The Residents Report - UCSF Medical Education

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
was introduced to this new, state-ofTeaching and Learning
the art educational facility, housed on
Center 1
the second floor of the library on the
News from SFGH 4
Parnassus campus.
APEX Update 4
VAMC Update 5
News from the Library
6
Out & About
8
Grand Rounds 10
Resident/Fellow Council 11
10 Questions 12
New Vice Chancellor of
Diversity & Outreach 14
GME Diversity 16
Pay Stub 101 16
ACGME Resident/Fellow
Survey 18
Cypher 20
UCSF School of Medicine
Graduate Medical Education
500 Parnassus Avenue
MU 250 East, Box 0474
San Francisco, CA 94143
tel (415) 476-4562
fax (415) 502-4166
www.medschool.ucsf.edu/gme
1
The Teaching and Learning Center (TLC)
occupies 22,000-square-feet in three
functional areas: technology enhanced
classrooms; a technology commons;
and the Kanbar Center for Simulation,
Kanbar Center for Simulation, Clinical Skills and Telemedicine Education
Clinical Skills and Telemedicine Education.
The TLC is open to students, residents, clinical fellows, and faculty of all health professional
schools at UCSF, including residents and clinical fellows. The center aims to promote
interprofessional education and encourages innovative approaches to teaching and learning,
such as those that incorporate technology into curricular design. With its unique lay-out
of simulation rooms adjacent to standardized patient rooms and technology enhanced
classrooms, there is plenty of opportunity to be innovative. Rooms can be connected to
each other with direct video broadcasting and extensive computer networks allowing for
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
has been a part of graduate medical education in a variety of disciplines, but more and more
programs are expanding their educational curriculum with standardized patient exercises,
simulation-based skills training, and web-based modules. A driving force is the ACGME with
its requirements for competency based learning and assessment which are often not easy
to meet in the real life environment because of the unpredictability of events and lack of
standardization. Standardized scenarios and direct observation can be used to meet some
of these challenges. Opportunities for formative feedback and discussion, often difficult to
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Teaching and Learning Center...
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find in the hectic clinical environment, can be created
by digitally recording and debriefing exercises.
rooms that can be configured to realistically recreate
the environment of an ICU, operating room or any
patient care room. High fidelity simulators include
eight state-of-the-art adult simulation mannequins
(“SimMan”), three pediatric mannequins (“SimBaby”),
and two neonatal mannequins (“SimNewB”). There
are also two task trainer rooms with a variety of partial
task trainers, including airway trainers, vascular
access trainers and birthing simulators to name a
few. All simulation rooms have multiple HD video
cameras and digital technology that allows for direct
broadcasting to adjacent debriefing
rooms or any of the larger classrooms
in the center. The simulation rooms are
even set up with infrared cameras for
the purpose of disaster training so that
actions can be recorded in the dark.
The TLC is the realization of one of UCSF’s strategic
goals — “to develop educational facilities and
infrastructures to keep UCSF at the forefront of health
sciences education and meet the growing demand for
health care professionals.” In 2005, UCSF identified
more classroom space, advanced technology,
capacity for increased simulations, health disparities
education and interprofessional
activities as essential to
maintaining innovative
educational programs. In 2006,
the Telemedicine and Program
in Medical Education for the
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 doublelibrary’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
student Colin Gershon with intubating a high fidelity
Additionally, the library’s
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 highcampus. 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 preproject 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
named in honor of San Francisco-based entrepreneur
Maurice Kanbar, who made a major founding donation
to establish the center, first in its temporary location
on Mount Zion and now integrated with Clinical
Skills and Telemedicine Education in the new TLC.
If you ever visited the temporary space, you will be
pleasantly surprised: not only is the new facility much
bigger, but it also has many more simulators and
associated equipment. There are two large simulation
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discuss the exercise in a bigger group.
The Technology Commons existed prior to the
renovation, but was expanded and improved in many
ways. There are multiple networked multimedia
pods for students and faculty to use with a variety of
software as well as Macintosh computers and devices
to create web-based modules. There is video and
audio recording equipment and a quiet media room
to practice presentations. Learning technology staff
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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
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.
Students working in the Technology Commons
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 [email protected]
Direct questions to:
Arpana Vidyarthi at [email protected]
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
Michael Blum, MD
Chief Medical Information Officer
The Apex Electronic Health Record (Epic) project
continues to move along at a rapid pace. The $165
million project is on schedule for the April 2011
go-live in the first ambulatory practices and the
October 2011 go-live for the in-patient enterprise.
The full rollout for the project will extend through
April 2012.
A group of 60 residents and clinical fellows have
been identified by the office of GME and the
departments to participate in the Fellows and
Residents Advisory Group (FRAG). The group will
be convening shortly to provide needed input into
the system’s development. If you are interested in
participating, please contact Dr. Arpana Vidyarthi
([email protected]).
Testing and training for the April Ambulatory golive will be starting soon. Residents and clinical
fellows will be thoroughly trained and will need
to demonstrate competency in order to receive
their userID and password for the system. More
extensive training will be offered to those who
volunteer or are nominated to be “super-users.”
4
The super-users will provide assistance during go-live
and help train their colleagues on the wards. We are
working with the departments to create the training
schedules and trainees will be informed as soon as
possible of their particular training sessions.
Along with regular updates in The Residents Report,
Medical Center Internal Communications, Managers’
Weekly, quarterly town halls and outreach from the
project team to specific departments, the APEX team
is providing the UCSF community a forum in which to
ask questions, clarify issues, and understand decisions
being made through their AskAPEX program. AskAPEX
is yet another way that trainees can get their questions
answered or concerns expressed regarding APEX. By
emailing:
[email protected], the APEX team will
respond to inquiries within 48 hours.
“AskAPEX is a way of allowing individuals to inquire
about specific topics of interest or express concerns
that they feel should be addressed” said Pam Hudson,
APEX Program Director. “The implementation of
APEX will have organization-wide impact therefore it is
important that we provide another venue for questions
to be answered in the quickest, most efficient way
possible.”
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
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library update....
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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 crossdepartmental 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 [email protected].
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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
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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
particular concern because of a host of LGBT health
disparities. Disparities found in the 2007 CHIS
include:
Shane Snowdon
Director, UCSF LGBT Resource Center
As lesbian, gay, bisexual, and transgender (LGBT)
people become more visible in our society, their health
concerns are receiving unprecedented attention. For
example, the Joint Commission issued a requirement
in January 2011 that the nation’s hospitals protect
LGBT people within their nondiscrimination policies.
The prestigious Institute of Medicine will issue a report
in March 2011 on LGBT health disparities, and Healthy
People 2020, the “federal blueprint for the nation’s
health”, released in December 2010, called for much
greater attention to LGBT health needs.
Given its location in San Francisco, which has the
highest LGBT population of any U.S. city, UCSF
has been a national leader in LGBT health. UCSF
Medical Center is the only healthcare institution in the
country to have received four perfect scores on the
national LGBT Healthcare Equality Index. In addition,
UCSF boasts an LGBT Resource Center, Center of
Excellence in Transgender Health, Division of LGBT
Services of the Department of Psychiatry, Center for
AIDS Prevention Studies, Positive Health Program,
Pacific AIDS Education and Training Center, and
Lesbian Health & Research Center. These nationally
renowned programs offer a wealth of LGBT health
resources locally and nationally.
•
•
•
•
27% of LGB respondents smoked vs. 16% of
heterosexual respondents;
44% of LGB respondents reported alcohol
abuse, vs. 33% of heterosexual respondents;
20% of LGB respondents reported
psychological distress in the past year, vs. 9%
of heterosexual respondents;
22% of LGB respondents needed mental
health medication, vs. 10% of heterosexual
respondents.
Although transgender individuals—those who identify
with a sex other than the one assigned them at
birth—cannot yet self-identify in the CHIS, other
surveys have documented even greater delays and
disparities for transgender people, whom one UCSF
faculty member has called “the most medically
underserved in America.” A recent survey of over
6,000 transgender Americans by the National Center
for Transgender Equality found that 28% had been
subjected to harassment in medical settings, 41%
had attempted suicide, and 2.6% were HIV positive
(four times the national infection rate).
Disparities like these are widely attributed to the
stress and stigma experienced by LGBT people, who
even today face substantial bias and discrimination.
While much research is needed on the health
and well-being of LGBT individuals, the combined
effects of health disparities and care delays are
clear cause for concern. In the 2007 CHIS, 9% of
LGB respondents reported a diagnosis of cancer
in their lifetime, compared to 6% of heterosexual
respondents—an alarming difference that has yet to
be investigated.
These and other LGBT health initiatives were created
to address the health disparities and obstacles to care
experienced by LGBT people, many of which arise
from bias and discrimination, past and present, feared
and encountered. Although many health surveys
do not yet allow LGBT respondents to identify as
such, research that is LGBT-inclusive has uncovered
disturbing evidence of LGBT patients’ estrangement
from healthcare. The large California Health Interview
Survey (CHIS) in 2007 found that lesbian, gay, bisexual
How can LGBT patients be encouraged to seek
(LGB) Californians were significantly likelier to delay
healthcare, particularly in light of the disparities they
and avoid healthcare than heterosexual respondents:
29% of LGB respondents reported delaying or avoiding experience? A recent survey conducted among
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UCSF Resident &
Fellow’s Council
Angela Walker, MD and Barak Bar, MD
Resident and Fellow’s Council Co-Chairs
Belated happy holidays and welcome to the New
Year! The first six months of this academic year have
been very busy. Here’s an update of the ongoing
accomplishments of the Resident & Fellows Council:
Several of our members have spearheaded projects
to work to improve efficiency in the daily tasks of
trainee physicians. Adam Schickedanz, MD is working
to develop an algorithm for scheduling inpatient
radiology scans. His hope is that this algorithm
can be circulated among housestaff and included in
orientation materials for incoming interns. So Young
Kim, MD has been meeting with multiple medical
and administrative individuals to try to duplicate
the 10ICC IV insertion cart on other units/floors.
Christina Robinson, MD has worked tirelessly to
extend shuttle transport between the Mt. Zion and
SFGH campuses. Nazia Jafri, MD has developed a
pilot project to evaluate whether direct Spectra-link
availability improves urgent/emergent communication
between radiology and surgery/neurology services. If
data shows notable benefits, she’d like to expand the
program. Finally, Gabe Aranovich, MD is investigating
interest in a consultation services website to allow
residents to best compile information and study results
prior to contacting colleagues for consults.
Progress towards the 2010-11 Housestaff Incentive
goals has met mixed outcomes. Patient care
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
to educate resident and attending leaders of hand
hygiene policies and compliance pitfalls, November
rates continued to trend at ~60%. Fortunately, data
has shown that “just in time” coaching or identifying
provider noncompliance and discussing policies with
that individual, can improve future compliance. To
reach our 85% compliance goal we are requesting all
providers consider this practice. Remember, hand
hygiene is required upon the entry and exit of
every patient room, every time. Arpana Vidyarthi,
MD, Paul Day from OGME, and Kara Bischoff, MD
continue to track efforts towards meeting all general
and program-specific goals. They deserve special
praise for the recognition by Maimonides Medical
Center in Brooklyn, whose residents recently designed
an incentive program patterned on the one at UCSF.
Resources continue to be available in the Patient Care
Fund. As you rotate through services at UCSF, think
of ways we can better provide for our patients and
submit a proposal. For any questions regarding the
Patient Care Fund, please contact Delphine Tuot, MD
at [email protected].
In December, housestaff returned to the recently
renovated cafeteria lounge space. Teams who use
this space regularly are thrilled to be back. If you
haven’t seen the new lounge, it is accessible 6:30am
to 8:00pm every day. Look for bulletin boards where
important resident/fellow information will soon be
posted and updated.
We marked the beginning of UCSF resident pay
parity in January, a goal accomplished through
arduous lobbying of many. Soon, equally important
conversations will occur to settle resident contract
negotiations at SFGH. We welcome the participation
of any resident who would like to become involved in
this project. The CIR/SEIU Area Director, Kelly Gray,
is happy to have you on board!
As always, if you have ideas for projects or would like
to get involved, please contact us, your department
representative… or come to a meeting!!! New
members are always welcome.
Happy 2011,
Angela and Barak
Confidential
GME Helpline
(415) 502-9400
Confidential line for housestaff, faculty, and program
administrators to voice their questions, comments,
or concerns 24 hours a day. The Office of Graduate
Medical Education will respond to all messages.
11
10 Questions from the Resident and Fellow Affairs Committee
permanent (also called whole-life, universallife, 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.
John K. Beeson, CFP, MBA, Registered Investment Advisor
and Mark Shone, CFP, Registered Investment Advisor, answer
resident and clinical fellow questions about purchasing life,
disability, and other forms of insurance
10 Questions.....from the RFA Committee
1) What is the purpose of life insurance for younger
people? For single people with no children? How
much insurance is the right amount?
When thinking about acquiring life insurance the two
important considerations are needs and age. Who
would need your income if you were to pass? For this
reason, children do not need life insurance. Adults who
do not have a spouse or children to support generally
have little need for life insurance unless they own real
estate and purchase life insurance to help cover the
estate taxes that will be levied on property passed on to
their heirs.
It is easier and much less expensive to obtain life
insurance while you are young and healthy, so those
individuals who are about to start a family can benefit
from purchasing life insurance while in good health.
When deciding coverage amounts consider the
amount your dependents would need, keeping in mind
all sources of income and the liquidity of your other
assets. If you were to pass, is there a social security
benefit that would pass on to your children? Is there
real estate that could be sold to provide monetary
support? Looking at your current cash flow and
investments can help you figure out the amount of
coverage you should buy. In general, the more
financial responsibility you bear, the greater the
amount of life insurance is needed.
2) What is the difference between term and
12
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
usefulness of life insurance as an investment
vehicle diminishes as one builds up retirement savings
and other investments. It is helpful to keep this in mind
when deciding what type of insurance you need and how
long you will need it.
Commissions paid to insurance salespeople for
permanent insurance policies are proportionally higher
than their commissions for term life policies. For that
reason, you should research your needs and options and
may wish to pay for a consultation with an investment
advisor before soliciting advice from the insurance
salesperson.
Accidental Death and Dismemberment insurance is a
different type of insurance that covers accidental death
and organ loss in the workplace. It should not be used in
lieu of life insurance as the parameters in which it pays
out are very narrow.
3) What does it mean to have a cash value for a life
insurance policy? How does this affect the death
benefit?
Term insurance has no cash value. Like automotive
insurance, it provides coverage while you are paying the
premiums but it accumulates no value. However, when
you pay a premium toward a permanent insurance policy
a portion of that premium goes toward the insurance and
a portion goes toward the investment vehicle. In general,
the insurance company invests in mutual funds which
accrue value at historical dividend rates. The value of the
investment vehicle is what is known as the cash value.
When selecting a permanent policy, you want a policy that
pays, upon death, the cash value plus the death benefit.
So, if you purchased a $500,000 permanent insurance
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
you wherever you go. Remember that personal disability
While permanent insurance has an investment vehicle
insurance is easiest to get while young and healthy. If
and is right for people in certain situations, permanent
insurance is not an efficient way to create an investment you try to get personal disability insurance when older,
pre-existing medical conditions can be excluded from
portfolio due to fees and other restrictions. Remember,
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?
Must it be Guaranteed Renewable with benefits
to age 65 or longer? What is a Residual Disability
Rider? A Future Purchase (FPO) Rider? A Future
Increase Option (FIO)?
Own-Occupation means the disability insurance covers
specifically what you do. For physicians, having a
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
It is always preferable to have a Guaranteed Renewable
after a thirty day waiting period.
policy with benefits to age sixty-five or longer if the
Trainees, especially those who are considering selfpolicy’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 Residual Disability Rider outlines specific injuries that
A personal insurance policy should have the broadest
may occur and the amount you are paid in the event
possible definition of disability and be guaranteed
of these types of injuries. Examples of this are the loss
renewable with future increase options. There are some
of an eye or a limb. This is usually included in most
companies that allow residents to purchase policies
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
4) How is life insurance paid out to beneficiaries? Is
it a lump sum, or can it be in payments over time?
It is paid out in a lump sum and is income tax free for the
beneficiary. Some beneficiaries may choose to take this
lump sum and buy an annuity which would pay out a set
amount each month. Although the death benefit is income
tax free it is subject to estate tax.
There are important differences between group
and individual disability insurance plans. One of the
differences is the taxability of benefits. If you pay the
premium for an insurance policy, the benefit you receive
is tax free. However, if someone else such as an
employer pays the premium for your policy, the benefit
you receive is taxable. For example, UCSF pays disability
insurance premiums for residents and clinical fellows.
This means the payment you receive while on disability
(66.66% of salary after a thirty day waiting period) is
subject to income taxes. For this reason, some choose
to carry both individual and group coverage policies.
are allowed without medical underwriting, meaning the
increases occur regardless of changes in one’s health.
These options will increase premiums, but need to be in
place to correct for inflation over the years and for those
who anticipate increased earning power over time.
7) Can I obtain disability insurance if I have any preexisting medical condition? What is a Guaranteed
Issue policy?
This depends on the medical condition. If you are
purchasing personal insurance there is a high probability
that the company will exclude your pre-existing condition
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)
nearly 5,000 LGBT people nationwide by Lambda
Legal, “the gay ACLU,” investigated this question.
Among its findings:
•
•
•
•
28% of transgender respondents and 8% of
LGB respondents had been refused needed
care;
60% of transgender respondents and 9% of LGB respondents believed they would be refused care because of their LGBT status;
73% of transgender respondents and 29% of
LGB respondents believed that medical
personnel would treat them differently
because of their LGBT status;
89% of transgender respondents and 49% of LGB respondents believed that not enough health professionals have been adequately trained to meet their needs as LGBT patients.
Data like these highlight the need for physicians
to relate to their LGBT patients sensitively and
knowledgeably. LGBT people deeply appreciate a
welcoming medical environment and it can make a
very substantial difference in their health and wellbeing. Although it is estimated that only about half
of LGBT patients now feel safe coming out to their
physicians, this number is much higher than in years
past and is growing daily as physicians become more
comfortable with LGBT people and more aware of
their health concerns.
Physicians who want to learn more about the
needs of their LGBT patients can access a host of
resources. The Gay and Lesbian Medical Association
(GLMA) has created LGBT clinical guidelines
(glma.org). Seattle’s public health department has
published LGBT information for clinicians
(kingcounty.gov/healthservices/health/personal/glbt.aspx) and
Kaiser Permanente has produced a detailed LGBT
handbook for physicians:
(madisonstreetpress.com/cgi-bin/shop.shtml?id=25).
Boston’s Fenway Institute (fenwayhealth.org)
has developed slide sets on key topics, including
interviewing techniques for LGBT patients as well
as an overarching text, The Fenway Guide to LGBT
Health.
the State of California:
(stdcheckup.org/provider/index.html). Physicians interested
in transgender care, including transition-related
hormone therapy and surgeries, can learn more
from the Vancouver Public Health Department
(transhealth.vch.ca/). Lesbian health concerns
are thoroughly reviewed in Lesbian Health 101: A
Clinician’s Guide, authored by Patty Robertson, MD,
of UCSF and Suzanne Dibble, RN, DNSc.
Like many groups who have historically faced
discrimination, LGBT people face healthcare
disparities and inequities, which can be intensified by
concern about entering the healthcare system and
coming out to physicians. By seeking out resources
like those mentioned above, however, individual
physicians can make a real and much appreciated
difference in the health and well-being of their LGBT
patients.
Upcoming Events
GME Grand Rounds
UCSF GME 2011: Annual Report and Town Hall Discussion
Bobby Baron, MD, MS
February 15, 2011
N-225, noon-1p.m.
Working with Communities from the Middle East, North Africa,
and the Arab World: Culturally Informed Perspectives
Jess Ghannam, PhD
March 15, 2011
N-225, noon-1p.m.
Every Physician is a Teacher: 10 Tips to Improve Clinical Teaching
Susan Promes, MD
April 19, 2011
N-217, noon-1p.m.
2011 UCSF PPD Clinics
March 9, 21, 23, 28, 30
Moffitt 195 (Old Discharge Room)
4pm-6:30pm
March 14 & 16
SFGH, Building 80, Room 319
4pm-6:30pm
2011 spring teaching skills workshop
April 5, 2011
Faculty Alumni House
3p.m. to 6p.m.
Resident and Fellows Council
Third Monday of each month
5:30p.m. to 7:30p.m.
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 ([email protected]) 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
November 4, 2010
(l - r) Anika Russell, MD, FCM Resident; Beth Wilson, MD, FCM; Alma
Martinez, MD, Director of Outreach and Academic Advancement
(l-r) Barak Bar, MD, Neurology Resident; Jayson Morgan, MD, Medicine
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
Diversity Recruitment Reception, Bistro 9
December 15, 2010
(l -r) Sarah C. Schaeffer, Med Student; Juno Obedin-Maliver,
Ob/Gyn Resident; Ob/Gyn Applicant
Residents enjoying some downtime at Bistro 9.
Second Look Reception Circolo Restaurant
January 21, 2011
Internal Medicine Resident Melissa Burroughs, MD speaking with Second
Look participants
Rene Salazar, MD, GME Director of Diversity meets with Second Look
participants
17
ACGME Resident/Fellow Survey is Coming Your Way
6 Reasons Why You Should Care
Heather Nichols, GME, Accreditation Manager
Each year from mid-January through early June,
the ACGME invites residents and clinical fellows,
from core specialty programs and subspecialty
programs with four or more trainees, to complete
a brief online survey regarding their clinical and
educational experience as well as duty hours
worked. Although the survey contains just 34
questions the results have a strong impact on
your training program as well as graduate medical
education at UCSF and on a national level.
Here are the top six reasons why you should care
about this survey:
#1: It ain’t the same ol’ survey.
The ACGME has once again updated the survey
with help from an outside consultant and input from
residents and fellows. The updated survey is a bit
longer (13 additional questions from last year), but
the questions are clearer, less ambiguous, and the
overall flow of the survey has improved.
# 4: The ACGME is watching…and acting.
Beginning in 2007 the ACGME and its Review
Committees standardized their methods for following up
with programs and institutions when the results of the
survey exceeded an established compliance threshold
for duty hours. In 2010, the ACGME began following
up with programs when their aggregated data showed
significant noncompliance in duty hours and in specific
survey “domains” (faculty, evaluation, educational
content, resources). Follow-up methods include
warning letters to the program director and designated
institutional official requesting that they implement
improvement plans to address the problem areas, and
for some programs scheduling early site visits. The
ACGME sends a copy of any letter sent to a program to
the chief executive officer of that program’s sponsoring
institution in order to involve him or her in supporting
program improvements.
Overall poor survey results can lead to a shortened
accreditation cycle for programs, focused program
and institution site visits, probation, or withdrawal of
accreditation.
# 2: It’s important to know what you know.
Let’s face it, despite the survey revisions there
is still a chance you will find some questions
confusing. It’s important that you have a clear
understanding of each question before you
respond. For this reason, we highly recommend
that you review the survey and discuss it with your
program director.
# 5: Pop quiz!
Your ACGME site visitor will discuss the survey with you
at your next accreditation site visit. The site visitor will
use the survey data to focus his or her questions during
the visit. He or she will probe and clarify any areas of
noncompliance and pay close attention to the duty hour
items.
# 3: Everybody’s doing it.
In 2010, 5,703 ACGME programs participated
in the survey. You will be asked to complete the
survey on the ACGME’s website between January
and June (as assigned by the ACGME). At that
time you will be given approximately five weeks to
complete the survey. If less than 70% of trainees
in a program complete the survey, the aggregate
data will not be available to the program. It’s
imperative that programs receive a high response
rate in order to use the data for program quality
improvement. ACGME site visitors and the ACGME
Review Committee will have access to the report
regardless of the program response rate. To help
protect anonymity, programs with less than four
trainees do not receive a summary report. So, just
do it!
BTW
Although the survey data is reviewed extensively the
responses are confidential. No names are associated
with the data. Aggregate, program-level data from
the survey are provided to the program directors and
designated institutional official for programs with four or
more residents if 70% completion is reached.
18
# 6: We need you!
The survey data plays a critical role in our oversight of
your program and overall graduate medical education.
We need your responses to help us continue to monitor
and improve graduate medical education.
FYI
A sample survey and survey report, resident survey
login, and more information can be found at
http://www.acgme.org/acWebsite/Resident_Survey/res_Index.asp
10 Questions.....from the RFA Committee
(continued from page 13)
A Guaranteed Issue policy typically refers to group
coverage such as that offered by employers where
the policy guarantees coverage without medical
underwriting. This means your health is not taken into
account when obtaining coverage. You are usually
required to enroll in the group policy within the first 30 to
90 days of employment; the requirements are different
depending on the employer plan. Personal Guaranteed
Issue disability policies are available but their cost is
usually prohibitively expensive
8) How do I find discounts on disability insurance,
such as “multi-life” or medical association
discounts? What are “gender neutral” or “unisex”
rates?
Group policies tend to be cheaper than individual
policies, but when you buy into a group policy you
generally are giving up the liberal definition of disability,
the “own-occupation” coverage, and the portability.
While personal disability insurance is more expensive,
it is important for physicians to insure themselves well
against potential loss of income due to disability.
When considering policies offered through professional
associations it is important to look through the
association that offers the policy and to the company
that manages the policy. When choosing an insurance
company you should consider the company’s history,
reputation, stability, and rankings. A.M. Best is the main
insurance rater and your insurance company should
have the highest ratings possible.
Women are more expensive to insure for disability than
men. If you are a woman it is usually more economical
to buy a policy that offers unisex rates, which are
blended rates assigned irrespective of gender.
9) What is an umbrella policy and should I have
one to protect my assets in case of a lawsuit
(malpractice or other)? Under what circumstances
should one consider travel insurance?
An umbrella policy is a separate policy that covers
liability over personal activities specifically named in the
policy. It insures large losses by providing coverage to
a level higher than the liability limits of your underlying
policies like automotive or homeowners. For example,
if you were involved in a car accident and were found
liable for personal injury expenses in excess of your
car insurance policy, the umbrella policy would come
into effect and help cover the additional expenses.
Umbrella policies are not expensive, and are useful for
those with high earning power who can be targets for
litigious individuals. Umbrella policies only cover personal
liability and do not come into play for professional liability.
Medical malpractice insurance covers professional liability
and losses.
Travel insurance covers a wide array of potential
problems that could occur while traveling, including
medical expenses, lost luggage, and trip cancellation.
Whether you should purchase travel insurance depends
on where you are traveling and the likelihood of
something going wrong. If you are in poor health going
to an underdeveloped area, or traveling to engage
in a potentially dangerous activity, you may want the
assurance of being able financially to get back home
quickly if you fall ill or are injured.
10) What is the right way to identify the agent or
company from whom to obtain insurance?
When looking at insurance companies you want to
investigate the company’s stability, length of time in
business, and industry ratings, including A.M. Best
Insurance Ratings. Seek out highly-rated insurance
companies and shop comparatively.
When looking for an insurance agent you want to find
someone who is experienced, has a good reputation,
and who will serve as your advocate rather than as a
salesperson. Talk with peers, family, and other trusted
advisers to get personal recommendations.
Alternatively, you can retain a certified financial planner
to get recommendations about insurance in the context of
your other financial plans. Since most certified financial
planners do not sell insurance you can work with them to
develop an insurance plan and then go to an insurance
broker knowing exactly what you want to buy. Certified
financial planners are hired to provide guidance and have
a fiduciary responsibility to their clients as part of the feeonly engagement. Insurance brokers do not have this
relationship with a purchaser. It is always correct to ask
any planner or broker how they are compensated and to
explore the terms and boundaries of their relationship with
you.
UCSF Insurance Coverage for Residents and
Clinical Fellows
UCSF trainees receive a $50,000 term life insurance
policy from Sun Life (principal insuree only, no
dependant coverage available) and disability insurance
that covers 66.66% of salary after a thirty day waiting
period. All UC employees can receive free travel
insurance if traveling on official UC business. For more
information visit:
www.rmis.ucsf.edu/RMISDetails.aspx?Panel=9
19
Winter 2011
The OFFICE OF
Graduate Medical Education
G M E
Welcomes New Program Directors
and Program Coordinators
Robert B. Baron, MD, MS
Solve the Winter
Program Directors
•
Jose Miguel Hernandez
Pampaloni, MD
Nuclear Medicine Residency
•
Norah Terrault, MD, MPH
Transplant Hepatology Fellowship
2 0 1 1
Svetlana Sogolova
Endcrinology, Diabetes, and
Metabolism Fellowship
•
Virginia Schuler
Infectious Disease Fellowship
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• Yvette Becnel
Pathology Residency
• Catherine Cooper
Thoracic Surgery Residency
Congratulations Fall 2010 Cypher Winner
Gabrielle Rizzuto, MD, PhD, Pathology
Resident, PGY1!!
C y p h e r
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lbhe orvat graqre jvgu gur lbhat,
pbzcnffvbangr jvgu gur ntrq,
flzcngurgvp jvgu gur fgevivat naq
gbyrenag bs gur jrnx naq fgebat.
Orpnhfr fbzrqnl va lbhe yvsr lbh
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Program Coordinators
•
C y p h e r
The
Residents
Report
Editorial Staff:
Robert Baron
Amy Day
Paul Day
Many Thanks
The Dean’s Office of
GME would like to
thank the following
contributors to articles
Instructions: The above is an encoded quote from a
famous person. Solve the cypher by substituting letters.
Send your answers to Justin Akers, Resident & Fellow
Affairs Manager, OGME: [email protected].
Correct answers will be entered into a drawing to win a
$50 gift certificate!
Faculty and Staff Assistance Program
University of California San Francisco
3333 California St., Suite 293
San Francisco, CA
94143-0938
(415) 476-8279
For additional information, please visit our
website at:
http://ucsfhr.ucsf.edu/index.php/assist/
For an appointment,
please call (415) 476-8279
in this issue.
Contributors
Justin Akers
Barak Bar
John Beeson
Michael Blum
Pat Cornett
Adrienne Green
Lauren Hammit
Rachael Kagan
Mary McGrath
Heather Nichols
Julie Philp
Rene Salazar
Mark Shone
Shane Snowdon
J o s e p h i n e Ta n
Sandrijn van
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
GME Confidential Help Line
(415) 502-9400
Director, GME Associate Dean, GME
UCSF Faculty & Staff Assistance Program (FSAP) (415) 514-0146
GME Website
[email protected]
(415) 476-3414
[email protected]
(415) 476-8279
www.medschool.ucsf.edu/gme
UCSF School of Medicine
Graduate Medical Education
500 Parnassus Avenue
MU 250 East, 0474
San Francisco, CA 94143
tel (415) 476-4562
fax (415) 502-4166
www.medschool.ucsf.edu/gme
20