Medical Leadership and Operations Fellowship for EM Graduates

Program Overview:

The Medical Leadership Operations and Leadership Fellowship is designed to prepare graduates of Emergency Medical residency programs to prepare for positions as emergency medicine and multispecialty group practice leaders of the future. We recognize that the success of future EM leaders will be dependent on skills beyond simply being the medical director of an ED.  Maximal success will accrue to those who understand hospital operations, ambulatory operations, and the remote delivery of healthcare through telemedicine.  In addition, the initiation of research leading to publication in peer review journals will be of paramount importance for future academic leaders. This fellowship will provide experience in all of these areas.  

The program is based in the Department of Emergency Medicine at the George Washington University with resources and opportunities provided by its clinically affiliated emergency departments and other areas within the University, faculty practice, and related institutions. 

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Goals:

The fellowship’s curriculum is divided into 5 sections

ED and EM academic departmental operations:

  1. Demonstrate expertise in core aspects of emergency department operations.
  2. Develop and analyze operational metrics to optimize emergency department processes and outcomes
  3. Create, employ and evaluate emergency department  quality improvement initiatives
  4. Understand the budgeting process for clinical and academic departmental operations
  5. Understand the essentials aspects of emergency physician coding and billing
  6. Identify the elements of a budget for an academic department of emergency medicine
  7. Recognize essential elements of an emergency department risk management program; understand the processes that occur when a claim is made
  8. Understand the essential elements of a physician evaluation and compensation program

Hospital Medical Direction

  1. Understand the structure and responsibilities of the Hospital Medical Staff
  2. Understand the Hospital’s credentialing and privileging process
  3. Understand the Hospital committee process and become a member of the Hospital Peer Review committee
  4. Understand the major Medicare-related quality initiatives
  5. Understand the role of JCAHO and local health departments in the Hospital’s accreditation process
  6. Understand the ED role in Trauma, Stroke, and Cardiac certification processes

Ambulatory Operations

  1. Understand  the  basic management and fiscal  challenges or running an outpatient, longitudinal, ambulatory practice
  2. Understand the basic management and fiscal challenges of running an outpatient, episodic urgent care center
  3. Understand the metrics of outpatient practice
  4. Understand the billing and coding of outpatient encounters
  5. Understand the development of quality metrics for outpatient longitudinal and episodic practice

Telehealth

  1. Understand the basic structure of a telehealth program including both the hardware and software support necessary
  2. Understand the and participate in the delivery of care through telemedicine
  3. Understand the billing, regulatory, and qa aspects of a telehealth program

Research

  1. Design and successfully complete a scholarly project related to emergency department or ambulatory operations that is publishable in a national peer-reviewed journal.

Educational Program

Curriculum Highlights

  1. Fellow will be funded to attend three phases of ACEP’s Emergency Department Directors Academy during the two year period.
  2. Fellow will work directly with  the Chief Medical Officers of George Washington and Fort Washington Hospitals
  3. Fellow will be a member of a minimum of two committees at either the Hospital or MFA (multispecialty group practice) levels
  4. Fellow will be involved in the monthly mortality and morbidity meeting by reviewing and analyzing cases.
  5. Fellow will attend the Department of Emergency Medicine joint Fellowship seminar series.

Clinical Responsibilities

May vary according to the fellow’s clinical background and visa status.  In general, fellows who are residency trained in EM and employable in the US will work as ED attendings in the Washington VA Hospital and Metro Immediate Urgent Care centers.  Those who cannot be employed as independent practitioners will have a clinical experience commensurate with their training and needs.

Educational Responsibilities

The two-year fellowship curriculum will provide a comprehensive exposure to the broad scope of healthcare operations as elucidated above.

In addition, Fellows will be expected to:

  1. Present one one residency-wide didactic presentation of grand rounds per year
  2. Present at least two class-specific presentations per year
  3. Participate in the residency interview process in the fall of each year. . 
  4. Attend 50% of the faculty meetings

Each fellow will be expected to conduct a research project during the time of their fellowship; expectation will be to submit two abstracts and one article during the two years.

Academic courses associated with an optional MBA

Each of the following subjects is 3 credits:

Fall 2015: Financial Accounting, Marketing

Spring 2016: Decision Making and Data Analysis, Global Perspectives

Summer 2016: Organizations and Human Capital, Operations Management

Fall 2016: Business Ethics and Public Policy, Perspectives on Leadership, Finance

Spring 2017: Managerial Accounting, Microeconomics for the World Economy, Strategic Management

Summer 2017: Electives

Other 27 Credits of elective will be added based on the fellow interest. 

Requirements and Contact information:

The term for the fellowship is July 1st 2017 to June 30, 2019. Fellows accepted into the program must have completed a 4-year ACGME accredited EM residency and be eligible for (or have successfully completed certification by the American Board of Emergency Medicine. 

Core text

Strauss and Mayer’s Emergency Department Management by Robert Strauss and Thom Mayer, McGraw-Hill Education, 2014.

Supervision & Evaluation

Supervision

  • Dr. Shesser will supervise the ED and Ambulatory administrative sections
  • Drs. Davis and Petinaux will supervise the Hospital Medical Directions segment
  • Dr. Sikka will supervise the Telemedicine section
  • Dr. Pines will supervise the Research section

Evaluation and Assessment

  • Self-assessment through regular meetings with the Program Director
  • Formally every 6-months by one of the programs directors
  • Direct feedback from fellowship directors (weekly)
  • Final formal performance review by the Program Directors
  • Assessment from medical student learners (Periodically)

Sample monthly schedule

Note that during office times, fellow will spend conducting research, writing, and engaging in scholarly activity related to the fellowship program.

Week 1:

Monday – Class for course credit (3-hours), office 4 hours

Tuesday – 8-hour clinical shift

Wednesday – 4-hour conference, office 4 hours

Thursday – Class for course credit (3-hours), office 4 hours

Friday – 2 hours meeting with mentors, office 6 hours

Saturday - off

Sunday – 8-hour clinical shift

Week 2:

Monday - Class for course credit (3-hours), office 4 hours

Tuesday – 8-hour clinical shift

Wednesday - 4-hour conference, office 4 hours

Thursday – Class for course credit (3-hours), office 4 hours

Friday – 2 hours meeting with mentors, office 6 hours

Saturday - Off

Sunday - Off

Week 3:

Monday - Class for course credit (3-hours), office 4 hours

Tuesday – 8-hour clinical shift

Wednesday - 4-hour conference, office 4 hours

Thursday – Thursday – Class for course credit (3-hours), office 4 hours

Friday – 2 hours meeting with mentor’s, office 6 hours

Saturday - Off

Sunday - Off

Week 4:

Monday - Class for course credit (3-hours), office 4 hours

Tuesday – 8-hour clinical shift

Wednesday - 4-hour conference, office 4 hours

Thursday – Thursday – Class for course credit (3-hours), office 4 hours

Friday – 2 hours meeting with mentor’s, office 6 hours

Saturday - Off

Sunday – 8-hour clinical shift

 

Effective Dates & Application Requirements:

The duration of the ED operations and administration fellowship will be two years. The academic year for the fellowship is August 1st – July 31st. Fellows accepted into the program must have completed an ACGME-accredited emergency medicine residency and be eligible for (or have successfully completed certification by the American Board of Emergency Medicine). The current application requirements include a copy of your curriculum vitae, a letter of intent (1-2 pages in length) expressing your interests/career goals, your expectations from the program, the strengths that you would bring to the fellowship, and three reference letters, including one from your emergency medicine residency program director. Please have the reference letters mailed directly from the author to:

Rober Shesser, M.D., M.P.H.
Fellowship Director
2121 L St. N.W. Suite 450
Washington, D.C. 20037
rshesser@mfa.gwu.edu