Year 3. October 21. Building Community.
With more than 1,200 full time faculty, 600 trainees and 2,500 staff members, our department represents a large and diverse community singularly focused on Leading in Innovation, Transforming Care and Advancing Health for All. Achieving these goals together requires us to collaborate, cooperate and jointly focus on advancing our strategic agenda. As such, building community, convening to hear from leadership, learning from and listening to each other represent essential activities to ensure that we are all on the same page as we plan for the future. This week, I share summaries of recent activities across our many constituents that exemplify this ethos.
2024 DMPG Annual Meeting
The Department of Medicine Professional Group’s (DMPG) annual meeting took place on Oct. 2 in Westwood, where DMPG President Michelle Hwang, MD chaired a sweeping overview of the state of the department and new initiatives at our clinical practices in the year ahead. Dr. Hwang began by summarizing impressive statistics about the UCLA Department of Medicine's (DoM) productivity: In the past fiscal year, faculty and providers in DoM saw more than 780,000 unique patients across 2.7 million visits and 6.3 million encounters. That is an increase of 12% over last year. These figures represent an enormous amount of work and dedication on the part of the DoM, and I am very grateful to all of you for your commitment to high-quality patient care.
Provider Page Comments Roll Out
The DMPG welcomed members of the UCLA Health patient experience team to discuss a new patient survey comment program that will roll out in 2025. Patient Experience Program Director Annie Infante and Clinician Patient Relationship Program Director Christopher Fonseca explained that adding patient comments to physician pages will give patients the transparency they need to make decisions about providers. These comments have and will continue to be collected through the ambulatory text survey that is sent out to patients following their encounter with a physician in our clinics. All of them are reviewed by Press Ganey before they are shared with providers, who will have the opportunity to appeal comments that do not accurately represent the encounter before they go live on the website. Our faculty are already being evaluated and online commentaries are being posted by third party vendors. This approach puts us in the driver's seat and provides a credible and trusted source of public-facing patient feedback. The good news is that the overwhelming majority of the feedback and comments obtained via these survey and posted for our faculty in a pilot rollout are superlative.
Comment reports will go out on an ongoing basis between October and May, so stay tuned for those in your inbox. I believe that this transparency, now widely adopted by most health systems, will not only improve the quality of care at UCLA Health but will demonstrate to those thinking of entrusting their care to us that they can be confident in doing so. I thank the members of the patient experience team for joining us to describe this program and answer the many faculty questions that were raised in the discussion period.
UCLA Ranked No. 1 by Vizient for Ambulatory Care
A highlight for me was sharing updates about the DoM and of course engaging with faculty during the subsequent Q&A. I was pleased to share the results of the performance of our outpatient clinics that were recently released by Vizient, an organization with membership from most health systems in the USA that is focused on performance and quality improvement. The most recent Vizient Ambulatory Quality and Accountability (AQA) Scorecard, which tracks the quality of outpatient care with regards to access to care, continuum of care, quality, efficacy and equity, was released on Sept. 18. For 2023-2024, our overall score made us the top-ranked health system among our peers, a significant milestone for our organization. Scores were largely driven by DoM clinics. We scored particularly well in the quality, continuity of care and access domains. Congratulations!!
The report also identified opportunities for improvement, and we will be focusing on these in the coming months as we strive to sustain the highest quality ambulatory health care services for our patients.
Strategic Plan in Full Swing
I also shared the DoM’s progress on strategic plan initiatives, starting with our goal of providing the highest quality patient-centered, innovative, integrated healthcare for all. Much work is going on behind the scenes on this front, specifically with regards to access, infrastructure and culture. For example, we are actively involved in discussions around service programming for the forthcoming increased capacity at Ronald Reagan, after the Resnick Neuropsychiatric Hospital relocates to mid-Wilshire. Similar conversations are going on with regards to the 260 additional beds we will have at UCLA West Valley.
Speaking of UCLA West Valley, much planning is underway for recruiting UCLA physicians to provide services there, starting with hospitalists. We are also planning for the deployment of subspecialty services to support the care of the growing number of UCLA patients that will be cared for in our new facility.
For the Research domain of the strategic plan, we are hard at work developing plans that will strengthen our research infrastructure; enhancing the quantity and quality of research support staff; onboarding new research focused faculty; and putting in place tools to raise the profile of the DoM research portfolio both internally and externally. One important milestone was the deployment and analysis of a department-wide survey that sought to identify research faculty priorities. The top domains that were identified for improvement in the survey clustered around infrastructure and support — specifically, strengthening and recruiting research personnel, providing administrative support for research and developing shared resources to support the research mission. We are actively working on all these and look forward to reporting progress in the future.
Our Education portion of the strategic plan is currently focused on mentorship and leadership development. We are in the process of creating mentorship guidelines and trainings for those who work with residents — whether in the clinic or in research— and look forward to providing more updates on that soon. We are also developing similar programs that focus on professional and career development of the staff who support the DoM’s missions.
I was pleased to preview the launch of our new online Journal, Proceedings of the UCLA Department of Medicine. As all our faculty know demonstration of creative work is an important expectation for academic advancement and promotion at UCLA. This new journal which builds on the legacy of Proceedings of UCLA Health, will be hosted on the open access journal platform Cureus and will offer many new benefits for faculty. While Proceedings does not officially launch until early next month, its first article — a case report on cardiac tamponade led by VA hospitalist Satya Patel, MD — already went live on Sept. 27, and additional submission reviews are underway. To support the work of Editor-in-Chief Michael Lazarus, MD, we recently appointed Dianne Cheung, MD, MPH and Ramya Malchira, MD to the role of associate editors. Be on the lookout for more information about Proceedings in the next few weeks.
Our strategic plan also includes community investment and engagement initiatives that align with our goal of advancing health and improving outcomes for the diverse communities we serve. Here we are currently focused on building collaboration with community organizations that care for under-resourced patients and on providing high-quality health equity training for everyone in the DoM. This includes strengthening our agreements with Federally Qualified Health Centers so that we can begin to deploy UCLA DoM faculty in those facilities. There has been overwhelming faculty interest in working in safety net settings, and I anticipate there will be many more of these opportunities moving forward. Additionally, within the DoM EDI Office, we have invested in a program manager for staff initiatives and initiated programming that supports understanding of EDI topics and builds community, such as the Lunch & Learn sessions.
Efforts to improve faculty well-being are a core part of our strategic plan as well. Our wellness initiatives, such as the creation of the DoM Wellness Office and its ambitious programming, appear to be paying off in the form of an overall decline in physician burnout that positions us ahead of many of our peers. We have appointed wellness champions in every division; these faculty members are the eyes and ears of the DoM with regards to faculty wellness, so please feel free to reach out to them with feedback. Our wellness champions have also helped lead our focus groups, which seek to obtain more granular data and feedback that will continue to inform our department's wellness initiatives. We have completed 20 focus groups so far, with four more to come. I want to express my appreciation to our focus group participants —your contribution offers us essential insights that will help improve both your own working conditions as well as those of your peers.
It was a pleasure to learn about and share our progress as a department, and I am grateful to the DMPG LEADERS who made this event a success. I also enjoyed engaging with you in the vigorous and robust Q&A session at the end of the DMPG meeting. A special thanks to Dr. Hwang for chairing and to the Department of Medicine Professional Education Committee Janet Pregler, MD; Arielle Bilek, MD; Amir Rabbani, MD; Joash Wampande and Paloma Rangel for organizing the meeting.
In other DMPG news, on Oct. 13 the DMPG held a webinar to discuss faculty compensation. It was good to see more than 300 of you in attendance. It was clear that there is a high level of engagement on these issues. We hope we were able to address many questions but recognize we did not have time to get to all of them. We have archived the ones we did not answer and will reply in various forums in the future, which may include a follow-up webinar. Thank you for your participation.
Internal Medicine Residency Recruitment is Under Way
A few weeks ago, I shared conversations with our fellowship program directors about their priorities, process and hopes for this recruitment cycle. Now it’s time to hear from those who lead our internal medicine residency programs, which will soon begin interviewing prospective trainees.
For Lisa Skinner, MD, program director of the UCLA Internal Medicine Residency Program, the top candidates are those who show signs of leadership potential, are passionate about what they do and are dedicated to providing the highest quality care for our patients.
“We want to train people who are going to make a mark in medicine in their area of interest, whether that’s research, advocacy, patient care, leadership or clinical operations,” she said. “Whatever it is, we want to equip these brilliant young physicians with the leadership and clinical skills to drive the future of medicine.”
Gifty-Maria Ntim, MD, MPH, director of the Med-Peds Residency Program, wants applicants to demonstrate that they share the program’s values of excellence, service and a commitment to diversity. They should also have reflected on their reason for applying to a combined program like hers, on top of having the academic track record to show that they can succeed in a robust environment.
“It’s not enough to pick a combined program because you can’t quite decide between the two,” she said. “You should have given some thought to it. We want to see the Med-Peds pitch.”
Excellence matters for the UCLA Dermatology Residency Program as well, according to Program Director Marcia Hogeling, MD. Dermatology is on the lookout for candidates who exhibit compassion, academic prowess and signs of being a team player — qualities that are essential in a small program where everyone has many responsibilities.
“The resident helps oversee the med students, independently evaluates patients and presents to the attending, so they need to be able to multitask and work as a group,” Dr. Hogeling explained. “We see a lot of patients and our appointment times are short, so to get through clinic we have to work as a team.”
Meanwhile, Mina Ma, MD, director of the UCLA Primary Care Residency Program, is seeking trainees with the excellent interpersonal skills a PCP needs to care for patients and develop longitudinal relationships.
“We hope they are excited about education and at the same time commit to social justice and health equity,” Dr. Ma said. “We also hope that our trainees demonstrate flexibility and adaptability which will be important for the changing landscape of primary care.”
To ensure that trainees are both highly qualified and come from a wide range of backgrounds, all of our IM residency programs employ a holistic review process that considers applicants’ trajectories to get where they are now, or their “road traveled.” Another way to ensure a diverse cohort is to have diversity among the reviewers themselves, as Med-Peds does.
“I think that by extension, diversity among reviewers helps to identify a diverse initial applicant pool of interviewees,” Dr. Ntim explained. She and other program directors noted that that when they speak of diversity, they’re not just talking about race — gender, LGBTQ identity, socioeconomic background and extracurricular interests are all considered.
“Diversity is important to us because we’re trying to create a microcosm of the world as it should be,” she said. “In helping us get to the next level, we really put diversity front and center as we review applications and decide who should be part of our Med-Peds family.”
To boost diversity among its trainees, the UCLA Physical Medicine and Rehabilitation (PM&R) Residency Program strategically blinds faculty interviewers to USMLE/COMLEX scores, program signals and geographic preferences so they can focus on personal interactions and character rather than test performance or a candidate’s perceived commitment to matching with the program.
“This method has resulted in some of the most diverse and successful ranked:matched ratios in recent years,” Dixie Aragaki, MD, program director of the PM&R residency, said. In addition, her program plans to continue to run completely virtual interview sessions to support equity of access by reducing the financial and time burden of travel and pressure to attend in-person events.
We invite specialists and research faculty who want to get involved in trainee recruitment. Please reach out to Dr. Skinner about interviewing applicants or respond to our outreach soliciting your participation. The effort is especially in need of gastroenterologists, rheumatologists and nephrologists to take part in the process.
“We find that while we have a lot of hospitalists interviewing and quite a number of primary care physicians as well, we have many fewer sub-specialists who are available to interview,” Dr. Skinner said. “More sub-specialists and more researchers would really round out our interviewer pool to show the applicants what the opportunities look like at UCLA.”
Additionally, Dr. Hogeling is interested in hearing from faculty who have worked with exceptional medical students who are interested in dermatology.
“If it’s a student, especially a UCLA student, who has done extremely well in internal medicine and is applying to derm, it is helpful to let residency leadership know that this person is outstanding or to write them a letter of recommendation,” she said.
As many of you already know, our residency programs are filled with LEADERS who excel in scholarship, teaching, leadership and patient care. When asked what they hoped for their incoming classes, all of our IM residency program directors shared a resounding sentiment: more of the same.
“I want them to follow in the footsteps of our current residents. I want them to publish in high impact journals like Amber Tang, MD has. I want them to engage as community leaders, as a lot of members of our Internal Medicine Resident Equity, Diversity & Inclusion Committee and our Minority Housestaff Organization have,” Dr. Skinner said. “I want them to show up bringing cheer and spirit to our retreats like Tyler Morad, MD and Sam Bolivar, MD have. Or show up ready and passionate about teaching and pushing their skills forward, like Nancy Miles, MD. A lot of what I want for them is the same things that our current residents have.”
And when it comes to where her residents goes next in their careers, Dr. Ntim noted that she views their success as her success.
“I honestly think that as a program director, one of the things about my job that I love the most is that I’m a facilitator of dreams. I believe I shouldn’t put a box around where people can go and I will share with you that I’m very happy with the recent classes that we’ve recruited,” she said. “The intern class is just amazing, and it’s really nice to see what they’re already coming in with and how we can help them take advantage of all that UCLA has to offer so they can be the best versions of themselves.”
Fall 2024 Internal Medicine Retreat
While recruitment season was getting underway, our education team was also busy preparing for the annual internal medicine retreat! This year, nearly 200 residents joined us at Covel Commons to take part in a day of workshops and team building activities. I was happy to join the residents and program leaders to discuss the latest developments in the UCLA Department of Medicine, such as the launch of our strategic plan — the roadmap that will position us at the forefront of innovation in medicine and allow us to lead in innovation, transform care, and advance health for all.
As we embark on this journey of transformation, I reflected on the impact that we are having across the health system. Our residents are caring for 45-50% of patients within the health system, underscoring the important role each plays in our mission. I know that each trainee is destined to become a LEADER in internal medicine. They will carry our legacy forward through their expertise and commitment developed while training here.
I already see their leadership as they are earning top awards such as the Teaching with Humanism Awards from the David Geffen School of Medicine at UCLA, publishing in high impact journals, being recognized for their exceptional patient care, and matching into prestigious fellowship programs. Notably, I see it in the morning case reports they produce on a weekly basis. Case reports are valuable scholarly works that can be submitted through our department’s new Cureus channel. I invite residents to submit their work, which continues to demonstrate our leadership in patient care.
Video Highlight: IM Residency Fall Retreat - Morning Session
The future of medicine is bright due to our trainees. I invite you to enjoy a few pictures from their day of learning, community building, and fun.
Video Hightlight: IM Residency Fall Retreat - Afternoon Session
2024 DoM Executive Admin Summer Retreat
IM residents weren’t the only ones who recently enjoyed some fun in the sun. On Sept. 26, over thirty staff members from the UCLA Department of Medicine Executive Administration Offices marked the change of seasons by holding the inaugural DoM Admin Summer Retreat. This event was a heartfelt thank you for the vital role they play in supporting our departments' operations, programs, and strategic initiatives. Taking advantage of both the perfect weather and UCLA’s fantastic recreational facilities, the group gathered at Sunset Canyon Recreation Center for an adventurously fun day of team building on the Challenge Course. Whether they were conquering a peak or supporting a teammate through a challenge, this day was all about building connections and celebrating their collective strength.
I am grateful to the DoM Executive Administration team for all their hard work throughout the year. Please enjoy these photos from the event!
In closing, it is a great and personal privilege for me to lead such an amazing community.
Dale
P.S.
I host many meetings in my office each week. Some are more special than others, particularly when I have the chance to meet family members of our amazing faculty and staff.
Meet Amaris (left) and Aleah (right) who were hanging out with their dad Juan Varela, Project Manager, earlier this week on Indigenous Peoples' Day.
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