Choctaw Nation Family Medicine Residency Todd Hallmark Executive Officer of Health Services Choctaw Nation Health Services Authority Halito Choctaw for Hello Excellence in Rural Health Care Choctaw Nation Health Services Authority ID: 1047647
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1. Graduate Medical Education in a Rural Tribal Health SystemChoctaw Nation Family Medicine ResidencyTodd HallmarkExecutive Officer of Health ServicesChoctaw Nation Health Services Authority
2. Halito(Choctaw for Hello)
3. Excellence in Rural Health CareChoctaw Nation Health Services Authority
4. OverviewChoctaw Nation Family Medicine ResidencyKey Elements for Starting a Residency ProgramConcept of being Academically FriendlyFunding - HRSA THC GrantBenefits of Having a Residency ProgramCNFMR
5. Choctaw Nation Health Services AuthorityTribal Health SystemSE OklahomaAbout 900 Primary Care visits per dayHospital – Talihina Oklahoma9 Satellite Clinics1600 FTE500-600 newborn deliveries per year
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7. Clinic LocationsAtokaBroken BowDurantHugoIdabelMcAlesterPoteauStiglerTalihina
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10. Specialties CardiologyEmergency & Urgent Care Endocrinology (Adult and Pediatric)ENT SurgeryFamily PracticeGastroenterologyGeneral SurgeryGeriatricsInternal MedicineNeurologyObstetrics & GynecologyOphthalmologyOrthopedicsOsteopathic Manipulative MedicinePediatrics PsychiatryPulmonologyRheumatologyOther ServicesOptometryPodiatryDentistry (General and Pediatric)Radiology (digital) CT, MRI, US Bone DensitometryDiabetes Wellness CenterAudiologySpeech PathologyPhysical TherapyPharmacyLaboratoryRespiratoryNutritionMemory Loss ClinicLarge Refill CenterElectronic Medical Records
11. Definitions Graduate Medical Education (GME)ResidentsFacultyTeaching Health Center (THC)
12. HRSA THC GME ProgramHealth Resources and Services AdministrationTHC GME: Teaching Health Center Graduate Medical Education Program, 2010 AFAPurpose is to increase the number of primary care residents and dentists trained in community-based ambulatory patient care settingsResidents trained in THC’sabout 3X more likely to practice in underserved settings3.4X more likely to practice in health centers
13. HRSA THC Program (cont’d)Eligibility“Federally Qualified Health Centers, Community Mental Health Centers, Rural Health Clinics, Health Centers operated by the Indian Health Service, an Indian Tribe or Tribal Organization, or an Urban Indian Organization”Primary Care Residencies“an accredited graduate medical residency training program in: Family Medicine; Internal Medicine; Pediatrics; Internal Medicine-Pediatrics; Obstetrics and Gynecology; Psychiatry; General Dentistry; Pediatric Dentistry; and Geriatrics”
14. HRSA THC Program (cont’d)FundingTHC GME payments support: Direct expenses associated with sponsoring an approved graduate medical or dental residency training program; and Indirect expenses associated with the additional costs relating to teaching residents in such programs.$150K per resident per yearCongress must vote every two years to fund program (Affordable Care Act)
15. Academically FriendlyMindset that views our local students as a precious natural resource for our health systemHigh SchoolLectures on health topics by physicians in local high schoolsHealth Career day for Juniors and SeniorsVisit and tour hospital in various departmentsDepartment Recruiting BoothsPharmacy, PT, IT, Med Staff, Radiology, LabQuick Fact sheets: Educational requirements, Duties, Starting salaries
16. Sample Fact Sheet
17. Academically FriendlyCollege – “Pre-Med”Policies in place that allow for “shadowing”Shadowing ProgramMust be enrolled in a pre-med program, at least 19 years oldCovers cost of PPD, Background check, UDS, Temporary ID Badges, MealsRequires Department Supervisor and CMO Approval
18. Academically FriendlyMedical StudentsPolicies in place that allow for PreceptorshipsPartnerships with Medical Schools for “Rural Hospital” rotationsProvide Student Housing Cover typical costs – Meals, PPD’s, Background checks, UDS, Temporary ID Badges“Grand Rounds”
19. Academically FriendlyOpportunity to showcase your system to your future staffTake advantage to your most valuable resourceEngages the Medical StaffFosters an environment of continuous learning
20. CNFMR Residents
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23. Key Elements for Starting a Residency ProgramSystem that is primed for medical trainingA Physician ChampionAttending Physicians on the staff are willing to support a residency programSufficient number of dedicated faculty within the department who will practice in the residency programHospital administration willing to support the programAdequate volume and acuity of patients to support the training curriculum
24. Basic Requirements for Starting a Residency ProgramProgram Director in the same specialty with AOA / AMBS Board Certification Sufficient faculty to implement the programOutpatient Clinical FacultyLibrary SupportOn Call QuartersDidactic ProgramAffiliation agreements with other institutions for resident rotations that cannot be provided in the hospital or outpatient area
25. Basic Requirements for Starting a Residency Program (cont’d)Accreditation by ACGMELengthy process, heavy on paperworkWill Designate program sizeUsually takes about one yearA relationship with a medical school
26. Benefits of Having a ResidencyFor the Health SystemPhysician RecruitingA Marker of QualityIn House Physician CoverageCommunity Service“Grow Your Own Medical Staff”Community Retention of Residency Graduates
27. Benefits of Having a ResidencyFor the Medical StaffLife Long LearningEnhanced CME OpportunitiesEncourages Medical Staff to be up on current literature and topicsEngages staff and is seen as a “breath of fresh air”
28. Rural Residency Benefits100% Board Certification Exam Pass Rate80% of CNFMR graduates practice in Rural Settings60% of CNFMR graduates work for CNHSA
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30. Benefits of Having a ResidencyFor the PatientsPresence of Residents 24/7Increases Patient Contact with PhysiciansProvides patients with the latest in medical science
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32. Choctaw Nation Family Medicine Residency (CNFMR)Accredited by the American Osteopathic Association and the American College of Osteopathic Family PracticeAccredited for 12 total residents 3 years (4+4+4)All residency spots are filled (100%)National average for FP Residencies is 53% filledRecruiting, recruiting, recruiting
33. Choctaw Nation Family Medicine ResidencyAffiliation Agreements with Regional Hospitals in Muskogee, OK, Tulsa, OK and Fort Smith, ArkansasRotations not available within our systemResidents have “Continuity Clinic” where they see their own panel of patients under the supervision of Board Certified Family PhysiciansDidactics 5 hours per weekResident lectures, Attending Physician lecturesJournal Article ReviewCase ReviewsBoard Study ReviewEncourage Medical Staff Participation when possible
34. Choctaw Nation Family Medicine ResidencyAcademic Research ProjectsMust abide by Medicare duty hour rulesStaff RequiredDirector of Medical Education (Physician Champion)Program Director (Physician Champion)Residency Coordinator
35. Choctaw Nation Family Medicine ResidencyResident BenefitsResident Salary is about $60K/yrFull Benefits PackageHousingCall rooms – very specific requirementsLibrary with access to a certified librarian (may be via telecommunication link)Pagers, Lab Coats, Scrubs, Meals while on duty, in service testing, board testingPaid attendance to one National Conference (required)
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37. Excellence in Rural Health CareChoctaw Nation Health Services Authority