Benefits of developing graduate medical education programs in community health systems.

The creation of new CMS-funded Graduate Medical Education (GME) cap positions by the Consolidated Appropriations Act 2021 offers a unique opportunity for systems in community and rural settings to develop and expand their training programs. This article provides a review of the evidence behind the value proposition for system administrators to foster the growth of GME in community health systems. The infrastructure needed to accredit GME programs may reduce the cost of care for both the patients and the system through improved patient outcomes and facilitation of system efforts to recognize and mitigate social determinants of health. Residents, fellows and medical students expand the capacity of the current healthcare workforce of a system by providing coverage during healthcare emergencies and staffing services in difficult-to-recruit specialties. Those trainees are the nucleus of succession planning for the current medical staff, can facilitate the creation and expansion of service lines, and may elevate the profile of the system through scholarly work and equity and quality improvement activities. While creating GME programs in a community health system may, at first glance, be perceived as cost-prohibitive, there are robust advantages to a system for their creation.

Remote onboarding and training of new program coordinators into the medical education office during Covid-19 social distance quarantine: process and recommendations.

BACKGROUND: The Medical Education Office at Rochester Regional Health was required to remotely onboard and train its new program coordinators using telework during the Covid-19 quarantine restrictions mandating all non-clinical administrative staff work from home. OBJECTIVE: To implement a remote onboarding and training process for new program coordinators that would introduce solutions for learning new tasks, maintain business operations effectively, and prevent employee feelings of isolation. METHOD: The System Director of Medical Education implemented eight actionable items to remotely train the new program coordinators, consisting of creating a virtual workday, planning for purposeful learning, developing spreadsheets for process flow, engaging other staff for mini-tutorials, scheduling remote meet and greets, assigning supplemental self-learning modules, establishing standard virtual meeting formats, and conducting regular one to one check-ins. RESULTS: Recommendations for successful results during training are to be specific in communication, think a step ahead and reassure the employee. CONCLUSION: The Medical Education Office successfully used the eight actions as a remote onboarding and training platform for new hires.

Evaluating the potential merger of two internal medicine residency programs: process and recommendations.

Background: Economic forces have led to significant consolidation within the health-care sector, but the effects of hospital mergers on graduate medical education programs are not well studied. Academic leaders may be expected to operationalize an institutional merger through educational program consolidation. Through a case study of our potential GME program consolidation, the authors present a helpful model for assessing the practicality of a program consolidation and share lessons learned. Methods: A novel exploratory process assessed the viability of four levels of integration for two internal medicine programs within a merged health system. Focused interviews with outside organizations, literature review, SWOT analysis by stakeholders, and a semi-quantitative scoring system resulted in the final recommendation to health system administration. Results: The two internal medicine programs will pursue educational and administrative synergies but will not merge. Discussion: Common challenges facing GME leadership in assessing the viability of a merger include: different organizational culture, mistrust of intentions, lack of a shared vision, lack of communication, and managing the pace of change to prevent erosion of the learning environment. Overcoming these challenges is best accomplished by establishing shared values, recognizing synergies and estimating organizational compatibility. Maximizing faculty and resident interactions while performing combined QI projects, research, or didactics can build trust over time and change the cultural norm. Early successes are vital to the process. Finally, even if residency programs do not merge, they should have common salaries and benefits so that disparities do not engender further distrust.