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Hospital Medicine Education


The hospitalist faculty at the University of Colorado Hospital are collectively seen as some of the best educators in our system and innovators in curriculum development.  

While the hospitalist training program is the cornerstone of our educational mission at the University of Colorado, we are broadly ensconced in all aspects of medical training at the University of Colorado Denver.  In addition to being outstanding educators, our faculty lead the internal medicine and palliative care fellowship programs, teach on the medical wards, provide instruction at the medical school, and proctor nurse practioner students. 

Additionally, our faculty includes nationally known speakers who have delivered high quality presentations at numerous regional and national venues.  The end result is that ample opportunity and mentoring exist for anyone who wants to become an expert educator or leader in the field of medical education.


Hospitalist Training Program

The hospitalist training program (HTP), which commenced in July 2004 and is the oldest continuously operating hospitalist training program in the country, provides a comprehensive and innovative preparation for residents seeking careers as hospitalists or hospital-based specialists. Because the program is designed to address gaps key gaps in most residency programs—specifically, clinical skills for hospitalist practice, intensive career mentorship, and systems improvement skill development-- our graduates are well prepared to function clinically as a hospitalist and act as leaders and change agents in improving healthcare systems. ​


HTP Tracks

The HTP is available to up to 24 residents and there are two tracks within the HTP--the Traditional Track and Leaders Track. The Traditional Track accepts applications during intern year for entry into the two-year program, which begins after a standard categorical intern year. This track trains participants to be outstanding hospitalists and also emphasizes leadership of projects to improve quality, patient safety, and hospital efficiency. The Traditional Track  also teaches basic  healthcare finance, business of medicine and leadership skills.

The Leaders Track enrolls HTP residents in a three-year program starting at the intern level and is geared towards learners who seek major leadership roles overseeing clinical/hospital delivery systems, quality improvement programs, or hospital administration. Prospective residents apply as 4th year medical students through the NMRP Match. Leaders Track residents attend  all curricular elements available through the Traditional Track, and spend extra time throughout residency focusing in-depth on  hospital operations, healthcare finance, policy, leadership, and management skills.

Both pathways utilize the backbone of the categorical track rotations such that residents are integrated into the overarching residency program and graduate with expertise in both inpatient and ambulatory medicine. However, the HTP substitutes track-specific clinical rotations for other general medical rotations to tailor the training to the needs of future hospitalists. The HTP also includes immersion training in quality improvement, patient safety and hospital efficiency through mentored implementation of quality improvement projects. Additional program features include an individualized mentorship program, a hospitalist-focused journal club, a monthly project conference that affords the housestaff the chance to utilize the key tools and tenets of hospital medicine, opportunities to publish and present work at regional and national level and biannual retreats (Fall in Vail, Colorado; Winter in Winter Park, Colorado). 

Click here​​ for more information! 

Hospitalist Training Program​ Faculty

​Jeffrey Glasheen, MD

​Program Director, Hospitalist Training Program

Darlene Tad-y, MD Associate Program Director, Hospitalist Training Program
Read Pierce, MD  ​Director, Hospitalist Training Program - Leaders Track
Emilie Wagner​ Program Coordinator
 

​Rotations

Hospitalist residents work closely with University of Colorado hospitalist faculty​ and are exposed to an innovative curriculum during their hospitalist rotations. Current rotations include a Hospitalist Preceptorship month that teaches residents the key curricular and structural components to be an outstanding hospitalist. The Consultative and Perioperative Medicine rotation offers ample opportunity to learn the tenets of co-management of surgical patients, medical consultation and acute stroke management. While rotating on the inpatient Acute Care for the Elderly service, hospitalist residents will learn how to expertly care for frail elderly patients, including the importance of care transitions. Finally, all residents design and implement a process or quality improvement project culminating with a one-month Quality Improvement rotation. For many residents, their QI project becomes a scholarly activity, giving them a head start on an academic career. All rotations are available as electives for those who are not in the program

Hospitalist Preceptorship

Residents spend one month during their second and third year in this innovative learning environment with the following attributes: 

• Unique mentorship experience in hospital medicine working one-on-one with an attending at University Hospital.

•High-yield educational experience for anyone considering a career in hospital medicine or health system leadership with structured learning around the role of hospital physicians in the rapidly changing healthcare environment.  

• A tailored curriculum which includes coaching on individual clinical efficiency, understanding the role of policy on physician practice, and learning “how hospitals work.”

•A schedule and workflow that approximates the community hospitalist model with no more than 18 shifts per month, daily admissions, and no overnight call.

 

Consultative, Perioperative Medicine and Stroke

​​Residents spend one month during their second and third year on the consultative and perioperative rotation. Data supports that nearly one-third of a hospitalists' job consists of consultative, perioperative and neurological work. This rotation stresses the co-management model of care whereby patients are seen collaboratively with our orthopedic and neurologic colleagues. Additional consultative work is provided to other non-medical services. Daily didactics stress key issues such as the pre-operative cardiac and pulmonary evaluation, perioperative diabetes and steroid management, the prevention of post-operative venous thromboembolism and the management of post-operative fever. The neurology component stresses the medical management of the acute stroke patient. As a member of the Acute Stroke Team, HTP residents see first-hand the presentation and management of acute ischemic and hemorrhagic strokes. Neurology-trained hospitalists guide the residents through the physical exam, imaging interpretation and management of acute stroke and TIA. These clinical offerings are complemented by didactics surrounding secondary prevention and hypertensive and glycemic control as well as general neuro-anatomy and the physical exam. Other acute neurologic disease states are covered as well. 

Acute Care for the Elderly

Recognizing that 20% of the population will be over the age of 65 years old and that this population suffers the highest burden of hospital avoidable harm, we have developed an inpatient geriatrics rotation focused on improving care of this vulnerable population.

All HTT residents rotate on this hospitalist-run service in the 2nd year.  A formal curriculum in hospital-based geriatrics has been developed and is taught through out the course of the month.  Additionally, resdients round with a multi-disciplinary team, which includes geriatricians, physical therapists, social workers, pharmacists and nurses all focused on improving the care we give to our elderly poplulation.  The ACE service aims to integrate a vulnerable population, a multi-disciplinary team and the learners burgeoning skills in process improvement to produce rapid tests of change, PDSA cycles and in-depth process improvement projects to ultimately provide the saftest, highest quality of care.

Specific Topics in the ACE Curriculum:

  • Physiology of Aging

  • Medications in the Elderly

  • Dementia and Delirium in the Elderly

  • Advanced Directives and Resuscitation


Palliative Care

Palliative care and end-of-life decision making are domains of hospitalist practice.  Still, few hospitalists have formal training in these areas.  The palliative care rotation incorporates both inpatient and outpatient palliative care with dedicated didactics to help improve this educational and experiential mismatch.  The rotation is a perfect complement to the annual palliative care retreats.

Specific Topics in Palliative Care Curriculum:

  • End-of-life decision making
  • Communication
  • Pain and symptom management
  • Determining decision-making capacity
  • The hospice benefit
  • Coordinating transitions of care

 

Quality and Systems Improvements

As part of the longitudinal QI curriculum present throughout the HTT track, this month provides HTT residents dedicated time to deepen their understanding of quality improvement (QI) principles and implement their projects.  Higher level teaching sessions are provided throughout this month which are complemented by QI coaching for each QI team.  Residents are able to put into effect small tests of change in a live environment.  This month serves to cement knowledge and skills residents have gained through authentic experience in QI.

Specific Topics in Quality and Systems Improvement Month:

  • Tools for quality improvement
  • Interpreting quality data
  • Graphical presentation of change data


Hospitalist Training Track Curricula


Longitudinal Curriculum

The promis​e of the hospital medicine movement is that hospitalists will provide higher quality care. However, this will not done by simply becoming better clinicians, rather through systematic quality improvement. Therefore we have developed a comprehensive curriculum focused on providing future hospitalists with the knowledge and skills required to become successful change agents in patient safety and quality improvement. Delivered in twelve, 4-hour sessions, the curriculum covers concepts of quality improvement, patient safety, the business of medicine, medical education and health care policy as they pertain to a practicing hospitalist. The teaching sessions also provide leadership skills that will enable our graduates to translate their patient safety and quality improvement knowledge into actionable process improvements. The sessions are highly interactive, informative and fun. Residents have the opportunity to apply the skills learned during these sessions during their formal, mentored QI project time. In the end, residents graduate well prepared to immediately improve the healthcare systems they enter as hospitalists.

Specific topics in the HTT Longitudinal Curriculum:

  • Quality improvement, including Tools of QI, Leading change and Implementing tests of change. Residents apply the knowledge and skills learned during QI rotation
  • Business of Medicine, including Business Drivers, Understanding Financial Statements, and the CEO's mindset
  • Health Care Policy, including the Role of the Physician in Health Care Policy, Understanding Medicaid and Medicare, and a visit to the Colorado State Capitol

Career Development Curriculum

As part of the longitudinal curriculum, the program prepares future hospitalists for the rigors of attaining and succeeding in their future profession.

Specific topics in Career Development Curriculum:

  • Developing an effective curriculum vitae
  • Techniques for successful job interviewing
  • How to approach contract negotiations
  • Differentiating academic and community hospitalist jobs

Quality Improvement Curriculum

All HTT residents participate in a longitudinal quality improvement project with the University of Colorado Hospital. The faculty-mentored QI project provides the experiential component to the 2-year curriculum, which includes an elective month dedicated to QI. The didactic curriculum covers the key tenets of QI and patient safety and teaches residents how to develop, implement and measure a QI project. The goal is to inspire and equip physicians to function as change agents in their future roles as hospital leaders.

The cornerstone of the QI curriculum is experiencing quality improvement first-hand as change agents for a quality improvement project at the University of Colorado Hospital (UCH). HTT residents work on a team-based project along with University Hospital stakeholders to improve hospital processes. The projects are closely mentored by hospitalist faculty with additional QI expertise and support from the group at each step of the project.

Recent Quality Improvement Projects:

  • Reducing Informal Restraints in the Frail Elderly Patient.  Faculty mentor: Heidi Wald, MD
  • Improving Quality and Timeliness of Residents' Discharge Summaries.  Faculty Mentor: Darlene    Tad-y, MD
  • System Redesign to Achieve Rapid Thrombolytic Treatment of Stroke: Applying Interdisciplinary QI Principles to Treat Patients in the Golden Hour.  Faculty mentor: Ethan Cumbler, MD, FACP
  • Physician-centered Initiative to Reduce Inpatient Falls at the University of Colorado Hospital.  Faculty mentor: Dimitriy Levin, MD​


HTT Scholarship

Hospitalist residents are provided ample opportunities to participate in scholarly activities.

Project Conference

This monthly conference allows HTT residents to use the basic concepts they are learning. All residents rotating on a hospitalist month present a short project to the HTT residents and hospitalist faculty. Conferences are themed around important tenets of hospital medicine such as patient safety, healthcare finance, hospital efficiency, healthcare policy and quality improvement.

Hospital-based Research

Residents are allowed to use 1-2 months during their residency toward completing a research project. Several hospitalist residents have chosen to work with our hospitalist faculty on hospital-based clinical research and quality improvement research projects.


Hospitalist Training Program—Leaders Track

Mission:  The Hospitalist Training Program (HTP)—Leaders Track at University of Colorado, Denver, prepares residents interested in hospital medicine and health care systems management for lifelong careers as physician executives. The program aims to produce leaders who are at the forefront of national and international efforts to improve the quality, safety, and value of health care.

Curriculum:  The HTP—Leaders Track is the nation’s only comprehensive, 3-year training program for internal medicine residents who seek careers as both clinicians and physician executives. The program utilizes structured educational sessions, intensive mentorship, and real-world multi-year projects to equip participants with expertise and advanced skills in 5 domains:
    • Management of hospital and health systems operations (R1 year)
    • Health care policy and financing (R1 year, R2 year)
    • Leadership of large, complex organizations (R2 year, R3 year)
    • Change management and quality improvement (R2 year, R3 year)
    • Practice of high-value, evidence-based hospital medicine (all years)
    The highlight of the program is a capstone “Leadership Project” during R2 and R3 year, which allows participants to apply their knowledge and skills by leading an important, highly visible operational initiative within University of Colorado Hospital or University of Colorado Health System. 

    Participants have protected time for HTP-Leaders Track activities across all 3 years of residency, including month-long electives during the R2 and R3 years. All HTP-Leaders Track participants are part of the broader Hospitalist Training Program, which includes tailored clinical rotations in hospital medicine and advanced quality improvement training during the R2 and R3 years.

    Graduates:
    Upon completion of the program, graduates are prepared to assume high-level roles leading clinical operations, organizational strategy, and quality and patient safety enterprises in hospitals or health care systems. Early in their careers, we expect graduates to pursue executive positions through which they can directly influence large-scale change (e.g., chief medical officer, chief quality officer, chief or chair of a large academic unit, chief health information officer, etc).

    For more information contact Read Pierce, MD​

    Advance​d Practice Fellowship in Hospital Medicine


    ​Background

    The Advanced Practice Fellowship (APF) is a one-year fellowship program developed to help early-career Nurse Practitioners and Physician Assistants (or those coming back to hospital-based medicine) succeed in the inpatient environment. Recognizing that Advanced Practice Clinician providers are increasingly being utilized in the hospitalist model, our goal is to ensure NPs and PAs have the necessary skills to succeed. Ideal candidates are those interested in becoming a hospitalist or working in a primarily hospital-based specialty. The APF is the first of its kind in the country, having started in 2009, and builds on the successes the University of Colorado Hospital Medicine Group has had in developing its Hospitalist Training Program for Internal Medicine Residents.  

    Program Description

    The program uses a step-wise approach to developing learners into well-rounded, competent inpatient providers.  It has a strong clinical core but also utilizes frequent didactic sessions and case-based learning.  Fellows will find dedicated MD, NP and PA faculty educators who are always available to assist their learning.  The program utilizes a Multi-phase system:

    Phase 1: Boot Camp (2 weeks)

    During the first two weeks, the learner will participate in aspects of the University and Hospital Medicine Group orientation including computer training, billing training and specific topic instruction such as how to take a history and perform a physical and the  approach to common clinical conditions.  

    Phase 2: Professional Development  (6 weeks)

    This phase focuses on the learner by placing the fellow in a team consisting of a physician faculty member, a NP or PA faculty and the fellow.  Beginning with one patient and increasing to as many as 4, the fellow will be responsible for the care of individual patients.  These patients will be presented to the attending physician and patient-based teaching and clinical reasoning instruction will be offered daily. In addition, a topic-based curriculum will be given to the fellows, averaging 2 talks a week for phase 2. 

    Phase 3: Clinical Development  (8 weeks)

    The focus turns more to clinical medicine with a concentration on the development of clinical competence and efficiency.  The pace picks up as fellows now carry a daily patient load of 4-6 patients, again dependent on the fellow.  The topic-based curriculum continues from phase 2.   

    Phase 4: Skills Refinement  (24 weeks)
    The focus of the third phase shifts toward more autonomous practice while sampling different care environments.  Learners rotate weekly through 9, 3-week blocks as follows:​
    • Week 1: Evenings (3p-12a) - Focus on refining admission skills through caring for a high-acuity panel of patients while developing triage skills.  Dedicated didactic time daily.
    • ​Week 2: Nights (7p-7a) - Focus on further refining triage skills and efficiency through cross coverage and admission of high-acuity medical patients. Dedicated didactic time daily.
    • ​Week 3: Subspecialty (days) - Focus on developing skills in neurology, oncology, stroke, geriatrics, palliative care consultative and comanagement medicine or other specialty of learner’s interest. This is also an opportunity for exposure to potential employers for the coming year. ​​​​Dedicated didactic time daily.
    Phase 5: Capstone (8 weeks)

    The focus of the final 8 weeks is to place the fellow on a service to perform admissions and care for daily patients to as much mimic a real-world position as a hospitalist NP or PA.  This phase is meant to hone the skills gleaned over the prior 10 months and improve the confidence and efficiency of the soon to be graduating fellow.  Average daily census of 7-10 patients.

    Optional Subspecialty Training (4 weeks)

    This optional rotation can be set up as part of the fellowship as an apprenticeship prior to starting work in a hospital subspecialty.  As graduates of the APF are expected to take jobs in hospitals, this extra rotation can be utilized to apply recently acquired general medical skills to a subspecialty area prior to commencing a job in that field.  For example, an APF interested in a position in the cardiac, neurosurgical or bone marrow transplant field could do an elective month rotation in that area of interest at the University of Colorado Hospital.  Rotations are subject to approval by the APF and Subspecialty Director and are completely optional.  This additional month is not guaranteed to all AP Fellows.

    Other Features

    The APF program utilizes simulation 2 times during the year to objectively measure the learner’s progress.  We also enroll learners in the Hospitalist Training Program curriculum such that they receive up to 50 hours of learning regarding healthcare finance, hospital business, quality improvement and patient safety.  The fellows will receive instruction on the job market, résumé development and contract review and negotiation.  Finally, fellows attend our monthly Journal Club, Project Conference and Grand Rounds as well as the Rocky Mountain Hospital Medicine Symposium.

    Hours

    The APF is generally a Monday-Friday program with 10-hour days.  During the third phase the fellows will rotate on the evening and night shifts as noted above.  No vacation will be permitted during the first 16 weeks of the fellowship.  After that, the fellows are allowed to take 4 weeks of vacation in one-week blocks (Mon-Friday). Vacation requests are accepted after the first month of fellowship on a first-come first serve basis.  Time off for major holidays cannot be guaranteed.

    Salary and Benefits

    We offer a competitive fellowship salary of $65,000 for the year.  AP fellows are full faculty members at the University of Colorado and receive the same benefits package as that offered to other faculty members.  This is a one-year fellowship with an optional subspeciality month (with APF Director approval) with no guarantee of employment beyond the fellowship period. Salary is commensurate with skills and experience. The University of Colorado offers a full benefits package. Information on University benefits programs, including eligibility.

    Application

    There will be six positions available each year for the following start dates:

    • August 1st
    • October 1st
    • December 1st
    • February 1st
    • April 1st
    • June 1st 

    If interested, please apply at www.jobsatcu.com under Job Posting F00976.  If you have additional questions, you may also email Emilie Wagner at emilie.wagner@ucdenver.edu.

    Minimum Qualifications

    • Must be an NP or PA
    • Must be Nationally certified and certification exam results must be provided 60 days prior to start date

    Desired Qualifications

    • Acute care training or experience in adult inpatient medicine preferred

    Special Instructions to Applicants

    Applications are accepted electronically through the University Job Site​, refer to job posting F00976. 

    The following (5) documents are required in order to be considered: a cover letter, CV/resume, (1) letter of recommendation, three (3) professional references contact information and a one-page personal statement explaining why you would like to be a part of the fellowship. Applications missing any of these documents will not be reviewed.

    Do not submit documents (via email) to the job posting contact.

    Review of applications will continue until the position is filled.

    The University of Colorado is dedicated to ensuring a safe and secure environment for our faculty, staff, students and visitors. To achieve that goal, we conduct background investigations for all prospective employees. Some positions may require a motor vehicle records check.

    The University of Colorado is committed to diversity and equality in education and employment.

    At this time The Division of General Internal Medicine is unable to support VISA sponsorship.

    Application

    We are currently hiring for Academic Year 2014 (July 2013 - June 2014).  The job posting is below. If you have additional questions, email Emilie Wagner​

    Hospital Medicine Fellowship

    Recognizing that many physicians finish residency unprepared to become highly functioning hospitalists we have developed an innovative fellowship training program constructed from the key tenets of our hospitalist training program but modifiable to the needs of the trainee.  This is especially attractive to internal- and family medicine-trained physicians from programs without a strong critical care background.  The program is also ideal for practitioners who have been away from hospital medicine for years and are looking to transition into the role of hospitalist.  The program excels at teaching both the clinical and non-clinical aspects needed to be an outstanding hospitalist in either an academic or community environment.​

    Hospitalist Training Program Residents​​​

    ​​​Steven Clements, MD ​Hospitalist Leaders Track, PGY1
    ​Elizabeth Corey-Pacheco, MD Hospitalist Leaders Track, PGY1
    ​Robert Fraser, MD Hospitalist Leaders Track, PGY1​
    ​Stefan Law, MD Hospitalist Leaders Track, PGY1
    ​Tyler Anstett, DO Hospitalist Leaders Track, PGY2 
    ​Gregory Barron, MD Hospitalist Training Track, PGY2 
    ​Michelle Barron, MD Hospitalist Training Track, PGY2 
    ​Matthew Hoegh, MD Hospitalist Leaders Track, PGY2 
    ​Mysha Mason, MD Hospitalist Training Track, PGY2 
    ​Tyler Miller, MD Hospitalist Training Track, PGY2 
    ​Ryan Murphy, MD Hospitalist Training Track, PGY2 
    ​Natalia Roldan, MD Hospitalist Training Track, PGY2 
    ​John Biebelhausen, MD Hospitalist Leaders Track, PGY3 
    ​Julia Clemons, MD Hospitalist Training Track, PGY3 
    ​Karina Handoyo, DO  Hospitalist Training Track, PGY3
    ​Matthew Hansen, MD Hospitalist Training Track, PGY3 
    ​Serena Jain, MD Hospitalist Leaders Track, PGY3 
    ​Kyle Lamb, MD Hospitalist Training Track, PGY3
    ​Adrienne Mann, MD Hospitalist Training Track, PGY3
    ​Allison Nitsch, MD Hospitalist Training Track, PGY3


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