Eligibility And Selection Of Residents

To apply, a completed application must be processed through the Central Application Service (CAS) and submitted along with your Dean's letter [after November 1.] We would also appreciate receiving a recent photograph sent directly to us, to make it easier for us to remember you when we review your file. With the exception of the Dean's letter, we will not accept any material after November 1, 2006.

Resident Eligibility - Applicants with one of the following qualifications are eligible for appointment to the UAMS Ophthalmology residency program:

1. Graduates of medical schools in the United States and Canada accredited by the Liaison Committee on Medical Education (LCME).
2. Graduates of colleges of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA).
3. Graduates of medical schools outside the United States and Canada who meet one of the following qualifications.:

1. Have received a currently valid certificate from the Educational Commission for Foreign Medical Graduates or
2. Have a full or unrestricted license to practice medicine in a U.S. licensing jurisdiction.

1. Graduates of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school.
2. All residents must demonstrate proficiency in verbal English and the ability to read cursive English.

Residency Selection - The selection of residents to fill positions in the department of ophthalmology is based on the following:

• Candidate's record of past academic and clinical performance;
• His/her maturity and emotional stability;
• Information gained through personal interviews and letters of recommendation;
• Communication skills and personal qualities such as motivation and integrity and;
• The applicant's apparent commitment for completing the entire training program as preparation for a career in ophthalmology.

Once an applicant has been found to meet minimal selection criteria, he/she is contacted by the program coordinator by mail to schedule an interview. An applicant invited for an interview should review and be familiar with the terms, conditions and benefits of appointment (and employment) listed here.

The interview consists of a full day of at least 3 one-on-one interviews with faculty members, lunch with the current residents, tours of Harvey & Bernice Jones Eye Institute, UAMS, John L. McClellan's Memorial Veterans Administration and the Arkansas Children's Hospital. Following the interview, the Training Program Selection Committee, composed of faculty and chief residents who perform interviews, reviews the applicant's file and written interview evaluations and ranks the applicant based on the criteria above. Following completion of resident interviews and discussion by the Training Program Selection Committee, the program director compiles a final list for submission to the OMP.

Appointment/Registration

Upon verification by the training program director that the applicant has met eligibility requirements, completed the application process and been selected according to established criteria, the applicant will begin the process of appointment and registration with the College of Medicine. An applicant is considered fully appointed and registered only after all of the following documents have been completed and returned to the Director of Housestaff Records. Once the Director of Housestaff Records has received all the documents, the applicant is registered in the payroll system to receive a stipend and may begin the training program.

1. Documentation of a negative drug test.
2. Verification of successful graduation if previously anticipated (e.g., final transcript, letter from Registrar, copy of diploma, currently valid ECFMG certificate, if applicable).
3. All of the following with valid signature:

• Resident Agreement of Appointment (contract)
• Medical Records Agreement
• Attestation acknowledging receipt of GME Committee policies and procedures.
• Confidential Practitioner Health Questionnaire
• Employee Drug Free Awareness Statement
• Housestaff Medical Screening Form
• Post Doctoral Medical Education Biographical Form
• Copy of currently valid ECFMG certificate and valid visa (if applicable)

Reappointment / Promotion

Housestaff appointments are for a period not exceeding one year. A housestaff agreement outlining the general mutual responsibility of the College of Medicine and the housestaff member is signed at the beginning of the term of service and is in effect for the full term of service. Renewal of agreement for an additional term of service is at the discretion of the chief of service. Promotion to the next level of training is dependent upon the resident performing at an acceptable level.

Evaluation

During the training period, each of the below elements of clinical competence will be assessed in writing on a quarterly basis by direct faculty supervisors and chief residents with subsequent review by the Program Director. Each resident will be evaluated in the following areas: Patient Care (clinical & surgical skills), Patient Care, Medical Knowledge, Professionalism, Practice-Based Learning & Improvement, Interpersonal & Communication Skills, and Systems Based Practice. Each area will be rated on a scale of 1-9.

An oral exam will be given at the end of each rotation.  The purpose of the exam is to ensure that each resident has gained the necessary knowledge base from each rotation and to give the resident experience in taking oral examinations in preparation for eventual board certification.  Only the following subject areas will be covered on the examination: 

ACH: Strabismus and General Ophthalmic Pediatrics

VA:    External Disease and Retina

JEI:    Optics, Anterior Segment, Neuro-Ophthalmology  

 Each subject will be taken in a twenty minute session.  Hence, residents ending a JEI rotation will have three twenty minute exams, whereas a resident ending a VA rotation will have two twenty minute exams.  A resident must successfully complete three of the four cases available in order to pass a subject.  If a particular case is troublesome to the resident during the exam, the resident has the option to "pass" to the next case.  This option may be used only once during a subject exam.  Overall exam performance will be reviewed with each resident by the residency director. 

The junior-most and senior-most resident will be excused from the exam in order to cover call starting 1 hour prior to the examination until the examination is completed.  The examination will be held the last week of the rotation.  No vacation is to be scheduled during this time unless approved by the residency director.

Each resident will have 360 degree global evaluations completed at least 4 times during their residency.  The 360 degree global includes evaluations completed by administrative staff, nurses, peers, self and patients (see evaluations entitled Administrative Staff, Nurses’ Survey, Peer Evaluation, Resident Self Evaluation and Patient Satisfaction Survey).  The ABIM Physician/Patient Communications Survey forms the backbone of this 360⁰ evaluation.  The first 10 questions on the Patient Satisfaction Survey have only been modified in punctuation so as to be readable at the 5^th grade level.  These questions’ validity and reliability were determined using Internal Medicine residents at UCLA and the University of Washington using 10 different clinical settings.  They have been used in a range of studies since 1989, and are used by ABIM for recertification of practicing physicians.  The other surveys, where seemingly appropriate, evolved from this survey and the recommendations of the Residents’ group.  Questions that seemed to delve into areas of concern for the Residents that could be appropriated from other research have been incorporated as well (i.e. nurses rating resident’s humanistic qualities).  These evaluations are used to evaluate the resident in the area of professionalism & interpersonal and communication skills.  

At least, on an annual basis (usually in the summer), the department chairman will formally review with each resident their rotation evaluations and academic performance; in addition, written evaluations will be reviewed by the residency program director with each resident at the end of each rotation (every 4 months) and signed by the resident to indicate that he/she has seen the evaluations.  The evaluations will be maintained in confidential files and only available to authorized personnel.  Upon request, the resident may review his/her evaluation file at any time during the year.

The resident may appeal an unsatisfactory evaluation by submitting a written request to the Program Director. The Program Director then reviews a summary of the deficiencies of the resident, and the resident has the opportunity to explain or refute the unsatisfactory evaluation. After review with the faculty, a final decision will be made.

At the completion of the training program the Program Director prepares a final evaluation of the clinical competence of the resident. This evaluation stipulates the degree to which the resident has mastered each component of clinical competence - clinical judgment, medical knowledge, clinical skills, humanistic qualities, professional attitudes and behavior, and provision of medical care. This evaluation verifies the resident has demonstrated sufficient professional ability to practice competently and independently. This evaluation remains in the program's files to substantiate future judgments in hospital credentialing, board certification, agency licensing, and in the actions of other bodies.

Academic And Other Disciplinary Actions

All of the disciplinary actions listed below are done in compliance with UAMS COM GME policy on disciplinary actions.

Academic Warning Status - is defined as the initial trial period in which a resident is permitted to redeem academic performance or behavioral conduct (before being placed on probation) for any one or more of the following:

• Failure to attend and perform satisfactorily at all scheduled conferences, morning rounds, the outpatient clinic and the operating room.
• Failure to score at least above the 20 percentile on the annual OKAP examination after being in the program for at least one year. Where appropriate, allowances will be made for the staggered entry date.
• Repeated reports of "below expectations" on the resident evaluation form.

When a resident is placed on academic warning status, the Program Director will provide specific remedial steps to correct the deficiency or problem and will indicate a specific amount of time to make the correction.

Probation - is defined as the trial period in which a resident is permitted to redeem academic performance or behavioral conduct for any one or more of the following:

• Failure to correct the deficiency or problem mentioned during the time allowed when previously placed on academic warning status.
• Failure to comply with the policies and procedures of the Training Program, the GME Committee, UAMS Medical Center or the participating institutions.
• Misconduct that infringes on the principles and guidelines set forth by this training program.
• Documented and recurrent failure to complete medical records in a timely and appropriate manner.
• When reasonably documented professional misconduct or ethical charges are brought against the resident which bear on his/her fitness to participate in the training program.

When a resident is placed on probation, the Program Director shall provide specific remedial steps to the resident in a written statement within a week of the notification. The statement will specify the period of time in which the resident must correct a deficiency or problem, the specific remedial steps and the consequences of non-compliance with the remediation. Based upon the resident's compliance with remedial steps, the resident may be:

• Continued on probation
• Removed from probation
• Suspended, or
• Dismissed from the residency program

Suspension - is defined as a period of time in which a resident is not allowed to take part in all or some of the activities of the training program. A resident may be suspended from clinical or other activities of the training program for reasons including, but not limited to, any of the following:

• Failure to meet the requirements of probation.
• Failure to meet the performance standards of the training program
• Failure to comply with the policies and procedures of the Training Program, the GME Committee, the UAMS Medical Center, or the participating institutions.
• Misconduct that infringes on the principles and guidelines set forth by this training program
• Documented and recurrent failure to complete medical records in a timely and appropriate manner defined as above
• Misconduct or failure to meet ethical standards which bear on his/her fitness to participate in the training program
• When reasonably documented legal charges have been brought against a resident which bear on his/her fitness to participate in the training program
• If a resident is deemed an immediate danger to patients, himself or herself or to others
• If a resident fails to comply with the medical licensure laws of the State of Arkansas

If suspension is deemed necessary, the Program Director notifies the resident through a written statement, with a copy to the Associate Dean for GME, to include:

• Reasons for the action
• Specific and appropriate measures to assure satisfactory resolution of the problem(s)
• Activities of the program in which the resident may and may not participate
• The date the suspension becomes effective
• Determination of leave with or without pay
• Consequences of non-compliance with the terms of suspension
• Whether the resident is required to spend additional time in training to compensate for the period of suspension and be eligible for certification for a full training year

During the suspension, the resident will be placed on leave, with or without pay as appropriate depending on the circumstances. At any time during or after the suspension, the resident may be reinstated with no qualifications, reinstated on probation, continued on suspension or dismissed from the program.

Dismissal - is the condition in which a resident is directed to leave the training program, with no award of credit for the current training year. Dismissal from the training program may occur for reasons including, but not limited to, any of the following:

• Failure to meet the performance standards of the training program
• Failure to comply with the policies and procedures of the training program, the GME Committee, the UAMS Medical Center, or the participating institutions
• Illegal conduct
• Unethical conduct
• Performance and behavior which compromise the welfare of patients, self, or others
• Failure to comply with the medical licensure laws of the State of Arkansas
• Inability of the resident to pass the requisite examinations for licensure to practice medicine in the United States

1. If dismissal is planned, the Program Director shall contact the Associate Dean for Graduate Medical Education and provide written documentation, which led to the proposed action.
2. Immediate dismissal can occur at any time without prior notification in instances of gross misconduct (e.g., theft of money or property; physical violence directed at an employee, visitor or patient; use of alcohol/drugs while on duty; other illegal conduct).
3. When dismissal is being considered because of performance or conduct, the Program Director shall notify the resident in writing of the basis of the action, the proposed action, the requirements for the resident and timeframe for satisfactory resolution of the problem(s).
4. In the event the situation is not improved within the timeframe, the resident will be dismissed.

A resident involved in the disciplinary actions of probation, suspension and dismissal has the right to appeal according to the GME Committee policy Adjudication of Resident Grievances. Please see the manual entitled General Manual for Housestaff, University of Arkansas for Medical Sciences, College of Medicine, for a full discussion of these procedures. These are the guidelines that will be used by the department.

Method to Communicate and Resolve Issues of Concern

When a resident has a concern, he/she should contact the chief resident or program director for discussion and resolution. If the issue cannot be resolved at this level, the resident should then contact a member of the Resident Council. The procedure for resolution will vary depending on the type of issue. For issues related to general work environment, the Resident Council may discuss the issue or arrange a meeting for the entire Resident Organization to discuss the issue and then submit recommendations to the GME Committee. For issues related to disciplinary action,  the procedure outlined in the GME Committee Policy on Disciplinary Action including Probation, Suspension and Dismissal will be followed. All proceedings that relate to an individual resident's concerns are confidential.

Duty Hours

Residents are expected to be present for all departmental activities including: conferences, clinics, surgery, and consultations.  Hours will, to some extent, be determined by the specific rotation; however, in general, duty hours are from 7:30 a.m. to approximately 6:00 p.m. Monday through Friday.  Weekend hours are variable, depending on the call schedule, special conferences, etc. Residents are off duty on weekend days unless they are on call, have special patient care responsibilities, or attending weekend conferences.

• Duty hours are defined as all clinical and academic activities related to the residency program, ie, patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.

• Duty hours will be limited to 80 hours per week, averaged over a four week period.

• Residents will be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.

• Adequate time for rest and personal activities will be provided. This should consist of a 10 hour time period provided between all daily duty periods.

On-Call Activities

 The objective of on-call activities is to provide residents with continuity of patient care experiences throughout a 24-hour period.

• Continuous on-site duty will not exceed 24 consecutive hours. Residents may remain on duty for up to six additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care as defined in Specialty and Subspecialty Program Requirements.

• No new patients, as defined in Specialty and Subspecialty Program Requirements, may be accepted after 24 hours of continuous duty.

• At-home call (pager call) is defined as call taken from outside the assigned institution.

1. Residents taking at-home call must be provided with 1 day in 7 completely free from all educational and clinical responsibilities, averaged over a 4-week period.

2. When residents are called into the hospital from home, the hours residents spend in-house are counted toward the 80-hour limit.  

3. The program director and the faculty will monitor the demands of at-home call in their programs and make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.

Work Environment

Staff physicians are available to residents during clinic hours, and after hours on an on-call basis, at all times. Appropriate technical support is provided in each outpatient clinic to provide proper care to patients.

International Medical Graduates (IMG)

Visas are handled through the Office of Human Resources (OHR). You may contact their office at (501) 686-5650. The OHR also provides an International Medical Orientation Handbook which contains useful information about the U.S. and Arkansas culture. An orientation session is provided during the Orientation/Registration each June and several departments assign incoming residents a mentor within the department who assists with the acclimation process.

Pre-Employment Drug Testing Program

UAMS has a drug testing policy which includes pre-employment, random and for cause testing. All residents accepted into training programs at UAMS must submit to a drug screen. Employment (or acceptance into the training program) will be finalized only upon completion of a negative drug screen. The procedure for submitting the sample is provided after Match Day.

Annual Records

Annually, all residents must have a TB skin test, complete the Practitioner Health Questionnaire, an attestation about policies and procedures, and an annual Graduate Medical Education Survey

Salary

Stipends for residents are competitive with other schools in the southern region. The PGY-1 level stipend for 2005-2006 is $38, 625. The PGY-2 level stipend (once you begin your residency) for 2005-2006 is $39, 140.

Insurance

Health, Life, Disability, and Professional Liability Insurance is provided for all residents and family coverage is available. UAMS will pay a portion of the premium for Dental Insurance for the resident and his/her family members in accordance with the University of Arkansas benefit plan document. In order to access the insurance plans, a resident must enroll in the plans within 31 days of their initial appointment to the training program or during any other open enrollment period.

Employee Health/Preventative Health Services

The UAMS Employee/Student Health Clinic provides annual TB skin testing, the MMR vaccine, and chemoprophylaxis medications if indicated following blood or body fluid exposures.

Paid Leave

Vacation - Residents receive three weeks (21 days including weekend days) of vacation each year. (This cannot be "carried over" from one year to the next.)

Sick/Parental Leave - Residents have 12 days of leave (including weekend days) for medical reasons during each year of training (cannot be "carried over"). Sick leave in excess of 12 days requires a special review by the Assistant Dean and the Program Director. Family Medical Leave (paid and unpaid) may be granted to care for a newborn child or seriously ill spouse, child or parent.

Professional Leave - Residents are given time to attend one out-of-state professional meeting each year of their residency. A stipend of $1,500 is provided for the meeting. An additional $1,500 will be provided for residents who present a paper at a professional meeting, and bonus funding will be provided for attending the required Armed Forces Institute of Pathology (AFIP) Conference in Washington, D.C.

Counseling/Psychological Support Services

The Employee Assistance Program (EAP) provides profess ional counseling and/or referral to community resources for a wide range of problems and situations including stress management, financial concerns, alcohol and other drug abuse, elder care, job/career issues, parenting, legal issues, marital/family problems and personal/emotional concerns. UAMS has pre-paid the entire cost of the program so that the resident is not required to make any contribution to the EAP. However, if the resident is referred to a community resource, he/she is responsible for the cost.

Miscellaneous Benefits

• Credit Union and Banking Services on Campus
• Five white lab coats are provided for the entire residency period
• Free parking
• Personal copies of AAO's Basic Clinical Science Course Series and Albert and Jakobiac's Principles and Practice of Ophthalmology are provided to residents
• Employee group discounts on purchases
• Annual monetary research presentation awards

Terms And Conditions For Employment

In order to enter a training program by the University of Arkansas College of Medicine, all applicants must meet the requirements for eligibility and selection as specified by the policy of the Graduate Medical Education Committee on Recruitment and Appointment (#01), complete a negative drug screen as specified by the UAMS Medical Center Drug Testing policy, review the packet of information sent to them following Match Day, and return employment forms to the Director of Housestaff Records by the designated date.

Moonlighting

In order to be eligible for moonlighting activities, the resident must follow the procedure as outlined in the UAMS College of Medicine GME Committee policy, Moonlighting and Malpractice Insurance Coverage while Moonlighting. Residents are not required to moonlight. The resident must submit a written request (you may obtain the Moonlighting Request Form from the Program Coordinator) to the Program Director and obtain his written approval. This information is contained in the resident's file. Professional liability coverage (malpractice insurance) provided through UAMS does not cover moonlighting activities. Malpractice insurance for such activities is the sole responsibility of the resident. It is the responsibility of the clinical facility hiring the resident to determine whether the appropriate credentials, adequate liability coverage and appropriate skill levels are in place.

Moonlighting privileges will be withdrawn if the resident is no longer performing satisfactorily in the program. In the event permission to moonlight is withdrawn by the program director, the obligation to notify an outside employer is the responsibility of the resident who established that employment and not the responsibility of the program director or UAMS.

Laundry

Five white lab coats are provided for the entire residency period. No laundry service is provided at the institutional level, although individual departments may provide this service.

Computer Facilities

All residents have access to several computer facilities at UAMS, including the Jones Eye Institute, Learning Resource Centers in the Main Library and the Academic Computing Laboratory classroom in the Education II Building.

Restrictive Covenants

Residents in training programs sponsored by the University of Arkansas College of Medicine are not required to sign any type of non-competition guarantee.

Closure/Reduction

In the event that the College of Medicine and/or Program Director decide to reduce the number of residency positions in any training program, the residents will be notified immediately. An attempt will be made to reduce the number of positions over a period of time so as not to affect the residents currently in the training program. If this is not possible, the Program Director will assist the residents in obtaining other residency program positions.

Administration and Oversight

The University of Arkansas College of Medicine Sponsors 53 residency/fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME), and educates approximately 500 housestaff members who rotate through 3 major teaching hospitals. The residency training Program Director, with the administrative assistance of a Program Coordinator, is directly responsible for the educational aspects of the training program. The Graduate Medical Education Committee (GMEC), composed of faculty members and residents, provides oversight of all programs and ensures compliance with the accreditation requirements. In keeping with the definitions used by the ACGME and for this fact sheet, any person in a training program is referred to as a resident which includes interns, residents, fellows (sometimes collectively called "housestaff").

Debra Fiser, M.D. is Dean of the College of Medicine. Jim Clardy, M.D. is the Assistant Dean for GME and the designated institutional official for oversight of the training programs. He is assisted by Mrs. Ann Norwood, the internal review coordinator. Mrs. Dwana McKay, the Director of Housestaff Records, and her staff, collect and maintain all records for employment and certification of residents.

The above information describes terms and conditions of employment and benefits for residents who are accepted into a training program and who complete the registration process. Additional information regarding policies, regulations, and benefits is available through the UAMS website at http://www.uams.edu/gme/toc.htm.