NewYork Presbyterian Graduate Medical Education Away Electives Guidelines Approved by GMEC in June 2010

Transcription

1 NewYrk Presbyterian Graduate Medical Educatin Away Electives Guidelines Apprved by GMEC in June 2010 These guidelines are t be used fr all away electives, except thse, which have been established and are the subject f current agreements. The guidelines will refer t these rtatins as Away Electives. Prcess Residents seeking Away Electives must cmplete the applicatin that can be fund n the NYP Infnet. Applicatins must be submitted sixty days prir t an Internatinal and/r lng term recurring Rtatin and thirty days fr a Dmestic ne time Rtatin. These requests will be reviewed and apprved by the GMEC executive cmmittee and presented fr apprval t the campus specific GMEC meetings. Rtatins requests unable t meet these timelines shuld be submitted t the GME Office fr evaluatin n a case by case basis by the DIO. Categrizatin f Elective Requests The fllwing criteria will be used t assess and queue the rtatin requests: a) RRC required and ccur utside f the NYP system b) Systems/Prgram Develpment/Infrastructure Design (ptentially-- prgrams that are nging and may be funded and accmpanied by faculty and might have little t n patient cntact). This might als include residents wh are invlved with multi-institutinal research effrts c) Clinical rtatins that are funded and nging with well develped relatinship t NYP r the medical schls. The expectatin is that there is a near cnstant presence f Clumbia r Crnell teaching faculty. d) Clinical rtatins that are value added t the residents educatin but nt mandatry fr bard certificatin ( fr example--wrking with a ppulatin with a surgical cnditin nt rutinely seen in the US r a ppulatin that has a high prevalence f rheumatic disease r cngenital defects) e) All ther clinical rtatins such as auditins, cultural immersin and language immersin Expectatins fr Away Rtatins All Away Electives must have specific educatinal gals and bjectives defined fr the rtatin. These shall be reviewed and apprved by the Residency Directr. Pre-requisites: Residents requesting Away Electives must be in substantial cmpliance with all departmental and hspital requirements. Residents wh have demnstrated a pattern f significant nn-cmpliance with hspital prgrams will nt be allwed t pursue these electives. All Away Electives must have an attestatin frm the Prgram Directr t state that csts, cntact infrmatin, educatinal gals and bjectives, specific evaluatin parameters and pst elective presentatins have been discussed with the resident and the s/he feels that they have been adequately addressed. Fr internatinal electives, this must als include medical cncerns such as vaccines and prphylaxis.

2 It is highly recmmended, especially fr first time travel t a cuntry that the resident review a reference resurce cncerning lcal custms and traditins. Fr internatinal Away Electives, residents are highly encuraged t prcure medical and emergency evacuatin insurance at their wn expense. This cverage is available frm multiple surces including majr credit card cmpanies. The links fr tw cmmercially available prducts, fr cmparisn purpses, are listed belw. Residents, wh are participating in internatinal electives, prir t their departure, will be required t prvide t their Prgram Directr a detailed travel itinerary including in-cuntry cntact infrmatin. Away Elective Supervisin All away elective rtatins must have a designated n-site supervisr fr the rtatin wh will wrk with the resident n a regular basis thrughut the rtatin and be in a psitin t prvide evaluatin and feedback n the resident s perfrmance during the rtatin. This individual must be identified and apprved by the Residency Directr prir t the apprval f the elective. The n-site supervisr must prvide bth written and verbal evaluatin and feedback t the resident and written evaluatin f the resident s perfrmance t the prgram. When feasible, it is best t use n-line access t E-Value t prvide this feedback. Summatin Residents wh return frm Internatinal away electives will be expected t prvide a reprt n their experience t their clleagues in the training prgram. This may cnsist f a frmal presentatin at a departmental educatinal cnference r ther frmat as deemed apprpriate by the Department. Safety f Residents An away elective may invlve sme finite risk t the individual resident. (ex. A surgical rtatin perating n patients with HIV.) Hwever, residents wh elect t perfrm an away elective shuld be wrking in a setting with apprpriate institutinal/rganizatinal structure and supprt. This means that fr all electives, especially internatinal, apprpriate and safe husing, fd, transprtatin, and persnal supprt shuld be available t the resident during the elective. The elective shuld be cnducted thrugh an apprpriate institutinal entity that can prvide assurance that such supprt is available t the resident. Residents wh are traveling utside f the United States, Canada, r Western Eurpe are strngly encuraged t cnsult with a physician t determine apprpriate vaccinatin status and t btain apprpriate prphylaxis r ther medicatins if indicated: The Center fr Disease Cntrl issues 4 levels f Travel Ntices. The highest level f ntice termed a Travel Health Warning recmmends that travelers pstpne any nn-essential travel t the area nted. Residents wh are applying fr an Away Out Rtatin must dcument the CDC level in their applicatin.

3 Residents wh plan travel t an area fr which a Travel Ntice has been psted will be required t cnsult with their Department and btain apprval fr travel t that area frm their Prgram Directr. A signed liability waiver must accmpany the applicatin. Residents wh are travelling utside f the United States, Canada r Western Eurpe must cnsult the U.S. Department f State Travel Warnings; Rtatins that are ccurring in lcatins that appear n this list must be apprved by the DIO prir t the submissin f the GME applicatin. If apprved, a signed liability waiver will be required.

4 ADDENDUM INTERNATIONAL AWAY ELECTIVES This addendum is prvided t help frame the design f an Internatinal Away Elective and can be used as a guide t help direct the discussins between yu and the resident. It has been excerpted frm The American Academy f Pediatrics. Overview Why d yu want t d an Internatinal Health Elective? Why nw during yur residency and hw will this effect yur career decisins? What are yur gals fr ding an elective? Sample Objectives: T gain perspective n the rle f pediatrics in health care delivery in the develping and develped wrld T gain experience with cmmn medical and public health prblems in develping and develped cuntries T experience different medical systems, cultural practices, and understandings f disease causatin and treatment T analyze residency and academic training curricula, issues, and prblems in develping and develped cuntries T gain facility in medical practice and scial interactin in a secnd language T share current scientific infrmatin in an area f expertise with internatinal clleagues. What d yu prpse t d and why? Wh will be yur prpsed preceptr at yur elective site? Wh will be yur NYP Pediatrics faculty preceptr? Where wuld yu like t wrk? In what cuntry? What setting? Urban (may r may nt be tertiary)

5 District level ("cmmunity hspital") Health Center, Rural r village health clinic Cmmunity health wrker Mbile medical team Refugee setting Cnflict area What type f elective? Clinical, Cmmunity r public health elective - identify a cmmunity health need and implement it. Research elective Is this an elective yu can self-design r is it an established, rganized elective? What will yu be able t cntribute? Wrking Cnditins What is yur wrk schedule? Hw many and at what kinds f facilities will yu be expected t wrk at? Hw far are the sites frm yur living quarters? Wh pays fr and arranges transprtatin? Are electricity and uncntaminated water available? What kind f medical equipment is available? Hw many patients will yu see per day? Will yu have time ff? What kinds f labratry, diagnstic, referral, and cnsultatin ptins are available? What kind f training has the supprt staff and yur clleagues had? In what language will yu cmmunicate and keep medical recrds? Are interpreters available?

6 If language training is required, wh will pay fr it? When will it take place? Living Cnditins What weather cnditins and insect r animal hazards can yu expect t cntend with? Where will yu live? Wh will pay fr rm and bard? Will yu have sufficient privacy and security? Will yu have access t electricity, sanitatin facilities, uncntaminated fd and water? Are there significant rad safety r ther transprtatin hazards? Is it feasible t bring alng yur family r a partner t whm yu are nt married? Are there recreatinal pprtunities? Dcumentatin and Licensing Are a passprt, visa, vaccinatin certificate, lcal wrk permit r even lcal medical license required? Are custms dcuments required fr medical supplies r husehld gds that yu may be taking alng? Will yur spnsring rganizatin assist with the paperwrk? Will yu be signing a frmal cntract fr yur services? Visit the U.S. Department f State website ( and click n Travel t d yur research. Insurance Will yur current health, disability and life insurance plicies cver travel and service verseas? Des yur spnsring rganizatin prvide any cverage? What malpractice insurance (if any) is required r recmmended? Is there a medical evacuatin plan? Fr medical and evacuatins insurance SOS Persnal Health What immunizatins are recmmended? Are malaria prphylaxis and msquit nets needed? Check the CDC website, specifically the yellw bk fr traveler health infrmatin.

7 Cmmunicatin Hw can yu cmmunicate with yur family and spnsring rganizatin back hme--mail, telephne, , fax, HAM radi, etc.? This may be a crucial educatinal link between yu and yur elective advisr. Ask hw reliable the cmmunicatin lines are. In Case f Truble What are the safety and security issues (accidents, crime, disease, plitical unrest)? What steps have yu taken t minimize risk and respnd t prblems? What help can yu expect frm yur wn cuntry and/r lcal authrities in the event f difficulties? Have yu left a detailed itinerary and ther infrmatin (regarding passprts, credit cards, travelers' checks) with a trustwrthy individual? Find ut abut safety at the State Department's website travel.state.gv and cnsider registering with the U.S. Embassy in the destinatin cuntry. Lcal cnsular fficials tend t have the mst recent infrmatin and specific travel warnings. Culture Which custms, tabs, and religius r cultural practices will affect yu, bth n and ff duty (bdy language, dress, dietary r alchl restrictins, differing cncepts f mdesty)? Fr example, in sme Muslim scieties it is ffensive t use the left hand fr gesturing r fr men t shake hands with unfamiliar wmen. Have yu cnsidered hw yu might react t culture shck, hmesickness, antifreigner sentiment, suspicin, r ingratitude fr yur services? What are the main health beliefs f the patient ppulatin? What are the main health prblems? Fr ppulatin statistics access Hw d peple view physicians as ppsed t ther healthcare prviders? Is medicine practiced in a paternalistic way?