Identifying Managerial Roles of General Surgery Coordinators: Making the Case for Utilization of a Standardized Job Description Framework.

OBJECTIVE: Residency coordinators are valuable members of the education leadership administration. In General Surgery, program directors must devote time to both their clinical practice and as the leader of the education program for surgical residents. With the introduction of competencies and the Next Accreditation System, the responsibilities of training programs have increased, with much of the necessary day to day management being driven by the residency coordinator. The purpose of this study was to identify the current roles of a residency coordinator in surgery to determine appropriate language for a standardized job description that accurately describes the responsibilities of a program coordinator. DESIGN AND PARTICIPANTS: A survey was created and distributed via email to 317 general surgery program coordinators in programs with continued, initial, or pre-accreditation status by the ACGME in October-December 2017. Questions were asked about coordinator demographics, ADS involvement, and communication with program director, recruitment, and professional development. 223 coordinators (70%) completed the survey. RESULTS: Thirty-five percent of coordinators reported that their program director expects them to complete the annual ADS update in its entirety with a final review by the program director before submission, whereas 15% stated that the program director expects the program coordinator to input, update, and submit the annual ADS update without oversite from the program director. Fifty percent of program coordinators speak with their program director 2 to 4 days a week, whereas 38% speak with their program director daily. Eighty-nine percent of coordinators reported that their program directors trust them to make appropriate administrative decisions during scheduled or emergent absences. Sixty-nine percent of coordinators strongly agreed that they assist their program directors with collating and analyzing recruitment data post-recruitment season. Eighty-six percent of coordinators regularly participate in one or more professional development activities. Forty-six percent of coordinators stated that they oversee administrative staff in their office, division, or department. CONCLUSION: Given the current makeup of today's residency coordinator in general surgery programs, the need for baseline qualifications and a standardized job description allowing for recruitment and retention of a coordinator capable of managing a residency along with a program director. The data from our survey indicate that most coordinators currently perform tasks and take on responsibilities of a manager, but they hold current job descriptions that do not adequately reflect the role. The current proposed ACGME revisions state that there must be a program coordinator for a residency program, citing the coordinator as an integral member of the residency leadership team. Therefore, human resource departments need a job description that identifies level of responsibility, contribution, leadership, and management required of a program coordinator.

The Perfect Storm Is on the Horizon!

PURPOSE: Provide analysis of data identifying the impending mass turnover of Directors and Coordinators of General Surgery residency programs and the potential effect on successful continuing accreditation including the ACGME Next Accreditation System (NAS) and associated self study. METHODS: The Association of Residency Coordinators in Surgery, Executive Committee (ARCS EC) anonymously surveyed 254 general surgery Program Coordinators in September/October 2016. This represents 60`% of all the members within the Association of Residency Coordinators in Surgery. Survey was accomplished using SurveyMonkey. Questions included demographics and experience of the Director and Coordinator, accreditation status, significant job stressors, and potential retirements or position changes planned or possible. RESULTS: 153 (60%) respondents completed the survey. Data from the survey indicates that 67% of Program Directors have been in their position less than six (6) years. 34% of Program Coordinators have been in their position less than five (5) years. 56% of coordinators have been on the job less than ten (10) years. Coordinators in 76% of programs reported significant levels of burnout. 59% have considered resigning from their position in the past year. Participants consistently reported increasing responsibilities and expectations combined with declining or inadequate levels of support as sources of job stress. Other contributors to Coordinator burnout were identified as related to the additional ACGME accreditation requirements and salaries not commensurate with workload. CONCLUSION: This survey represents a sentinel preliminary look at the possible impending manning crisis in general surgery residency program leadership. A Program Director is supported by a Program Coordinators who are burned out and considering a job change. The resultant potential turnover in personnel and loss of collective program knowledge may have devastating ramifications to program accreditation. Subsequent survey of the workforce will evaluate proposed solutions and interventions to prevent this outcome and secure the future success of general surgery programs.

A Monte Carlo study of isomers and structural evolution in benzene-cyclohexane clusters: (C6H6)(C6H12)n, n=3-7, 12.

Monte Carlo simulated annealing strategies, carried out on four different potential energy surfaces, are applied to benzene-cyclohexane clusters, BCn, n=3-7, 12, to identify low-energy isomers and to trace the evolution of structures as a function of cluster size. Initial structures are first heated to ensure randomization, and subsequent annealing yields optimized rigid, low-energy clusters. Five major structural isomers are identified for BC3: one assumes the form of a symmetric, modified sandwich; the remaining four lack general symmetry, assuming distorted tetrahedral arrangements. For BC4 and larger clusters, the number of low-temperature isomers is large. It is, nevertheless, feasible to classify isomers into groups based on structural similarities. The evolution of BCn structures as a function of cluster size is observed to follow one of two primary paths: The first maximizes benzene-cyclohexane interactions and places benzene in or near the BCn cluster center; the competing path maximizes cyclohexane-cyclohexane interactions and distances benzene from the cluster's center of mass. Results for BC3 and BC4 are discussed with reference to experimental results and models previously applied to interpret benzene-argon cluster spectra.

Monte Carlo studies of isomers, structures, and properties in benzene-cyclohexane clusters: computation strategy and application to the dimer and trimer, (C6H6)(C6H12)n, n = 1-2.

Low-temperature isomeric energies, structures, and properties of benzene-cyclohexane clusters are investigated via Monte Carlo simulations. The Monte Carlo strategy is first documented and then applied to (C(6)H(6))(C(6)H(12)) and (C(6)H(6))(C(6)H(12))(2) using four different potential energy surfaces. Results identify a single parallel-displaced dimer isomer. MP2 optimizations and frequency calculations support the Monte Carlo dimer structure and identify the van der Waals mode observed in vibronic spectra. Caloric simulations identify two temperatures where structural transitions occur and imply an experimental temperature below 10 K for dimers in cold supersonic expansions. The (C(6)H(6))(C(6)H(12))(2) studies identify eight independent trimer isomers: three form parallel-stacked (sandwich) arrangements with the two cyclohexane moieties related through a D(6)(h) transformation. The remaining five trimer isomers are trigonal, with no overall symmetry. Caloric studies indicate that the sandwich and trigonal isomeric classes coexist independently below 60 K, consistent with trimer vibronic spectra that contain two independent van der Waals progressions.