Applications are now being accepted (Deadline: December 20, 2019)

Introduction

The New York Academy of Medicine, in collaboration with the Accreditation Council for Graduate Medical Education (ACGME), is pleased to announce the call for applications for the 2020-22 Jeremiah A. Barondess Fellowship in the Clinical Transaction: Reinvigorating the patient-physican relationship. The overall goal is to enhance the ability of young physicians to conduct the essential elements of the clinical transaction, such as taking the patient’s history, conducting the physical examination, and the application of clinical reasoning, capabilities required for effective clinical care. The program invites early-career (junior) faculty in internal medicine with a university appointment to develop innovative programs that enhance these fundamental elements of clinical care through educational innovation. 

This prestigious award includes funding of $25,000 per year for two years. Awardees will develop and implement programs that lead to significant enhancements in the areas of communicating with patients, conducting the physical examination, and applying clinical reasoning.

Background

The clinical transaction consists of three core skills that impact the patient-physician relationship: obtaining a comprehensive and accurate clinical history; performing a thorough and accurate physical examination; and engaging in a rigorous process of clinical reasoning from the data acquired through these techniques. During recent decades, there has been an erosion of the transmission to medical students and graduate trainees of these critically important skills. There commonly are deficits in the ability of trainees' ability to communicate with patients, conduct the physical examination, and apply clinical reasoning. Importantly, this has occurred in the face of major changes in clinical practice, driven by the aging of the population and an increased burden of chronic diseases. The complexity of patients requires well-developed clinical skills, substantial clinical sophistication, and appropriate use of technology. There is a need to energize medical education and post-graduate training in these basic clinical skills. While the importance of the clinical transaction has long been recognized in medical education, there remains a need to innovate and strengthen teaching of these critically important capacities.

Jeremiah A. Barondess Fellowship

To honor the visionary role of Jeremiah A. Barondess, MD in medical education, and to recognize his teaching of clinical skills at the bedside to generations of medical students and residents, the New York Academy of Medicine established The Jeremiah A. Barondess Fellowship in the Clinical Transaction. The Fellowship will support one fellow with special interest and expertise in medical education related to the elements of the clinical transaction in 2020-22.  The fellow will develop and test an innovative approach to educating medical students, residents, and/or fellows in elements of the clinical transaction.  The Fellowship also will promote supportive institutional structures and processes, with a specific focus on building successful educational experiences related to the elements of the clinical transaction.  An example of responsive applications is the expansion of successful institutional initiatives focused on mentoring for clinical proficiency in the setting of a supportive clinical environment.

Through the Internal Medicine Milestones Project, the internal medicine community, with support and guidance from the ACGME and the American Board of Internal Medicine, has identified four milestones that relate directly to elements of the clinical transaction: Milestones Patient Care 1 (1), Professionalism 1 (16), Professionalism 3 (18), Professionalism 4 (19), and Interpersonal and Communication Skills 1 (20).  The Barondess Fellowship is intended to complement this effort by supporting systematic efforts to develop internists who, by the end of their training, have achieved the aspirational goals for internists in each of these areas.

Fellowship Goals

The goals of the Fellowship are to enhance the quality of the clinical care through innovative and rigorous educational experiences related to the elements of the clinical transaction, to develop evidence of the power of the well-conducted clinical transaction, and to improve the patient experience in clinical care by emphasizing high clinical and technical competence of these elements as well as empathy and compassion. The fellowship funding is intended to provide protected time for a single recipient to address these goals within their institution.

Eligibility

Applications are invited from a medical school, department of medicine, and medical school-affiliated teaching hospitals with an approved internal medicine residency program in the United States.  Candidates should have exemplary clinical skills and a commitment to innovative teaching and training focused on the development of excellence in the fundamental elements of clinical care that impact the patient-physician relationship. The Fellowship is for early-career (less than or equal to five years) faculty with a regular university/faculty appointment (e.g. assistant professors), with key responsibilities for developing, directing, and teaching in a robust, innovative clinical training program. Clinical fellows or senior residents in their last year of training may apply, but must have a junior faculty position/university appointment at the start of the Fellowship funding period on July 1, 2020.

Application Submission and Review

The applications will be submitted online. The Fellowship Committee will review all applications and select the awardee for 2020-22. Applicants are asked to provide a personal statement that addresses the following questions: 1) Why do I want the Barondess Fellowship? and 2) What would the Fellowship mean to me?  They are also asked to address how the Fellowship will have a lasting impact on the institution's internal medicine program.  In addition to a primary focus on the fundamental clinical skills, candidates may wish to include consideration of the impacts on educational and training programs of new factors in the clinical environment, such as the electronic medical record, patient questionnaires, and the use of electronic communication between doctor and patient. 

The award will be $50,000 ($25,000 per year for two years).  The Academy will award the Fellowship to a Medical School and a Department of Medicine with an internal medicine program and its nominee at the 2020 ACGME Annual Educational  Conference, taking place February 27 - March 1, 2020 in San Diego, California. The Fellowship will support the awardee's time and effort (.25 FTE) on the two-year Fellowship related to the training of medical students, residents and/or fellows: the funds from the award can only be used to support the awardee.  Progress Reports will be required at the end of years 1 and 2.

To Begin the Application Process

Create a login and password if you are not already registered.  With your login and password, you will be able to access the online application, including the forms that you must complete and upload.  The application includes sections to be completed by a) the candidate; b) the candidate's department Chair; and c) the Dean.  A letter of support from the internal medicine program director is also required.

For additional Information, contact Laura Pronovost, Senior Associate in the Office of Trustee and Fellowship Affairs, at lpronovost@nyam.org.

CLICK HERE TO APPLY ONLINE

The application should work in all browsers. We recommend that you use Firefox, Chrome or Internet Explorer.

References
Iobst W, Aagaard E, Bazari H, Brigham T, Bush RW, Caverzagie K, Chick D, Green M, Hinchey K, Holmboe E, Hood S, Kane G, Kirk L, Meade L, Smith C, Swing S. Internal medicine milestones. J Grad Med Educ. 2013 Mar; 5(1 Suppl 1):14-23.

Aagaard E, Kane GC, Conforti L, Hood S, Caverzagie KJ, Smith C, Chick DA, Holmboe ES, Iobst WF. Early
feedback on the use of the internal medicine reporting milestones in assessment of resident performance. J Grad Med Educ. 2013 Sep; 5(3):433-8.

Holmboe ES, Yamazaki K, Edgar L, Conforti L, Yaghmour N, Miller RS, Hamstra SJ. Reflections on the First 2  Years of Milestone Implementation. J Grad Med Educ. 2015 Sep; 7(3):506-11.

RECIPIENTS

2019-2021

Chelsea Hook Chang, MD

Development of an innovative curriculum for the Barondess Elective-Advanced Clinical Reasoning

Research conducted at the University of Texas Rio Grande Valley School of Medicine

 

2018 – 2020 

Bethany Brisbin Lockwood, MD

An innovative program with patient- centered aims related to the clinical transaction that focuses on interpersonal skills to impact patient and physician outcomes

Research conducted at The Ohio State University Wexner Medical Center

 

2017 - 2019

Reza Sedighi Manesh, MD

Examining the use of the Human Diagnosis Project ( Human Dx) as a scalable and objective measure of clinical reasoning

Research conducted at Johns Hopkins University School of Medicine 

 

2016 - 2018

Brian Garabaldi, MD

Improving Cardiopulmonary Physical Examination Skills

Research conducted at Johns Hopkins University School of Medicine