Saturday, February 7, 2015

ACGME Core Competencies & Milestones


  • ACGME has 6 core competencies for every resident physician to meet prior to graduating. 
  • The ACGME milestones are used as a system for programs to evaluate residents and promote residents based on the 6 core competencies. 
  • The Clinical Competence Committee (CCC) meets semi-annually and evaluates each resident's progression through the milestones
  • Milestones are graded on a 1 - 5 scale with 1 being "critically deficient" to 5 being "aspirational."
Click links below for more details

Patient Care (PC)
Medical Knowledge (MK)
Practice Based Learning and Improvement (PBLI)
Interpersonal and Communication Skills (ICS)
Professionalism (PROF)
Systems Based Practice -working with health care system (SBP)



1. Gathers and synthesizes essential and accurate information to define each patient's clinical problem: monthly eval, chart review, miniCEX 
2. Develops and achieves comprehensive management plan for each patient: monthly eval, chart review 
3. Manages patients with progressive responsibility and independence: monthly eval, chart review
4. Skill in performing procedures: Met 5 required procedures
5. Request and provides consultative care: monthly eval, chart review
6. Clinical Knowledge: monthly eval, Peer review
7. Knowledge of diagnostic Testing and procedures: monthly eval, chart review
8. Works effectively within an interprofessional team: peer eval, nursing eval, patient survey
9. Recognizes system error and advocates for system improvement: monthly eval
10. Identifies forces that impact the cost of health care, and advocates for, and practices cost effective care: monthly eval
11. Transitions patients effectively within and across health care delivery systems: montlhy eval
12. Monitors practice with a goal of improvement: self eval
13. Learns and improves via performance audit: quality data (i.e. pap smears, mammograms, diabetes checklist, pcoft)
14. Learns and improves via feedback: monthly eval, peer review
15. Learns and improves at the point of care: monthly eval
16. Has professional and respectful interactions with patients, caregivers and members of interprofessional team: monthly eval, nursing eval, patient survey
17. Accepts Responsibility and follow through on tasks: monthly eval, patient survey
18. Responds to each patient's unique characteristics and need: monthly eval, nursing eval
19. Exhibits integrity and ethical behavior in professional conduct: monthly eval, peer review, nursing eval
20. Communicates effectively with patients and caregivers: monthly eval, peer review, patient survey
21. Communicates effectively in interprofessional teams: monthly eval, peer review, nursing eval, patient survey
22. Appropriate utilization and completion of health records: PCOFT, Problem/Med List, unapproved abbreviations, delinquent records

Friday, February 6, 2015

Continuity Clinic Evaluations

Many of you already know this but for those who don't, please note the following ways you are evaluated in continuity clinic:

  • Mini-Cex which includes faculty bedside evaluation of residents
  • Nursing evaluation
  • Chart Audits
  • Dan Burke Bedside Behavioral Science evaluation

Diagnostic Cardiac Catheterizations at KMC

Please note that we do have the ability to perform diagnostic cardiac caths at KMC and have for quite some time. Of note there were 50 caths done last year.

 Our cath lab has receive a makeover is  fully operational for at least 3 weeks now.

Thursday, February 5, 2015

A Message From Glenn Goldis, Chief Medical Officer

From: Glenn Goldis, MD, CMO
Date: February 5, 2015
Subject: Confidential Communication 


In response to ACGME process improvement recommendations, I would like to begin extending my availability to any of our Residents who wish to have a “safe place” to discuss sensitive issues or topics that affect the learning environment and your experience as a Resident at KMC.

Therefore, please know that effective immediately, I am available to discuss any personal or professional issues you may wish to share. I hope to use any learning from our discussions to improve the process, operations, or function of our facility and the Residency program itself. Any topic is “fair game” and held in the strictest of confidence.

Thank you in advance for your willingness to work with me toward improving the academic and clinical services we offer here at KMC.

If you would like to arrange a time to speak with me, please contact Tracy Subriar:
Office: 661-326-2718 or
E-mail: subriart@kernmedctr.com

Glenn Goldis, MD, MMM
Chief Medical Officer
Chief Academic Officer/DIO
Kern Medical Center
1700 Mt. Vernon Ave.
Bakersfield, CA 93306
Goldisg1@kernmedctr.com
(949) 445-4758 (cell)
(661) 326-2123 (office)

Weekend Call Schedule and Dr. Duggal Endocrine

Ladies and gentlemen,

Please note the weekend call schedule has been updated on Amion to reflect the changes.

Additionally for those of you on ambulatory care, pay attention to the subspecialty schedule regarding the Endocrine rotation with Dr. Duggal.
No longer are the days set for Tuesday and Friday.
Each week the endocrine rotation days are different so that we can accommodate the Family Practice Program.


Thursday, January 29, 2015

New Weekend Call Schedule Trial

We will be "beta" testing a new call schedule for the weekend to ensure that residents don't work for more than 24 hours.

The following will only apply to residents and NOT interns:

Old Schedule:
Night float Thursday 9pm - Friday 7am
Wards Friday 7am - Saturday 7am
Wards Saturday 7am - Sunday 7am
Wards Sunday 7am - Sunday 9pm
Night Float Sunday  - 9pm - Monday 7am


New Schedule
Night float Thursday 9pm - Friday 10am (13hour call)
Wards Friday 10am - Saturday 10am (24 hour call)
Wards Saturday 10am - Sunday 10am (24 hour call)
Wards Sunday 7am - Sunday 9pm (12 hour call)
Night float Float Sunday 9pm - Monday 7am

Sunday night throughout Thursday morning, The scheduling will remain the same


What does this mean?

  • There will be a 3 hour window where you'll be on call WITHOUT your intern while you admit to the incoming team.
    • Example: Night float is on until 10am on Friday morning. A consult comes in at 9am. The senior resident is not available yet but the intern from Platinum team is there already. The night float senior will take the consult information, triage the patient appropriately, then supervise the ward intern during the encounter with the patient. The admission will be to platinum. Once the senior arrives at 10am, there will be a senior to senior sign out.
    • Example: Platinum team is now on 24 hour call from Friday 10am to Saturday 10am. A consult is called on Saturday at 8am. The Platinum senior will take the consult, triage the patient appropriately, then supervise the incoming ward intern (Purple) to see the patient. Once the next team senior (Purple) arrives at 10am, there will be a senior to senior sign out.
  • We will be using a consult pager that will be passed on from senior to senior. The pager number is 307-2191. This will simplify the process for the hospital to know who to contact for medicine consults.
  • This new schedule means you will come 3 hour later on the 24 hour calls so you can leave by 10am and not hit the 24 hour mark.
  • We understand this sounds complicated but the alternative more simple approach to avoid  >24 hour call is to extend night float from 5 nights to 6 so we can cover friday nights and then have residents that are on non call rotations (Cards, ID, AC, Neuro, etc..) Saturday night float. ---This means you will give up 1-2 weekends off while on non call rotations
If you have any questions or confusion, please don't hesitate to call us or ask questions in the comments.

Tuesday, January 13, 2015

Endocrine Round Table Discussion - Dr. Ettinger Schedule Change

Please note the Endocrine lecture has been changed to 1 pm tomorrow 1/14/2015 in the platinum room so that more people can make it.

We will schedule more lectures during noon conference from now on.