• Internal Medicine, Subspecialty Training at Record Levels
• The ACOI Annual Convention Experience for Residents and Students
• The Evolution of How We Learn
• 2009 Convention Approaches
• Appeals Court Rules Resident Earnings are Taxable/Training Grants Announced
• News of Note
• ACOI Staff Resources for Residents and Fellows
• Resident/Fellow Check List of Responsibilities
• ACOI Contacts
• Council on Education and Evaluation

INTERNAL MEDICINE, SUBSPECIALTY TRAINING AT RECORD LEVELS

Overall, the survey reflects another significant increase in the number of osteopathic internal medicine residents.


DUAL PROGRAMS –
The survey captured data on whether the responding programs are also approved by the ACGME. Twenty-six programs reported dual approval. They are training 174 residents (including combined EM/IM and IM/PEDS). That is 26 more residents and one more program than last year.

The number of available programs has increased to 89 (six more than 2008-09). There are now 187 fellows training in 15 specialty areas. This is up from 163 fellows last year. There are no approved programs or trainees in allergy/immunology and hospice and palliative care medicine. Training is occurring in all other specialties. The first new hospice and palliative program was approved in September and training is expected to commence there shortly.

Beginning in 2008, the online Resident Annual Reports required graduating residents to report their future plans. For June 30, 2008 graduates, here are the results:

Brian J. Donadio, FACOI

THE ACOI ANNUAL CONVENTION EXPERIENCE FOR RESIDENTS AND STUDENTS

I would like to take this opportunity to talk to you about the ACOI’s annual convention. I have been lucky enough to be able to attend the last three conventions, and I look forward to this year’s meeting in Tucson. Every year I am happy that I attended and think that it was both worth my time and my expense. I would like to take this time to look at the benefits of the convention for students, residents and young physicians.

The ACOI has been particularly dedicated to the residents and students that attend the convention. Each year the convention sets aside a day that is tailor-made for internists in training. The Resident and Student session has developed into a great educational experience as well as a place for everyone to meet ACOI's leaders and discuss any issues they may have, in a face-to-face talk. This year the Resident and Student session features a hands-on experience as well as lectures specifically aimed at the resident or student.

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THE EVOLUTION OF HOW WE LEARN

In my last year of college while tallying up my credits, I discovered a gross miscalculation. I was, indeed, four credits shy from completing my major. Scrambling to find a class that would fulfill my last requirement and not overly tax my schedule, I stumbled upon the Psych class, Learning and Memory. Like many other college students at the time, I was filled with senioritis, excited to begin a new chapter in my life, and really did not think that I would take much from the course.

Much to my surprise, however, theory and practice fit like hand and glove – what we learned in the classroom we witnessed in the lab. Unlike all my other psych courses, emphasis was placed on cognitive development. I discovered that the way in which we process and retain information is woven intricately with our physical and emotional stages of development. As we change physically and emotionally with time, so too, do our cognitive abilities undergo transformation.

Adhering to these principles has served me well as a resident. As medical students we spend the first two years predominantly in a classroom learning about the physical manifestations of a disease state. The last two years on the wards we are exposed to the emotional consequences. By the end, the really astute students can pick up the relationship between the two.

As residents, where our education involves a limited amount of time in the classroom, we learn to diagnose based on our experiences – we develop a pattern for recognition. Learning and memory for the adult is intimately related to our experiences and is one of the foundations for adult learning theory.

First, he touched on the point of accountability. Compared to other professions, we as physicians are held to a higher standard. The majority of our time is not behind a desk calculating numbers, it is face to face with a patient. We are entrusted with the care of people at their most vulnerable. As a result, our trainers must hold us accountable to this awesome responsibility. Though we are human and prone to error, we must learn to minimize the frequency and to accept gentle correction.

Secondly, the way in which we process and retain information has changed. We rely heavily on our experiences and in order to truly learn we must know WHY a concept is important for retention. For example, each day, I have made a habit of reading about one case that I have managed. I draw from my experiences with the patient and link the theory together. In this way, when another patient presents with a similar concern I can form a rapid assessment and implement a safe strategy.

Lastly, as a part of our training, we should be giving lecture presentations regularly. Teaching reflects mastery. By teaching, we demonstrate competence and confidence in a subject matter, qualities necessary for leadership development of senior residents. Additionally, teaching is an avenue for interactive learning. We are more likely to retain what we have experienced and taught.

Our cognitive development has profound implications to our success as residents. Success then, is contingent upon holding ourselves accountable to a higher standard, recognizing the best practices for learning and memory and ensuring that we teach as we have been taught.

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2009 CONVENTION APPROACHES

Hello, again, Residents and Fellows,
Starting October 14th the 69th ACOI Annual Convention and Scientific Sessions begin in Tucson, Arizona. This is meant to be a chance for us to share fellowship as a profession, to gain new insight and share new ideas. Yet I always felt, before learning about the ACOI, that the convention was not meant for residents. It was a place for the good old boys of medicine to get together, drink, and play golf. I struggled with the idea that I was too small to even matter to the other physicians that gathered, let alone the Board. I imagined that residents were relegated to the back of the room, behind anyone who paid a full membership. We were the sometimes unwilling participants sought by our residency directors. Now, I worry that a new generation of doctors is feeling the same way. I am concerned that many of you will look at ACOI or AOA conventions as obligations and not as opportunities. Each year at the convention there is time dedicated to the education of the residents. This time belongs to each of us and I hope it will provide us with helpful information as we develop as physicians.

The residents section of the Convention will begin a little earlier this year. We have been very fortunate to invite the ultrasound company SonoSite to provide some breakout sessions demonstrating how ultrasound is changing the practice of medicine. Our hope is that this time will allow you to see firsthand how ultrasound can be utilized in daily hospital practice, and to allow you to interact with a knowledgeable demonstrator. Many of you have utilized ultrasound before, but these sessions promise to give new insight. After lunch, we will reconvene and have a time for interaction with the ACOI Board and Education Council. These are individuals that may seem beyond you, but believe me they have your interests in mind every day. Our hope is that you will come with questions and be prepared to have a conversation. After this meeting of minds, we have scheduled several talks that will give insight on everything from ethics to research. Everything that has been put into this schedule has been done, not to showcase, but to give you each insight into what the future of medicine holds.

I said that the convention always seemed like a place that we don’t belong, but I want you to know that ACOI has a strong regard for the quality of residents that are being educated under its wing. I have had the pleasure over the last year to be your voice to the ACOI Board. They have been attentive to my thoughts and suggestions, and I have a new respect for the sacrifice that is made on our behalf. I am always available. Please e-mail me at acoiresidentrep@gmail.com anytime. I have had some great interactions with residents and am always interested in what you think.

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APPEALS COURT RULES RESIDENT EARNINGS ARE TAXABLE

The Eighth Circuit U.S. Court of Appeals recently reversed two previous decisions and ruled that the Internal Revenue Service (IRS) may collect Social Security taxes from medical resident salaries. The decisions that were overturned previously found that the IRS had erred in collecting taxes from residents at the University of Minnesota and the Mayo Foundation for Medical Education and Research. The appeals court ruling stems from 2004 regulations issued by the IRS which state anyone who works at least 40 hours a week is considered a full-time employee and subject to Social Security taxes, even if the work has educational and training aspects. The court focused on the full-time employee limitation and concluded that the IRS’ interpretation was consistent with the “origin and purpose of the student exemption as initially enacted.”

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