30. THE BENEFITS OF A TRULY INDIVIDUALIZED CURRICULUM

Background In response to the 2013 ACMGE Program Requirements that mandated “a minimum of six educational units of an individualized curriculum determined by the learning needs and career plans of each resident and... developed through the guidance of a faculty mentor,” many pediatric programs developed career-based tracks. Because tracks have the potential to introduce unnecessary and potentially harmful rigidity, our program aimed for each resident to develop a truly individualized schedule. Objective Allow each resident in our program to develop a unique individualized schedule through faculty guidance. Methods A new position, the Director of Individualized Education (DIE) was created with 0.05 FTE departmental support, which translates to approximately 100 hours of protected time, or approximately 2.5 hours per resident in a program of approximately 40 total residents. A new resident block schedule was created that is broadly divided into three categories: A) Required rotations (94 weeks) include those mandated by ACGME requirements plus other rotations required by the program. B) Selectives (12 weeks in the third year) are chosen from a limited menu based on hospital staffing needs. C) Electives (38 weeks, available as 2- or 4-week experiences) are structured to meet ACGME requirements for “key subspecialties,” “additional educational units,” and the “individualized curriculum,” following the “double counting” rules from prior ACGME FAQs. For the 32 such weeks that occur in the PGY2 and PGY3 years, rotations are chosen after a meeting between the resident and the DIE. A flowsheet for each resident is reviewed annually by the DIE and semi-annually by the Program Director or an Associate Program Director to ensure compliance with ACGME requirements. Results 54 residents have completed our program under the current scheduling system, and no two residents have had identical schedules. On the ACGME annual survey of PGY3 residents from 2016 to 2018: 1) 97.4% of our residents (vs. 86.6% nationally) chose Agree or Strongly Agree for the question, “In my training program, a portion of my training is based on my learning needs related to my career plans.” 2) 94.8% of our residents (vs. 92.9% nationally) chose Agree or Strongly Agree for the question, “My training program provides a faculty mentor or advisor to help develop learning activities to meet my learning needs related to my career plans.” Outcomes A relatively small investment (0.05 FTE for the DIE) has been sufficient to allow each resident to receive proper mentoring in the context of thoughtful discussions about both career goals and current strengths/weaknesses. The DIE has also had time to invest in building relationships with divisions and departments throughout our childrens hospital and academic medical center, resulting in many new and innovative rotations, including GI pathology, transport (prehospital) medicine, maternal-fetal-medicine, complex primary care, and many others. Ultimately, we have been able to provide each resident with a unique schedule and a high level of satisfaction with the individualized curriculum.