. Thanks are due to the 100 residents and faculty who will match wits in the presentation and discussion of interesting cases. This year the the CPC has been approved for 7 hours of category I credit. There is no registration fee to attend the CPC Competition and all CORD members are urged to attend and support the residency programs.
The regional coordinators and judges will evaluate the presentations and will select the Best Discussant and Best Presenter from each of the five competitions. These recipients will be announced during the CPC Reception which will be held at 5:30 pm-6:30 pm and will compete in the National CPC Competition at the ACEP Scientific Assembly in San Diego on October 13.
Bylaws Amendments
Each year the CORD Bylaws are reviewed for potential amendments which should be brought before the membership for consideration. On January 26, the CORD Board of Directors approved the amendments proposed by the Bylaws Committee. The following amendments are provided for the membership's consideration at the annual business meeting on May 18:
Article III, Section 3: Each full member and associate member program shall pay annual dues to the organization an amount to be determined by the Board of Directors. Member privileges will be suspended if dues are six months past due. Membership will terminate if dues are 12 months past due. Any program whose membership has been canceled for failure to pay dues shall lose all privileges of membership.
Article V, Section 6: A. Annual election of officers and members-at-large of the Board shall take place during the semiannual meeting that is held in conjunction with the SAEM meeting. The President shall appoint members to fill vacancies and unexpired terms on the Board of Directors until the next scheduled election.
Article XI: These bylaws may be altered and amended at any time in accordance with Article IV Section 4 of these Bylaws at any properly noticed meeting held for that purpose. proposed amendments shall be submitted in writing to the CORD office by any full member forty five (45) days prior to the meeting.
Council of Academic Societies Spring Meeting, March 26-29, 1998
Five plenary sessions were held:
Specifically within academic medicine there is:
Joseph LaMantia, MD
CORD Representative to CAS/AAMC
Emergency Medicine Residency Coordinators' Forum
The inaugural Residency Coordinator's Forum will be held on May 18-19 in the Ohio Room of the Sheraton Hotel in Chicago. The goal is to provide information, networking opportunities and sharing of ideas between residency coordinators and the national organizations associated with academic emergency medicine. Topics will include presentations from the ABEM, RRC-EM and CORD; the Electronic Residency Application Service; recognizing the problem resident; the interview process; conference and alumni tracking; and resident evaluations. The registration fee is $150 and includes handout materials, continental breakfasts, and lunch. To register, contact Marie Wegeman, 504-387-7870 or fax at 504-387-7872.
Avoiding Legal Pitfalls Related to Residents - Part II
Resident Evaluation / Discipline
Hypothetical Case
You believe that a resident, who entered your program in his second year, misstated information in his employment application, forged a letter of recommendation, and has questionable credentials. You discovered this inadvertently when you were reviewing his personnel file and discovered an earlier application, which had distinctly different information in it. In addition to the misstatements in his application, he has also engaged in misconduct in his program which has placed patients at risk.
Core Content Task Force Update
The Core Content Task Force has concluded its work with a report distributed in March. The recommendations are
printed below. The full report is availabe upon request from the CORD office. The members of each of the parent
organizations should review the work to date and send comments to their respective boards. If the patent
organizations approve Task Force #2 would continue on toward the development of a revised Core Content based
upon a practice analysis. Despite formidable political differences with some other members of the Task Force, the
CORD Board is eager to move forward with Task Force #2. Please send your comments to the CORD office at
517-485-5484 or Sam Keim, MD at
Task Force #1 Recommendations:
There should be some continuity from Task Force #1 to Task Force #2 as it will be difficult to pass along the full sense of the work of the first task force. Each organization should decide who its representatives to Task Force #2 will be. Any individuals who are new to the process should be oriented to the project prior to the first meeting of Task Force #2.
Carey Chisholm, MD
New Chief Resident Forum to Precede Annual Meeting
On Saturday, May 16 in the Superior Room of the Sheraton Hotel, the inaugural Chief Residents Forum will be co-sponsored by SAEM, CORD, and EMRA. This Forum was developed to assist newly appointed Chief Residents
in meeting the demands and responsibilities during the upcoming academic year. Historically, few Chief Residents
have had any prior exposure to skill sets vital to the performance of their job. Many indicated that such skills
developed through a period of trial and error, which unfortunately added to the stress of the position and diminished
effectiveness. It is also anticipated that enrollment in the newly developed Chief Resident list server will occur,
along with the opportunity to begin peer networking for future problem solving. The planning committee for the
Chief Residents Forum is Rita Cydulka and Steve Dronen (SAEM), Carey Chisholm and Steve Hayden (CORD),
and Cherri Hobgood and Henry Souto (EMRA).
Registration is limited to 200 participants and the registration fee is only $90, which will cover the costs of breakfast,
lunch, and audiovisual equipment. Over 100 chief residents have already registered. Contact the CORD office or
complete the SAEM Annual Meeting registration form to register your chief residents.
The schedule of events is as follows and a special thanks is due to all the faculty members who have donated their
time and energy to make this Forum a success:
Indiana University - Methodist
Sam Keim, MD
University of Arizona
7:30 - 8:00 am Registration and Continental Breakfast
8:00 - 8:05 am Welcome & Overview
8:05 - 8:30 am Optimizing Your CR Experience, Pam Dyne, MD, Olive View-UCLA
8:30 - 9:00 am RBC-EM: How a Residency Works: Debra Perina, MD, University of Virginia
9:00 - 9:30 am Transitioning to a Leadership Role, Kevin Rodgers, MD, Brooke Army Medical Center
9:30 - 9:45 am Break
9:45-10:30 am Staying Organized/Time Management Skills: Carey Chisholm, MD, Indiana University-Methodist 10:30 - 11:30 am The Resident in Crisis/Recognizing Impairment/Confidentiality, Bob McNamara, MD, Allegheny University of the Health Sciences
11:30 - 1:00 pm Lunch
1:30 - 1:45 pm Scheduling & Back-up Systems: Rita Cydulka, MD, MetroHealth Medical Center
1:45 - 2:30 pm Middle Management Techniques for the CR: Bob Knopp, MD, Regions Medical Center
2:30 - 2:45 pm Break
2:45 - 3:30 pm Teaching Skills for the CR: Steve Hayden, MD, University of California, San Diego
3:30 - 4:00 pm Dealing Ethically with the Biomedical Industry: Sam Keim, MD, University of Arizona
4:00 - 4:30 pm Developing Academic/Research Skills: Steve Dronen, MD, University of Michigan
4:30 - 5:30 pm Panel Discussion: Beyond the Macy Conference: Emergency Medicine in the 21st Century: Glenn Hamilton, MD, Wright State University
Louis Ling, MD, Hennepin County Medical Center Peter Rosen, MD, University of California, San Diego