Milestones & Evaluations

Evaluation of Fellows

The NAS from the ACGME measures the fellow’s progress through 23 Internal Medicine Subspecialty Reporting Milestones. The milestones are a measurement of the fellow’s progress in the 6 core competencies. This is determined by various forms of evaluations, including: faculty MedHub evaluations, elective MedHub evaluations, patient evaluations, self-evaluations, direct observations, procedural logs, conference presentations and attendance, in-training exam scores, QI participation, research participation, mandatory compliance participation, etc. The various forms of evaluations are then compiled for the Clinical Competency Sub-Committees’s semi-annually, where the fellow’s progress in each of the 23 Internal Medicine Subspecialty Reporting Milestones is determined by the committee. This provides the basis for promoting or graduating the fellows. The Clinical Competency Sub-Committees is composed of the Program Director, Associate Program Director, Rheumatology faculty members, and the program administrator.

The results of the Clinical Competency Sub-Committees are communicated and discussed fully to each fellow by the Program Director. The IM Subspecialty Reporting Milestones are communicated to the ACGME, GME, Departmental Chairman, and the Core Program Director.

One of the core components of measuring the fellow’s progression is the direct observation, daily training, and correction as needed that occurs in the clinical setting under the close supervision of and interaction with the attending that is characteristic of this program. This ongoing daily training and corrective process is important in achieving the goals for graduation.

The daily ongoing training and evaluation process encourages free two-way communication between faculty and fellows so that areas for improvement can be identified quickly and corrective action is taken. Fellows are encouraged to discuss any disagreement directly with the faculty involved and then, if necessary, the program director, the core program director, and the department chairman, in that order. If this process does not result in the resolution of the fellow’s grievance, the grievance can be further addressed according to established institutional guidelines.

In addition, annual formal evaluations are completed by the program director for each fellow for the GME, ABIM, and other organizations.

Evaluation of Faculty and Program

Fellows evaluate faculty on a semi-annual basis using MedHub. Evaluations are collected in a fashion to assure the anonymity of the fellow as much as possible through MedHub. The level of confidentiality on the site is set to its' highest degree of 10. The program director and the program coordinator hold a monthly fellowship meeting to discuss any topics, address any concerns, and notify fellows of changes in the program. Fellowship topics are also addressed at the monthly faculty section meeting and on an as-needed basis. Bulletins and mandated program changes from the ACR, ABIM, RRC, etc., are discussed, notified and implemented in a timely fashion during the monthly faculty and fellowship meetings.

The ACMGE, the GME, and the program annually collect evaluations from the faculty and the fellows. The results of these evaluations are discussed by the Program Evaluation Sub-Committees (PEC). The PEC committee is composed of the Program Director, Faculty, Program Coordinator, and fellows. The PEC works on planning, developing, implementing, and evaluating educational activities of the program, addressing areas of non-compliance with ACGME standards, and reviewing and making recommendations for revision of competency-based curriculum goals and objectives. The PEC then prepares a written plan of action to improve performance and follows-up on the previous academic year’s action plan. The plan is documented for the GME Annual Program Review of Effectiveness and reviewed by the GME office.

Fellows are encouraged to maintain a high level of communication with the program director, faculty, and coordinator on an ongoing basis. The information and feedback received during informal and formal meetings and annual forms are used to make improvements within the program.

The program director reports to the department chairman monthly at regularly scheduled Division Chief Meetings and approximately every month regarding fellowship program development and other issues. Informal evaluation of the program occurs at these meetings. Annual formal summaries of the program, faculty, and fellows are provided to the chairman and/or program director.