The clinical practice pathway Conflicts None for this talk Three General tracks Physicianscientist Generally laboratorybased but can be in health policystatistics Clinical Investigator May include limited ID: 1043780
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1. Alice MaUNC Chapel HillThe clinical practice pathway
2. ConflictsNone for this talk
3. Three General tracksPhysician-scientistGenerally laboratory-based, but can be in health policy/statisticsClinical InvestigatorMay include limited labwork as part of a translational project.May encompass projects having to do with health care outcomesClinical Practice
4. Goals of the Clinical Practice TrackTrainee GoalsTo improve medical knowledgeTo improve systems-based practiceTo improve professionalismTo gain skills needed for practice managementProgram GoalsService to patientsService to facultyService to fellows
5. Program requirementsPhysician ScientistClinical InvestigatorClinical PracticeResearch/scholarly activity++++Needs some activity, perhaps helping with someone else’s project, writing a review article. May be a quality improvement projectContinuity Clinic in 2nd and third yearsOne half dayHalf day +another half day in area of interest5 half days/week, unless away or on a different rotationOther clinical rotationsSameSameSame
6. Additional requirements/RotationsBusiness of PracticeThe trainee will work with the outpatient business office to go over to go over issues of documentation, Medicare denials and payments, chemotherapy reimbursement and infusion fee structures. The trainee will compile a report of his or her work to show to the division administration.“Away rotations”Work with a UNC-affiliated outside practice for 1-2 months per year to understand the pace, practices, and culture of private practiceInfusion CenterTwo one month long block. The fellow who runs the infusion center will make rounds twice a day with the charge nurse and will be readily available to answer questions from the nursing staff about orders or side effects when the patient’s regular physician is not available. In addition, if the fellow is not busy in one of his/her continuity clinics, the fellow may be asked to help patients and their friends and /or family understand the side effects of treatment.Quality Improvement Project Examples have included Developing a hospital-wide DVT prophylaxis protocol and order set, Developing and tracking a protocol to decrease Inpatient Oncology line infections.Developing a standard order set for anaphylaxis in the Infusion area
7. Other noveltiesOutpatient oncology rotating clinic monthsIn addition to continuity clinicsOne month for all fellows in the first yearAs many as needed for boards in the second and third yearsOutpatient non-malignant heme rotating clinicOne month for all fellows in the first yearOne month in the second yearPractice track fellows usually opt for a third month in the third yearOutpatient BMT
8. NumbersYearTrackOutcomePSCICPAcademicPP200904123201041232011212322012050??
9. Funding the fellowsHematology T32Oncology T32Hematology K12Oncology K12Preventive Medicine residencyPublic HealthClinical Funds