Department of Internal Medicine Policy and Procedure Manual ________________________________________________________________________
Section 4 – Standing Committees
Department of Internal Medicine Committees Standing Committees and Membership Committee Terms of Reference
Executive Committee
Finance Committee
Undergraduate Medical Education Committee
Postgraduate Medical Education Committee
Core Internal Medicine Residency Training Committee
Medicine Program – Ambulatory Coordinating Committee
Department of Internal Medicine
STANDING COMMITTEES
COMMITTEE CHAIR FUNCTION
Executive Committee
Dr. Dan Roberts
Executive advisory group to Department Head.
Finance Committee
Dr. Andrew MacDiarmid
Review and approve budget. Develop and recommend policies
regarding practice plan.
Promotion and Tenure Committee
Dr. Elizabeth A. Cowden
To review applications for faculty promotions and to advise Department Head on each applicant.
Research and Faculty Development Committee
Dr. Bruce Light
Advise on career development for junior faculty and make recommendations regarding faculty development fund.
Review research performance for all faculty with research commitment greater than 25%.
Undergraduate Education
Dr. Nick Hijadiacos
Medicine responsibilities for Med III & IV of MD program including rotations, evaluation programs.
Subspecialty Postgraduate Education
Dr. Pamela Orr
Policies for all Residents training programs in the Department of Internal Medicine.
Core Internal Medicine
Dr. Ken Kasper
Planning, policies and procedures, and admissions for CORE Internal Medicine Program.
Resident Education Fund
Dr. Pamela Orr
To support Postgraduate Medical Education in the Department.
Dale Iwanoczko Award
Dr. Ken Kasper
To identify recipient of annual award.
Updated: February 11, 2008
Department of Internal Medicine
EXECUTIVE COMMITTEE MEMBERSHIP DEPARTMENT HEAD Dr. Dan Roberts
SECTION HEADS
Clinical Allergy Dr. Richard Warrington Cardiology Dr. James Tam Critical Care Dr. Bruce Light Dermatology Dr. Jack Toole Endocrinology/Metabolism Dr. Gregoire Nyomba Gastroenterology Dr. Charles Bernstein General Internal Medicine Dr. Ken Van Ameyde Geriatric Medicine Dr. Phil St. John Hematology/Oncology Dr. Eric Bow Hepatology Dr. Gerald Minuk Infectious Diseases Dr. Ethan Rubinstein Nephrology Dr. David Rush Neurology Dr. Alan Jackson Physical Medicine & Rehabilitation Dr. Dan Roberts, Acting Proteomics & Systems Biology Dr. John Wilkins Respiratory Medicine Dr. Sat Sharma Rheumatology Dr. Hani El-Gabalawy
SITE MEDICAL DIRECTORS
Health Sciences Centre Dr. Dan Roberts St. Boniface General Hospital Dr. Karen Humphreys Grace General Hospital Dr. Elizabeth A. Cowden Victoria General Hospital Dr. Al Lipson
VIRTUAL CLINIC GROUP REPRESENTATIVE Dr. Matthias Kramer
BUSINESS MANAGER Mrs. Kathy Blair Colbert
STANDING COMMITTEE CHAIRS Finance Committee Chair Research Performance Review Committee Chair Promotions and Tenure Committee Chair Core Residency Program Director Undergraduate Medical Education Director Postgraduate Medical Education Director
Dr. Andrew MacDiarmid Dr. Bruce Light Dr. Elizabeth Cowden Dr. Ken Kasper Dr. Nick Hajidiacos Dr. Pamela Orr
GRAND ROUNDS COORDINATOR Dr. Fred Aoki
September 2008
FINANCE COMMITTEE
Dr. Andrew MacDiarmid, Chair
Dr. Charles Bernstein
Dr. Martin Karpinski
Dr. Mathias Kramer
Dr. Elizabeth A. Cowden
Dr. Karen Humphreys
Dr. Bruce Light
PROMOTIONS & TENURE COMMITTEE
Dr. Elizabeth Anne Cowden, Chair
Dr. Elizabeth Boustcha
Dr. Bill Leslie
Dr. Lindsay Nicolle
Dr. John Wilkins
Dr. Hani El-Gabalawy
Dr. Brendan MacDougall
Dr. David Rush
RESEARCH and FACULTY DEVELOPMENT COMMITTEE
Dr. Bruce Light, Chair
Dr. Charles Bernstein
Dr. Hani El-Gabalawy
Dr. Andrew Halayko
Dr. Ken Van Ameyde
Dr. Patrick Choy
Dr. John Foerster
Dr. Dan Roberts
Dr. John Wilkins
July 2008
Department of Internal Medicine
TERMS OF REFERENCE
EXECUTIVE COMITTEE
Section: Standing Committees Page: 1 of 1
Review/Revision Dates: Sept. 2005,
Chair Head, Department of Internal Medicine Membership
Department of Internal Medicine Section Heads
Postgraduate Medical Education Director
Undergraduate Medical Education Director
Site Medical Directors for WRHA Medicine Program
Business Manager
Virtual Clinic Group Representative
Chairs of Standing Committees
Purpose of Meetings 1. To serve as a forum to discuss issues relevant to patient care, academia, education,
administration and research.
2. To receive information and approve recommendations arising from the Department of Medicine’s Standing Committees.
3. To develop strategic directions for the Department of Internal Medicine.
4. To monitor changes in the WRHA Medicine Program that will impact on
departmental activities.
Committee Meetings The Committee will meet every Second Wednesday of each month, September to June at 0730 hours – 0855 hours unless otherwise stipulated by the Chair.
Department of Internal Medicine
TERMS OF REFERENCE
FINANCE COMMITTEE
Section: Standing Committees Page: 1 of 1 Review/Revision Dates: June 13, 2006
Membership The Committee shall consist of:
Three elected full-time members of the Department of Internal Medicine Three appointed full-time members by the University Department Head The Chair, Research and Faculty Development Committee One representative of part-time members One representative from each of the teaching hospitals The University Department Head (ex officio) The Business Manager, Department of Internal Medicine (ex officio) The Assistant Business Manager, Department of Internal Medicine (ex officio)
The Chair of the Finance Committee is appointed by the Department Head, usually but not necessarily, from the members of the Committee, based on relevant experience and willingness to serve, and sits on the University Medical Group Executive. Each term is for a three-year period, renewable once.
Reporting Relationships
The Committee will report through the Chair to the University Executive and to the
Department membership at large.
Purpose
The Committee shall: Be an advisory committee to the Department Head on matters related to finance. Review the annual budget for the Department. Review the financial status of the Department on a quarterly basis. Review terms of reference and expenditures for:
GFT Travel Fund Develop a framework for any changes in funding mechanisms for the Department. Review department investments quarterly and develop strategies for maximizing
the return on investments within limits imposed by the University of Manitoba.
Meetings
The Committee will meet quarterly during the period September – June.
Department of Internal Medicine
TERMS OF REFERENCE
UNDERGRADUATE MEDICAL
EDUCATION COMITTEE
Section: Standing Committees Page: 1 of 4
Review/Revision Dates: February 18, 2008 Rev. 1,
Chair Undergraduate Medical Education Clerkship Director Membership Clerkship Director and Chair – Appointed by the Head, Department of Internal Medicine ITC/CPA Director Core Internal Medicine Chair Members-at-Large (2) Site Coordinator for each site the chair is not based at Elected Postgraduate Representatives (3) 1 - RI Resident
1 - RII Resident 1 - RIII Resident
Elected Undergraduate Representatives (2) 1 - 3rd year med student 1 - 4th year med student
Reporting Structure
The Committee reports through its Chair to the Head, Department of Internal Medicine.
Purpose of Meetings The Committee shall develop, implement and evaluate educational policies relevant to
undergraduate medical education. It is the Department of Internal Medicine’s goal to ensure that medical students will acquire the
skills needed for them to develop as competent clinicians and health care providers. These skills are also to be applied and evaluated in the context of CanMEDS 2005 core competencies.
1. Medical Expert a. Cognitive: The teaching of basic medical knowledge falls outside the scope of
any one department, with a large obligation falling on the pre-clinical years. The clinical exposure afforded by the Department of Internal Medicine is designed to reinforce previously taught concepts and disease processes by placing them in a clinical context, and by stimulating the student to develop a pattern of problem-based, patient-focused self-learning. Standardized teaching (tutorials, EKG interpretation, radiological interpretation, etc.) is designed to fill the gaps between the pre-clinical years and skills required for functioning in a clinical venue.
Terms of Reference: Undergraduate Medical Education Committee
Page: 2 of 4
b. Problem solving: This is seen as a graded process that is carefully supervised by the preceptor-mentor. Early sessions (Med II Clinical Skills) are primarily aimed at techniques of data collection (history and physical examination). The introduction to clerkship teaches differential diagnosis through hypothesis generation. The medical clerkship involves the application of this process in the actual care of patients. Thus, there is an expectation of graded problem solving abilities commensurate with the student’s expanding knowledge base and clinical acumen.
c. Clinical skills: As in problem solving, this is seen as a continuum in the student’s education. A stereotyped checklist approach (Med II Clinical Skills) gradually gives way to higher-order problem-oriented history and physical examination.
2. Communicator The students learn to deal with a variety of patient and family situations for the
purpose of data collection, explaining diagnosis and management, and building patient trust. It is expected that students will have the opportunity to observe and practice such communication skills as “giving bad news,” discussing resuscitation decisions, assessing patients’ knowledge of their illness, etc.
3. Collaborator The students will learn to work in a healthcare team. They will learn to
understand the roles of other healthcare professionals in the assessment, management and ultimate disposition of patients in a medical setting. The students will learn to work with and communicate with other healthcare providers in order to ensure high level patient care and to prevent conflict between members of the healthcare team.
4. Manager
The students will learn through observation and practice the role of properly managing finite healthcare resources and the skills needed to properly allocate those resources. Examples being: ordering the correct test in the correct order on a patient or reevaluating the need for frequent blood work on a patient.
5. Health Advocate
The students will learn to identify the roots of endemic health problems in the areas they serve and what resources are out there to address them. They will also learn what avenues and to who to advocate for their patients.
6. Scholar
The students will continue to learn and assimilate new information (teaching sessions, tutorials, self-directed readings). They will learn to incorporate this information into better patient care and best practice. Evidence based medicine will be the gold standard. They will learn to share newly acquired information with colleagues and other health care professionals.
Terms of Reference: Undergraduate Medical Education Committee
Page: 3 of 4
7. Professional Students are expected to demonstrate an appropriate level of professional responsibility towards their patients and colleagues. This includes but is not limited to: confidentiality, reliability, honesty, compassion, and support for patients, colleagues and the profession of medicine.
Evaluations
The Committee will develop appropriate evaluation techniques for the: Evaluation of the trainee:
a) Cognitive: assessed by the NBME and LMCC examinations, and to a lesser extent on the ITER by observing the students’ clinical performance.
b) Problem solving: Assessed as part of the ITER clinical evaluation.
c) Clinical skills: This is assessed on the ITER clinical evaluations with a final
comprehensive assessment on the CCE. d) Interpersonal skills: Assessed on the ITER clinical evaluations along with the
comprehensive assessment on the CCE. e) Professional skills: assessed on the ITER clinical evaluations.
Evaluation of Program:
a) The success of the Department of Internal Medicine program can be partially judged by the success of its candidates on external examinations (NBME, LMCC). Failures on the in-training examination (NBME) are not infrequent, but are usually passed on the subsequent attempt. Repeat failures are uncommon and undergo a formal, supervised remediation program which is usually successful in helping the student attain a passing grade.
b) Each group of students completing the Medical CTU rotation is collectively interviewed
by the Medical Clerkship Director/Coordinator for each hospital. If a consistent problem is encountered then this is brought to the attention of those responsible.
c) Each Medical CTU and Medicine Selective attending physician is evaluated by the
students using an anonymous, standardized computerized form and this information will be summarized for each attending physician on an annualized basis.
d) The students evaluate the Medical CTU and Medical Selective rotation using an
anonymous, standardized computerized form and this information will be used for continuous quality improvement of the rotations.
e) The students evaluate each Medicine tutorial series with respect to content and structure
using an anonymous, standardized, computerized form and this information will be used to improve the quality of the presentations and to evaluate the need to replace sessions/presenters.
Terms of Reference: Undergraduate Medical Education Committee
Page: 4 of 4
Committee Meetings The committee will meet on average every six (6) weeks aiming for a minimum of six (6) meetings per year. As well, at the discretion of the chair, extra meetings will be scheduled to discuss urgent issues (ex: student failures). An agenda will be circulated prior to the meeting. Minutes will be taken. Any member may add items to the agenda or discuss them at the meeting under other business.
Department of Internal Medicine
TERMS OF REFERENCE
POSTGRADUATE MEDICAL
EDUCATION COMITTEE
Section: Standing Committees Page: 1 of 4
Review/Revision Dates: Aug. 29, 2005;
The University of Manitoba's Department of Internal Medicine currently sponsors 15 accredited postgraduate training programs for residents in the following medical specialties or subspecialties:
• Cardiology
• Clinical Immunology and Allergy
• Endocrinology and Metabolism
• Gastroenterology
• General Internal Medicine
• Geriatrics
• Hematology
• Infectious Diseases
• Intensive Care
• Nephrology
• Neurology
• Oncology
• Physical Medicine and Rehabilitation
• Respiratory Medicine
• Rheumatology
In compliance with the accreditation guidelines of the Royal College of Physicians and Surgeons of Canada, the day-to-day operation of each program is supervised by a designated Program Director and a Resident Training Committee. The role of the Postgraduate Medical Education Committee within the Department of Medicine is to provide direction and support for these 15 Program Directors and Resident Training Committees, to help promote the highest standards for postgraduate medical education within the resident training programs, and to help ensure the limited resources for postgraduate education within the department are used effectively.
Chair
Director, Postgraduate Medical Education, Department of Internal Medicine
Terms of Reference: Postgraduate Medical Education Committee
Page: 2 of 4
Membership The Postgraduate Medical Education Committee is made up of the Program Director from each of the 15 accredited resident training programs within the Department of Medicine, and chaired by the Director of Postgraduate Education for the Department. The Committee also includes the Departmental Representative on the Faculty Postgraduate Medical Education Committee and the Chair of the Department of Medicine. The complete make up of the Committee is summarized below:
Director, Postgraduate Medical Education, Department of Internal Medicine (Chair)
Program Director, Cardiology Program Director, Clinical Allergy and Immunology Program Director, Critical Care Program Director, Endocrinology and Metabolism Program Director, Gastroenterology Program Director, General Internal Medicine Program Director, Geriatrics Program Director, Hematology/Oncology Program Director, Hepatology Program Director, Infectious Diseases Program Director, Nephrology Program Director, Neurology Program Director, Palliative Care Program Director, Physical Medicine and Rehabilitation Program Director, Respiratory Medicine Program Director, Rheumatology Head, Department of Internal Medicine
The Program Director for any new postgraduate resident training program within the Department of Medicine, recognized by the Royal College of Physicians and Surgeons of Canada, will automatically become a member of the Committee. Other faculty members and trainees will be invited to participate in Committee activities as required.
Reporting Structure
The Committee is an advisory body to the Head of the Department of Internal Medicine through the Department's Director of Postgraduate Education and the Departmental University Executive Committee. The Committee is also an advisory to the Associate Dean, Postgraduate Medical Education through the Faculty Postgraduate Medical Education Committee.
Terms of Reference: Postgraduate Medical Education Committee
Page: 3 of 4
Specific Duties and Responsibilities The specific duties and responsibilities for the Departmental Postgraduate Medical Education Committee can be summarized as follows:
A. Program Development
The Committee is responsible for ensuring that each postgraduate resident training program within the Department of Medicine is compliant with the accreditation guidelines of the Royal College of Physicians and Surgeons of Canada, and provides the best educational and training experience possible, within the limits of the resources available. As part of the process the Committee will ensure that each resident training program:
has clearly defined and up-to-date educational goals and objectives
has adequate facilities, personnel and support services to function effectively
uses effectively the patient care and educational resources available at the
two major teaching centres
are administered effectively, efficiently and fairly. B. Resident Selection
The Committee is responsible for assigning all MATH-funded training positions allocated to the Department of Medicine, to the various resident training programs within the Department. The Committee, will also assist each of the training programs in developing more effective methods of recruiting qualified trainees.
C. Resident Evaluation
The Committee is responsible for ensuring that each resident training program within the Department of Medicine, has effective policies and procedures for evaluating the performances of trainees. In the event that a resident wishes to contest an evaluation, the Committee will also provide a formal appeal mechanism, or if necessary refer the evaluation and appeal to the Faculty PGME Committee for review. The Department will also ensure that each resident training program has effective procedures for evaluating the performance of faculty members, in accordance with the rules and regulations of the Department and Faculty of Medicine Faculty evaluation process.
Terms of Reference: Postgraduate Medical Education Committee
Page: 4 of 4
D. Program Evaluation
The Committee will be responsible for ensuring that each resident postgraduate teaching training program has effective ongoing program evaluation procedures, as required by the Royal College of Physicians and Surgeons of Canada. As part of this responsibility, the Committee will delegate one representative to participate as a member on internal review survey teams established by the Faculty Postgraduate Training Committee to evaluate resident training programs within the Department.
D. Research
The promotion of research is a major priority for Postgraduate Training Programs within the Department of Medicine. The Committee therefore has a responsibility to assist individual programs within the Department in carrying out this mandate by encouraging broad participation in Resident Research Day.
E. Resident Counseling
The Committee will be responsible for ensuring that each Resident Training Program provides career counseling for all trainees, and that mechanisms are in place for ensuring residents have access to counseling or other support services when required.
F. Manpower Planning
The Committee will participate with individual Resident Training Programs and the Chair of the Department of Medicine in Manpower Planning to help ensure that the needs of both the trainees and the health care system are being considered in planning postgraduate medical education activities.
H. Quorum
A quorum shall consist of five Committee members. Members who are in contact by telephone shall also be included in a quorum.
Updated: August 29, 2005
Department of Internal Medicine
TERMS OF REFERENCE
CORE INTERNAL MEDICINE
RESIDENCY TRAINING COMITTEE
Section: Standing Committees Page: 1 of 3
Review/Revision Dates: April 29, 2005;
Chair Program Director, Core Residency Training Program Membership
• Program Director, Core Residency Training Program (Chair) • Chair, Postgraduate Medical Education, Department of Medicine • Chair, Undergraduate Medical Education Committee, Department of Medicine • Associate Program Director, Internal Medicine Residency Training • Service Chief, Health Sciences Centre (unless already represented) • Service Chief, St. Boniface General Hospital (unless already represented) • Chief Medical Resident, Health Sciences Centre • Chief Medical Resident, St. Boniface General Hospital • One Senior Medical Resident (R III/IV) • One Junior Medical Resident (R I/II) • Up to three other Faculty members, at the invitation of the Chair and with the
approval of the Committee, for assistance with a specific issue and for a two year term, renewable for another two years if they so wish.
Ex-Officio Members
• Head, Department of Internal Medicine • Department of Medicine Representative Faculty P.G.M.E. Committee
(where applicable) Reporting Structure
University Department Head through the Chair of Postgraduate Medical Education, Department of Internal Medicine
Goals
To develop, implement, and evaluate educational policies relevant to the core internal medicine training program of the Department of Internal Medicine
Terms of Reference: Core Internal Medicine Residency Training Committee
Page: 2 of 3
Scope and Function
1. The Committee will endeavour to establish an environment conducive to teaching and
learning which will encourage academic excellence. 2. The Committee will make recommendations regarding the structure and content of
the core training program based on educational principles relevant to professional training.
3. The committee will review, evaluate, and recommend modifications to the structure
of the core training program including: the resident selection process specific rotational requirements academic half day, and external elective rotations
4. The committee will work with individual sections within the Department of Internal
Medicine to develop and/or modify appropriate curriculum guidelines which meets the training requirements of core residents on individual subspecialty rotations.
5. The committee will monitor and assess the educational/service balance on all
rotations.
6. The committee will establish an evaluation system to provide residents with reliable and valid feedback on their clinical competence.
7. The committee will encourage resident participation in either clinical, basic sciences,
or educational research including the resident research day.
8. Assist and support faculty teaching evaluation system in cooperation with Specialty Postgraduate Training Committee and Department Head.
9. The committee will support and develop resident teaching skills through both
educational interventions and evaluation methodologies.
10. The committee will establish programs to enable residents to receive appropriate career and personal counseling, where appropriate.
11. The committee will hear appeals and decide on all resident appeals challenging
rotational or yearly evaluations.
Terms of Reference: Core Internal Medicine Residency Training Committee
Page: 3 of 3
Committee Meetings
Chairperson: The Chair shall call the meeting and set the agenda The Chair or delegate, shall preside at all meetings The Chair shall ensure that decisions are communicated to appropriate individuals
or sections, for implementation Quorum
A quorum shall consist of 5 members.
Number of Meetings
The committee will meet at least six (6) times per year on the First Monday of each month, at 0800 – 0900 hours unless otherwise stipulated by the Chairperson.
Notice of Meeting
The notice of the meetings, with the agenda and minutes from the prior meeting, will be sent out to all members seven days prior to each subsequent meeting.
Terms of Office
The Chair of Postgraduate Education and the Chair of the Undergraduate Medical
Education Committee will be members of the Committee for the duration of their respective terms of office.
The Director of the Core Program will be appointed by the Department Head for
three years.
Service Chief at both teaching hospitals (unless already represented) will be members of the committee for 2 years, and will be appointed upon the recommendation of the Chair of Postgraduate Education.
The two chief medical residents will be members for the term of their
appointments.
The Senior and Junior medical resident representatives will be elected to the Committee by the Resident Committee for the Department of Medicine for one year.
Updated August 29, 2005
Department of Internal Medicine
TERMS OF REFERENCE
Medicine Program AMBULATORY COORDINATING
COMMITTEE
Section: Standing Committees Page: 1 of 1 Review/Revision Dates: Feb. 2006,
Preamble
This committee functions in keeping with the Health Sciences Centre Vision, Mission, Core Values and Code of Conduct.
Accountability/Reporting Relationship Winnipeg Regional Health Authority (WRHA) Medicine Program
Health Sciences Centre (HSC) Medicine Program
Health Sciences Centre (HSC) Clinical Programs Leadership Team
Membership
Medicine Program Ambulatory Care – Dr. Dan Roberts Director of Patient Services Medicine Medicine Managers of Patient Care – Ambulatory Care Ambulatory Care Physician – Dr. Ken Van Ameyde Quality Engineer, Medicine Program MSI Systems and Process Manager Business Manager, Department of Internal Medicine
Purposes
To provide a forum for discussion and decision-making related to ambulatory systems management within the HSC Medicine Program
To discuss and develop policy to support best-practice for Medicine Ambulatory programming
To determine prioritization of services
To progress the Medicine Programs’ goals toward timely response to consultation and services
Process for determining i8mpact and approval of new patient equipment and associated supply requirements.
To support quality, patient safety, performance evaluation and utilization initiatives Chair: TBD Meetings: A minimum of ten meetings per year