Integrated Program Manual: Plastic & Reconstructive Surgery

University of Minnesota Graduate Medical Education
2016-2017 Program Policy & Procedure Manual

Department of Surgery
Division of Plastic & Reconstructive Surgery
Independent & Integrated Residency Program

 

i.  Introduction/Explanation of Manual

This Program Manual is designed to provide specific policies relating the to the Plastic & Reconstructive Surgery Independent & Integrated Residency Programs.

Residents are expected to review this manual completely at the start of training, and use this as a reference guide for questions that come up throughout the course of training. Policies pertaining to only certain years will be designated by program abbreviation (Ind. or Int.) and Resident Level (RL).

The University of Minnesota's Institution Manual is designed to be an umbrella policy manual. Some programs may have policies that are more rigid than the Institution Manual in which case the program policy would be followed. Should a policy in a Program Manual conflict with the Institution Manual, the Institution Manual would take precedence. Residents are not expected to review the Institution Manual in full, but can be accessed when appropriate.

Due to the large number of topics covered within this manual, we understand that you may find errors, broken links, and out of date information. Please notify the program coordinator any time you find something that should be updated. Major changes (eg. changes to policies) will be emailed out, however minor changes (e.g. grammatical errors, link updates, etc.) will be changed without notification.

ii.  Department Mission Statement

Department of Surgery Mission and Vision

iii. Program Mission Statement

The Plastic Surgery Residency Program strives to achieve excellence in research and education by ongoing outcomes measurements for all ACGME core competencies.  Upon completion of the residency, all graduates will function independently, skillfully, and ethically, with a solid foundation to continue their lifelong development as Plastic Surgeons.

Residents will achieve competency in;

• Patient Care, measured by direct observation in a variety of clinical settings. Residents will be allowed to function as effective and safe surgeons in all aspects of Plastic Surgery with independence, skill, and maturity.
• Practice-Based Learning, achieved by repeated exposure to surgeries and improvement by evaluation of evidence-based information and use of the best-available knowledge.
• Medical Knowledge, measured by direct observation of expert faculty, in-service scores, and eventual successful completion of the American Board of Plastic Surgery written and oral examinations.  The application of this knowledge allows our graduates to achieve optimal patient outcomes in all aspects of Plastic Surgery.
•  Interpersonal and Communication Skills, achieved by mentoring, and evaluated as residents move from novice to expert Plastic Surgeons in their interactions with staff, peers, and patients.
• Professionalism, achieved by mentoring, and evaluated so graduates will always maintain continuity of care, responsiveness to clinical changes, availability, and practice with the highest ethical standards.
• Systems-Based Practice, evaluated so all graduates become team members in the global health care system to achieve the best possible outcomes for their patients.
   

SECTION 1 - STUDENT SERVICES

Email

The University provides each resident with an email address at the start of training. The University assigned email account is the University's official means of communication with all residents. Residents are responsible for all information sent to them via their University assigned email account. Your @umn.edu account is considered "secure" and Protected Health Information (PHI) can be exchanged to other secure email accounts (e.g. @umphysicians.umn.edu, @fairview.org, etc.). To maintain the security of your @umn.edu account, you cannot set up mail forwarding to your personal (non-secure) email account (e.g. @gmail.com, @yahoo.com, etc.).

• Check your email at mail.google.com
• Information and set-up guides for email; http://www.oit.umn.edu/email

Email and Protected Health Information (PHI)

If it is essential to include confidential information within e-mail, restrict the amount of information to the minimum necessary to complete the purpose of the transmission and send it only to those with a legitimate need to know. In addition, follow these guidelines:

Subject Line: If an e-mail contains confidential information, type the word “PHI” or “Confidential” in the subject line so it is clear that the contents should be protected. Take measures to limit or exclude patient information or patient identifiers in the subject line since the subject line is readily viewable when an account is open on a desktop.

Identifiers: When able, exclude patient names, birth dates, and other unique identifiers so that if the e-mail is routed to an unintended recipient, it would be difficult or impossible for that person to determine the identity of the individual referenced in the e-mail. For example, if the e-mail is in reference to a situation that is very familiar to both parties, exclude unnecessary identifiers and communicate only the required information. If names and other identifiers are necessary for patient safety, you should include the identifiers and not take the risk of compromising patient safety.

If a patient would like to contact your @umn.edu address and your response may include PHI, you should inform them of the risks;

•  E-mail sent over the Internet can be intercepted by others.
•  If you receive e-mail at work, your employer may have the right to save and read your e-mail. Your Internet service provider may also have the right to save and read your e-mail.
•  If you share an e-mail account, others may see your e-mail.
•  A copy of an e-mail may be saved on a computer system even though you deleted it.
•  If an e-mail address is not entered correctly, the e-mail can be sent to people it is not intended for.
•  E-mail can be used to spread computer viruses.

Fairview provides an email consent form if you or the patient prefer to have written authorization; Fairview E‐mail Consent Form.

Proofpoint Secure Email Center

This is a tool that enables users to send email that contain private information, including Protected Health Information (PHI), via a secure message reader.

Sharing PHI via email is still discouraged, but this new feature is available for situations when email is the  only available option to share PHI. Typically, these involve one-time communication with an individual, such as a patient.

Using UMN Secure Email Center

Sending Secure Email: Proofpoint Secure Email Center uses a software to secure email messages containing personal health information (PHI). To activate Proofpoint's encryption, simply enter "[phi]" or  "[encrypt]" (brackets included) in the subject line of your email. Doing so will secure the message regardless of its content.

Receiving Secure Email: Every time you are sent an encrypted email using UMN Secure Email Center, you will receive an email notification. This notification will include a link that takes you directly to a Proofpoint website. (Note: If it is your first time using Proofpoint, you will be prompted to set up an account.) To view a decrypted version of the message, simply log in to Proofpoint.

Using this feature ensures that the University is in compliance with the Health Insurance Portability and Accountability Act, which requires that patient personal health information (PHI) be secured.

For more information about sending or receiving emails using UMN Secure Email Center, please see the Secure Email Center Self-Help Guide.

Email Signatures

In an effort to establish consistency in the way we all share contact information with our audiences, an email signature standard has been developed. We have implemented this within University Relations and ask for your help in implementing this within your campuses, colleges, and units. Please note that this standard is based on email signature best practices and does not allow for the addition of graphics or images.

Visit Our Brand: How to Convey It for email signature templates.

If you communicate PHI via email, Fairview recommends adding the following disclaimer to your signature:

The information transmitted in this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material, including 'protected health information'. If you are not the intended recipient, you are hereby notified that any review, retransmission, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please destroy and delete this message from any computer and contact us immediately by return e-mail.

Google Apps

Apps available to the Academic Health Center under our Business Associate Agreement with Google include:

• Gmail
• Google Calendar
• Google Drive
• Google Sites

Google Groups is also available, however users will be subject to certain controls to ensure that no Protected Health Information is contained in Google Groups.

You will not have access to other University Google Apps. This includes:

• Google Hangout (includes Google Talk/Chat)
• Google Analytics
• YouTube (posting/editing content; you can still view videos)

Request an exception

If you are part of the University’s healthcare component (HCC) and believe you have a business need to access Youtube/Hangouts/Analytics (the “Additional Google Applications”), please review and complete the AHC Google Apps Exception Request Form. Please keep in mind that access to the Additional Google Applications will not be permitted in the event your need would result in transferring, creating, maintaining, storing or otherwise making accessible any Protected Health Information (“PHI”). Also, please keep in mind that an exception for Youtube is only needed for those who need to post or edit content on Youtube.

Once the AHC Google Apps Exception Request Form is completed, it will be reviewed by the Privacy Office and OIT. You may be contacted for additional information.
Protected Health Information and Google Apps

The University has a number of policies and procedures regarding the use and/or disclosure of PHI, including the Protection of Individual Health Information by University Health Care Components. Compliance with these policies and procedures is required whenever using and/or disclosing PHI, including when using any of the Google Apps.

Additionally, specific guidelines pertain to the following:

• Documents/Drive: PHI should not be stored in Google Drive/Docs. The University recently launched a HIPAA compliant, cloud-based storage solution called Box Secure Storage. Box Secure Storage is intended for storing, sharing, and accessing sensitive or “Private-Highly Restricted” data. Even when storing sensitive data in Box Secure Storage, great care should be taken to ensure only authorized users can access the data.

Learn more about Box Secure Storage including how to activate your account.

• Gmail: In general, PHI should not be sent via Gmail. If email is the only option to share PHI with an organization or individual, HCC members should use the newly implemented Proofpoint Secure Email Center. Proofpoint is HIPAA compliant and allows HCC members to send encrypted emails to users outside the HCC. The receiver will be directed to retrieve the message from a secure, online portal. Additionally, both parties can respond securely to messages back and forth via the Proopoint portal.

Internet Access

The Office of Information Technology (OIT) recommends all University employees and students use the "UofM Secure" wireless service using Wi-Fi Protected Access 2 (WPA2) while on campus. This is a wireless security standard that provides strong data security and network access control. WPA2 limits network usage to authorized users by requiring user authentication. Another feature of WPA2 is data encryption, which secures wireless network traffic from eavesdropping.

Set-up guides

Mail

Outgoing mail can be left in the appropriate bin in the the Department of Surgery Duplicating & Mail Room, PWB 11-142 (across the hall from PWB conference room 11-157).

Incoming mail is collected by the program coordinator. Residents will be notified via email if they receive mail, with a scanned copy if possible. Mail that cannot be scanned/originals will be available for pick up at the program coordinator’s office (PWB 11-145B).

Journals must be delivered to resident's home address to ensure they are received in a timely manner.

USPS & Campus Mail address:
420 Delaware Street SE, MMC 195
Minneapolis, MN 55455

Delivery & Courier Service address:
Mariah Ipsan
Phillips Wangensteen Building, Room 11-145B
516 Delaware Street SE
Minneapolis, MN 55455

Pagers

The program coordinator supplies alpha-numeric pagers from UMMC, Fairview to the incoming residents at the start of their training. The number residents are assigned remains the same for the duration of their training. All U of MN faculty, staff, and resident pagers are alpha-numeric.

• Alpha-text paging: Pages sent numerically should be considered urgent and a call-back is expected. Alpha text does not usually require a response, unless indicated (e.g., Call me). Abbreviated text is used liberally. If in doubt, call the sender.
• Keep devices at least 6 inches apart to avoid interference. Pagers carried too close to each other are prone to missing pages.
• Batteries can be obtained from your Program Coordinator.
• American Messaging User Guides
• Coverage Map

If your pager breaks or malfunctions, bring it to the UMMC, Fairview Hospital (University or Riverside) information desk, and they will provide you with a new pager. Information desks are staffed 24/7, 365 days a year. If you have additional questions regarding this process, contact;

Karen Bloomberg
Telecommunications Analyst
[email protected]
Phone: 952-924-5860

PageCopy

PageCopy is optional service provided by American Messaging, which allows pages to be sent to your mobile phone (in the form of a text message), or to your secure @umn.edu email address. To opt-in, sign in with your UMN ID and password to complete the request form. Notify the program coordinator if you'd like to opt-out at any time.

Privacy and Data Security Training (HIPAA) Training

The University of Minnesota provides online training courses to comply with HIPAA (the Health Insurance Portability & Accountability Act of 1996) regulations. Although the University’s data privacy and security training courses fulfill the training requirement contained within the HIPAA rule, they also provide the entire University community, including those who do not work with protected health information covered by HIPAA, with information about securing private University data. Residents will be assigned appropriate courses through MyU.

Tuition and Fees

Tuition and fees are being waived at this time. Residents enrolled in Graduate School pay tuition and fees.

SECTION 2 – BENEFITS

ASAPS Resident Program Enrollment

Residents must complete Aesthetic Society Resident Program Enrollment Form at the start of training to receive Aesthetic Surgery Journal. Return signed form to Program Coordinator for processing. Residents will be in the program until the completion date listed on their enrollment form.

ASPS Residents & Fellows Forum

The program coordinator will enroll residents in the ASPS Residents and Fellows Forum Application at the start of every academic year to continue receiving Plastic & Reconstructive Surgery Journal. Return signed form to Program Coordinator for processing.

Discounts

Fairview Employee Perks & Discounts

    Health Club Discounts
    Tickets including;
        Local attractions
        Movie tickets
        Broadway shows
        Concerts & other special events
        Sporting events
    Gift & Dining Cards
    Bus Passes & Stamps
    Cell Phones & Plans, including;
        Verizon Wireless offers a 22% discount on service plans of $34.99 or higher and 250 free text messages.
        AT&T offers a 20% percent discount on service plans (not including iPhone 2G services). Discount is limited to two family members with a $9.99 monthly charge for additional lines. iPhone 3G voice and data plans are included.
        Sprint PCS offers a 17% discount on new accounts.
    Hotels & Car Rental
    Discounts for Medical Plan Members (residents not eligible)
    Daycare Services & Discounts
    Pharmacy

Visit https://intranet.fairview.org/Benefits/EmployeeDiscounts/index.htm for more details. You will be asked to log in with your Fairview username and password to access site.

UMN Employee Perks & Discounts

Minnesota Employee Recreation & Services Council (MERSC) Discounts, including;
Coupons
Theatres - Music - Museums
Sports Tickets
Entertainment & Recreation
Auto Sales & Service
Education - Child Care
Event Services
Health & Wellness
Home Services
Professional Services
        Retail & Restaurants
        Travel - Hotels - Resorts
        Employee Services Resources
        Advertising Specialties / Awards
        Event Services & Sites / On-Site Sales
        Group Events / Consignment Tickets
    U Card Faculty & Staff Checking
    MetroPass
    Technology Products, including
        AT&T - Receive an 8% discount on your cell phone plan through AT&T
        Sprint Nextel - Receive a 10% discount on your cell phone plan through Sprint Nextel
        T-Mobile - Receive a 10% discount on your cell phone plan through T-Mobile
        Discounts on Apple & Dell products (% varies)
        Discounts on Software (e.g. Microsoft Office, Photoshop)
        Discounts on Operating Systems
    Discounted Tickets and Passes, including;
        Movie Passes
        Minnesota Zoo
        Moose Mountain Adventure Golf
        Minnesota Sea Life Aquarium
        Minnesota Children's Museum
        Water Park of America
        Science Museum of Minnesota
        Nickelodeon Universe
        Vertical Endeavors
        Additional seasonal offerings (e.g. State Fair, Renaissance Festival, Minnesota Wild, St. Paul Saints, etc.)

    Travel: It is recommended that travelers use the University's U-Wide travel vendors for personal/business travel. Substantial cost savings accrue to the University when travelers use any of these contracts.
        Delta airfare (Discounts start at 2% and are negotiated on an annual basis based on usage)
        lodging
        car rental

Grants
Educational Materials
The program provides a one-time $300 reimbursement toward academic book purchases or journal subscriptions not provided by the program, to be used during Int. RL3-6 and Ind. RL1-3.

Residents are expected to pay out-of-pocket for educational materials, and provide receipts to LuAnn Zeilinger ([email protected] or fax to 651-254-2808) for reimbursement out of Regions IBARS account.
Surgical Loupes

The program provides one pair of surgical loupes to each resident at the start of Int. RL3 and Ind. RL1, with a target expense of approximately $1,200. Residents may work with the vendor of their choice.
Residents are expected to pay out-of-pocket for their loupes, and provide receipts to LuAnn Zeilinger ([email protected] or fax to 651-254-2808) for reimbursement out of Regions IBARS account.

Kevin Brennhofer
Designs For Vision
Regional Sales Representative
Cell: 651-734-8698
Office: 631-585-3300 or 800-345-4009
[email protected]

Barb Lindquist | Territory Manager
Orascoptic / Surgical Acuity
3225 Deming Way, Suite 190| Middleton, WI 53562
Phone: (612) 638-7040    Fax: (888) 307-7674
www.orascoptic.com | www.surgicalacuity.com
[email protected]

From March 2014 email;
"We do still have resident pricing available, which is a substantial discount off of retail.  The most popular loupes are our 2.5x HiRes loupes on the titanium frames or Rudy Project sports frames.  These retail for $1,650 but residents get them for $995.  We also have new frames, including our Rudy Project Ultimatum (wayfarer style) and the new Oakley Flak Jacket frames which are the same price for residents.  I have attached some pictures of the new frames as they are not on our website yet (available here).
Health & Professional Liability Insurance

Refer to Institution Policy Manual.

Medical Malpractice Credentialing / Insurance Verificaton information available here: https://sites.google.com/a/umn.edu/medcred/
Health Services

Fairview Employee Occupational Health Services (612-672-5050) is open Monday - Friday, 7:30 AM - 4:00 PM, and located at;
Mayo Memorial Building
420 Delaware Street SE, room B324 (3rd floor, B-wing)
Minneapolis, MN 55455

They provide support to residents through services such as;

    immunizations (seasonal flu, MMR, TDAP and Varicella)
    mantoux screenings and testing
    coordination of fit testing/respiratory protection
    blood-borne pathogen exposure follow-up

Lab Coats
Incoming Int. RL1 residents receive two lab coats embroidered with their name and the Department of Surgery. At the start of Int. RL3 and Ind. RL1, residents will receive two lab coats embroidered with their name and Plastic Surgery.

If needed, residents may purchase additional coats at their own expense (e.g. at the U of MN Book Store, or by mail order through TEK Products, Inc - contact Program Coordinator if interested in this option).
Laundry Service

Soiled coats can be dropped off in the hamper in the Department of Surgery. Clean coats may be picked up one to two weeks later at the same location. Contact Christine Vincent for the key to the locked closet that the hamper and coats are stored in.
Leave Policies

Int. RL1-2 residents follow General Surgery Resident Manual for all leave policies.
Academic (Professional) Leave
Time off to attend an event that holds educational value is considered academic leave. Two travel days are included for out-of-town events (domestic). Additional travel days are allowed for international trips. Examples of academic leave;

    Conferences (e.g. society meetings, board review courses, board exams, approved industry events)
    Medical mission trips
    Interviews during Chief year  

Academic leave does not count against your vacation balance. You are responsible for accurately logging academic leave in RMS. Whenever applicable, your RMS academic leave logs should include weekends and holidays.
Bereavement Leave

Refer to Institution Policy Manual.
Family Medical Leave Act (FMLA)
Refer to Institution Policy Manual.
Holidays
Regions Rotations: Vacation may not be taken from December 24 - January 1. The site director will arrange for every resident to have three days off during the period of December 24th through January 1st, allowing all residents time off during these dates.

All other rotations: There are no other site-specific restrictions. Residents are expected to divide holiday coverage fairly/equitably amongst themselves. Historically, 3rd/4th year residents have covered major holidays (e.g. Thanksgiving, Christmas), and in return have this time off in their 5th/6th year.
Jury/Witness Duty
Refer to Institution Policy Manual.
Medical Leave
Refer to Institution Policy Manual.
Military Leave

Refer to Institution Policy Manual.
Parental Leave
Refer to Institution Policy Manual.
Personal Leave of Absence

Refer to Institution Policy Manual.
Sick Leave

When a resident knows that illness will cause an absence from clinical responsibilities, they are responsible for notifying the following people of their unexpected leave;

    Program Coordinator
    Program Director
    Any faculty that will be affected
    Any other resident that may cover call responsibilities

A physician’s note may be requested to support the resident’s request for sick leave.
Residents will not be expected to use vacation time for up to 5 business days of missed work due to illness per academic year. However, sick leave will be counted as time off for Board training requirements. If the resident does not follow the policy outlined above (notifying all parties), the absence will be deducted from vacation balance.
Vacation
Residents receive a total of 20 vacation days each academic year (July 1 to June 30). A maximum of 5 days should be taken every 3 months;  

July - September
October - December
January - March
April - June

Weekends and holidays are not counted against your vacation balance, but need to be listed on this form for call schedule purposes. Residents are responsible for accurately logging vacation time in RMS, which is the “source of truth” for your vacation balance. Do not include weekends or holidays as vacation time in RMS.
Resident Leave Calendar

This item does not apply to Int. RL1-2 residents - follow General Surgery Resident Manual for all leave policies.

Prior to requesting time off, residents are expected to review the Resident Leave Google calendar to ensure there will be alternate coverage. Residents are responsible for arranging call coverage during their time away.
Resident Leave Form

This item does not apply to Int. RL1-2 residents - follow General Surgery Resident Manual for all leave policies.

Residents are required to submit all requests for time off via the Leave Request Form: http://z.umn.edu/prsleaveform
Your request will forwarded to the Program Director for approval before sending to Rotation Director for any of the following;

    If three residents are already listed out on the calendar.
    If more than one resident is out from your site.
    If your request is for time off less than two months in advance.
    If your request is for Academic Leave to attend an Industry Event.

Effect of Leave for Satisfying Completion of Program

The American Board of Plastic Surgery considers a residency in plastic surgery to be a full-time endeavor and looks with disfavor upon any other arrangement. The minimum acceptable training year is 48 weeks.

Should absence exceed four weeks per annum for any reason, the circumstances and possible make-up time of this irregular training arrangement must be approved by the program director and the additional months required in the program must be approved by the RRC-PS and documentation of this approval must be provided to the Board by the program director.

The 48-weeks can be averaged over the training years in the program. Any additional months required in the program must be approved by the RRC-PS. Documentation of this approval must be provided to the Board by the program director. No credit, but no penalty, is given for military, maternity/paternity or other leaves during training
(source).
Meal Cards

Meal cards are provided for use in the UMMC, Fairview Bridges Cafeteria and the UMMC, Fairview Riverside West Bank Cafe. At the VA, the kitchen has a list of who is on call. At all other sites, the on-site Education Office should provide you with the details of your meal allowances, if applicable.

In order to receive a UMMC, Fairview meal card, residents will be provided with the Meal Card Policy and Procedure at the start of each academic year, and be required to sign and return the Statement of Acknowledgement to the program coordinator.
Parking
Motorist Assistance Program (MAP)
Free for all legally parked PTS customers. Coverage encompasses University meters, surface lots, ramps, garages, loading zones and vendor stalls. MAP can:

    unlock vehicles
    give jump-starts
    add air to flat tires
    provide referrals upon request

MAP is available on the Twin Cities campus from 7 am to 10 pm, Monday - Friday. Call 612-626-PARK (7275). Service is not available on official University holidays.

Patrons who call for a private company (AAA, service station, etc.) to service their car while parked in a U of M facility-please be sure to inform the company that they must pay the posted parking fee to enter or exit the facility.
UMMC, Fairview University Campus (East Bank)
Contract Parking Cards
Residents on a U service should use the gray Contract Parking Cards for East River Road Garage. Residents are expected to hand off these Contract Parking Cards to the next resident scheduled to start service at the U throughout the academic year. The expectation is to hand off the Contract Card to the next resident on U rotation within your last week on service, or their first week on service.

Contract Cards are used on Exit only, so if you're planning on handing off your Contract Card while at the U, use your Budget Charge Card when entering, since you won't have your Contract Card when exiting.
Budget Charge Card
Int. RL3-6 and Ind. RL1-3 will receive a white Departmental Budget Charge Cards, to be used for parking at the U for conferences or other program-related business when not on service, or during rotation transition periods (e.g. before you receive the Contract Card from the resident leaving the U service).

The white Budget Charge Card can be used at any U ramp (not the Fairview-owned Patient Visitor Ramp on Delaware Street). Washington Ave, River Road, and Oak Street are the closest U ramps to the Health Sciences buildings and hospital.

Budget Charge Cards must be used on both Entry & Exit (you're charged for the exact time you're parked). Use the card to activate the gate arm. Card readers are located before the ticket dispenser in each facility.

If you don't use the Budget Charge Card for both entry and exit, we'll be charged the full daily maximum for that visit, regardless of how long you were actually parked.

The Program Coordinator will monitor Budget Charge Card usage on a monthly basis, and residents will be notified if there are any irregularities with their card.
UMMC, Fairview Riverside Campus (West Bank)

Parking is embedded in UMMC, Fairview ID Badge. Contact Fairview Parking Services at 612-273-7275 with questions regarding parking on the Riverside campus.

A refundable payment of $25 is required for Riverside parking, and includes night/weekend parking privileges on the East Bank. Residents should return their Fairview ID badge at the end of their residency to receive their $25 deposit back, so this expense is not reimbursed by the program.
UMMC, Fairview Additional Night/Weekend Privileges

After paying the $25 deposit described above, residents receive reciprocal parking privileges which allow you to park in a specific location on a campus other than your assigned facility, if space is available. Reciprocal space is not guaranteed. When event rates are in effect or there is a large group reservation, space availability is at the discretion of the parking attendant on duty.
Monday - Friday, after 4:30 PM
All day Saturday - Sunday
Official University holidays

East Bank

    Lots C33, C55, C58, C59
    Gateway Lot
    Gold Lot
    Gopher Lot
    Fourth Street Ramp
    Oak Street Ramp
    Patient/Visitor Parking Ramp
    University Avenue Ramp
    Washington Avenue Ramp
    East River Road Garage
    Nolte Center Garage

West Bank

    19th Avenue Ramp
    21st Avenue Ramp
    West Bank Office Building (lower levels)
    C86
    C98 (top of WBOB Ramp)

St. Paul

    Gortner Avenue Ramp

Other Hospital Sites

Parking information will be provided with off-site hospital orientation materials. If non-refundable payment is required at other hospital sites, follow steps for Reimbursement.
Pay Dates

Trainees are paid an annual stipend, which they receive via biweekly paychecks. Trainees are encouraged to use the direct deposit system, as paychecks have the potential of being lost or delayed in the mail. Paychecks are mailed or credited to bank accounts of those using the direct-deposit system on these payroll dates.
Reimbursement
Residents are expected to pay out-of-pocket for program-approved expenses, and Regions will reimburse if the necessary steps have been taken prior to purchase.

Prior to reimbursement, HealthPartners requires a completed W-9 to be on file for all companies/individuals to which they make payments. Submit completed W-9 to LuAnn Zeilinger ([email protected] or fax to 651-254-2808).

    W-9 Form

Resident Room

The resident room is located in DVRC 247, available 24/7. Door key code is available from Program Coordinator upon request. Room is equipped with laptop, phone, and small library of journals, Selected Readings, and past In Service Exams.

There is also a touch-down space available at PWB 11-145, with desktop computers and a phone.
Step 3 Exam

As of 7/1/2016, the program will no longer reimburse the cost of the Step 3 exam.

Per the institution manual;

All trainees must provide their program with documentation of a passing score on the United States Medical Licensing Examination (USMLE) Step 3 or an equivalent examination that qualifies for medical licensure (i.e. Comprehensive Osteopathic Medical Licensing Examination-COMLEX) by January 1 of their PGY-2 year.

Residents receive two days leave for the exam, which should be arranged with the General Surgery Program Coordinator. Generally, the exam is taken in the spring of your PGY-1 year, or the fall of your PGY-2 year.

Residents are required to provide a copy of your full score report to the Program Coordinator for your residency file. Residents should download your full score report during their open window (approximately 120 days from the date of your e-mail notification that it is available). If you do not download your full score report during the open window, you will have to pay the $70 USMLE transcript request fee out of pocket. (x)
Stipends
Base Rates and Policies
Tech Center

The Academic Health Center Office of Information Systems (AHC-IS) Tech Center is your one stop shop for all of your computer needs. Services range from a general computer question to a complete operating system restore. Our technicians are Apple and Dell certified so you can rest assured that your computer needs will be met. We have the same troubleshooting tools and certifications that you would find at a Genius Bar in an Apple store. Think of us as your computer’s doctor. If you have a serious problem or if you have a general concern, we are here to help.

Support is offered to residents, but not undergrad students.
Tech Stop

The Office of Information Technology (OIT) Tech Stop provides a central location for students (e.g. residents) to receive face-to-face technology consultations, support and training.

Tech Stop staff offer walk-in assistance and support for University technology services including Google Apps, email application configuration; Internet password changes; Symantec AntiVirus installation or assistance; consultations on virus removal; wireless network configuration for mobile devices; ResNet connection problem troubleshooting; updating drivers; VPN installation; common good software such as email, Moodle; and much more, including general "how do I get started with…" questions.
Tech Warranty & Repair

The M Tech Store at the U of M Bookstore in Coffman Memorial Union is the official Apple Authorized Service provider for University of Minnesota students, staff, and faculty. Also offers fee-based out of warranty repairs on all makes and models of PC computers and common repair services for many brands of cell phones and tablets including Apple and Samsung.

Visit M Tech Warranty & Repair for detailed information about services offered.
Travel (Domestic)
Pre-Travel Instructions

    Review Travel Discounts for discounted travel programs available.
    In order to receive reimbursement, the following forms must be submitted at least 10 weeks in advance of anticipated travel:
        W-9 (if not submitted previously)
        Travel Request Form (TRF)
    Provide forms to LuAnn Zeilinger ([email protected] or fax to 651-254-2808).
    Failure to complete this paperwork within the required timeline will prohibit the program from reimbursing your trip.

Post-Travel Instructions

    Provide LuAnn Zeilinger ([email protected] or fax to 651-254-2808) with all purchase/travel receipts, including meals. Residents will be reimbursed for all pre-approved trip expenses.

Travel (International)
Pre-Travel Instructions

    Review Travel Discounts for discounted travel programs available.
    The University of Minnesota requires all residents to register any/all international travel. Review the steps listed under "Students NOT working through an education abroad office" (second list on the site). Residents are responsible for keeping copies of completed documentation - the program does not require copies.
    The program encourages residents to use a U of MN Contracted Travel Agency for international travel.
    In order to receive reimbursement, the following forms must be submitted at least 6 months in advance of anticipated travel:
        W-9 (if not submitted previously)
        International Travel Attestation Form
        Travel Request Form (TRF)
    Provide forms to LuAnn Zeilinger ([email protected] or fax to 651-254-2808).
    Failure to complete this paperwork within the required timeline will prohibit the program from reimbursing your trip.

Post-Travel Instructions

    Provide LuAnn Zeilinger ([email protected] or fax to 651-254-2808) with all purchase/travel receipts, including meals. Residents will be reimbursed for all pre-approved trip expenses.

National Conference Policy by Resident Level
Int. RL1-2

    The program does not provide travel funds for residents in their 1st and 2nd years (no change from previous policy).

Int. RL3

    The program will provide up to $2,000 to attend at least one national meeting for 3rd year residents who score above 30th percentile in the previous year’s In Service Exam. If a resident has funds remaining, they may be applied toward subsequent meetings with Program Director prior approval.

Int. RL4, Ind. RL1

    The program will provide up to $2,000 to attend the ASMS Summer Course in Chicago or Philadelphia. If a resident has funds remaining, they may be applied toward subsequent meetings with Program Director prior approval.

2016 ASMS Attendees (Chicago)
Dr. Christine Stewart (Int. RL4)
Dr. Pamela Portschy (Ind. RL1)
Dr. Teresa Gonzaga (Ind. RL2)

2017 ASMS Attendees (Philadelphia)
Dr. Cordes (Int. RL4)
Dr. Chris Stewart (Int. RL4)

2018 ASMS Attendees (Chicago)
Dr. Borad (Int. RL4)
Dr. Nikizad  (Int. RL4)

2019 ASMS Attendees (Philadelphia)
Dr. Liu (Int. RL4)
Dr. Toshinskiy (Int. RL4)
Int. RL5, Ind. RL2

    The program will provide up to $2,000 to attend at least one national meeting for residents who score above 30th percentile in the previous year’s In Service Exam. If a resident has funds remaining, they may be applied toward subsequent meetings with Program Director prior approval.

Int. RL6, Ind. RL3

    The program will provide up to $2,000 to attend at least one national meeting for residents who score above 30th percentile in the previous year’s In Service Exam. If a resident has funds remaining, they may be applied toward subsequent meetings with Program Director prior approval.

    While not required, the program will also provide up to $2,000 for residents to attend the ASPS Senior Resident Conference. Funds remaining from ASPS Senior Resident Conference do not accrue, and may not be applied to other meetings.

All years

Residents should not feel obliged to spend the entire travel allowance for each conference/each year. These are educational funds being made available at the faculty’s discretion. For example, with early meeting registration at resident rates, early flight and hotel reservations, and shared rooms, most travel can be accomplished for less than the allowance. Travel funds do not accrue across academic years.

Residents are encouraged to apply for scholarships/grants to attend conferences whenever available.

For all residents who score below the 30th percentile, refer to In Service Exam policy for additional conference restrictions.
Podium Presentation

If a resident gives a podium presentation at a national meeting, the program will provide up to $2,000 for the resident to attend the day prior, and day of the presentation. Funds left over from Podium Presentations do not accrue, and may not be applied to other meetings.

Residents must provide the program coordinator with a copy of the letter indicating acceptance of the presentation/abstract/manuscript, and a copy of the presentation/abstract/manuscript itself. A copy of the cover letter to the editor of the journal to which the manuscript has been submitted should also be enclosed, if applicable.
UCard

Your student UCard may be used for:

    After Hours Door Access (contact Program Coordinator if needed)
    Authorized Secured Building Access (contact Program Coordinator if needed)
    Computer Labs
    Gopher GOLD
    Passport Photos
    Recreational Sports Center
    TCF Checking
    Ticket discounts
    University Libraries

URL shortening service

z.umn.edu is available to anybody with a University of Minnesota X500 account.
Worker’s Compensation

Refer to Institution Policy Manual.
SECTION 3 - INSTITUTION RESPONSIBILITIES

Refer to Institution Policy Manual.
SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES

Residents are encouraged to communicate directly with any staff or faculty regarding issues, problems, concerns or stresses that they may be experiencing. In particular, if there are logistical problems in their current rotations, conflicts with staff, or issues regarding resident evaluations, the site director for that rotation should be notified to discuss possible solutions. The program director can address general concerns affecting more than one rotation.

The program also offers several confidential options for reporting problems with the program or personnel:

Confidential Program Improvement Form
Use this link to confidentially report any program issue that you'd like us (Mariah, Dr. Mahajan, and Dr. Choudry) to be aware of, throughout your training.

Negative Behaviors: Professionalism
Use this link to confidentially report any personnel issue (resident, faculty, staff, etc.). The result will be routed to our Surgical Education Manager, Emily Langerak, and she will determine the appropriate Program or GME personnel to notify and involve in the resolution.

Results will not be shared with Program personnel (Program Director, Associate Program Director, Program Coordinator), unless deemed necessary by Emily.

GME Dispute Resolution Resources
If you do not feel comfortable using either of confidential links, our GME office offers several alternative reporting methods.

Grievances and resolutions must be documented with a written account. This type of documentation is often necessary to initiate official UMN sanctions, when indicated.

Residents may also contact the ombudsman, Marie Claire Buckley, MD, if they are reluctant to voice minor concerns to the program director, faculty, or staff. The ombudsman position is intended to facilitate communication at an informal level before resident complaints reach a point where intervention is required by the program director. Residents are encouraged to contact the ombudsman to air their concerns and solicit advice on an informal basis.

Additional resources are available in the Institution Policy Manual on the following topics;

    Discipline, dismissal, non-renewal
    Dispute resolution resources
    Sexual harassment and discrimination reporting
    Sexual assault victim's rights policy
    University Senate sexual harassment policy

SECTION 5 - GENERAL POLICIES AND PROCEDURES
ACGME Competencies
Refer to Plastic Surgery Program Requirements, IV.A.5. ACGME Competencies (pages 13 - 17).
ACLS/BLS/PALS Certification Requirements

Certification requirements vary by hospital site. Fellows are expected to maintain certification as requested by hospital sites. Review the UMN GME Affiliated Sites Life Support Certification Resource for information, costs, and contacts for scheduling life support certification training at other affiliated hospital sites.

Additional information provided at: http://hub.med.umn.edu/resident-fellow-administration/life-support-certification
Attending Physician Notification Guidelines

At the start of training, residents receive a small card, the size of an ID Badge, that lists when to notify an attending physician;

Attending Physician Notification Guidelines

This card lists certain changes in a patient's status or other events that should prompt you to contact the attending physician. This is not meant to be an all-inclusive list; rather it is a guideline to assist in decision-making.

    Admission to the hospital
    Transfer to ICU or higher level of care
    Unanticipated intubation or ventilatory support
    Development of new significant neurological changes (e.g. CVA, seizure, new onset of paralysis, acute decline in level of consciousness)
    Development of new significant cardiac changes (e.g. CODE, serious arrhythmia, PE, hemodynamic instability)
    Development of major wound complications (e.g. dehiscence or evisceration)
    Medication or treatment errors requiring clinical intervention (e.g. invasive procedure(s), increased monitoring, new medications except Narcan)
    Unanticipated blood transfusion without prior attending knowledge or instruction (before or after operation)
    Development of any clinical problem requiring an invasive procedure or operation
    Patient, family, or clinical staff request for attending notification
    Death

Clinical Competency Committee (CCC)

A Clinical Competency Committee (CCC) is the ACGME-required body comprising three or more members of the active teaching faculty who is advisory to the program director and reviews the progress of all residents in the program. Committee members and description of responsibilities available at: https://drive.google.com/file/d/0B8TnVkthh-q4X2F3YzREZzZXdWs/view?usp=sharing
Dictation Expectations

Op notes and clinic encounters will regularly be dictated by faculty, unless otherwise delegated. Residents are generally expected to dictate discharge summary, unless otherwise noted. At various times throughout training, faculty will request that residents dictate op notes, clinic encounters, and prior authorization letters in order to review for accuracy.
Dress Code

Refer to Institution Policy Manual.
Duty Hours

The Program policy for duty hours follows ACGME Common Program Requirements. Duty hours are defined as all clinical and academic activities related to the program, such as;

    inpatient and outpatient care
    administrative duties relative to patient care
    the provision for transfer of patient care
    time spent in-house during call activities
    scheduled activities (e.g. conferences)

Duty hours do not include reading and preparation time spent away from the duty site.

Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities. Residents must be provided with one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call.

Adequate time for rest and personal activities must be provided. This should consist of a 10-hour time period provided between all daily duty periods and after in-house call.

Residents are expected to enter and approve their duty hours daily via RMS (Institution Name: MMCGME). Residents are encouraged to contact the site director, program director, or Ombudsman if they feel their workload is negatively affecting the quality of their education, or not adhering to required guidelines.

Quick Reference Guide to Logging Duty Hours
Duty Hour Violations

When residents remain on duty beyond scheduled hours, they must justify the violation in RMS by selecting one of the following from the provided drop-down menu;

Duty Hour violation reports are run by the Program Coordinator each month, and emailed to the Program Director, Associate Program Director, and Dept. of Surgery Vice Chair for Education. Justifications are reviewed, and discussed with either the resident or the rotation director, as appropriate.
Evaluation
Faculty
Residents are asked to evaluate faculty performance after each rotation. These evaluations include a review of the faculty’s clinical teaching abilities, commitment to the educational program, clinical knowledge, professionalism, and scholarly activities.

Residents also evaluate faculty performance overall during annual program evaluation.

Faculty may request a summary report of their evaluations from the program coordinator at any time. The program coordinator will provide the report if at least three residents have evaluated the faculty member, in order to keep resident responses confidential.

The program director will review resident evaluations of faculty and approve the continued participation of program faculty based on evaluations.
Resident (Formative)
Program faculty are expected to evaluate resident performance in a timely manner at the conclusion of each rotation. Faculty complete resident evaluations using RMS.

Faculty are expected to provide objective assessments of resident competence in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.

Residents may request a summary report of their rotation evaluations from the program coordinator at any time. The program coordinator will provide the report if at least three faculty have evaluated the resident, in order to keep faculty responses confidential.

Throughout the course of training, residents will also be evaluated by peers, patients, self, and other professional staff.
Resident (Semiannual)
The program director meets with each resident individually for a semiannual evaluation of performance with feedback, in January and June. The meeting will focus on the previous months of training (July - Dec.., Jan. - June.), and will include a review of the following;

    Case logs
    Compliance in completing rotation and faculty evaluations
    Conference attendance (Core Curriculum, Journal Club, Grand Rounds, M&M, Operative Prep)
    Duty Hours Summary, including violations
    Evaluations
        Faculty Evaluation of Resident
        Milestones
        Professionalism Evaluation (linked on business cards)
    In Service Exam scores (available mid-May)
    Research Expectations

Resident (Summative)
The program director provides a summative evaluation for each resident upon completion of the program. The program director can provide a copy of the summative evaluation to the resident at the time of the meeting.

This evaluation documents the resident’s performance during the final period of education, and verifies that the resident has demonstrated sufficient competence to enter practice without direct supervision.
Resident Advancement
Our goal is to advance and graduate residents to function as qualified practitioners of surgery at the high level of performance expected of a specialist at their level. To achieve this goal, we engage residents in a planned curriculum delivered via lectures and conferences, In Service exams, at bedside and in the operating room with progressively graded clinical and operative experience. Through appropriate supervision and guidance and a structured evaluation system, residents develop a high level of professionalism, as well as the requisite clinical and surgical skills.

Residents are expected to demonstrate competency in the six ACGME Core Competencies.

During CCC meetings, each resident’s evaluations, attendance, In-Service scores, teaching performance, academic development, and record keeping habits are reviewed and discussed by all faculty in attendance. Suggestions for remediation and formal academic probation may result from this meeting. This discussion on each resident is brought to conclusion with a majority vote on one of the following recommendations:

    Advancement with statement of exemplary performance and areas that need development.
    Advancement with statement of deficiencies to be improved.
    Advancement with notification of academic probation and statement of deficiencies to be improved.
    Unsatisfactory performance and dismissal from the program.

Program Evaluation and Improvement
Residents and faculty have the opportunity to confidentially evaluate the program annually. This includes;

    evaluation of the curriculum
    resident performance
    faculty development
    program quality

The program director and PEC will use the results of these assessments to improve the program.
Fairview Attire Policy (UMMC, East & West Banks)
Review Attire, Surgery/Invasive Procedure areas and Personal Belongings - Perioperative Services, UMMC policy.

As of September 2015, auditing of compliance to the policy will occur. Each campus, including Sports and OB, will be audited each month by Infection Control. "In the moment" corrections will be made by the auditor for anyone not adhering to the policy. Auditors will report names to the appropriate department leadership each month. Because this is a policy, push back to the auditors will not be tolerated. Any push back will be reported to the appropriate leader and may result in discipline. Please, also, feel free to correct attire noncompliance as you see it. It is everyone's responsibility to provide the safest environment for our patients.
Fairview Laboratory & Pathology Services
Fairview Diagnostic Laboratories Guidelines and Tools

Fairview Laboratory and Pathology Contacts, Policies and Procedures
Pharmacy/Prescription Services

DEA rules require an approved prescriber signature on all class II-V narcotic prescriptions. Only trainees with their own individual DEA number can legally sign for these medications.

You cannot electronically submit a class II-V narcotics prescription to any pharmacy. When you enter these prescriptions into Epic, the paper script will automatically print locally (at the printer assigned to the workstation). This paper script must be signed by an attending and sent to the pharmacy.
Fairview Discharge Pharmacy
If the patient will not be filling their prescription at the Fairview discharge pharmacy, they need a hard copy prescription, signed by an attending. If the prescription isn’t signed by an attending, a pharmacy will not fill it.

Effective Tuesday, March 25th, 2014: If a patient will be filling their prescription at a Fairview discharge pharmacy, controlled II narcotic prescriptions (Dilaudid, Percocet, MS Contin, etc.) that are sent to the Discharge Pharmacy and signed by a resident that is not recognized as a valid provider by the patient’s insurance will be sent back to the respective unit.

The original prescription must be signed by an attending physician or by prescriber with their personal DEA number. Prescriber must also legibly print their name and DEA number to clearly identify who signed the prescription.

Discharge Pharmacy will not fill these prescriptions until they receive the original signed copy. This change in policy will ensure that compliance with Minnesota Pharmacy statutes as well as federal DEA regulations. The Discharge Policy is asking for full cooperation to prevent any disruptions in patients being discharged from the hospital.

Questions can be directed to Jeff Fahrenbruch, RPh, Site Manager, UMMC Discharge Pharmacy at 612-273-2770 or [email protected].
Fairview Radiology Services
Fairview Radiology and Imaging Information
Fatigue / Sleep Deprivation / Wellness

Residents are educated to recognize the signs of fatigue during their GME orientation, and are expected to adopt and apply policies to prevent and counteract the potential negative effects.

Sleep Deprivation (TED Ed video: approx. 4:34) - This TED Ed lesson contains information for trainees about sleep, sleep deprivation and its effects on the body.

Taking Charge of Your Health & Wellbeing: Sleep - From UMN Center for Spirituality and Healing; connects to recommendations for healthy sleep and additional resources.

Review the GME - Cab Voucher Policy and Procedure. Additional reimbursement may be provided by program if cab fare exceeds GME cap. Work with Program Coordinator if this occurs.

Additional resources from the National Sleep Foundation:

    Sleep Tools & Tips
    Shift Work and Healthy Sleep

Alcohol and Drug Misuse - This website provides information on alcohol and drug misuse, self-assessment tools, and local resources.
Fax/Copy/Scan/Print

A multi-function fax/copy/scanner is available for residents to use in PWB 11-145 and DVRC 247. The program coordinator will not perform copying tasks for the residents. A color printer is also available, so items can be scanned in color, and printed; essentially creating a color-copy.

A Gopher GOLD™ Departmental Copy Card is needed in order to make copies in the Biomedical Library. This is available upon request from the program coordinator.
At Regions Hospital, residents may photocopy on the Department's copy machine located in the office as long as they adhere to copyright laws. Support staff will not perform copying tasks for the residents. Journals from the Regions library must be checked out and brought to the office for copying.
Goals and Objectives for Teaching Medical Students

Any resident who supervises or teaches medical students must be familiar with the educational objectives of the course;

The student will be exposed to the full spectrum of Plastic and Reconstructive problems while on the rotation. Areas covered may include basic hand surgery, breast reconstruction, aesthetic surgery, facial reconstruction, microsurgery, wound management and surgical research.
Students are required to be involved in the pre-operative evaluation and post-operative management of patients on the plastic surgery services and in clinic, and are expected to assist in the operating room. The rotation is based between experiences at the University of Minnesota Medical Center, Fairview, Regions Hospital and at the Minneapolis Veterans Administration Health Care Center (VAHCS), as well as surgery centers used by the service.
Hospital Sites

A full list of sites that residents are able to rotate at is listed below. If a site is not listed, we do not have a legal agreement with that hospital, and it is not possible for residents to rotate there. Notify the Program Coordinator of any hospital sites you would like to rotate at that are not included on the list below. Processing time for legal agreements is approximately three months.
The rotation schedule lists the hospital sites a resident is expected to go to while on that rotation. If a site is not listed for a particular rotation, please notify the Program Coordinator

If a unique learning experience occurs outside of the rotation you are scheduled at, notify the Program Coordinator well prior to the case so we can allow time for hospital site to complete any required on boarding for the resident prior to their arrival.

We do not receive funding for resident time at sites in gray. We ask residents to limit their time at these sites to exceptional educational cases, whenever possible.

ABNW - Abbott Northwestern Hospital
CENTMC - Centennial Lakes Medical Center
CHMS - Children’s Hospital-Minneapolis
FMGC - Fairview Maple Grove Medical Center
FVSD - Fairview Southdale
FWHI - Fairview Wound Healing Institute
GCH - Gillette Children’s Specialty Healthcare-St. Paul
MGH - Maple Grove Hospital
NMCM - North Memorial Clinics-Minnetonka
NMMC - North Memorial Medical Center
PEI - Phillip’s Eye Institute
PNSL - Park Nicollet-St. Louis Park
RGHP - Regions Hospital
SMMC - Essentia Health-St. Mary's Medical Center (Duluth)
UMCH - UMN Masonic Children's Hospital
UMH - UMN Health; includes UMMC Hospital and Clinics & Surgery Center (CSC)
UNTD - United Hospital
VAMC - Minneapolis VA Health Care System
WHPS - WestHealth Plastic Surgery
In Service Exam Policy by Resident Level
All Residents

    Residents who score at the 50th percentile of their peer group or below in the most recent year’s In Service Exam are not eligible to moonlight until their next In Service exam scores are in, and the Program Director will construct a performance improvement plan.

    Resident research output and program conference attendance will also be reviewed by Program Director and Associate Program Director at this time, and taken into consideration when constructing performance improvement plan.

Int. RL1-2

    Residents are expected to take Plastics In Service Exam, but more weight is given to ABSITE exam during first two years.

Int. RL3

    Residents who score at the 30th percentile of their peer group or below in the most recent year’s In Service Exam will not be eligible for academic leave or reimbursement to meeting(s), with the exception of podium presentations at national meetings.

Int. RL4, Ind. RL1

    Residents who score at the 30th percentile of their peer group or below in the most recent year’s In Service Exam will not be eligible for academic leave or reimbursement to meeting(s), with the exception of the required ASMS meeting, and podium presentations at national meetings.

Int. RL5, Ind. RL2

    Residents who score at the 30th percentile of their peer group or below in the most recent year’s In Service Exam will not be eligible for academic leave or reimbursement to meeting(s), with the exception of podium presentations at national meetings.

    Residents will also be required to attend one of the following board review courses;
        ASPS Oral and Written Board Preparation Course
        Plastic Surgery Board Review Course - The Osler Institute

Int. RL6, Ind. RL3

    Residents who score at the 30th percentile of their peer group or below in the most recent year’s In Service Exam will not be eligible for academic leave or reimbursement to meeting(s), with the exception of podium presentations at national meetings, and the ASPS Senior Resident Conference (2-day conference, not full ASPS national meeting).

    Residents will also be required to attend one of the following board review courses;
        ASPS Oral and Written Board Preparation Course
        Plastic Surgery Board Review Course - The Osler Institute

Lockers
There are assigned shared lockers at UMMC, Fairview OR (3C) for Plastic Surgery residents and students. Contact the OR desk for locker number and code.

Lockers are also available for a fee in Coffman Union: http://sua.umn.edu/info/lockers/
Medical Records

Fairview Medical Record Contacts and Forms

Fairview Medical Record Content Policy
Monitoring of Resident Well-Being
The Program Director and faculty working closely with residents are expected to monitor resident stress level, including mental or emotional conditions inhibiting performance or learning, and drug-related dysfunction.

The University's GME office provides a comprehensive listing of "well-being tools" and resources for residents; http://www.med.umn.edu/residents-fellows/current-residents-fellows/health-wellness/wellbeing-tools.
Resident and Fellow Assistance Program (RAP)
RAP is for residents and their family members, faculty, attending physicians, department heads and supervisors who need help in dealing with resident- and fellow-related concerns. There is no charge associated with assessment and short term counseling services provided through the RAP program.

Counselors are available to help address issues and personal concerns such as the examples listed below.

    My debts have become overwhelming. How can I get a handle on them?
    I think the stress of my residency is impacting my health. How do I discreetly find out?
    I worry about my career choice. Who should I talk to?
    My relationship isn't fulfilling but I don't want to be alone. What do I do now?
    My spouse is having difficulty adjusting to my residency. How do we adjust in a way that works for both of us?

Student Mental Health - UMN

Find resouces for:

    Alcohol and Drug Misuse
    Counseling
    Crisis / Urgent Consultation
    Disability Accommodations
    Medication Options
    Online Self Assessment
    Online Therapy
    U of M Textline
    Stress Management
    Get Involved
    Topic-Specific Info

Tip sheet: How To Raise a Sensitive Issue

Additional information at: http://www.mentalhealth.umn.edu/
Moonlighting
Int. RL1 residents are not permitted to moonlight.

Per the In Service Exam policy, residents who score at the 50th percentile of their peer group or below in the most recent year’s In Service Exam are not eligible to moonlight until their next In Service exam scores are in.

Prior to moonlighting, eligible residents must complete the GME Standard Moonlighting Request Form, and return the completed/signed copy to the Program Coordinator.

Residents must have their own personal medical license and DEA prior to beginning any moonlighting activity that requires a medical license and DEA. The program will not reimburse the cost for these items. The program coordinator must receive a copy of the medical license and DEA with the signed moonlighting form.

The University's professional liability insurance for residents does not cover moonlighting or any other activities outside the curricular components of the training program. Residents must obtain separate professional liability insurance which covers any liability for moonlighting activity.

Moonlighting must not interfere with the ability of the resident to achieve the goals and objectives of the educational program. Time spent by residents in External Moonlighting must be counted towards the 80-hour Maximum Weekly Hour Limit. Residents must log their moonlighting time in RMS as part of their Duty Hours (use "Moonlighting" assignment).

Failure to log hours or get prior approval is grounds for discipline under Section 7 of the Residency/Fellowship Agreement;

    Grounds for discipline and/or dismissal of a resident/fellow for non-academic reasons, as set forth in the Resident/Fellow Institutional Policy Manual, include, but are not limited to, the following:

    7.1. Failure to comply with the bylaws, policies, rules, or regulations of the University, affiliated hospitals, medical staff, department, or with the terms and conditions of this document.

The program director may deny or approve the request. The completed request form will be saved in the files and notes section of the resident's personnel record in RMS.

Refer to Institution Policy Manual for additional information.
Needle Sticks & Blood Borne Pathogen Exposure (BBPE) Management
Follow this link for detailed instructions; http://www.gme.umn.edu/residents/needle/home.html. Residents are considered employees as far as bloodborne pathogen exposures are concerned (not students). Identify yourself as a resident to Employee Health, as this is considered a worker's comp issue and should be handled accordingly.

    Go to the Employee Occupational Health Service at the site the needle stick occurred ASAP. Initial care should occur at your training site, either through the Employee Health Service or the Emergency Department. If the exposure occurs when these facilities are not open, go to the nearest HealthPartners Urgent Care location or Emergency Department. The Centers for Disease Control and Prevention recommend that the exposed person seek treatment within 1-2 hours after initial exposure. It is your responsibility to learn facility-specific exposure protocols when you begin your rotation.

        If you are unsure of where to receive treatment, call the 24-hour HealthPartners Care Line at 612-339-3663 or 800-551-0859. The Triage Nurse will direct you to the appropriate location for care.

    Identify the source patient with the help of your preceptor and/or the designated representative of the facility. The source patient’s blood should be tested after consent is obtained according to your treatment site practices. If the source patient has a known history of HBV, HCV, or HIV, it is unnecessary to test for the specific disease.

    Within 8 hours, submit an e-FROI (First Report of Injury). This is to ensure appropriate follow-up and to be eligible for Workers Compensation coverage. After you complete the E-FROI, you will be contacted for post-exposure care within 3 business days by HealthPartners Occupational and Environmental Medicine (HPOEM).

    Within 24 business hours (3 work days), residents must ask the faculty member who was supervising them at the time of the stick to complete a Supervisor Incident Investigation Report (DOC).

    If a resident, fellow, or medical student is infected with HCV, HBV, or HIV, he/she must report this infection to the Medical School’s Bloodborne Infectious Disease Review Panel by contacting the University of Minnesota Office of Occupational Health and Safety at [email protected] or 612-626-5008. This reporting is required by Minnesota law.

        If the exposure occurred as a result of contact with a contaminated sharp, the injury must be reported to the Office of Occupational Health and Safety at [email protected]. The log will protect the confidentiality of the injured employee but will contain the following information:

            the type and brand of device involved in the incident;
            the department or work area where the exposure incident occurred; and
            explanation of how the incident occurred.

If you encounter any problems with this process, notify Carol Sundberg, GME Operations Director, at [email protected] or 612-626-3317.
On Call Rooms

UMMC, Fairview has 18 on call rooms located on the 4th floor of the Mayo building. All rooms have punch code security access which is changeddaily and contain a desk, TV, clock radio, and air conditioning, with a security monitor on duty from 2:00 pm - 8:00 am. On call residents, medical students, fellows, physicians and certain on call hospital staff are eligible to check-in to a call room. Check-in can only occur during the designated check-in hours of 2:30 pm until 7:00 am.

Go to the check-in desk located in the Resident Lounge (Mayo C496). The check-in desk is staffed by a security monitor during set hours 7 days/week and will require you to present your hospital ID badge. The security monitor will assign you a room and give you the access code along with the locker room and lounge access codes. All individuals must be out of their rooms by 8:00 am. Housekeeping will come to begin cleaning by 7:00 am. If you wish to sleep until 8:00 am, make sure your DO NOT DISTURB sign is indicated on your door. No room is checked out to the same service two days in a row. Belongings left in room past noon will be removed and kept in a security locker. Belongings can be picked up any time after 2:30 pm from the security monitor.

UMMC, Fairview on call room assignments are made in order of priority based on the individual’s status and responsibilities. Assignment Order:

    Residents and fellows required to take call from the hospital
    3rd and 4th year medical students required to take call from the hospital (1st and 2nd year medical students are not required to take in-house call)
    Faculty required to take call from the hospital
    All other trainees, staff physicians, or medical students needing an on-call room
    Non-medical staff, excluding CRNAs

A trainee who is on call and must remain at UMMC, Fairview is guaranteed a room in which to sleep. The trainee will have the first option for selection of on call rooms on the 4th floor of the Mayo Building until 9:00 PM. Thereafter, call rooms will be distributed on a first-come, first-served basis. If the on-call rooms on the 4th floor of the Mayo Building are full, the nursing supervisor will be contacted and they will locate a room for the trainee. Every effort will be made to secure call rooms for 3rd and 4th year medical students and/or attending staff physicians who are on call and need to remain in the hospital overnight.

    Mayo Lounge: 612-626-6330
    Nursing Supervisors:
        Riverside: 612-273-6535
        University: 612-273-6235

On Call Schedules

Int. RL1-2 residents follow General Surgery Resident Manual for all call schedule policies.
Holidays

Chief Residents will create special schedules for the holidays, and will involve cross covering hospitals and off-service responsibilities.

    Major holidays: Thanksgiving, Christmas and New Years
    Minor holidays: Labor Day, Memorial Day, and 4th of July
    All residents on call at least one major holiday.
    Hand Fellows at Regions must cover call for one major and one minor holiday each.

NMMC

    Resident on NMMC service takes Regions home call.
    NMMC faculty take first call, and will notify resident if assistance is needed with trauma case.
    Resident should not be assigned Regions call when Dr. Van Beek is on call. Unfortunately, his call schedule is only built about two weeks out, and his staff doesn't regularly notify residents of call schedule.
    If scheduled to take Regions call, do not go if called in to NMMC.

Regions Hospital

    The resident call schedule is created by the senior resident at that site.
    Resident call will be distributed fairly and equitably, irrespective of PGY level.
    Faculty call schedules are created by the administrative support.
    Call schedules are available on amion.com.

UMH

    The resident call schedule is created two months in advance by the senior resident at that site.
    Residents on UMH plastic surgery rotations will not cross cover Regions call.
    Residents on UMH sub-specialty rotations (e.g. ENT, OMF) may be assigned to cover Regions call.
    Faculty call schedules are created by Tina Russell, Admin. Assistant, and emailed to residents, faculty, and clinic staff at the end of every month.

Program Curriculum

All program conferences and events are noted on the Plastics Conference Calendar. This calendar is shared with resident's @umn.edu account at the start of training. Reminders for major conferences are sent by the program coordinator via email. Residents are expected to refer to the conference calendar regularly to be aware of upcoming conferences.

Residents are expected to attend at least 90% of mandatory educational conferences (Core Curriculum, Journal Club, Grand Rounds, M&M, Operative Prep). Attendance will be reviewed during semi-annual review, and if the minimum isn't met, residents may be subject to remediation, including possible academic leave and/or national conference reimbursement privileges revoked for a period of time deemed appropriate by the Program Director.
Core Curriculum: Regions

    Faculty presenter selects topic for 4th week. Topic is M&M when there is a 5th week in the month.  
    Faculty Host: Rotates between Regions faculty
    Occurrence: 4th and 5th Wednesdays, 6:30 - 8:30 AM
    Resident Attendance: Varies by week;
        4th week: All residents are expected to attend, and must be excused from clinical work.  
        5th week: All residents on Regions rotations are expected to attend, and must be excused from clinical work.

Core Curriculum: UMN

    Incoming Chief Resident selects topics for upcoming academic year from PSEN Plastic Surgery Curriculum.  
    Faculty Host: Umar Choudry, MD
    Occurrence: 2nd and 3rd Wednesdays, 6:30 - 7:30 AM
    Resident Attendance: All residents are expected to attend, and must be excused from clinical work.

Craniomaxillofacial Trauma Conference: UMN

    Faculty host selects topic/speaker. Program Coordinator assists with scheduling conference room and ordering food.
    Faculty host: Warren Schubert, MD
    Occurrence: No set schedule, but there is generally one event per 2-3 months from 6 - 7 PM.
    Resident Attendance: All residents are expected to attend, and must be excused from clinical work.

Grand Rounds (GME): UMN

    GME Grand Rounds is a quarterly gathering of the Twin Cities Graduate Medical Education community. Sessions typically consist of a GME Forum, a Keynote Address, and a Reception. All members of the GME community across Twin Cities teaching hospitals and clinics are welcome.
    Faculty host: John Andrews, MD (DIO)
    Occurrence: No set schedule, but there is generally one event per 2-3 months from 4:00-6:30 PM.
    Resident Attendance: Optional, residents will not be be excused from clinical work, but may attend if schedule allows.

Grand Rounds (Plastic Surgery): UMN

    Incoming Chief residents are responsible for selecting topics and coordinating with speakers for their chief year. Program Coordinator will assist with scheduling conference room and ordering food. Options for speakers include; faculty, chief residents, and visiting professors. At least one speaker should be a visiting professor;

        ASPS PSF Visiting Professors Program
        ASSH Visiting Professors Program
        ASMS Visiting Professor Program
        ASAPS Traveling and (Visiting) Professor Program
        ACAPS Recommended Visiting Professors

    Faculty host: Umar Choudry, MD
    Occurrence: Four per academic year (quarterly), from 6 - 7 PM at University of Minnesota. Generally scheduled July, October, January, April.
    Resident Attendance: All residents are expected to attend, and must be excused from clinical work.

Grand Rounds (Surgery): UMN

    UMH Division Chief reviews DOS Grand Rounds schedule and selects conferences relevant to plastic surgery.
    Faculty host: David Rothenberger, MD
    Occurrence: Weekly (as indicated) on Tuesdays, generally 7:30 - 8:30 AM
    Resident Attendance: All residents on UMH rotations are expected to attend, and must be excused from clinical work.

Hand & Upper Extremity Conference: Regions

    As of 7/1/16, this conference has been reduced from twice monthly, to once monthly to more accurately represent the contribution of hand to our In Service Exam. There is a list of 24 topics so that most relevant hand curriculum is covered every two years.

Year 1
Hand anatomy and exam
Hand/soft tissue Infections
UE Nerve Palsies/Compression Syndromes
Rhematoid Hand
Replants
Congenital Hand  
Hand tumors  
CMC and Wrist Arthritis
Flexor tendons
Finger Fractures/dislocations/PIP Injuries
Bennet/Rolando Fracture
Finger Tip/Nail Bed Injuries

Year 2
Dupuytren's
Distal Radius
Nerve Laceration/Repair
Scaphoid Fractures
Carpal Instability
Swan neck/Boutonniere Deformity
Game Keepers
Finger Arthritis/Arthroplasty
Soft Tissue Coverage Hand
Extensor Tendon Injuries
Trigger Finger/Dequervain's
OT Protocols

    Faculty Host: Christina Ward, MD
    Occurrence: 1st Wednesday, 6:30 - 7:30 AM
    Resident Attendance: All residents on Regions rotations are expected to attend, and must be excused from clinical work.

Industry Events: Off-site

    Industry selects topic, speaker, date, time, and location without UMN involvement. Program Coordinator forwards flyers to plastic surgery conference email list (includes; faculty, residents, students, admin. support).
    Occurrence: No set schedule, but there is generally one dinner event per month.
    Resident Attendance: Optional, residents will not be be excused from clinical work, but may attend if schedule allows.
    Per GME Institutional Vendor/conflict of interest Policy;

    In accordance with guidelines set forth by the American Medical Association Statement on Gifts to Physicians, acceptance of gifts from industry vendors is discouraged. Any gifts accepted by trainees should not be of substantial value. Accordingly, textbooks, modest meals and other gifts are appropriate only if they serve a genuine educational purpose. Acceptance of gifts should not influence prescribing practices or decision to purchase a device.

Journal Club: UMN

    Chief residents are responsible for selecting articles. Program Coordinator assists with scheduling conference room and ordering food.
    Faculty Host: TBD
    Occurrence: TBD
    Resident Attendance: All residents are expected to attend, and must be excused from clinical work.

Maxillofacial Trauma Cases w/ Plastics and ENT

    Faculty presenter selects topic.
    Faculty Host: Rotates between Regions faculty
    Occurrence: Weekly on Mondays, 6:30 - 7:30 AM
    Resident Attendance: All residents on Regions rotations are expected to attend, and must be excused from clinical work.

M&M: UMN

    The senior resident on the UMH rotation is expected to submit complications weekly, and present if case is selected. Review instructions for submitting cases. Questions regarding this system should be directed to Michelle Lunden, Exec Ofc & Admin Asst., Dept. of Surgery Education Office ([email protected] or 612-626-2590).
    Faculty host: David Rothenberger, MD
    Occurrence: Weekly on Tuesdays, generally 7 - 7:30 AM
    Resident Attendance: All residents on UMH rotations are expected to attend, and must be excused from clinical work.

Operative Preparation Conference: NMMC

    Sherry Richgels, Clinical Director for Allen Van Beek, MD, assigns private practice faculty to dates based on availability. Faculty select topic.
    Faculty Host: Rotates between private practice faculty
    Occurrence: 3rd Monday of the month, from 5:30 - 6:30 PM
    Resident Attendance: All residents are expected to attend, and must be excused from clinical work.

Orthopaedic Grand Rounds: Regions

    Faculty presenter selects topic.
    Faculty Host: Rotates between Regions plastic surgery and ortho faculty
    Occurrence: 2nd Tuesday of even months, 7:00 - 8:15 AM
    Resident Attendance: All residents on Regions rotations are expected to attend, and must be excused from clinical work.

Research Meeting: Off-site

    Faculty host moderates discussion.
    Faculty Host: Martin Lacey, MD
    Occurrence:  No set schedule, but there is generally one event per 2-3 months from 6 - 8 PM.
    Resident Attendance: All residents are expected to attend, and must be excused from clinical work.

Program Evaluation Committee (PEC)

A Program Evaluation Committee (PEC) is the ACGME-required body comprising at least two program faculty members and at least one resident from each program. PEC should participate actively in:

    planning, developing, implementing, and evaluating educational activities of the program;
    reviewing and making recommendations for  revision of competency-based curriculum goals and objectives;
    addressing areas of non-compliance with ACGME standards; and,
    reviewing the program annually using evaluations of faculty, residents, and others.

Committee members and description of responsibilities available at: https://drive.google.com/file/d/0B8TnVkthh-q4d1Y3Tk83ZlFNVUk/view?usp=sharing
Program Goals and Objectives

The goal of training is to train academically oriented surgeons by fostering and facilitating independent discovery and research, and assist residents in preparing a broad based foundation for their future clinical and research endeavors.  The faculty serve as a clinical and intellectual database to which the resident can refer to for assistance in answering questions stimulated by reading or clinical exposure.

Residents will acquire the necessary technical skills in several ways. In addition to didactic lectures and conferences, dissection on cadaver specimens will provide anatomical experience in flap anatomy and aesthetic surgery.  The basic fundamentals of microsurgery are taught and practiced.  As the resident demonstrates a mastery of the basic skills, he or she will be provided progressively increasing operative responsibility in the clinical area.
The rotation schedule is designed to allow maximum exposure to the requirements outlined by the ACGME. Residents will be exposed to the full range of surgical care environments, from busy community hospitals to the clinical private practice setting. The bulk of the surgical experience takes place at four core facilities (University of Minnesota Medical Center, Fairview, Minneapolis VA Health Care System, Regions Hospital, and North Memorial Medical Center). Residents may sometimes follow cases to a number of affiliated hospital sites.

Residents and faculty are expected to review rotation-based goals and objectives as needed.
Remediation, Probation, and Dismissal

See Institution Policy Manual > Discipline, Dismissal, Non-Renewal Policy and Procedure
Remediation

Remediation is a non-disciplinary action that precedes probation. It is sometimes referred to as “Performance Improvement Plan” or “At-Risk” status. There is no requirement under due process principles or the Institution Policy Manual to do remediation.
Remediation may be undertaken before probation, to give the resident early warning of problems so as to avoid disciplinary probation, and assists the resident with strategies for correction or improvement.
Probation

Academic probation is a disciplinary action for residents with a pattern of unsatisfactory or marginal academic performance. Probation is required by the Institution Policy Manual before dismissing a resident for academic reasons. Due process requirements are as follows:

    Give resident notice of performance deficiencies;
    Give resident opportunity to remedy the deficiencies; and
    Give resident notice of possibility of dismissal if deficiencies are not corrected.
    Length of probation must be specified at the outset (typically 3 months).

Probation letter should include measurable goals related to performance deficiencies. Examples include:

    No failed rotations;
    Medical knowledge evaluated at satisfactory or better on all rotations;Work with assigned faculty mentor to develop reading program and meet every two weeks to discuss readings;Arrive on time, remain present and engaged for all clinical duties.
    For residents who pass probation, the program will send a letter returning resident to good academic standing. Letter will include statement that future performance deficiencies (e.g., failed rotations, repeat of professionalism problems) may result in dismissal without a further probationary period.

Probation occasionally is used as a sanction, short of suspension or dismissal, for misconduct violations. In this circumstance, the more formal non-academic disciplinary procedures apply (see Institution Policy Manual > Discipline, Dismissal, Non-Renewal Policy and Procedure).
Medical Referrals and Counseling Resources

Consent of resident is required under state law to obtain medical information after employment has commenced. Referrals for medical assessment and psychological counseling should not be mandated, although they may be strongly encouraged. A resident generally cannot be disciplined for failure to obtain evaluation, but can be disciplined for poor performance or misconduct, regardless of possible underlying medical factors.
There is an exception for mandatory evaluations where resident qualifies as an impaired physician. See Institutional Policy Manual > Impaired Resident/Fellow Policy.

University resources for residents include;

    Medical School Office of Learner Development (OLD)
    Resident Assistant Program (RAP)
    Disability Resources Center (DRC) (UReturn program)

DRC reviews disability documentation, determines disability status, and recommends reasonable accommodations. Residents should be referred to DRC if there appears to be a disability or health condition that may be affecting performance (OLD can facilitate referral). Residents seeking accommodations for a disability must register and work with DRC in order to receive accommodations from the training program.
Resignation Agreements

Residents with performance problems may choose to resign to avoid dismissal or probation. Once a program decides to dismiss, one option is for resident to sign a resignation settlement agreement. Office of the General Counsel negotiates agreement with resident’s representative (Student Conflict Resolution Center, or legal counsel if the resident has an attorney).
Agreement typically includes these terms:

    Resident resigns in lieu of dismissal;
    Parties agree on amount of academic credit resident receives and language for references and credentialing verifications;
    Resident releases claims.

Credentialing/Verification

Negotiated resignation agreements may use language/format different from GME Standard Verification form. Guiding principles for verification/credentialing:

    Statements must be supportable by record.
    Be as favorable to resident as possible but not inaccurate or misleading.
    One option is to verify only dates of training and PGY level/rotations completed.

Research and Quality Improvement (QI) Expectations
Every resident must be involved in research starting in their first year. Residents are expected to use their first three years to write protocols, get IRB approval, etc. Research rotation should be used for writing paper, data collection, preparing podium presentations, etc. Residents must report research  details to WikiSpaces for inclusion in ACGME’s WebADS (Web Accreditation Data System) annual updates.

Every resident must be involved in QI/Patient Safety initiatives starting in their first year. Residents must report QI/Patient Safety details to WikiSpaces for inclusion in ACGME’s WebADS (Web Accreditation Data System) annual updates.

It is expected that every resident publishes at least 1 paper and present at least 1 podium presentation by their chief year.

Per ACGME Program Requirements, all residents must actively participate in interdisciplinary clinical quality improvement and patient safety programs. Progress on Research and QI/Patient Safety projects will be monitored by Dr. Lacey. Program Director will check with resident at start of 3rd year to determine if research rotation should be scheduled at the end of 3rd year, or pushed to 4th year if resident is not yet ready.
Residency Management Suite (RMS)

Residents will be provided with access to Residency Management Suite (RMS) when they enter the program. Residents are expected to regularly access RMS to log Duty Hours, complete evaluations, and review rotation curriculum. Residents may contact the program coordinator or RMS Help (612-624-0750 or [email protected]) with questions.
Security/Safety

The Security Monitor Program (SMP) is a branch of the University of Minnesota Police Department. SMP offers a walking/biking escort service to and from campus locations and nearby adjacent neighborhoods. This service is available completely free to students, staff, faculty, and visitors to the University of Minnesota Twin Cities campus.To request an escort from a trained student security monitor, call 624-WALK shortly before your desired departure time.

UMMC, Fairview employees security officers who are on duty 24 hours a day to respond to emergencies and to escort persons to and from the parking facilities. Call 612-273-4544 if you wish to have an escort, and a security officer will meet you at your location.
Supervision
Levels of Supervision

Refer to Institution Policy Manual.
Faculty Responsibility for Supervision

All patient care must be supervised by qualified faculty. The program director will ensure, direct, and document adequate supervision of residents at all times. Residents will be provided with rapid, reliable systems for communication with supervising faculty. Residents must be supervised by faculty in such a way that the residents assume progressively increasing responsibility according to their level of education, ability, and experience. Faculty are expected to recognize signs of fatigue, and comply with program policy to send resident home.

On call schedules for faculty must be structured to ensure that supervision is readily available to residents on duty.  Faculty determine the level of responsibility given to each resident.

Per the Institution Manual, faculty are expected to:

    Set clear expectations
        When to call
        Situations in which trainees should always call
        How to call – provide accurate pager/phone numbers
        Trainees role in the care of the patient
    Create a safe learning environment
        Reassure the trainee that is is always appropriate to call if uncertain
        Recognize and address uncertainty in the trainee
    Be readily available
        Answer pages and phone calls promptly
        Planned communication (schedule times for calls)
    Balance supervision with trainee autonomy.  Provide input but don’t take over the case
    Be respectful
        Be patient with the trainee regardless of time of day
        Don’t yell at or belittle a trainee

If a faculty member fails to do any of the above, residents are expected to notify the program via Faculty Evaluation, or one of the other methods described in the Grievance Procedure section.
Supervision at UMMC, Fairview & VAHCS

If the patient undergoes surgery in either a major operating room or the ambulatory surgery suite, the nursing staff will not call for the patient unless faculty is present in the surgical suite. Faculty is available by pager, and telephone 24/7, and a call schedule for faculty and residents is published monthly. Inpatient hospital care is provided by the residents with direct supervision of faculty on a daily basis. The faculty rounds with residents on assigned inpatients daily.

Similarly, all patients seen in the clinic area are seen by faculty  and resident alike, and their management is discussed fully. When patients are seen in the emergency department at night or on the weekends, they are evaluated first by the resident on call, consistent with duty hour limitations. The resident ultimately conveys the information to the supervising faculty by telephone, and, if it is a minor problem, the resident, based on their experience level, manages it, directed by the faculty. If the patient problem requires admission, intra-operative treatment, or has any problems, the faculty comes to the hospital, evaluates the patient, and supervises their care from there. This policy extends to all UMMC, Fairview clinics and satellite surgery centers at all times.
Supervision at NMMC

Residents are involved with primarily one faculty assisting or managing the patient in a directly supervised manner. Patient care in these rotations occurs with direct communication and supervision by the faculty. Residents are assigned periodically to trauma call. It is required that they communicate with the faculty by telephone to formulate a treatment plan, prior to initiating treatment. In most cases thefaculty comes to the hospital to provide direct supervision, and frequently only involves the resident in cases with strong educational potential. The faculty rounds with residents on assigned inpatients daily.

At Regions Hospital the resident always has on-site staff supervision. Ninety-seven percent of all patients seen in clinic, and all patients scheduled for the operating room are seen personally by the faculty who coordinates care with the resident. Often the residents will see the patient and then present the patient to the faculty member. Patients with minor injuries seen in the emergency room may be treated by the resident but must be discussed with the faculty to confirm the treatment plan, prior to treatment. All cases performed in the operating room are under the direct supervision of the faculty. The resident may be involved with managing some outpatient problems in the emergency room without direct visual supervision by the staff, but the staff is always available by pager or by phone.
Effective Supervisee (Resident) Behaviors

Residents are expected to communicate directly with attending staff at any time there is a change in the condition of the patient. Death, ICU transfers and end-of-life decisions are quite rare for the Plastic Surgery program. When these specific issues arise, however, the resident is mandated to inform the attending or on-call staff if the event is after hours.

Common events involving the change in condition of patients for plastic surgery include reconstructions that have threatening complications (e.g. lack of blood supply for a reattached finger). Other examples would be post-operative complications (e.g. bleeding/hematoma, acute infections, open fractures) where delay in treatment may adversely affect outcomes. Residents are instructed to communicate directly with attending staff if these issues occur while they are caring for the patient. There is always attending staff coverage available for plastic surgery patients at all of the teaching sites.

Residents at all levels of training must contact attending for the problems listed above. For residents in the first and second years of the training program, specific instruction will be given to contact staff if there is any question about a change in a patient or a clinical problem. Third year residents are expected to anticipate problems and demonstrate advanced judgment in addition to contacting staff for patient changes or clinical problems.
Progressive Responsibilities for Patient Management

Residents’ progressive patient management responsibilities are determined on an individual basis through faculty review of resident performance using the end of rotation evaluation data as well as information gathered through specific observations made by faculty. Criteria are provided in rotation evaluations to help determine if a resident is ready to assume additional clinical autonomy.
Support Services

Refer to the Program Coordinator for all program-related questions, including but not limited to all of the topics covered in this Program Manual.
Training/Graduation Requirements   
Refer to American Board of Plastic Surgery (ABPS) Resident and Training Information.
Transitions of Care and Hand-offs

Residents receive focused and relevant transitions of care and hand-offs training during their GME orientation to build these skills, use clear assessment strategies, and document this competency. The GME has posted additional resources online: http://hub.med.umn.edu/resident-fellow-administration/teaching-evaluation-resources/patient-handoffs.

Residents and faculty members are expected to demonstrate responsiveness to patient needs that supersedes self-interest. They must recognize that under certain circumstances, the best interests of the patient may be served by transitioning that patient’s care to another qualified and rested provider.
Hand-off Checklist - University of MN Health

    Patient name and medical record number
    Consult vs. primary patient
    Attending for the patient
    Procedure performed or reason for consult
    # days post op or # of days in-house if pre-op
    Any complications or unusual circumstances re procedure
    Issues with recovery, medical comorbidities, special medications
    Weight bearing status, elevation, dangling
    Anticipated discharge date, possible discharge issues (if over the weekend and covering resident is going to discharge)
    Anticipated pages and response (what to do if a situation arises that is specific to the patient)

The resident on the service discusses the above checklist with the resident either taking over for the evening or weekend, prior to the time changeover occurs. The resident on the service keeps the patient list current in EPIC.

The resident on evening call or weekend call will give a check out to the resident on the service prior to the time changeover occurs in the morning. Any changes in the patient's status or important clinical activity is discussed in the check out. Any new admissions, surgical cases or consults are also discussed with the above checklist used as a template.
Visa Sponsorship

The J-1 alien physician visa sponsored by ECFMG is the preferred visa status for foreign national trainees in all UMN graduate medical education programs; therefore, the Plastic & Reconstructive Surgery Independent Residency Program sponsors only J-1 visas. We do not sponsor H-1B visas. More information on the J-1 visa can be found on the GME International Medical Graduates & Visas site.
SECTION 6 - ADMINISTRATION
Contact Information

Contact information for all University faculty, staff, students, etc. is searchable at; http://search.umn.edu. If contact information is not listed, check with program coordinator.
Hospital Site Coordinators
Questions about services offered at off-site hospitals should be directed to that hospital's site coordinator. A list of site coordinators for each hospital is available online at http://www.mmcgmeservices.org/resources--forms.html > “Rotating Trainee Reference Document.”
Surgical Administrative Center Contacts

http://hub.med.umn.edu/administrative-services/administrative-centers/sac/staff-sac
GME Resident/Fellow Resources

http://www.med.umn.edu/residents-fellows/current-residents-fellows
Intranet
Fairview

https://intranet.fairview.org
To access Fairview Intranet from home, a username and password will be required. Use your Fairview username/password to log in.
University of Minnesota Physicians (UMP)

http://resource.umphysicians.com

To access reSource from home a username and password will be required. Use your University X500 username to log in with a default password of “welcome11”, which can be changed using the link at the top of every reSource page.
Confirmation of Receipt of Policy Manual

Sign in with your UMN ID and password to complete the confirmation form.