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Residency Redesign Challenge Grant Recipients

2013 Grant Winners

Surgical Residency Redesign Faculty Team

Project Title: Changing the Face of Plastic Surgery Training: A 5-Year Residency

Richard J. Redett, MD

Associate Professor, Department of Plastic and Reconstructive Surgery and Pediatrics
Director, Center for Cleft Lip and Palate
Director, Facial Paralysis Center
Director, Pediatric Plastic Surgery
Director, Residency Program

Scott D. Lifchez, MD

Assistant Professor, Department of Plastic and Reconstructive Surgery and Department of Orthopaedic Surgery
Director, Hand Surgery
Associate Director, Residency Program

Amir H. Dorafshar, MBChB

Assistant Professor, Department of Plastic and Reconstructive Surgery and Department of Neurological Surgery

Carisa M. Cooney, MPH

Instructor and Clinical Research Manager, Department of Plastic and Reconstructive Surgery

Abstract of Project: Graduate Medical Education (GME) training programs currently face many challenges. GME funding cuts, healthcare funding changes, adapting to the Next Accreditation System (NAS), reduced resident work hours, increased requirements to document specialty-specific competencies, and an ever-increasing knowledge stream all exert considerable forces on resident training. While all training programs are struggling to adjust, these forces particularly threaten surgical training, and plastic surgery training in particular. Plastic and reconstructive surgery is unique in its ability to treat any part of the human body and to address many levels of defect severity. This can range from superficial (i.e., skin) wounds to complex and potentially life-threatening (i.e., traumatic or congenital craniofacial) defects. This variability is reflected in the Plastic and Reconstructive Surgery ACGME-required caseload. PGY-6 graduating residents must complete a minimum of 930 cases in 29 areas consisting of 78 category listings. With these internal and external forces in mind, the Johns Hopkins Department of Plastic and Reconstructive Surgery proposes a new pilot residency design that will shorten GME training from six years to five. Additionally, by expanding our use of skills labs and incorporating a business education curriculum, we propose to cut indirect GME costs resulting from resident care decisions. For these reasons, we propose to conduct a pilot residency program beginning July 1, 2014 consisting of a 5-and-1-year program in which 2 residents will be enrolled for 2 consecutive years.

Non-Surgical Residency Redesign Faculty Team

Project Title: The GREAT Curriculum for Genetics Residency Training at Johns Hopkins

Tao Wang, MD, PhD

Assistant Professor, Pediatrics
Faculty, McKusick-Nathans Institute of Genetic Medicine

Hans Thomas Bjornsson, MD, PhD

Assistant Professor, Pediatrics and Genetics
Faculty, McKusick-Nathans Institute of Genetic MEdicine

David Valle, MD

Professor, Departments of Pediatrics, Ophthalmology and Molecular Biology and Genetics
Henry J. Knott Professor and Director, McKusick-Nathans Institute of Genetic Medicine

Abstract of Project: Medical genetics residency traditionally focuses on trainings in the diagnosis and management of patients with rare Mendelian disorders and in clinical and laboratory research related to these disorders. With rapid advancement in genomic technology and genetic information generated from the human genome project, medical genetics has now progressed from the study of rare iseases to a rapidly expanding appreciation of the genetic contribution to all diseases in all areas of clinical medicine. However, in parallel to the rapid growth of genetics in medicine, it is increasingly recognized that many physicians in training and in practice have little formal education in medical genetics and genomics, are insufficiently trained to order and interpret appropriate genetic testing results, are unable to effectively utilize medical genomic information in their clinical training and practice. This sharp contrast between the demand for genetic knowledge versus the state of education poses both a challenge and a wonderful opportunity for medical geneticists to play a crucial role in education to promote the integration of genetics in edicine. Accordingly, there is a pressing need to change the way we train medical genetics esidents so that they not only become skilled practitioners but also excellent educators. To achieve the rapidly evolving training objectives, we have recognized an urgent need for genetics residency program to develop novel educational resources and curriculum, to provide the esidents with sufficient educational tools and teaching skills, and to create opportunities for residents to teach medical genetics and genomics to resident and faculty colleagues in other medical disciplines during their training.

We propose to initiate an integrated Genetics Resident As Teacher (GREAT) curriculum that emphasizes teaching by residents as a key objective for medical genetics residency training at Johns Hopkins. The GREAT program consists of four basic elements (1) establish a Clinical Genetics Teaching Database (CGTD), (2) build integrated theme electives that emphasize the expanding field of clinical genetics including medical genomics, (3) conduct annual resident retreat that focus on adult teaching concept and skill development, and (4) implement structured teaching opportunities by residents with feedback evaluation throughout the residency training. These four elements of the GREAT program are highly integrated. The overall aims are to equip genetics residents with sufficient knowledge, tools, and skills to teach medical genetics and genomics to all levels of health professionals so that our residents will be best prepared to meet the challenges of becoming leaders and educators of next-generation medical geneticists. The residency redesign challenge grant sponsored by the IEE provides an excellent opportunity for us to test and implement these ideas leading to an overall redesign of our medical genetics and enomics residency training at Johns Hopkins.