The Residents Report

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					                                                                                                                                 Winter 2011


    The Residents Report
                                Newsletter of the Office of Graduate Medical Education I University of California, San Francisco



                                UCSF Teaching and Learning Center
                                Sandrijn van Schaik MD, PhD
                                Education Director of the Kanbar Center for Simulation, Clinical Skills and
                                Telemedicine Education

                            After many years of planning, the
                            new Teaching and Learning Center
                            has opened its doors! With four days
                            of tours, demonstrations, workshops
     in this issue and other events, the UCSF campus
      Teaching and Learning was introduced to this new, state-of-
                  Center 1
                            the art educational facility, housed on
        News from SFGH 4
                            the second floor of the library on the
           APEX Update 4
                            Parnassus campus.
            VAMC Update 5       The Teaching and Learning Center (TLC)
    News from the Library   6   occupies 22,000-square-feet in three
            Out & About     8   functional areas: technology enhanced
          Grand Rounds 10
                                classrooms; a technology commons;
                                and the Kanbar Center for Simulation,         Kanbar Center for Simulation, Clinical Skills and Telemedicine Education
 Resident/Fellow Council 11
                                Clinical Skills and Telemedicine Education.
           10 Questions 12
                                The TLC is open to students, residents, clinical fellows, and faculty of all health professional
      New Vice Chancellor of
                                schools at UCSF, including residents and clinical fellows. The center aims to promote
    Diversity & Outreach 14
                                interprofessional education and encourages innovative approaches to teaching and learning,
          GME Diversity 16
                                such as those that incorporate technology into curricular design. With its unique lay-out
            Pay Stub 101 16     of simulation rooms adjacent to standardized patient rooms and technology enhanced
    ACGME Resident/Fellow       classrooms, there is plenty of opportunity to be innovative. Rooms can be connected to
                 Survey 18      each other with direct video broadcasting and extensive computer networks allowing for
                 Cypher 20      completion of web-based modules and assessment exercises that are an integral part of any
                                course conducted in the center.
                                Technology, simulation, standardized patient-based exercises are all becoming increasingly
                                important in the education of health care professionals. Simulation of resuscitation events
UCSF School of Medicine         has been a part of graduate medical education in a variety of disciplines, but more and more
Graduate Medical Education      programs are expanding their educational curriculum with standardized patient exercises,
500 Parnassus Avenue            simulation-based skills training, and web-based modules. A driving force is the ACGME with
MU 250 East, Box 0474
                                its requirements for competency based learning and assessment which are often not easy
San Francisco, CA 94143
tel (415) 476-4562
                                to meet in the real life environment because of the unpredictability of events and lack of
fax (415) 502-4166              standardization. Standardized scenarios and direct observation can be used to meet some
www.medschool.ucsf.edu/gme      of these challenges. Opportunities for formative feedback and discussion, often difficult to

                                                                                                                                (continued on page 2)
1
Teaching and Learning Center...
                                                                 rooms that can be configured to realistically recreate
(continued from page 1)
                                                                 the environment of an ICU, operating room or any
find in the hectic clinical environment, can be created          patient care room. High fidelity simulators include
by digitally recording and debriefing exercises.                 eight state-of-the-art adult simulation mannequins
The TLC is the realization of one of UCSF’s strategic            (“SimMan”), three pediatric mannequins (“SimBaby”),
goals — “to develop educational facilities and                   and two neonatal mannequins (“SimNewB”). There
infrastructures to keep UCSF at the forefront of health          are also two task trainer rooms with a variety of partial
sciences education and meet the growing demand for               task trainers, including airway trainers, vascular
health care professionals.” In 2005, UCSF identified             access trainers and birthing simulators to name a
more classroom space, advanced technology,                       few. All simulation rooms have multiple HD video
capacity for increased simulations, health disparities           cameras and digital technology that allows for direct
education and interprofessional                                                  broadcasting to adjacent debriefing
activities as essential to                                                       rooms or any of the larger classrooms
maintaining innovative                                                           in the center. The simulation rooms are
educational programs. In 2006,                                                   even set up with infrared cameras for
the Telemedicine and Program                                                     the purpose of disaster training so that
in Medical Education for the                                                     actions can be recorded in the dark.
Urban Underserved Education                                                              The School of Medicine’s old Clinical
Facilities Initiative – a part of                                                        Skills Center on the Mount Zion
California Proposition 1D –                                                              campus was housed in a small facility
offered a funding opportunity                                                            where office space often doubled as
for the creation of a new                                                                clinical exam rooms and students
educational facility that could                                                          would bump into actors playing
address these needs. Since                                                               standardized patients in the lobby. In
space is at a premium, the                                                               the new facility, standardized patients
options of utilizing space                                                               come in via their own entrance and
in existing buildings were                                                               have a separate lounge. The 12 clinical
explored. Placing the TLC in                                                             exam rooms all have dividing walls
the library strengthens the                                                              and can be opened up to be a double-
library’s role in education and                                                             sized room. This not only allows
its leadership in technology.      Sandrijn van Shaick, MD assists Nurse Practitioning
                                                                                            bigger groups to participate in an
Additionally, the library’s        student Colin Gershon with intubating a high fidelity
                                                                                            exercise, such as interprofessional
                                   simulation mannequin
central location ensures the                                                                team activities, but also makes it
center is easily accessible to                                                              possible for the clinical exam rooms
learners from all professional schools on the UCSF                 to function as simulation rooms with any of our high-
campus. The first phase of construction, to transform fidelity simulators. Each clinical exam room has a
the library’s second floor began in early 2009, but the            computer station outside for the completion of pre-
project was temporarily put on hold due to the state               and post exercise assessments and evaluations, and
budget crisis and was restarted in January of 2010.                adjacent classrooms can be utilized to review and
The Kanbar Center, a component of the TLC, was                   discuss the exercise in a bigger group.
named in honor of San Francisco-based entrepreneur               The Technology Commons existed prior to the
Maurice Kanbar, who made a major founding donation               renovation, but was expanded and improved in many
to establish the center, first in its temporary location         ways. There are multiple networked multimedia
on Mount Zion and now integrated with Clinical                   pods for students and faculty to use with a variety of
Skills and Telemedicine Education in the new TLC.                software as well as Macintosh computers and devices
If you ever visited the temporary space, you will be             to create web-based modules. There is video and
pleasantly surprised: not only is the new facility much          audio recording equipment and a quiet media room
bigger, but it also has many more simulators and                 to practice presentations. Learning technology staff
associated equipment. There are two large simulation
                                                                                                               (continued on page 3)
2
Teaching and Learning Center...
(continued from page 2)

are available to help navigate the facility and give advice on projects and use of equipment. Additionally, an
expandable technology classroom is available for classes requiring computers.
                                               The catalyst for the TLC, telemedicine education, is becoming increasingly
                                               important in the care of the underserved because it allows remote access to
                                               patients who have trouble coming to our health care facilities. The TLC has
                                               special carts containing high-definition video-conferencing and telemedicine
                                               examination equipment and similar equipment is available at affiliated
                                               sites. The networked clinical exam rooms at the TLC facilitate telemedicine
                                               simulations.
                                               The center was designed with sustainability in mind and we expect that it
                                               will achieve the Leadership in Energy and Environmental Design (LEED)
                                               certification with the U.S. Green Building Council. An example is the
                                               extensive reuse of materials, such as the granite on the original floor that
                                               now serves as sink counters in the clinical exam rooms and the wooden
                                               sides of bookshelves that were used for the paneling of the walls in the
                                               hallways. Another example is the heating system for the floor, which is
                                               rechanneled heat generated in the server room.
                                 The TLC will realize the campus vision of exceptional educational space and
  Students working in the Technology Commons

                                help to ensure that UCSF remains a leader in health sciences education. If
you missed the opening week, check out the website: http://tlc.ucsf.edu/open-house or stop by anytime during
library hours: Parnassus Campus Library, 2nd floor, 530 Parnassus Ave, San Francisco.




                                               2011-2012 Department-Specific Resident
                                                      Incentive Goal Application
The UCSF Medical Center sponsors three resident incentive goals valued at $400 for achieving each goal. Residency
programs again have the opportunity in 2011-2012 to develop a department-specific goal for review by Medical Center and
GME leadership.

The department-specific resident incentive goal should be:
 • Aligned with the department and medical center quality improvement strategies
 • Feasible to measure; and
 • Relevant from an educational perspective

Proposed goals should be discussed with the Resident’s Council. These will go through a preliminary review and feedback
process with the Director for Quality and Safety Programs for GME.

Applications are due March 15, 2011 for an incentive for the 2011-2012 academic year. Please submit the application to:
Paul Day at ucsf-gme@medsch.ucsf.edu

Direct questions to:
Arpana Vidyarthi at arpana@medicine.ucsf.edu

2011-2012 Incentive Goal Application: http://medschool.ucsf.edu/gme/residents/incentives.html




                                                                                                                              3
                                                 NEwS FROM SFGh
                                                Rachael Kagan
                                                Chief Communications Officer, SFGH




The SFGH rebuild is going behind the fence. That means we are finally finished rerouting underground utilities
and changing the campus every two minutes. It’s time to build the new hospital!
The completion of site utilities relocation is a major milestone that signals a more “normal” construction project
going forward. With all obstructions, tunnels, and lines out of the way the builders will settle in behind the
fence. First up is the building’s foundation. The base-isolated design will make our new hospital the most
seismically safe in the city.
We are also delighted to report that so far, the budget is running 13% ($17.6 million) under estimates, as major
trade packages have come in low. These include structural steel, elevators, and concrete. Construction is also
on schedule with completion slated for 2015.



APEX UPDATE                                              The super-users will provide assistance during go-live
Michael Blum, MD                                         and help train their colleagues on the wards. We are
Chief Medical Information Officer                        working with the departments to create the training
                                                         schedules and trainees will be informed as soon as
The Apex Electronic Health Record (Epic) project         possible of their particular training sessions.
continues to move along at a rapid pace. The $165
million project is on schedule for the April 2011        Along with regular updates in The Residents Report,
go-live in the first ambulatory practices and the        Medical Center Internal Communications, Managers’
October 2011 go-live for the in-patient enterprise.      Weekly, quarterly town halls and outreach from the
The full rollout for the project will extend through     project team to specific departments, the APEX team
April 2012.                                              is providing the UCSF community a forum in which to
                                                         ask questions, clarify issues, and understand decisions
A group of 60 residents and clinical fellows have        being made through their AskAPEX program. AskAPEX
been identified by the office of GME and the             is yet another way that trainees can get their questions
departments to participate in the Fellows and            answered or concerns expressed regarding APEX. By
Residents Advisory Group (FRAG). The group will          emailing:
be convening shortly to provide needed input into         AskApex@ucsfmedctr.org, the APEX team will
the system’s development. If you are interested in       respond to inquiries within 48 hours.
participating, please contact Dr. Arpana Vidyarthi
(arpana@medicine.ucsf.edu).                              “AskAPEX is a way of allowing individuals to inquire
                                                         about specific topics of interest or express concerns
Testing and training for the April Ambulatory go-        that they feel should be addressed” said Pam Hudson,
live will be starting soon. Residents and clinical       APEX Program Director. “The implementation of
fellows will be thoroughly trained and will need         APEX will have organization-wide impact therefore it is
to demonstrate competency in order to receive            important that we provide another venue for questions
their userID and password for the system. More           to be answered in the quickest, most efficient way
extensive training will be offered to those who          possible.”
volunteer or are nominated to be “super-users.”

4                                                                                                                 4
                                               NEwS FROM SF VA MEDICAL CENTER
                                               Patricia Cornett, MD
                                               Associate Chief of Staff for Education,
                                               SF Veterans’ Affairs Medical Center




The San Francisco VA Medical Center was recently designated a Center of Excellence in Primary Care
Education. This competitive grant, sponsored by the VA Office of Academic Affiliations, seeks to utilize VA
primary care settings to develop and test innovative approaches to prepare physician residents, students,
advanced practice nurse and undergraduate nursing students, and associated health trainees for primary care
practice in the 21st Century.
Thirty-seven VA facilities competed for the grant and five VA Medical Centers were selected. The San
Francisco proposal, a joint collaboration between the UCSF School of Medicine and Nursing, was led by
Rebecca Shunk, Maya Dulay, Bridget O’Brien, Susan Janson, and Pat Cornett and featured the creation of a
center dedicated to education of internal medicine residents, nurse practitioner students, pharmacy residents,
psychology fellows, and other allied health trainees in the core principles of patient centered medical care.
This center, called EDPACT (Education in Patient Aligned Care Teams) will focus on education in
interprofessional collaboration, shared decision-making, sustained relationships, and performance
improvement. The actual implementation of new clinics and collaborative education will start in July 2011 with
full implementation planned for July 2012.




                                                                                                                 5
                                                  NEwS FROM ThE UCSF LIbRARy

                                                  Josephine Tan, MLIS
                                                  Education and Information Consultant, Clinical Sciences




In your precious downtime between clinical responsibilities and getting some food and sleep, every second
counts. It can be presumed that it is also an expectation that you should be keeping up with the medical
literature to stay at the top of your game in your field. This is where setting up a MyNCBI account in PubMed
can come to the rescue to bring order out of the mayhem of all the PubMed searches you plan to do.
MyNCBI is a free account that you set up in PubMed!
Here are some key features that are the most useful for making your PubMed research a more efficient and
enjoyable experience:
    (1) Select the MyNCBI link at the upper right of PubMed
    (2) Use the Register for an account link below the green “Sign In” button to create your free account
    (3) Once you’ve set up an account, click on the MyNCBI link once more at the upper right of PubMed
    (4) Select the Preferences link in the left menu bar of MyNCBI
Key Preferences to Set Up
Highlighting – choose a color and “Save”; your search terms will be highlighted to help you quickly scan your
results that can indicate the possible level of relevance to your research question.
Abstract Supplemental Data – check the “Open” box and save this option; medical subject heading (MeSH)
terms that are assigned will then automatically appear below the abstract, offering other terms that you may
want to use to refine your search.
PubMed Filters & Icons – use this feature to create filters that will get you to certain types of literature quickly
(ie, meta-analysis, systematic reviews, randomized controlled trails, clinical trials, reviews).
how to create PubMed search filters
  (1) Select the Preferences link in the left menu of MyNCBI and then the PubMed Filters & Icons link
  (2) Select the Search for Filters tab
  (3) Search each one of these following terms and check the corresponding box in front of each listing
      (meta-analysis, systematic reviews, randomized controlled trial, clinical trial, review). You can select up
      to 15 filters.
To see the filters in action, run a search in PubMed, after signing into your MyNCBI account. In the right menu
of the results page will be the filters that you set up, allowing you to easily jump to those types of papers in the
results. Go to http://tinyurl.com/pmquick to view a video tutorial on how to set up search filters.
how to Save your searches
When you’ve come across a set of search results that look worthy of saving, use the Save search feature to
save your search strategy.
    (1) Run your search
    (2) On the results page, select the Save search link above the search box
    (3) Choose how often you would like new search results sent to your email
Once you save your search, you have essentially set your research on cruise control. Whenever a new article
is published that meets your search criteria, it will be emailed to you.
how to Send articles to the Clipboard and save them
As you run your searches in PubMed, you will hopefully be finding articles that you want to keep in your
                                                                                (continued on page 7)
6
LIbRARy UPDATE....
(continued from page 6)

research notes. Instead of copying and pasting citation information to a Word document or wherever else you
keep your notes, you can collect interesting articles first on PubMed’s Clipboard and then save these items to
a Collection.
best way to streamline your PubMed search session
I’m a huge proponent of making your PubMed search sessions high yield and efficient. Here are tips on how to
set yourself up to achieve maximum benefit from your MyNCBI account:
    (1) Sign into your MyNCBI account in PubMed. It’s okay if you forget this step. You can always sign in
        as you are searching and all the features you set up will appear. When you sign in, you will have an
        option to always keep you signed in. If you are working on your own computer, it’s most convenient to
        choose this option.
    (2) Use the filters in the right column of your results. This helps you quickly jump to papers with higher
        levels of evidence.
    (3) View the MeSH terms assigned to abstracts. Below an abstract will be MeSH terms that describe
        the content of that article. Adding some of these terms to your search phrases can improve the
        accuracy of your search. If the article was recently published, MeSH terms will not yet be assigned but
        will eventually have MeSH terms soon.
    (4) Send interesting articles to the Clipboard. Collecting articles on the Clipboard will make it fast and
        easy to save them for future reference.
    (5) Save your Clipboard items. Once finished with your entire searching session, click on the Clipboard
        icon that appears in the upper right hand column of your search results. Using the “Send to:”
        Collections dropdown option allows you to save these interesting articles to an electronic file of sorts
        that you can later retrieve them for further review. Leaving all the boxes unchecked in your Clipboard
        list defaults to select all to be sent to Collections.
    (6) Save your search strategies. If you are finding some of your searches are yielding good results,
        remember to save the search to avoid having to start this research from scratch the next time you
        return to PubMed.
    (7) Click on the MyNCBI link in the upper right of PubMed’s page to retrieve the searches and collections
        that you’ve saved.
Let the New Year begin with PubMed’s MyNCBI. Cheers to happy searching the next time you go to PubMed!


RESIDENT RESEARCh SyMPOSIUM

  CTSI is pleased to announce the fourth annual UCSF Multi-disciplinary Clinical & Translational Science
  Research Symposium for Residents on Wednesday, May 4, 2011, in Millberry Union from 4-7 pm. This
  research symposium will provide an opportunity for residents to present their work and to develop cross-
  departmental collaborations.
  Application Instructions and Deadlines:
  Interested Residents are encouraged to submit projects at all stages of development, including posters
  already presented in another venue, and projects that are currently in-progress. Resident abstracts will be
  reviewed for both oral and poster presentation.
  Abstract Submission Form will be available online in early February at
  http://ctsi.ucsf.edu/training/resident#research. AbSTRACT DEADLINE is April 3, 2011.

  For additional questions please contact Christian Leiva at cleiva@psg.ucsf.edu.

                                                                                                                7
OUT & ABOUT from the Resident and Fellow Affairs Committee
Where members of the Resident and Fellow Affairs Committee recommend their favorite scenes outside UCSF.

Pizza in SF
Brian Waldschmidt, MD
Resident, Anesthesia
Living in San Francisco, we are surrounded by excellent cuisine, with fresh seafood and sushi, neighborhood
                                           farmers markets, and world-class wine country just a short drive
                                           away. But I confess that after a long week of work, the comfort
                                           food I crave most is pizza! Thankfully, San Francisco boasts more
                                           than a few amazing pizzerias delivering succulent pies for even
                                           the most discerning pizza lover. Here are my favorite spots for
                                           grabbing a slice.
                                            My list must begin with LITTLE STAR. This is the best deep
                                            dish in the city and probably in the Bay Area (but don’t tell
                                            Zachary’s). The cornmeal crust blended with butter and olive oil
                                            is delicious. The spinach and ricotta-based “little star” pie is my
                                            favorite, and meat-lovers rave about the “classic” with sausage
                                            and mushrooms. The thin crust pizza is good too, but go here for
                                            Chicago-style deep dish. A great selection of beer rounds out a
hearty meal at either the NOPA or Mission location.
If you’re as wild about Neapolitan pizzerias as I am, you’ve probably already been to PIZZERIA DELFINA. In
addition to thin crust classics like margherita and quattro formaggi, this restaurant also serves up daily specials
listed on their chalk blackboard. I recommend trying the popular broccoli rabe pizza, made with olives and hot
peppers. Both locations (Pacific Heights and Mission) offer exciting Italian wine lists, with nearly all available
by the glass.
For a quirky San Francisco pizza experience, head to PIZZA ORGASMICA. Great for a group, the menu here
offers humorously-named pies with creative ingredient combos. There are several locations, but I like the spot
on Clement St. near the VA hospital. Here a group can dine while seated on floor cushions and can sample
the restaurant’s beer made by its own brewing company.
Lastly, SOMA has a new pizza parlor that is already a huge hit: ZERO ZERO. Named for a flour used in
Naples pizza dough, Zero Zero serves up my favorite thin-crust in the city. Crispy around the edges, this
chewy crust has a perfect flavor. With a modern upstairs dining room and two trendy bars, this is sure to
become a hot new dining spot.
The true pizza connoisseur will find ultimate gustatory satisfaction in San Francisco. From BERETTA in the
Mission, to A16 in the Marina, this is a city that takes pizza pie seriously. Bon appétit!

NorCal Excursions
Julie Philp, MD
Resident, Dermatology
Having lived in various parts of the Bay Area since birth (well, except for one very cold year in Boston), I have
had time to explore this great area of the world we all call home. I grew up in Santa Rosa and recently moved
to Marin so will focus on some of my favorite places North of SF.
If you have a day…
    •	 And you don’t mind the cold: Go whale watching (sfbaywhalewatching.com). Verne is the man who runs
                                                                                                   (continued on page 9)
8
OUT & ABOUT
Where members of the Resident and Fellow Affairs Committee recommend their favorite scenes outside UCSF.

(continued from page 8)


        the show, he’s a retired professor and one of the coolest people you’ll ever know. They have a naturalist
        on every trip and the motor catamaran gets you out to the Farallon islands quickly and with the least
        turbulence possible.
     •	 And you don’t want to drive: Take the ferry to Sausalito. Then get away from the crowds by wandering
        north on Bridgeway. Have a sustainable seafood lunch at Fish (a little pricey and cash only but worth
        it) then wander though the neighborhood on the hill (winding roads, hidden staircases, interesting
        houses). Come back down by the water for a long, lingering dinner at Le Garage, delicious French
        food on the water in a renovated garage.
     •	 And you want to escape the fog: Go to the cute town of Fairfax. If you like to hike the Cataract Falls trail
        is quite beautiful and not too tough - one waterfall after another along the whole trail. Reward yourself
        with ice cream at Fairfax Scoop (they are famous for their honey lavender flavor). Wander through the
        shops (there is not a single chain store in town). Listen to some live music at The Sleeping Lady.
     •	 And you want to get some exercise: Mt. Tamalpais is where mountain biking got its start. China Camp
        in San Rafael also has some great mountain biking trails. The Tourist Club (www.touristclubsf.org) is an
        Alpine lodge that serves beer and snacks overlooking Muir Woods. Although you can get there by car
        it’s more fun to hike in from Mill Valley – just check the website because they’re not always open to the
        public.
If you have a weekend…
     •	 Spend some time in the Sonoma County wine county, I find it a little more down to earth than Napa.
        Healdsburg is my favorite town for lunch (try Ravenous or Barn Diva). Some of my favorite wineries are
        J (sparkling), Silver Oak (red), Twomey (amazing views from the property) and Preston (great place
        for a picnic and you can play Bocce ball there). Each year there’s an event called “Taste of the Valley”
        where you pay one fee and can taste wines and food all weekend long.
     •	 Have a mud bath in Calistoga. Indian Springs has been there forever and was recently renovated and
        very beautiful. If you go to the spa you can spend all day at the
        mineral pool, which is always perfectly warm.
     •	 Get a group of people together and rent a house along the
        Russian River. Float down the river in the summer or hike
        through the redwoods at Armstrong Grove.
And if you have a few days…
      •	 Drive way north to the redwood trees. Humboldt Redwoods
         State Park will take your breath away – it contains some of
         the tallest and oldest trees still standing. If you want a relaxing
         getaway drive through the Avenue of the Giants, take a quick
         nature hike, then relax at the Benbow Inn (they have frequent
         specials which make it more affordable). You can also car
         camp (the campgrounds in the park are all beautiful) or
         backpack (but be aware that as soon as you ascend from the
         forest floor the scenery changes quite dramatically).


                                   Enjoy!!


                                                                                                                  9
GME GRAND ROUNDS                                            care compared to 17% of heterosexual respondents.
                                                            This marked difference appeared in every racial/
                                                            ethnic group, and white LGB respondents were
                                                            likelier to delay and avoid care than heterosexuals
                                                            who were African American, Latino/a, or from Asian
                                                            or Pacific Island backgrounds.

LGbT health Concerns: An Overview                           Needless to say, this estrangement from healthcare
                                                            has significant health consequences and raises
Shane Snowdon
                                                            particular concern because of a host of LGBT health
Director, UCSF LGBT Resource Center
                                                            disparities. Disparities found in the 2007 CHIS
As lesbian, gay, bisexual, and transgender (LGBT)           include:
people become more visible in our society, their health     •	     27% of LGB respondents smoked vs. 16% of
concerns are receiving unprecedented attention. For                heterosexual respondents;
example, the Joint Commission issued a requirement          •	     44% of LGB respondents reported alcohol
in January 2011 that the nation’s hospitals protect                abuse, vs. 33% of heterosexual respondents;
LGBT people within their nondiscrimination policies.        •	     20% of LGB respondents reported
The prestigious Institute of Medicine will issue a report          psychological distress in the past year, vs. 9%
in March 2011 on LGBT health disparities, and Healthy              of heterosexual respondents;
People 2020, the “federal blueprint for the nation’s        •	     22% of LGB respondents needed mental
health”, released in December 2010, called for much                health medication, vs. 10% of heterosexual
greater attention to LGBT health needs.                            respondents.
Given its location in San Francisco, which has the          Although transgender individuals—those who identify
highest LGBT population of any U.S. city, UCSF              with a sex other than the one assigned them at
has been a national leader in LGBT health. UCSF             birth—cannot yet self-identify in the CHIS, other
Medical Center is the only healthcare institution in the    surveys have documented even greater delays and
country to have received four perfect scores on the         disparities for transgender people, whom one UCSF
national LGBT Healthcare Equality Index. In addition,       faculty member has called “the most medically
UCSF boasts an LGBT Resource Center, Center of              underserved in America.” A recent survey of over
Excellence in Transgender Health, Division of LGBT          6,000 transgender Americans by the National Center
Services of the Department of Psychiatry, Center for        for Transgender Equality found that 28% had been
AIDS Prevention Studies, Positive Health Program,           subjected to harassment in medical settings, 41%
Pacific AIDS Education and Training Center, and             had attempted suicide, and 2.6% were HIV positive
Lesbian Health & Research Center. These nationally          (four times the national infection rate).
renowned programs offer a wealth of LGBT health
resources locally and nationally.                           Disparities like these are widely attributed to the
                                                            stress and stigma experienced by LGBT people, who
These and other LGBT health initiatives were created        even today face substantial bias and discrimination.
to address the health disparities and obstacles to care     While much research is needed on the health
experienced by LGBT people, many of which arise             and well-being of LGBT individuals, the combined
from bias and discrimination, past and present, feared      effects of health disparities and care delays are
and encountered. Although many health surveys               clear cause for concern. In the 2007 CHIS, 9% of
do not yet allow LGBT respondents to identify as            LGB respondents reported a diagnosis of cancer
such, research that is LGBT-inclusive has uncovered         in their lifetime, compared to 6% of heterosexual
disturbing evidence of LGBT patients’ estrangement          respondents—an alarming difference that has yet to
from healthcare. The large California Health Interview      be investigated.
Survey (CHIS) in 2007 found that lesbian, gay, bisexual
(LGB) Californians were significantly likelier to delay How can LGBT patients be encouraged to seek
and avoid healthcare than heterosexual respondents:     healthcare, particularly in light of the disparities they
29% of LGB respondents reported delaying or avoiding experience? A recent survey conducted among
                                                                                                  (continued on page 15)
10
UCSF RESIDENT &                                           and program-specific goals. They deserve special
FELLOw’S COUNCIL                                          praise for the recognition by Maimonides Medical
Angela Walker, MD and Barak Bar, MD                       Center in Brooklyn, whose residents recently designed
Resident and Fellow’s Council Co-Chairs                   an incentive program patterned on the one at UCSF.
                                                          Resources continue to be available in the Patient Care
Belated happy holidays and welcome to the New             Fund. As you rotate through services at UCSF, think
Year! The first six months of this academic year have     of ways we can better provide for our patients and
been very busy. Here’s an update of the ongoing           submit a proposal. For any questions regarding the
accomplishments of the Resident & Fellows Council:        Patient Care Fund, please contact Delphine Tuot, MD
Several of our members have spearheaded projects          at Delphine.Tuot@ucsf.edu.
to work to improve efficiency in the daily tasks of       In December, housestaff returned to the recently
trainee physicians. Adam Schickedanz, MD is working       renovated cafeteria lounge space. Teams who use
to develop an algorithm for scheduling inpatient          this space regularly are thrilled to be back. If you
radiology scans. His hope is that this algorithm          haven’t seen the new lounge, it is accessible 6:30am
can be circulated among housestaff and included in        to 8:00pm every day. Look for bulletin boards where
orientation materials for incoming interns. So Young      important resident/fellow information will soon be
Kim, MD has been meeting with multiple medical            posted and updated.
and administrative individuals to try to duplicate
the 10ICC IV insertion cart on other units/floors.        We marked the beginning of UCSF resident pay
Christina Robinson, MD has worked tirelessly to           parity in January, a goal accomplished through
extend shuttle transport between the Mt. Zion and         arduous lobbying of many. Soon, equally important
SFGH campuses. Nazia Jafri, MD has developed a            conversations will occur to settle resident contract
pilot project to evaluate whether direct Spectra-link     negotiations at SFGH. We welcome the participation
availability improves urgent/emergent communication       of any resident who would like to become involved in
between radiology and surgery/neurology services. If      this project. The CIR/SEIU Area Director, Kelly Gray,
data shows notable benefits, she’d like to expand the     is happy to have you on board!
program. Finally, Gabe Aranovich, MD is investigating
                                                          As always, if you have ideas for projects or would like
interest in a consultation services website to allow
                                                          to get involved, please contact us, your department
residents to best compile information and study results
                                                          representative… or come to a meeting!!! New
prior to contacting colleagues for consults.
                                                          members are always welcome.
Progress towards the 2010-11 Housestaff Incentive
                                                          Happy 2011,
goals has met mixed outcomes. Patient care
                                                          Angela and Barak
satisfaction remains high and as of July-September
data, we were within a 5% margin of meeting our
goal to decrease the use of aggregated lab tests.
Unfortunately, physician hand-hygiene compliance
continues to be “less than desirable.” Despite efforts                        Confidential
to educate resident and attending leaders of hand
hygiene policies and compliance pitfalls, November                             GME Helpline
rates continued to trend at ~60%. Fortunately, data
has shown that “just in time” coaching or identifying                       (415) 502-9400
provider noncompliance and discussing policies with
that individual, can improve future compliance. To
                                                              Confidential line for housestaff, faculty, and program
reach our 85% compliance goal we are requesting all
                                                               administrators to voice their questions, comments,
providers consider this practice. Remember, hand
                                                               or concerns 24 hours a day. The Office of Graduate
hygiene is required upon the entry and exit of
                                                                Medical Education will respond to all messages.
every patient room, every time. Arpana Vidyarthi,
MD, Paul Day from OGME, and Kara Bischoff, MD
continue to track efforts towards meeting all general
                                                                                                                       11
       10 Questions from the resident and fellow affairs Committee
                                                                        permanent (also called whole-life, universal-
                                                                        life, variable-life) life insurance?
                                                                        Term is pure insurance with no investment
                                                                        features. It is less expensive than permanent
                                                                        insurance, but the premiums can adjust (i.e. rise)
                                                                        as the policy ages. Term insurance is suitable for
                                                                        short term needs such as the time spent raising
                                                                        your children.
                                                                        Permanent insurance is insurance plus an
                                                                        investment/savings vehicle. It is more expensive,
                                                                        has fixed premiums, has cash value, and is
                                                                        suitable for meeting some long-term investment
                                                                        needs. It is useful for people who need insurance
                                                                        through their later years and because of its
                                                                        liquidity at the time of death can be used by heirs
                                                                        to pay estate taxes on property that is passed
                                                                        on to them. With careful financial planning, the
 John K. Beeson, CFP, MBA, Registered Investment Advisor                usefulness of life insurance as an investment
and Mark Shone, CFP, Registered Investment Advisor, answer
                                                                 vehicle diminishes as one builds up retirement savings
 resident and clinical fellow questions about purchasing life,
           disability, and other forms of insurance              and other investments. It is helpful to keep this in mind
                                                                 when deciding what type of insurance you need and how
  10 Questions.....from the RFA Committee
                                                                 long you will need it.
1) what is the purpose of life insurance for younger
people? For single people with no children? how                  Commissions paid to insurance salespeople for
much insurance is the right amount?                              permanent insurance policies are proportionally higher
When thinking about acquiring life insurance the two             than their commissions for term life policies. For that
important considerations are needs and age. Who                  reason, you should research your needs and options and
would need your income if you were to pass? For this             may wish to pay for a consultation with an investment
reason, children do not need life insurance. Adults who          advisor before soliciting advice from the insurance
do not have a spouse or children to support generally            salesperson.
have little need for life insurance unless they own real
                                                                 Accidental Death and Dismemberment insurance is a
estate and purchase life insurance to help cover the
                                                                 different type of insurance that covers accidental death
estate taxes that will be levied on property passed on to
                                                                 and organ loss in the workplace. It should not be used in
their heirs.
                                                                 lieu of life insurance as the parameters in which it pays
It is easier and much less expensive to obtain life              out are very narrow.
insurance while you are young and healthy, so those
                                                                 3) what does it mean to have a cash value for a life
individuals who are about to start a family can benefit
                                                                 insurance policy? how does this affect the death
from purchasing life insurance while in good health.
                                                                 benefit?
When deciding coverage amounts consider the
                                                                 Term insurance has no cash value. Like automotive
amount your dependents would need, keeping in mind
                                                                 insurance, it provides coverage while you are paying the
all sources of income and the liquidity of your other
                                                                 premiums but it accumulates no value. However, when
assets. If you were to pass, is there a social security
                                                                 you pay a premium toward a permanent insurance policy
benefit that would pass on to your children? Is there
                                                                 a portion of that premium goes toward the insurance and
real estate that could be sold to provide monetary
                                                                 a portion goes toward the investment vehicle. In general,
support? Looking at your current cash flow and
                                                                 the insurance company invests in mutual funds which
investments can help you figure out the amount of
                                                                 accrue value at historical dividend rates. The value of the
coverage you should buy. In general, the more
                                                                 investment vehicle is what is known as the cash value.
financial responsibility you bear, the greater the
                                                                 When selecting a permanent policy, you want a policy that
amount of life insurance is needed.
                                                                 pays, upon death, the cash value plus the death benefit.
2) what is the difference between term and                       So, if you purchased a $500,000 permanent insurance

12
10 Questions.....from the RFA Committee                     Another important distinction between personal and
                                                            group disability insurance plans is the portability of
policy and the cash value is $30,000, that policy would     coverage. Group plans usually cover you while working
pay out $530,000.                                           for a specific employer while personal plans stay with
While permanent insurance has an investment vehicle         you wherever you go. Remember that personal disability
and is right for people in certain situations, permanent    insurance is easiest to get while young and healthy. If
insurance is not an efficient way to create an investment you try to get personal disability insurance when older,
portfolio due to fees and other restrictions. Remember,     pre-existing medical conditions can be excluded from
you buy life insurance in case you die. How long you need your policy. Statistics show that one-third of people will
the policy and your other financial conditions help dictate develop a disability at some point in their working lives.
the type of policy you should buy.                          6) what is Own-Occupation disability insurance?
4) how is life insurance paid out to beneficiaries? Is     Must it be Guaranteed Renewable with benefits
it a lump sum, or can it be in payments over time?         to age 65 or longer? what is a Residual Disability
It is paid out in a lump sum and is income tax free for theRider? A Future Purchase (FPO) Rider? A Future
beneficiary. Some beneficiaries may choose to take this    Increase Option (FIO)?
lump sum and buy an annuity which would pay out a set      Own-Occupation means the disability insurance covers
amount each month. Although the death benefit is income    specifically what you do. For physicians, having a
tax free it is subject to estate tax.                      specific definition of your occupation, including your
                                                           specialty, is an important consideration. A physician
5) why might a resident or fellow purchase personal without Own Occupation coverage might still be
disability insurance while in training? when is the        employable in a less remunerative occupation and
best time to buy a disability insurance plan? Are          ineligible for disability coverage. It is critical to confirm
group disability plans through employers adequate? that your policy is specific and has the most liberal
The group disability insurance at UCSF provides trainees definition of disability.
with disability insurance that covers 66.66% of salary
after a thirty day waiting period.                         It is always preferable to have a Guaranteed Renewable
                                                           policy with benefits to age sixty-five or longer if the
Trainees, especially those who are considering self-       policy’s premiums are affordable. This is another reason
employment, may want to consider obtaining personal        to consider buying coverage at an earlier age since this
disability insurance, which is readily available and       is less expensive if bought when you are young.
less expensive for those who are young and healthy.
A personal insurance policy should have the broadest       A Residual Disability Rider outlines specific injuries that
possible definition of disability and be guaranteed        may occur and the amount you are paid in the event
renewable with future increase options. There are some     of these types of injuries. Examples of this are the loss
companies that allow residents to purchase policies        of an eye or a limb. This is usually included in most
without financial underwriting. This means you can insure policies.
yourself at a guaranteed benefit level that is higher than Future Purchase Riders and Future Increase Options
what you are currently earning. Insurance companies        allow you to increase disability coverage as your
are willing to do this because they realize your earning   income increases. Future Purchase Riders allow a flat
potential is much higher after completing residency or     dollar amount increase over time while Future Increase
fellowship.                                                Options allow a percentage increase. These increases
There are important differences between group                 are allowed without medical underwriting, meaning the
and individual disability insurance plans. One of the         increases occur regardless of changes in one’s health.
differences is the taxability of benefits. If you pay the     These options will increase premiums, but need to be in
premium for an insurance policy, the benefit you receive      place to correct for inflation over the years and for those
is tax free. However, if someone else such as an              who anticipate increased earning power over time.
employer pays the premium for your policy, the benefit        7) Can I obtain disability insurance if I have any pre-
you receive is taxable. For example, UCSF pays disability     existing medical condition? what is a Guaranteed
insurance premiums for residents and clinical fellows.        Issue policy?
This means the payment you receive while on disability        This depends on the medical condition. If you are
(66.66% of salary after a thirty day waiting period) is       purchasing personal insurance there is a high probability
subject to income taxes. For this reason, some choose         that the company will exclude your pre-existing condition
to carry both individual and group coverage policies.         from coverage.
                                                                                    (continued on page 19)           13
UCSF Appoints Rene Navarro First-Ever
Vice Chancellor of Diversity and Outreach
Lauren Hammit
Senior Public Information Representative, UCSF

                               The University of California, San Francisco has appointed an exceptional physician
                               and campus leader in the health sciences as its first vice chancellor of Diversity and
                               Outreach, charged with creating and maintaining a diverse university environment
                               where everyone has an opportunity to excel. The appointment of Jerolyn [Renee]
                               Chapman Navarro, PharmD, MD, as UCSF Vice Chancellor was officially announced
                               on December 2, 2010 following approval by the UC Board of Regents.

                               As Vice Chancellor of Diversity and Outreach, Navarro will work closely with other
                               senior administrators to address issues of diversity that cut across faculty, student,
                               staff and operational lines. Navarro will serve as a campus expert on diversity goals,
                               act as the campus spokeswoman for best practices, and establish and lead an
                               advisory group.

                           Navarro has served the UCSF community in several capacities since joining the
Anesthesia faculty in 1990. Among her contributions was her directorship of UCSF’s first focused effort in
academic diversity within the office of the Chancellor in 2007, where she coordinated the university’s goal
of increasing diversity among faculty, students, and trainees. Navarro also has served as acting chief of
Anesthesia for San Francisco General Hospital, chief of the medical staff and medical director of the hospital’s
perioperative services.

During her 20-year medical career, Navarro has taught, mentored, and served on dozens of committees
and commissions for local, regional, and national initiatives to advance the efforts of women, people with
disabilities, African Americans and vulnerable populations as well as trauma and critical care providers. She
has received numerous accolades for her work, including a proclamation from the city and county of San
Francisco making June 18, 2003, “Dr. J. Renee Navarro Day.” Navarro is a steering committee member of the
African American Health Initiative for San Francisco County and a member of the UC President’s Task Force
on Faculty Diversity.




      UCSF Patient Care Fund Improves Patient Experiences
     The Patient Care Fund, established by the UCSF Medical Center, is an opportunity for UCSF trainees to improve patient
     experiences at UCSF. Clinical trainees from all disciplines (medicine, nursing, pharmacy) have a unique perspective on
     patient care provided at UCSF Medical Center and are in a great position to recognize unmet patient needs and make
     important, innovative contributions!

     This year’s projects include:
     * Condolence cards for families of deceased patients
     * Purchasing and coordinating additional computers for inpatient access to the internet and Skype

     We are always seeking new proposals. Get those creative juices flowing--no project is too small! Scrutinize your work
     environment and determine how patient experiences can be enhanced.

                                                   For more information visit:
                                      http://medschool.ucsf.edu/gme/residents/pcfund.html



14
GRAND ROUNDS....
(continued from page 10)
                                                                the State of California:
                                                                (stdcheckup.org/provider/index.html). Physicians interested
nearly 5,000 LGBT people nationwide by Lambda                   in transgender care, including transition-related
Legal, “the gay ACLU,” investigated this question.              hormone therapy and surgeries, can learn more
Among its findings:                                             from the Vancouver Public Health Department
                                                                (transhealth.vch.ca/). Lesbian health concerns
•	        28% of transgender respondents and 8% of
                                                                are thoroughly reviewed in Lesbian Health 101: A
          LGB respondents had been refused needed
                                                                Clinician’s Guide, authored by Patty Robertson, MD,
          care;
                                                                of UCSF and Suzanne Dibble, RN, DNSc.
•	        60% of transgender respondents and 9% of
          LGB respondents believed they would be                Like many groups who have historically faced
          refused care because of their LGBT status;            discrimination, LGBT people face healthcare
•	        73% of transgender respondents and 29% of             disparities and inequities, which can be intensified by
          LGB respondents believed that medical                 concern about entering the healthcare system and
          personnel would treat them differently                coming out to physicians. By seeking out resources
          because of their LGBT status;                         like those mentioned above, however, individual
•	        89% of transgender respondents and 49% of             physicians can make a real and much appreciated
          LGB respondents believed that not enough              difference in the health and well-being of their LGBT
          health professionals have been adequately             patients.
          trained to meet their needs as LGBT patients.
Data like these highlight the need for physicians
to relate to their LGBT patients sensitively and                                    Upcoming Events
knowledgeably. LGBT people deeply appreciate a
                                                                                       GME Grand rounds
welcoming medical environment and it can make a                         UCSF GME 2011: Annual Report and Town Hall Discussion
very substantial difference in their health and well-                                 Bobby Baron, MD, MS
                                                                                        February 15, 2011
being. Although it is estimated that only about half                                    N-225, noon-1p.m.
of LGBT patients now feel safe coming out to their
physicians, this number is much higher than in years                   Working with Communities from the Middle East, North Africa,
                                                                          and the Arab World: Culturally Informed Perspectives
past and is growing daily as physicians become more                                      Jess Ghannam, PhD
comfortable with LGBT people and more aware of                                              March 15, 2011
                                                                                          N-225, noon-1p.m.
their health concerns.
                                                                     Every Physician is a Teacher: 10 Tips to Improve Clinical Teaching
Physicians who want to learn more about the                                                  Susan Promes, MD
needs of their LGBT patients can access a host of                                              April 19, 2011
                                                                                             N-217, noon-1p.m.
resources. The Gay and Lesbian Medical Association
(GLMA) has created LGBT clinical guidelines                                           2011 uCsF PPd CliniCs
                                                                                         March 9, 21, 23, 28, 30
(glma.org). Seattle’s public health department has                                  Moffitt 195 (Old Discharge Room)
published LGBT information for clinicians                                                      4pm-6:30pm
(kingcounty.gov/healthservices/health/personal/glbt.aspx) and                               March 14 & 16
Kaiser Permanente has produced a detailed LGBT                                        SFGH, Building 80, Room 319
                                                                                             4pm-6:30pm
handbook for physicians:
(madisonstreetpress.com/cgi-bin/shop.shtml?id=25).                      2011 sPrinG tEaChinG skills workshoP
                                                                                              April 5, 2011
Boston’s Fenway Institute (fenwayhealth.org)                                              Faculty Alumni House
                                                                                             3p.m. to 6p.m.
has developed slide sets on key topics, including
interviewing techniques for LGBT patients as well                            rEsidEnt and FEllows CounCil
                                                                                       Third Monday of each month
as an overarching text, The Fenway Guide to LGBT
                                                                                           5:30p.m. to 7:30p.m.
Health.
One of many helpful resources for treating men who
have sex with men (MSM) is a website developed by
                                                                                                                                          15
GME DIVERSITy
Rene Salazar, MD
GME Director of Diversity

On December 15, 2010, GME co-hosted a diversity holiday reception for applicants, housestaff, and faculty.
Over 40 people attended the event at Bistro 9.
Our fourth annual Diversity Second Look program was held on January 21, 2011. Several departments
participated in this opportunity for applicants to revisit UCSF and learn more about our training programs
including our commitment to promoting diversity in our residency training programs. Activities included a
discussion entitled “Diversity at UCSF” led by Dr. René Salazar, GME Director of Diversity. This was followed
by a panel discussion with current housestaff led followed by a reception at Circolo Restaurant in San
Francisco’s Mission District. Over 40 applicants, faculty, and housestaff from several departments attended the
evening reception.
Thank you to everyone who participated and to Paul Day, who helped organize this year’s activities.
GME will be sponsoring an exhibit booth at the upcoming Student National Medical Association meeting
on April 20-24, 2011 in Indianapolis. Funds for housestaff to attend this meeting are available. For more
information or to learn how you can get involved, please contact Dr. René Salazar, GME Director of Diversity
via email (salazarr@medicine.ucsf.edu) or phone (415) 514-8642.




Pay Stub 101

Responding to
trainee questions,
the Resident and
Fellow Affairs
Committee
decodes trainee
paystubs.



*As of the February 2,
2011 paycheck, SFGH
salary and housing will
appear as two separate
lines like all other
rotations.




16
                                                          GME EVENTS GALLERy
    Dean Hawgood’s Diversity Reception                                            Diversity Recruitment Reception, Bistro 9
           November 4, 2010                                                                  December 15, 2010




     (l - r) Anika Russell, MD, FCM Resident; Beth Wilson, MD, FCM; Alma          (l -r) Sarah C. Schaeffer, Med Student; Juno Obedin-Maliver,
         Martinez, MD, Director of Outreach and Academic Advancement                           Ob/Gyn Resident; Ob/Gyn Applicant




     (l-r) Barak Bar, MD, Neurology Resident; Jayson Morgan, MD, Medicine                  Residents enjoying some downtime at Bistro 9.
     Resident; Meena Ramchandani, MD, Medicine Resident; Hyman Scott,
     MD, ID Fellow; Neil Powe, MD, Chief of Medicine, SFGH; Michelle Guy,
               MD, Medicine; Tacara Soones, MD, Medicine Resident


                                                      Second Look Reception Circolo Restaurant
                                                                 January 21, 2011




                                                                                 Rene Salazar, MD, GME Director of Diversity meets with Second Look
Internal Medicine Resident Melissa Burroughs, MD speaking with Second                                      participants
                           Look participants
                                                                                                                                                      17
ACGME Resident/Fellow Survey is Coming your way
6 Reasons why you Should Care
                                                       # 4: The ACGME is watching…and acting.
Heather Nichols, GME, Accreditation Manager
                                                       Beginning in 2007 the ACGME and its Review
Each year from mid-January through early June,         Committees standardized their methods for following up
the ACGME invites residents and clinical fellows,      with programs and institutions when the results of the
from core specialty programs and subspecialty          survey exceeded an established compliance threshold
programs with four or more trainees, to complete       for duty hours. In 2010, the ACGME began following
a brief online survey regarding their clinical and     up with programs when their aggregated data showed
educational experience as well as duty hours           significant noncompliance in duty hours and in specific
worked. Although the survey contains just 34           survey “domains” (faculty, evaluation, educational
questions the results have a strong impact on          content, resources). Follow-up methods include
your training program as well as graduate medical      warning letters to the program director and designated
education at UCSF and on a national level.             institutional official requesting that they implement
                                                       improvement plans to address the problem areas, and
Here are the top six reasons why you should care       for some programs scheduling early site visits. The
about this survey:                                     ACGME sends a copy of any letter sent to a program to
#1: It ain’t the same ol’ survey.                      the chief executive officer of that program’s sponsoring
The ACGME has once again updated the survey            institution in order to involve him or her in supporting
with help from an outside consultant and input from    program improvements.
residents and fellows. The updated survey is a bit     Overall poor survey results can lead to a shortened
longer (13 additional questions from last year), but   accreditation cycle for programs, focused program
the questions are clearer, less ambiguous, and the     and institution site visits, probation, or withdrawal of
overall flow of the survey has improved.               accreditation.
# 2: It’s important to know what you know.             # 5: Pop quiz!
Let’s face it, despite the survey revisions there      Your ACGME site visitor will discuss the survey with you
is still a chance you will find some questions         at your next accreditation site visit. The site visitor will
confusing. It’s important that you have a clear        use the survey data to focus his or her questions during
understanding of each question before you              the visit. He or she will probe and clarify any areas of
respond. For this reason, we highly recommend          noncompliance and pay close attention to the duty hour
that you review the survey and discuss it with your    items.
program director.
                                                       # 6: We need you!
# 3: Everybody’s doing it.                             The survey data plays a critical role in our oversight of
In 2010, 5,703 ACGME programs participated             your program and overall graduate medical education.
in the survey. You will be asked to complete the       We need your responses to help us continue to monitor
survey on the ACGME’s website between January          and improve graduate medical education.
and June (as assigned by the ACGME). At that
time you will be given approximately five weeks to     BTW
complete the survey. If less than 70% of trainees      Although the survey data is reviewed extensively the
in a program complete the survey, the aggregate        responses are confidential. No names are associated
data will not be available to the program. It’s        with the data. Aggregate, program-level data from
imperative that programs receive a high response       the survey are provided to the program directors and
rate in order to use the data for program quality      designated institutional official for programs with four or
improvement. ACGME site visitors and the ACGME         more residents if 70% completion is reached.
Review Committee will have access to the report
                                                       FYI
regardless of the program response rate. To help
                                                       A sample survey and survey report, resident survey
protect anonymity, programs with less than four
                                                       login, and more information can be found at
trainees do not receive a summary report. So, just     http://www.acgme.org/acWebsite/Resident_Survey/res_Index.asp
do it!
18
10 Questions.....from the RFA Committee                         litigious individuals. Umbrella policies only cover personal
(continued from page 13)
                                                                liability and do not come into play for professional liability.
A Guaranteed Issue policy typically refers to group             Medical malpractice insurance covers professional liability
coverage such as that offered by employers where                and losses.
the policy guarantees coverage without medical
                                                                Travel insurance covers a wide array of potential
underwriting. This means your health is not taken into
                                                                problems that could occur while traveling, including
account when obtaining coverage. You are usually
                                                                medical expenses, lost luggage, and trip cancellation.
required to enroll in the group policy within the first 30 to
                                                                Whether you should purchase travel insurance depends
90 days of employment; the requirements are different
                                                                on where you are traveling and the likelihood of
depending on the employer plan. Personal Guaranteed
                                                                something going wrong. If you are in poor health going
Issue disability policies are available but their cost is
                                                                to an underdeveloped area, or traveling to engage
usually prohibitively expensive
                                                                in a potentially dangerous activity, you may want the
8) how do I find discounts on disability insurance,             assurance of being able financially to get back home
such as “multi-life” or medical association                     quickly if you fall ill or are injured.
discounts? what are “gender neutral” or “unisex”
                                                                10) what is the right way to identify the agent or
rates?
                                                                company from whom to obtain insurance?
Group policies tend to be cheaper than individual
                                                                When looking at insurance companies you want to
policies, but when you buy into a group policy you
                                                                investigate the company’s stability, length of time in
generally are giving up the liberal definition of disability,
                                                                business, and industry ratings, including A.M. Best
the “own-occupation” coverage, and the portability.
                                                                Insurance Ratings. Seek out highly-rated insurance
While personal disability insurance is more expensive,
                                                                companies and shop comparatively.
it is important for physicians to insure themselves well
against potential loss of income due to disability.             When looking for an insurance agent you want to find
                                                                someone who is experienced, has a good reputation,
When considering policies offered through professional
                                                                and who will serve as your advocate rather than as a
associations it is important to look through the
                                                                salesperson. Talk with peers, family, and other trusted
association that offers the policy and to the company
                                                                advisers to get personal recommendations.
that manages the policy. When choosing an insurance
company you should consider the company’s history,              Alternatively, you can retain a certified financial planner
reputation, stability, and rankings. A.M. Best is the main      to get recommendations about insurance in the context of
insurance rater and your insurance company should               your other financial plans. Since most certified financial
have the highest ratings possible.                              planners do not sell insurance you can work with them to
                                                                develop an insurance plan and then go to an insurance
Women are more expensive to insure for disability than
                                                                broker knowing exactly what you want to buy. Certified
men. If you are a woman it is usually more economical
                                                                financial planners are hired to provide guidance and have
to buy a policy that offers unisex rates, which are
                                                                a fiduciary responsibility to their clients as part of the fee-
blended rates assigned irrespective of gender.
                                                                only engagement. Insurance brokers do not have this
9) what is an umbrella policy and should I have                 relationship with a purchaser. It is always correct to ask
one to protect my assets in case of a lawsuit                   any planner or broker how they are compensated and to
(malpractice or other)? Under what circumstances                explore the terms and boundaries of their relationship with
should one consider travel insurance?                           you.
An umbrella policy is a separate policy that covers
liability over personal activities specifically named in the     UCSF Insurance Coverage for Residents and
policy. It insures large losses by providing coverage to         Clinical Fellows
a level higher than the liability limits of your underlying      UCSF trainees receive a $50,000 term life insurance
policies like automotive or homeowners. For example,             policy from Sun Life (principal insuree only, no
if you were involved in a car accident and were found            dependant coverage available) and disability insurance
liable for personal injury expenses in excess of your            that covers 66.66% of salary after a thirty day waiting
car insurance policy, the umbrella policy would come             period. All UC employees can receive free travel
into effect and help cover the additional expenses.              insurance if traveling on official UC business. For more
Umbrella policies are not expensive, and are useful for          information visit:
those with high earning power who can be targets for             www.rmis.ucsf.edu/RMISDetails.aspx?Panel=9

                                                                                                                            19
                                                                                                            Winter 2011
       ThE OFFICE OF
 GRADUATE MEDICAL EDUCATION                          G M E             C y P h E R
                                                                                                                           The
   Welcomes New Program Directors                                    Robert B. Baron, MD, MS
      and Program Coordinators                                                                              Residents
  Program Directors                                       Solve the winter
                                                                                                                   Report
  •	    Jose Miguel hernandez                             2 0 1 1        C y p h e r
        Pampaloni, MD
        Nuclear Medicine Residency
  •	    Norah Terrault, MD, MPh                       Ubj sne lbh tb va yvsr qrcraqf ba
        Transplant Hepatology Fellowship                                                                  Editorial Staff:
                                                      lbhe orvat graqre jvgu gur lbhat,                   Robert Baron
  Program Coordinators                                pbzcnffvbangr jvgu gur ntrq,                        Amy Day
                                                      flzcngurgvp jvgu gur fgevivat naq                   Paul Day
  •	    Svetlana Sogolova
        Endcrinology, Diabetes, and                   gbyrenag bs gur jrnx naq fgebat.
        Metabolism Fellowship                         Orpnhfr fbzrqnl va lbhe yvsr lbh
                                                                                                          Many Thanks
                                                      jvyy unir orra nyy bs gurfr.
  •	    Virginia Schuler                                                                                  The Dean’s Office of
        Infectious Disease Fellowship
                                                                                                          GME would like to
                                                      Trbetr Jnfuvatgba Pneire
  •	 yvette becnel                                                                                        thank the following
     Pathology Residency                                                                                  contributors to articles
  •	 Catherine Cooper                                                                                     in this issue.
     Thoracic Surgery Residency                  Instructions: The above is an encoded quote from a
                                               famous person. Solve the cypher by substituting letters.
                                                                                                          Contributors
                                                Send your answers to Justin Akers, Resident & Fellow      Justin Akers
Congratulations Fall 2010 Cypher Winner         Affairs Manager, OGME: akersJT@medsch.ucsf.edu.           barak bar
Gabrielle Rizzuto, MD, PhD, Pathology           Correct answers will be entered into a drawing to win a   John beeson
                                                                 $50 gift certificate!                    Michael blum
            Resident, PGY1!!
                                                                                                          Pat Cornett
                                                                                                          Adrienne Green
                          Faculty and Staff Assistance Program                                            Lauren hammit
                                                                                                          Rachael Kagan
                          University of California San Francisco                                          Mary McGrath
                                                                                                          heather Nichols
                                                                                                          Julie Philp
       3333 California St., Suite 293            For additional information, please visit our             Rene Salazar
                                                                  website at:                             Mark Shone
            San Francisco, CA                     http://ucsfhr.ucsf.edu/index.php/assist/                Shane Snowdon
               94143-0938                                                                                 J o s e p h i n e Ta n
             (415) 476-8279                                  For an appointment,                          Sandrijn van
                                                          please call (415) 476-8279                      Schaik
                                                                                                          brian
                                                                                                          wa l d s c h m i d t
                                                                                                          A n g e l a wa l k e r



                  Important GME Contact Information
         Office of GME                                                (415) 476-4562                      UCSF School of Medicine
                                                                                                          Graduate Medical Education
         GME Confidential help Line                                   (415) 502-9400                      500 Parnassus Avenue
                                                                                                          MU 250 East, 0474
         Director, GME                                                (415) 514-0146                      San Francisco, CA 94143
                                                                     daya@medsch.ucsf.edu
                                                                                                          tel (415) 476-4562
         Associate Dean, GME                                          (415) 476-3414                      fax (415) 502-4166
                                                                     baron@medicine.ucsf.edu
                                                                                                          www.medschool.ucsf.edu/gme
         UCSF Faculty & Staff Assistance Program (FSAP)               (415) 476-8279

         GME website                                         www.medschool.ucsf.edu/gme
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