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Pulmonary & Critical Care Fellowship

Position Identification: Fellows

Position Summary: There are 3 tracks of training for our PCCM fellowship – a physician scientist track, a clinician-educator track and a clinical scholars track.

For the purpose of this document, the term “Resident” includes medical and dental residents and fellows, including those in ACGME, CODA and non-ACGME accredited programs.

General Overview of the Resident Role

A resident’s responsibilities include patient care responsibilities within the scope of their clinical privileges commensurate with level of training and other responsibilities required of all members of the medical staff. Under the supervision of attendings, general responsibilities of the resident may include:

  • Initial and ongoing assessment of patients’ medical, physical and psychosocial status
  • Performing history and physical examination
  • Developing assessment and treatment plan
  • Performing rounds
  • Recording documentation, including progress notes, admission notes, procedure notes and discharge summaries
  • Ordering tests, examinations, medications and therapies
  • Arranging for discharge, referral and after care.
  • Providing patient education and counseling about health status, test results, disease processes and transition of care planning
  • Performing procedures
  • Assisting in surgery
  • Teaching and evaluating junior learners, such as medical students

UW GME Expectations for Professional Behavior

Essential Functions

Essential functions are the fundamental job duties of the position that cannot be eliminated or substantially modified without changing the nature of the position.

A job function may be considered essential for the following reasons:

  • The reason the position exists is to perform that function
    • Resident educational requirements and patient care responsibilities
  • A limited number of available residents can perform that function
  • Varies by program, rotation, year, risk pools, etc.
  • The function may be highly specialized so that the trainee in the position is hired for their expertise or ability to perform the particular function
    • Cannot easily hire more trainees, especially of a specific R level
  • The percentage of time spent on a function does not determine whether or not it is essential.

Essential functions for GME residents must include consideration of:

  • ACGME program requirements
  • Specialty board requirements
  • UW program requirements
    • Unique to each UW training program and must consider:
      • Complexity of rotations/service requirements
      • Size of program
      • Structure and depth of risk pools
      • Please refer to the program’s Clinical Coverage Policy
    • Inclusive of the hospital system requirements:
      • Rotations dependent on residents’ service for patient care
      • Coverage options available

A resident must perform the position’s essential job functions with or without an approved reasonable accommodation. Reasonable accommodation means modifying or adjusting practices, procedures, policies, job duties, or the work or application environment so that a qualified individual with a disability can still perform a position’s essential functions. Approved reasonable accommodations are determined via an interactive process involving the resident, DSO/HR/GME and the program.

Essential functions ensure the safe and smooth delivery of education and patient care and are identified in alignment with program aims to facilitate trainee readiness for independent practice across an appropriate range of clinical settings for that specialty. Transparent documentation of a program’s essential functions is also an important resource for applicants evaluating the training program during recruitment.

Essential Program Administrative Functions

Onboarding

The Resident must:

  • comply with all program and institutional tasks required for credentialing and onboarding by the requested deadlines

Program Tasks and Documentation

The Resident must:

  • participate in all requests for schedule preferences, requests for absence or schedule changes of requests for clinical coverage on the requested timelines or deadlines.
  • complete in a timely manner all evaluations requested for medical students, peer residents, faculty or other members of the team
  • complete MedHub clinical and educational hour logs
  • complete case or procedure logs
  • complete the annual ACGME Resident Survey
  • complete the program’s annual confidential internal survey
  • complete required examination preparation and/or testing requirements, to include USMLE or COMLEX Step 3, in-training examinations and program-specific guidelines for national board certification
  • attendance at all required program meetings, including semiannual meetings, mentorship meetings, program retreats, etc.
  • attend other required educational conferences and training sessions as scheduled

Essential Program Core Educational Functions

Didactics

The Resident must:

  • Comply with all standards for attendance at didactics or other core educational activities
  • Adhere to the preferred mode of attendance (in-person, virtual, hybrid)

Scholarship

The Resident must:

  • Comply with all program or specialty requirements for research or scholarship, quality improvement, national or regional conference presentation, publication or scholarly writing or teaching and presentations internal to the program (e.g. journal club, didactics, case conference, M&M, etc.)

Essential Patient Care Functions

Presence and preparedness

The Resident must:

  • present to work as physically, mentally and emotionally fit for duty
  • arrive at the patient care setting on schedule
  • arrive at work in attire appropriate for the professional and safe delivery of patient care
  • meet expectations for chart review or pre-rounding
  • satisfy expectations that precede sign-out and/or departure from the clinical setting, including an appropriate handoff and follow up on all patient assessments/data/studies that will alter care in the near term.

Administrative

The Resident must:

  • complete patient health record documentation on the schedule prescribed by the program or medical center. (Examples include but are not limited to progress notes/visit summaries, discharge summaries, operative or procedure notes, perioperative records)
  • comply with expectations for EHR inbox management, including timely responses to messages from patients, medical staff and tracking and patient follow up of expected results

Patient Care Communication

The Resident must:

  • respond in a timely manner to pages, phone calls and Epic Secure Chat
  • remain within the program-prescribed geographic range while on call or eligible for coverage

Patient Care Volumes

The Resident must:

  • work toward (with supervision) or meet benchmarks for patient care volumes in all clinical settings
  • appropriately request and utilize supervision
  • work toward or ultimately meet procedure certification standards

Consultation

The Resident must:

  • appropriately respond to, triage, and staff consultations in a timely manner
  • document findings and recommendations in a timely manner
  • communicate with the requesting service directly (e.g. in-person, phone) in advance of and following the assessment
  • ensure that consultations are staffed and finalized with a faculty member in a timely manner

Essential Shift and Schedule Functions

Settings

  • complete assigned shifts in settings deemed essential by the program, such as inpatient units, NICU, PICU, emergency department, and outpatient specialty and primary care clinics
  • complete assigned away rotations deemed essential by the program

Shift length and timing

The Resident must:

  • complete shifts of all lengths deemed essential by the program, which may include daytime, swing, nights, weekends, and holidays
    • Shifts must not exceed ACGME limits of up to 28 hours per shift, and up to 80 hours per week averaged over a 4 week period
  • where appropriate, comply with designated break lengths (to meet personal needs and not impact patient care)
  • Assigned to 2-4 24-hour shifts per year

Call Responsibilities

The Resident must:

  • complete assigned shifts of overnight call, as deemed essential by the program
  • complete assigned shifts of home call, as deemed essential by the program
  • remain within the prescribed geographic range while on call or eligible for coverage
  • assigned to approximately 8-12 weeks of home call per year

Essential Cognitive Functions

Nothing specific

Essential Communication Functions

(including verbal and written)

Nothing specific, other than communicate fluently with staff and patients

Essential physical functions

(including senses, stances and mobility, manipulation and technical skills)

Nothing specific other than participate in rounds and procedures as required

Statement Of Nondiscrimination

The University of Washington prohibits discrimination, harassment and sexual misconduct in any education program or activity that it operates. Individuals may report concerns, make complaints, or direct inquiries to the Civil Rights Compliance Office. View the Statement of Nondiscrimination.

Key Principles for ADA-Compliant Language:

  • Focus on results, not methods
  • Essential function is a completed task, not how that task is completed
More Inclusive Term Example of Physical Demand
Move/traverse Walk, run
Ascend/descend Climb
Transport Carry
Relocate Lift
Stationary position Sit, stand
Position, detect, operate Feel, handle
Maneuver Pull, push
Attain Reach
Retrieve from ground level Squat
Repetitive movement Performing a task repeatedly
Communicate Speak, talk, hear
Communicate in written language Write
Input data Use keyboard
Position self (to move) Crouching, stooping, crawling
Work atop Balance
Determine, identify, assess, recognize See
Assess Hear
Review Read
Adhere Remember
Apply Think

This document reflects requirements, established practices, policies, procedures, and resources as of the date of publication; however, parts of this document may be updated from time to time in accordance with changes in the law and applicable requirements, established practices, policies, procedures, and resources. Continued participation by a resident in the program will demonstrate agreement by the resident to adhere to the updates. The program will communicate such change as required.