Distributed on Fridays via e-mail to all Medical School employees, students, residents, and postdoctoral fellows, UT 2 Me is Dean Giuseppe Colasurdo's weekly update of news and items of interest. He also welcomes feedback through this two-way communication.

Hello,
This has been a week of healthy discussion and debate, which was kicked off Monday with our Town Hall meeting. I thank everyone for their attendance and participation. As we are trying to increase two-way communication, I continue to be impressed by your questions and involvement. For those of you who were not able to attend, you can see the Webcast here, which includes the update and questions that range from workforce productivity to research growth.

Productivity also was discussed at the School of Public Health’s Fleming lecture, “The Future of Academic Medicine: What do we change, what do we keep?” Leaders of Texas Medical Center, including our President, Dr. Larry Kaiser, addressed issues relevant to all academic institutions. Dr. Kaiser said that it is hard to find “triple threats” these days – those who excel in all three areas of our mission: teaching, research, and clinical care. He also noted that it is difficult to fund education and research today as we are dependent upon healthy state budgets and philanthropic support to fund these areas. Nevertheless, Dr. Kaiser confirmed his strong commitment to our academic mission – the UTHSC will continue to value and grow research without disrupting our internal balance and financial accountability. The “value of medicine,” defined as a ratio of outcomes and cost, also was discussed – we must produce compelling products and reduce costs to succeed in our competitive environment.

Aging, the history of the Health Science Center, international programs, and scholarships were the topics of discussion at a very nice lunch I attended with Dr. Cheves Smythe and his good friend Robert Greer. I appreciate their time and attention to our school.

I had a good meeting with the Harris County Hospital District leadership this week to discuss how we can take the tremendous accomplishments and care provided at LJB General Hospital to the community clinics. We are looking at bridging our services to the community via a network of primary care physicians. I want to thank Dr. Steve Brown for his leadership and remarkable work he is doing with the county.

Spotlighting department chairs this week, I want to thank Dr. Carin Hagberg, chair of the Department of Anesthesiology, for her leadership in the recent growth of her department, which has been strongly supported by Juanita Romans, CEO of Memorial Hermann – Texas Medical Center. I applaud Cynthia Adkins, TIRR Foundation’s Executive Director, Dr. Pramod Dash, professor of neurobiology and anatomy, and our faculty involved with TIRR/Mission Connect.  This group, which is committed to research for brain and spinal cord injury, recently received a $3 million grant for, “Project Victory” to provide comprehensive treatment to the wounded returning from Iraq.

I enjoyed meeting with representatives from Gravelle yesterday. They are working on creating an organized approach and message to the community about the Health Science Center, and I look forward to working with them in this important branding/marketing initiative.

I also have been in discussions with Juanita Romans, Craig Cordola, Dr. Jon Tyson, Dr. Eric Thomas, and Dr. Jeffrey Katz regarding a new structure for quality improvement programs at MHH built on the success of the Academy for Quality and Safety. I’ll keep you posted.

I know everyone is concerned about Swine Flu. I urge you to stay updated on this issue by following the information put out by the Health Science Center, MHH, and HCHD. As you know, your homepage has been temporarily changed to the Health Science Center’s Intranet to keep you informed of the latest details. I want to thank Dr. Brent King, who is working with Andrew Casas and others, for preparing our clinics in this situation. Starting Monday we will have a specific area for UT Physician patients who are experiencing flu symptoms.

The discussion on the future of our educational programs (system-based versus subject-based teaching) continues as demonstrated by the portions of e-mail exchange below between Dr. Stanley Schultz and student Senate President Christopher Schneller.

Dr. Schultz wrote, “I've often compared educating future physicians to painting a surface; first you put on a coat of primer, then one coat of paint, and then another etc. Often, because of the complexity of the basic sciences, pathophysiology, clinical medicine, a subject has to be presented over and over again and allowed to ‘mature.’  I think the problem with many ‘integrated programs’ is that there is only one coat---usually a primer. I think there is a place for thoughtful ‘repetition’ in education and that we should not necessarily identify ‘repetition’ as ‘redundant.’' And Christopher wrote: “the best solution is to keep our subject-based curriculum but integrate the classes more and provide as much cohesion week to week as possible.”

We look forward to the upcoming meetings/retreats with students, residents, clerkship directors, and program directors of residency/fellowship training programs as this discussion continues to evolve.

It is fitting, therefore, that we have Dr. Patricia Butler and the Office of Graduate Medical Education tackle the six questions this week:

1.What are the top three objectives of your office?
In collaboration with the Graduate Medical Education Committee and all residency and fellowship programs, the GME Office strives to ensure that residents and fellows receive the highest quality of education that prepares them for their future practices.

Additionally, the GME Office is committed to providing a high level of service to all graduate medical education programs, resident, and fellows and to work diligently on their behalf to offer competitive stipends and favorable benefit plans.

Finally, the GME Office provides support to the UT Medical School in its education effort by enforcing the standards of the Accreditation Council for Graduate Medical Education and other appropriate agencies.

2.       How do the goals of your office support the mission and goals of the Medical School?
The goals of the GME Office are congruent with those of the Medical School in its commitment to excellence in teaching, research, and patient care.  By focusing on thorough internal reviews of our residency and fellowship programs and through close monitoring by the GME Committee, we ensure that the residents are receiving an excellent education. It is always gratifying when some of our graduating residents and fellows elect to join the Medical School faculty. One of the institutional goals is to attract our residents and fellows into academic positions where they will continue to make contributions to the missions of the Medical School.

3.       What are you doing differently in your office this year? What is new?
In order to streamline some of our processes, we have placed much of our application paperwork for the new residents online. Incoming residents will print and return all documents to us. This should reduce operational expenses as well as save time for both residents and the GME Office.  Our goal is to develop this further so that all documents can be submitted online.

This year we will be conducting the non-payroll/benefit portion of new resident orientation online through the Training and Resource Center.  Our speakers have converted their talks to PowerPoint presentations and with the assistance of Megan Williford in the TRC, the new module will be ready to launch for the upcoming orientation sessions.

4.       What role will your office play in the future of the Medical School?
With the increase in medical school class size, we anticipate an increase in applicants to our residency programs.  The GME Office will work closely with our residency programs and the ACGME to increase our residency complements, where feasible and with Dean Colasurdo’s and our affiliated hospitals’ support. We want to ensure placement of these residents and also obtain adequate funding support.

5.       Which accomplishments of your office are you most proud?
The GME office has begun to take advantage of available technologies to help streamline various processes.  As indicated above, parts of the application process will be online in addition to a portion of the new resident orientation. 

Additionally, the office is developing an imaging system to store documents.  Like many other GME offices, we maintain information on all past residents and fellows to enable the office to respond to residency verification requests.  Historically, this information has been stored in paper format in files located both in the Medical School and in the Jesse Jones Library Building.  This year we have implemented a process to image relevant documents from resident files that will allow quick online retrieval of this verification information and free up much needed file space.

6.       Other stories/opportunities/challenges you would like to share?
The Medical School as the sponsoring institution for 58 programs has struggled with compliance with duty- hour regulations, as reflected in our recent institutional letter of notification from the ACGME.  We have put several processes in place to stringently monitor programs’ compliance with the duty-hour standards and are beginning to see results from those efforts. With the implementation of the proposed Institute of Medicine’s duty hour recommendations, we will have to seriously examine the structure of our programs and the hospital support of the programs in order to maintain compliance.  As one of the largest institutions in the country, and with limited staff in the GME Office, we are challenged on a daily basis by ever increasing compliance requirements, and by the need to remain vigilant about quality-of-life issues for our residents.  These challenges provide opportunities for us to invest our time and energy into providing excellent educational experiences for our residents and fellows in an environment that supports and encourages their learning.

Have a great weekend,

For archives of this newsletter, visit the Dean's Communications homepage.