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Organization of Resident Representatives

2004 AAMC-ORR Annual Meeting

BOSTON, MA
NOVEMBER 5 - 7, 2004
SESSION SUMMARIES

ORR Business Breakfast (Saturday, Nov. 6th)

Jane Broecker welcomed new and old ORR members to the Annual Meeting. Grayson Wheatley went over a brief description of the ORR in the context of other AAMC member groups and its role. Dr. Jordan Cohen spent a few minutes reviewing current issues for the AAMC.

Highlights include:

On 8/12/2004 the U.S. District Court Judge Paul Friedman granted the AAMC's motion to dismiss the Jung lawsuit, due to the passage of legislation which clarifies that the NRMP does not violate antitrust law. This was based on the provision "Confirmation of Antitrust Status of Graduate Medical Education Resident Matching Programs," that was included in the Pension Funding Equity Act of 2004. President Bush has signed the bill into law. Dr. Cohen also said that the plaintiffs will likely appeal the decision with minor revisions (leaving out the NRMP), still alleging collusion on the part of the teaching hospitals.

The Institute for Improvement in Medical Education and the Institute for Improvement in ______?? Which are currently tasked with evaluating necessary changes in medical education and _____??

The feasibility of a "Second Match" is currently being explored by the NRMP.

Contrary to initial predictions, there is likely to be no surplus of physicians in the US in the coming years, and based on current projections, a shortage is actually possible.

HEAL website-a centralized medical education website-continues to expand with contributions from multiple institutions (e.g., videoclips of lectures, assessment tools, pathology slides, virtual patients). It is currently in its collection phase, and implementation/assess options are being discussed.

Summarized by Corinne Horn, M.D.

Patient Care Information Exchange in the Era of Duty Hours: Practical Problems and Solutions
ORR/GRA Joint Plenary Session (Saturday, Nov. 6th)

The Institute of Medicine's (IOM) 2000 report, "To Err is Human" asserted that medical errors were not due to bad people in health care-but the fact that good people are working in bad systems that need to be made safer. In America's teaching hospitals, unregulated resident physician work hours have been implicated as a primary systemic problem contributing to medical. The recent data from the Harvard Work Hours and Health Study Group have substantiated this theory - that healthcare provider performance can be improved and medical errors decreased with work schedules that minimize extended periods of duty. However, an unavoidable consequence of these types of work schedules is the need for frequent patient handoffs. If the knowledge of essential patient information is not maintained during these exchanges, our ability to provide effective care is challenged.

The ORR/GRA joint plenary session, "Patient Care Information Exchange in the Era of Duty Hours: Practical Problems and Solutions", explored how we can ensure the integrity of information transfer in this team-centered approach to medical care in our teaching hospitals. Dr. Rachel Allen (PGY-2 Internal Medicine Resident at the Mayo Clinic, Rochester, MN), provided an overview of how her residency program took a grass roots approach to changing the culture of information exchange. Dr. Eric Van Eaton, (PGY-4 general surgery resident at the University of Washington in Seattle and National Library of Medicine Biomedical Informatics Post-doctoral Fellow) presented a remarkable computerized system that he developed to support this critical process and improve resident efficiency. Finally, Dr. Ajit Sachdeva (Director of the Division of Education at the American College of Surgeons and Adjunct Professor of Surgery at The Feinberg School of Medicine at Northwestern University), put all of these issues into a more global text and defined the key factors needed to ensure the integrity of information transfer in our teaching hospitals.

IOM report summary "To Err is Human" (2000)
Results from the Harvard Work Hours and Health Study Group (PubMed)
Dr. Rachel Allen's Slides
Dr. Eric Van Eaton's Slides
Dr. Ajit Sachdeva's Slides

Summarized by Francis Nuthalapaty, M.D.

ORR Hot Topics Session (Saturday, Nov. 6th)

This year's "hot topics" session was designed to tap into the current interests and concerns of our resident members, and areas of interest were varied. Members expressed voiced a need to take a closer look at a variety of concerns including resident teaching skills, the core competencies, legal and financial issues facing the resident and practicing physician, practice management issues, the use of information technology in research, and the state of the medical malpractice crisis, to name just a few. Because the members of the ORR represent the resident voice at the AAMC, this year's open discussion forum resulted in a better understanding of the topics of concern and interest among our members. The topics gleaned from this session will help shape the agenda for the ORR and provide topics of discussion for future meetings.

Summarized by Jane Dopkins Broecker, M.D.

Health Law -Negotiating Physician Employment Contracts
ORR Education Session (Sunday, Nov. 7th)

After the completion of several years of medical training, residents and fellows finally begin their long sought after professional careers in the academic or private practice environment. Medicine is the primary focus of a busy resident's life, not health care law; seeking legal advice and counsel is important since the process of evaluating an initial employment contract often proves to be a challenge. Bruce Armon, Esq., a partner in Saul Ewing's Health Law practice group, addressed several contract issues in his engaging session. Included in his discussion were many different health care subjects which could potentially impact a physician contract. These topics included regulation of healthcare providers, reimbursement issues, healthcare fraud and abuse, and credentialing of health care providers. Other contract details which were reviewed included varied compensation formulas, term and termination, and non-competition provisions. This session was particularly insightful to many of our ORR members, as over half of the representatives will be concluding their training within the next couple years.

Summarized by Eric A. Wang, M.D.