How do residents/fellows "study" in a residency/fellowship? How are they "graded?"
Residents take and study for yearly in-training exams throughout residency, to prepare for the test they will take at the end of their training, in order to become board certified in their chosen specialty, i.e. internal medicine, pediatrics, psychiatry. (The in-training exam is a practice version of the board certification exam, so they study regularly for this. They also take licensure-related exams, called Step exams, to complete a series, i.e. Step 1, 2 and 3, which they start in medical school. Step 3 is the last step and that is taken during residency, so that is another exam that they study for, in addition to their clinical work.) Residents and fellows are evaluated throughout the year based on the following six core competencies determined by the ACGME: patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice. The evaluation system uses milestones, which the residents and fellows must achieve, in order to get to the next level and be promoted within their program and ultimately graduate, and all of this relies on feedback from their attending physician faculty, staff members, patients and peers.
Please discuss how new residents and fellows are chosen.
Most new residents and fellows are selected through the
National Resident Matching Program
. (Some fellowship programs do not participate in this but nearly all residency programs and most fellowship programs do.) Medical students submit their applications in the fall of their fourth year of medical school, travel for interviews typically in the fall/winter months, then submit a rank list of where they would like to go. Programs submit a rank list of the applicants they want to recruit. The results are released in mid-March on
, when everyone finds out where they are going to be for residency on July 1. On Match Day, the GME Office goes to work to start on-boarding the next class of new residents and fellows.
How many more residences would you like to see in Las Vegas?
I would like to see every specialty and subspecialty of adult and pediatric medicine offered in our GME programs in Southern Nevada. Our community has grown to deserve (and should demand) this level of care and medical expertise.
How many residencies do new doctors apply for?
It depends on the program, but the application numbers have gone up in recent years due to increased competition. Fourth-year medical students typically apply to at least several programs (ranging 4-8), but some can apply for many more.
How are doctors chosen to be the "faculty" for each residency/fellowship?
The ACGME specifies that faculty must be board-certified (or have equivalent qualifications) in their specialty or subspecialty field, so they are held to that standard for competency. The residency and fellowship program faculty have a passion for teaching, often years of experience in an academic setting, but all have some alignment with our mission of education, research and clinical service in a GME setting.
Has your team heard from SOM students who wish there were more residencies/fellowships here?
Yes, and so we are working on bringing more fellowships online and are already expanding our current programs in psychiatry, ob/gyn, critical care medicine and critical care surgery.
How does your team support residents/fellows?
The GME team provides support through their individual roles. In addition, the GME office serves as a safe space for residents and fellows to bring concerns and have issues addressed that may be going on within their programs or the institution at-large. Our office also provides assistance with processing of loan deferment requests, acts as a liaison with HR, sponsors several subcommittees on topics important to the residents/fellows such as well-being, space/learning environment, and policy creation/review. We also carry out the Graduate Medical Education Committee (GMEC) meetings, which bring the core residency program directors, program coordinators and residents together to discuss important accreditation, program and institutional issues every other month. The GME Office hosts an annual resident/fellow research day, a chief resident retreat (for the new/incoming senior-level residents) and institution-wide orientations for new residents and fellows each year. We have an annual Program Director Retreat for the faculty as well. The GME Office also funds residents and fellows to travel around the country to present their research at national conferences.
We often hear that residents/fellows work many hours? How many hours can they work?
Per ACGME requirements, residents may work no more than 80 hours per week with one day off in 7, averaged over a 4 week period. The GME Office and residency/fellowship programs monitor work hours closely and make schedule adjustments to stay in compliance.
Please describe the role of each of your staff members.
Dr. Kate Martin, Associate Dean for GME
- Collaborates with internal (SOM Chairs, GME Program Directors) and external (UMC Hospital, VA) stakeholders to align GME programs with the mission of the university and develop long-range strategic plans for academic initiatives, secure sufficient institutional resources for design and implementation of GME programs. As Designated Institutional Official (DIO) for the university, ensure the GME programs maintain compliance with ACGME accreditation standards.
Priscilla Manrique, GME Director
- Engages the GME team/oversees the GME office operations, including verifying the financial spreadsheets, maintaining accreditation survey results and responses for all of the GME programs, assisting with strategic planning for GME, staying up-to-date on institutional accreditation requirements. Serves as a point of contact for residents and fellows, including as chair of our resident/fellow wellness subcommittee.
Megan Cortney, Institutional Coordinator
- Trains new residency and fellowship program coordinators, provides support to current program coordinators, assists with onboarding process of new residents/fellows, collaborates with community partners to obtain/renew ACGME-required program letters of agreement (PLAs) for educational and financial support of programs.
Nicole Sherman, Financial Specialist
- Prepares GME budget, including monthly financial reports that involve billing for the resident and fellow rotations, works closely with residency and fellowship programs to obtain accurate information regarding resident/fellow work hours and invoices associated with their time commitments. Assists residents and fellows by making their travel arrangements so they can present their research at national conferences.
Tessa Newman, Administrative Assistant IV
- Coordinates schedule and manages the Associate Dean's calendar, maintains compliance of required activities for the residents/fellows, such as fatigue awareness and sexual harassment training, yearly flu shot and TB test records, creates graduation certificates for the residents/fellows, transcribes the Graduate Medical Education Committee (GMEC) and other GME meeting minutes, manages classroom reservations for the GME programs, is the first-line employee to greet someone who enters the GME Office.
Diana Anguiano, Student Worker
- UNLV pre med student who joined the GME team a year ago, works on special projects, including assisting with the upcoming holiday party for the residents/fellows, delivering food/drink to their work spaces at the hospital, scanning/organizing all of the resident/fellow records from the past to present, which comprises the majority of her time.
Adnan Mohsin, Surgical Skills & Simulation Lab Coordinator
- Supports simulation and skills lab activities that residents and fellows perform at the Simulation Center as part of their training program, i.e. suturing workshops, simulated surgical procedures.
Belen Adams and Rosetta Maravilla, American Sign Language Interpreters
- Members of the GME office, although not picture. They provide ASL interpretation services.