PGY1 BOOTCAMP COURSE

Profesionalism,Supervision, and
Pearls for PGY1
Presented by :
Prof.Dr.Abdul Gofar Sastrodiningrat,SpBS(K)
Director of Neurosurgery Residency Training Program
Departement of Neurosurgery
School of Medicine University of Sumatera Utara

Accreditation Council for Graduate Medical Education

 ACGME
Accreditation Council for Graduate Medical Education
Lembaga Akreditasi untuk PPDS/Residen

 PGY1
Post Graduate Year 1
PPDS/Residen tahun 1

Accreditation Council for Graduate Medical Education

 Professionalism
Definitions

- Highly educated ***

(Berpendidikan tinggi)

- Impressive competence ***

( Kompetensi yang meyakinkan)

- Autonomy
(Mandiri)

- “Comfortable” salary ***

(gaji yang cukup)

- Creative and intellectually challenging work

(kreatif dan pekerjaan yang menantang intelektual)

- Trust
(Bertanggung jawab)

- Strict ethical and moral standards ***

(Standar-standar etika dan moral yang ketat)

Accreditation Council for Graduate Medical Education

 Professionalism
 Professionalism also includes :

- Ethical Behaviour (Bertatakrama)

- Confidentiality (Menjaga kerahasiaan)

- Putting the client’s interest ahead of one’s own (Menempatkan

kepentingan ‘client’ diatas kepentingan pribadi)

- Moral compass (Lingkungan yang bermoral)

- Work ethic and motivation (Etos kerja dan motivasi)

- Willingness to share in the transmission of professional knowledge

and values (like to day)
(Kesediaan untuk berbagi dalam penyebaran ilmu dan nilai-nilai
profesional)

- Positive attitude towards the profession (sikap yang positif terhadap

profesi)

Accreditation Council for Graduate Medical Education

 Professionalism

ACGME (Accreditation Council for Graduate Medical Education)

Outcome Project includes
Six Competencies : (enam kompetensi)
- Patient Care (Perawatan pasien)
- Medical Knowledge (Pengetahuan Kedokteran)
- Professionalism (Profesionalisme)
- Interpersonal and communication skills (hubungan
interpersonal dan kemampuan berkomunikasi )
- System-based Practice (Paktek berbasiskan sistim)
- Practice-based Learning and Improvement
(Pembelajaran dan Perbaikan berbasiskan praktek)

Accreditation Council for Graduate Medical Education

 Professionalism

 When is professionalism measured?

(Bila profesionalisme di nilai ?)
through (melalui) :
 Assessments : such as
. Peer (‘360 degree’) (dalam kelompok)
. “On the fly” evaluations (clinical and operative) ( evaluasi
pada keadaan yang sedang berlangsung)
. By rotation (melalui rotasi)
. Annually (berkala tahunan)

Accreditation Council for Graduate Medical Education

 Professionalism

 How is it measured :
through :
- Duty hour adherence and documentation
(Kepatuhan terhadap jam kerja dan pencatatan /dokumentasi)
- Nursing interaction
(interaksi dalam merawat pasien)
- Patient interactions
(interaksi terhadap pasien)
- Demeanor and dress
(sikap dan cara berpakaian)
- Devotion to patient care
(ketaatan merawat pasien)
- Ethical decision making
(Pengambilan keputusan yang ber etika)
- Contribution to the profession
(kontribusi terhadap profesi)

Accreditation Council for Graduate Medical Education

 Professionalism

 As professionals you have to deal with bad outcomes :

Sebagai profesional anda harus berurusan/menangani hasil
yang buruk

- Bad patient outcomes are sometimes unavoidable

(Hasil yang buruk kadang- kadang tidak dapat dihindarkan)

- Perfection is unobtainable
(kesempurnaan tidak dapat diraih)

Accreditation Council for Graduate Medical Education

Pearls nasihat

 Do not forget that you (actually) are

physicians
 Where do you hide your stethoscope?
 Facts : Patients come to you with her/his
main complaints but they may be hide a
pocketful of illnesses

 Use common sense

Accreditation Council for Graduate Medical Education

Pearls nasihat

 It’s a long road ... It’s hard work ...

- If you don’t enjoy the process, it may be
difficult to finish it ...

Hard work without talent is a shame, but talent without

hard work is a tragedy
- Robert Haf, 20th cent.

Goodness without knowledge is weak, knowledge without
goodness is dangerous
- John Phillips. 1781

Accreditation Council for Graduate Medical Education

Supervision
 Close supervision at every training level
 Attending staff
 Senior/Chief resident staff
 Defined psychomotor goals for each training level
 Hierarchy

Accreditation Council for Graduate Medical Education

Fatigue

 Fatigue compromises:
 Patient safety
 Quality outcomes
 Resident health

Accreditation Council for Graduate Medical Education

Fatigue
 Two imperatives:
 Regulatory compliance for PGY1s
 16 hours shift limit ABSOLUTE
 80 hours per week, averaged over 4 weeks
 One in 7 days off, averaged over 4 weeks
 8 hour minimum inter-shift break
 Direct or on-site supervision (senior resident or
faculty)
 Quality and safety
 Self monitoring
 Ask for help, don’t drive tired

Accreditation Council for Graduate Medical Education

Pearls

 Don’t be afraid to ask

 Silence is often mistaken for understanding
 Ask attendings/senior residents when you don’t
know
 It’s OK to say “I don’t know”
 Particularly to patients
 Don’t provide wrong information!
 Most of all, remember that sometimes you don’t
know when you don’t know…

Accreditation Council for Graduate Medical Education

Pearls

 Prioritize
 Who are the sickest patients?
 Emphasize their hand-offs
 Re-examine them
 Prioritize their care
 Stay organized!
 Keep lists
 Be practical

Accreditation Council for Graduate Medical Education

Accreditation Council for Graduate Medical Education