- What Can ACOI Do For You?
- Young Leadership Wanted: You Can Make A Difference
- Board Question of the Month
- Everyone Needs a Good CV
- Patient/Physician Relationship Must Come First in Efforts to Reform Health Care System
- News of Note
- Resident/Fellow Check List of Responsibilities
- ACOI Contacts
- Council on Education and Evaluation
WHAT CAN ACOI DO FOR YOU?
A new training year is underway and the ACOI extends a warm welcome to all new and returning residents and fellows. There are more than 1000 of you in osteopathic internal medicine and subspecialty training programs, which is greater than any other specialty in the profession. We are very proud of the growth in osteopathic internal medicine and in the numerous excellent training opportunities available to osteopathic college graduates.All residents and fellows are Candidate members of the ACOI at no cost to the resident. As you complete your training, the ACOI can be a true resource for you. The College is responsible, with the AOA, for all of the training standards guiding the operations of your programs. Through the Council on Education and Evaluation, program quality undergoes continuous scrutiny. The Council also is responsible for assuring that your individual training is completed successfully. The Council is comprised of nine internists who are deeply involved with and committed to osteopathic education. Residents have a voice on the Council, as well, in the person of Belinda Kakos, D.O. a second-year resident at Henry Ford Health System Macomb-Warren Campus.
The ACOI website (www.acoi.org) includes many of the documents that are essential to your training. In addition to the Basic Standards for internal medicine and all subspecialty training, there is a Model Curriculum which outlines the education content that internal medicine residents are responsible for learning during the course of your training. The American Osteopathic Board of Internal Medicine, which administers the internal medicine and subspecialty certifying examinations, draws the test content directly from the Curriculum.
Residents and fellows also complete required annual reports via the ACOI website. The website also is the portal to your ACOI membership record and the numerous listservs available to residents, fellows and all other members.
The ACOI invites you to consider the College as the first source for answers or assistance with any questions or concerns about your training. Christina Smith (Christy@acoi.org) is the primary staff contact for training matters. Keisha Oglesby (Keisha@acoi.org) can help with certification questions. Susan Stacy (Susan@acoi.org) and I (bjd@acoi.org) are also available to help. It is ACOI policy that all phone calls and e-mails will be acknowledged and responded to within 24 hours of receipt. Please take advantage of the wealth of information that is available to you now and throughout your careers as osteopathic internists.
Brian J. Donadio, FACOI
Brian J. Donadio, FACOI, is the Executive Director of the American College of Osteopathic Internists. He may be reached via email at bjd@acoi.org.
YOUNG LEADERSHIP WANTED: YOU CAN MAKE A DIFFERENCE
It is difficult to explain to most people the importance of July in the medical year. For most people, this is the peak of summer or the biggest vacation month of the year. July is a month for barbeques, beaches, pools, and other outdoor activities. For medicine, this is the start of a new year. July sees the new intern wandering the wards at night and the new class of students hard at work on their first H&P. It is statistically the slowest month, nationwide, for admissions, yet sees the highest number of medical errors. There are new personalities to learn and attendings have to learn the best way to teach a new group of individuals. The nursing staffs at most hospitals are learning which interns to trust and the new doctors are learning which nurses to depend on. Administrations know that there will be more tests run per patient this month. Returning residents know that they will be receiving more phone calls this month. For the field of medicine, July can be quite unnerving.
To that end, the Board of Directors recently met to discuss the vision of ACOI and how to best meet the needs of our members, including osteopathic internal medicine residents. In those discussions, there was a lot of talk about the future of our organization, including where the Board sees residents playing a role. The truth is, our profession is getting younger every year and our leadership is having a tough time following the same path. The Board recognizes the importance of growing as an organization. This was made very clear as the accomplishments of the last 10 years were placed one at a time upon a timeline at the Board meeting. Those accomplishments happened because ACOI isn't afraid to try something new, even if it feels uncomfortable. The groundwork is set for a new generation of leaders and, over the next few years, ACOI is poised to help with that transition. ACOI has set a two-year goal to increase utilization of younger physicians in the development of our organization. We understand that in order for ACOI to continue to train, mentor, and advocate in the best interests of our members, we cannot limit our vision to the status quo. As residents, you are that next generation. Our hope is that you take part in this organization, the more you are going to want to give back.
I look forward to meeting all of you. Please send me an e-mail if there is anything that you have want or need. I hope to see many of you at this year’s annual convention in Tucson, Arizona.
Mat Hardee, DO ACOI Board of Directors Resident Representative Mat Hardee, DO, is a second year internal medicine resident at Northeast Regional Medical Center in Kirksville, MO. He may be reached via email at ACOIResidentRep@gmail.com..
BOARD QUESTION OF THE MONTH
This series of questions is to help residents understand how board questions are written and what kind of information these questions are testing. In order for residents to better understand the process, the ACOI has asked Joanna R. Pease, DO, who was a member of the American Osteopathic Board of Internal Medicine for 10 years, to write sample questions, explain how the questions are constructed and demonstrate some of the concepts that will enhance test taking.
A 65 year old patient presents with severe pain down his right arm for 4 days. Yesterday he noticed a rash on his arm and presents to your office today for evaluation. On physical exam the patient appears in pain. He is afebrile. On the lateral surface of his right arm, starting in the cervical area, he has a vesicular rash that extends to his hand. There is erythema surrounding the vesicles but no purulence and no signs of lymphangitis.
Which of the following treatment plans would provide the best care for this patient?
A. Acyclovir 800 mg 5 times a day plus amitriptyline 25 mg at bedtime
B. Acyclovir 800 mg 5 times a day plus gabapentin 600 mg 4 times a day
C. Famciclovir 750 mg 3 times a day plus ibuprofen 800 mg 3 times a day
D. Valacyclovir 1000 mg 3 times a day plus nortriptyline 25 mg at bedtime
E. Valacyclovir 1000 mg 3 times a day plus topical lidocaine 12 hours a day
The answer is d. The patient probably has herpes zoster. Studies have shown that anti-viral treatment shortens the duration of the acute illness. Both tri-cyclic antidepressants and anti-virals decrease the incidence of post-herpetic neuralgia, a major cause of HZV morbidity and TCA’s provide some pain relief. Therefore, a combination of an anti-viral and a TCA would provide the best care for this patient. Of the anti-virals, famciclovir and valacyclovir have longer half-lives and better outcomes so are preferable choices. Either low dose amitriptyline or nortriptyline is an acceptable TCA for prevention and treatment of postherpetic neuralgia but nortriptyline is preferable because it has a better side-effect profile. Nonsteroidal anti-inflammatory drugs have little efficacy for pain relief in HZV infections and do not lessen the incidence of postherpetic neuralgia. Topical lidocaine has only been shown to have marginal effectiveness for pain control in this disease and should not used on skin with open lesions.
EVERYONE NEEDS A GOOD CV
Well, the summer is upon us. It is hard to be working the long days of a resident with the weather as nice as it is outside; but hang in there, all of your hard work will be rewarded.
Now is the time for putting together a good CV. The Curriculum Vitae is an essential piece of documentation that you will use again and again throughout your career, and I would like to give you a few tips to help you craft a worthwhile document.
Start Now:No matter what year of residency you are in, you need to have an updated CV on hand. Everyone from students to established attending physicians should have a good CV available to use for a variety of reasons. A CV should be a "living document" kept in an accessible file that can be updated easily. If you have a bare bones CV on hand now, you can add events as they happen. This will make things easier when your CV is needed on short notice. Update often:
This will make your life easier. If you add publications or committee appointments when they happen, it will be much easier to produce a CV that is up to date and reflects your current accomplishments. You may find it hard to remember the exact date of the poster session where you presented as an Intern when you are a third year resident! Put in all the important things:
A good CV will showcase your work during medical school and residency. You should include where you went to undergraduate and medical schools. If you placed in the top of the class, that can be noted, as well. You should include where you did (or are doing) your residency. You should include any honors you receive during residency (intern of the year, house staff president, etc). Include committees that you were a part of during your residency or medical school career. Include research that you did, posters that were presented, and of course, any publications. You should also include all society memberships (ACOI, for example). Any extra education that you participated in (a quality improvement course, etc), certifications (ALS, etc), volunteer work, and anything you are very proud of and would like to discuss during your interview (you may mention that you are an avid runner and have completed five marathons while doing your residency). Things not to include:
Some people want to put everything into a CV. Avoid including non-relevant things that make it look like you are trying to fill space. Do not put in work experience not directly related to the medical field. You do not need to include your work experience before medical school unless it was directly related to the medical field. You can put in your hobbies if you like, but do not put in that you won your high school soccer championship (I have seen it, one person even included their jersey number!!). Make it look professional:
There are a number of ways to do this. There are computer programs that will help you organize the material logically. These will often convert the file into PDF format as well, which will help with distribution and make it look professional. You can also pay someone to craft the CV for you. These often look the best and sometimes can include your photo on the cover page. And, of course, the Internet is full of sites that provide tips and recommendations. Any of these ways are fine, but the most important things are that it looks professional, is set up in a logical manner, is easy to read and shows the reader everything you want them to know about you and what you have to offer their program. Have someone else read it:
Let someone you trust look at your CV. Ask them if they think it looks professional; have them check it for grammar and spelling errors. A lot of employers look down on a CV with spelling or grammatical errors. They reason that if you cannot spend the time putting together a quality CV, then you may not be able to do quality work. Your CV should speak for you and showcase your talents. Your CV is your first impression and others will start to judge you based on your CV, so spend some time and make it a document you are proud of.
Please feel free to drop me an email regarding questions or feedback about these articles.
Scott Girard, DO Scott Girard, DO, is a hospitalist in Danville, PA. He completed his internal medicine training at Geisinger Medical Center in Danville in July, 2008. During his training, Scott served for two years as the resident representative to the ACOI Board of Directors. He now serves as liaison and advisor for residents and the College. He may be reached at slgirard@geisinger.edu.
PATIENT-PHYSICIAN RELATIONSHIP MUST COME FIRST IN EFFORTS TO REFORM HEALTH CARE SYSTEM
As we continue to move through the summer months here in Washington, there is a debate waging on issues that have the potential to change fundamentally the future of medical training and practice. Legislators in both the House and Senate, on both sides of the isle, are discussing how to expand access to care, increase the number of physicians, and restructure the health care delivery system to meet these goals. The ultimate success of health care reform efforts will rely on Congress’ ability to promote greater efficiency and increased quality. The ACOI has taken an active role in this debate and encourages you to do the same.Humayun Chaudhry, DO, MS, ACOI President, recently sent a letter to Speaker of the House Nancy Pelosi in response to ongoing efforts to advance the “America’s Affordable Health Choices Act of 2009” (H.R. 3200). In his letter he emphasized the need to protect the patient-physician relationship and ensure that patients continue to have a choice with regard to where they obtain their health coverage. In addition, the letter discussed the importance of expanding the availability and reducing the cost of graduate medical education. Finally, it stressed discussed the importance of reforming the current Medicare physician payment formula and the financial savings that could be realized by including provisions to reform the medical liability system. Understanding that any legislation signed into law to reform the health care delivery system will change the future of medicine, the ACOI commented on areas that would promote an increase in the number of physicians, protect the patient-physician relationship, and encourage the ability of patients to maintain control over their health care.
While committees in the House and Senate have considered comprehensive health care reform legislation, there is a great deal of work that remains before legislation is signed into law by the President. To this end, the ACOI will continue to advance issues of importance to its membership and patients. Because the final health care reform package fundamentally will impact the training and practice of physicians in the future, you are encouraged to get engaged in this important dialogue.
You may view Dr. Chaudhry’s letter discussing health care reform and H.R. 3200 at www.acoi.org. As always, please feel free to contact Tim McNichol or by calling toll-free 1-800-327-5183 if you have any questions or concerns regarding this or other legislative issues.
Tim McNichol, JD Timothy McNichol, JD, is the Deputy Executive Director of the ACOI and is responsible for the College's advocacy efforts. He may be reached via email at tmcnichol@acoi.org..
Attendance at ACOI Annual Convention
A recent change in the Basic Standards for Residency Training in Internal Medicine requires that each osteopathic internal medicine resident attend the ACOI annual convention or another ACOI continuing education meeting at least once during the training program. The standard change requires the training institution to provide resources for residents to meet this requirement.
The ACOI provides free registration to the convention for all residents, fellows and students. This includes most meal functions. In addition, trainees are provided with a voucher worth $100 towards the purchase of a textbook through one of the exhibiting book companies. The convention program also includes a separate program for trainees in addition to the education sessions available for all ACOI members. The change in standards is effective July 1, 2009. The 2009 ACOI Convention will take place October 14-18 in Tucson, AZ. For further information, contact Susan Stacy at susan@acoi.org of the ACOI staff.
ACOI Staff Resources for Residents and Fellows
The ACOI staff and the Council on Education and Evaluation are important sources of information and assistance for osteopathic internal medicine residents and fellows. Two staff members are available on a daily basis to address questions and concerns. Christy Smith serves as postdoctoral administrative coordinator and can answer questions about general training requirements and specific individual training issues. Keisha Oglesby (keisha@acoi.org) is the ACOI certification liaison. Residents and other certification candidates are urged to contact her to clarify questions about completion of certification requirements.
ACOI policy is that all phone calls and e-mails are acknowledged and returned within 24 hours of receipt. Please take advantage of these resources available to you.
ACOI President
hchaudhr@nyit.edu
Michael B. Clearfield, DO, FACOI
President-Elect
michael.clearfield@touro.edu
Matthew R. Hardee, DO
Board of Directors Resident Representative
ACOIResidentRep@gmail.com
Brian J. Donadio, FACOI
Executive Director
bjd@acoi.org
Timothy W. McNichol, JD
Deputy Executive Director
tmcnichol@acoi.org
Susan B. Stacy, FACOI
Director of Administration and Finance
susan@acoi.org
Christina A. Smith
Post-Doctoral Training Coordinator
christy@acoi.org
Keisha L. Oglesby
Membership Coordinator/
Certification Liaison
keisha@acoi.org
jbulger@geisinger.edu
Thomas J. Mohr, DO, Vice Chair
tmohr@rockyvistauniversity.org
Gary L. Slick, DO (AOBIM)
aobim@mail.com
Robert A. Cain, DO
racain@sbcglobal.net
Susan M. Enright, DO
senright@genesys.org
Joanne Kaiser-Smith, DO
jksdoc@aol.com
Robert T. Hasty, DO
hasty@nova.edu
Joanna R. Pease, DO
strixvaria@sbcglobal.net
Frederick A. Schaller, DO
frederick.schaller@touro.edu
Belinda Kakos, DO - Resident Representative
bkakos1@hfhs.org