What a Week! The 1st Hospitalist Mini-College and our Annual Hospital Medicine CME Course

By  |  October 31, 2008 | 

Rolling out a new “product” in a nasty economy is usually a formula for disaster. But last week we held the first-ever “Hospitalist Mini-College,” and it was an rousing success.

The idea was this: hospitalists have lots of places to go to hear clinical lectures, and now a few options for leadership training and to learn “how to run a program.” But rank-and-file hospitalists, who now number nearly 25,000, have no opportunity to recapture what was fun about residency (we tend to block out the bad parts): to examine a patient with an virtuoso teacher, to learn new procedures under supervision, to try to puzzle out a complex diagnosis.

With this in mind, I decided to build a new kind of CME experience for hospitalists: an intense, 3-day immersion experience, delivered on-site at UCSF Medical Center. My hope was that it would provide both unique educational content and even a bit of inspiration for the attendees – recharging their batteries in a way that no traditional CME conference could do.

One of the wonderful parts of my job is that after I come up with these partly-baked ideas (“half-baked” would be too charitable for this one), I get to work with spectacular colleagues who turn it into a beautiful soufflé. In this case, the key colleagues were Niraj Sehgal and Arpana Vidyarthi (who co-chaired the conference and did 99% of the work), and our division administrator Maria Novelero, ably assisted by our staff (Kat Li, Oralia Schatzman, Christine Lam, and Kapo Tam). The reason the staff part was so important was that there is a good reason that nobody does this kind of on-site course: we had to credential 25 community hospitalists, making sure none of them got lost or violated HIPAA or committed any of 100 other deadly sins.

So last Monday morning, 25 community hospitalists arrived, hailing from Maine to Alaska. We were in a spectacular conference room on the top floor of our library, with a drop-dead view of the Golden Gate Bridge. But that would only get us so far. I wondered: would all the logistics come together? Would the group gel, and bond? Would the mix of direct patient contact and classroom activities be right? Would they recommend the course to their friends? And would the faculty – particularly the ones running 3-hour patient care rounds 3 days in a row (we broke the group up into 3 so that no clinical posse was larger than 8-9 folks) enjoy it enough to be willing to do it again.

Well, yes, yes, yes, yes, and yes. We haven’t reviewed the formal evaluations yet, but the vibe was extraordinary. Seeing hospitalized neurology patients with master clinicians like Andy Josephson, learning procedures by sticking central lines under ultrasound guidance into (dead) chickens (more on the chickens later), having 3 hours to talk perioperative medicine with med consult guru Quinny Cheng, listening to Goop Dhaliwal explicate how he thinks through a complex case, even performing a mock root-cause analysis of a sentinel event with me – these experiences couldn’t be replicated anywhere else. By the end, when we posed for the group picture (below), it was clear that our 25 guests had had an amazing few days, that our faculty had really enjoyed their work, and that it had been a tremendous success.

I won’t say much about our big, more traditional CME course which followed (our 12th Annual “Management of the Hospitalized Patient” course at the Fairmont Hotel), other than a) we broke our previous attendance record (nearly 700 people attended), b) I am so proud of our faculty – they are really spectacular teachers, and c) it also received out-of-sight feedback.

We’ll do the Big Course again next year, September 24-26th at the Fairmont, and we’ll run another Hospitalist Mini-College in the three days before (September 21-23). We’ll open both conferences to registration relatively soon. In addition, we will probably hold a standalone Mini-College sometime in the late spring – I’ll announce it here when we’ve settled on the date. I expect both Mini-Colleges will sell out (we cap attendance at about 25 people to preserve the small group feel), so if you’re interested, please register early.

Oh, about those chickens. About a week before the course, Arpana was briefing me on the planning. “Everything’s in place….” She gulped, as if wondering whether to spill a dirty secret, “but… have you heard about the chickens?” This couldn’t be good. “Chickens?” I asked, intrigued but slightly nauseated. Turns out that Diane Sliwka, the wonderful director of our new procedure service, had ordered several now-deceased chickens for her procedure workshop – prepped specifically for this purpose (red dye in their carotids, blue in their jugulars) – which would arrive by FedEx on the morning of the procedure session.

“Arpana – have we checked the UCSF Policy Manual to be sure there isn’t any specific regulation prohibiting livestock in the library?” I asked, only half in jest. Unbelievably, she had. “Yep, we checked, and there doesn’t seem to be a rule against it.” “OK,” I said, “ let’s do it.” Predictably, the session with the chickens was amazingly popular with the attendees – one of the highlights of the course.

And just as predictably – I’m not sure if this was irony or someone’s idea of a joke – the attendees were served chicken for lunch that day. I think, but can’t guarantee, that they weren’t the ones from the procedure workshop. If they were, at least the catheters had been removed.

Mini-college attendees and faculty

A million thanks to our superb faculty, our great staff, our exhibitors and supporters (including SHM, which co-sponsors the CME course), and particularly to the attendees – especially the Mini-College folks, who really were our guinea pigs. I look forward to welcoming some of you to one of these courses next year.


  1. WRS November 1, 2008 at 10:58 am - Reply

    With regards to education on ultrasound guided central line placement:
    1. Was a “Time-out” performed?
    2. Was the central line bundle used?

    I hope a Credentials Committee doesn’t give US-Guided central line privileges based on an applicant’s ability to put a CVC in a chicken. That would be a classic case of the fox guarding the henhouse, and besides, it would be a pretty fowl situation for patients.

  2. blackwhitereadallover November 6, 2008 at 11:23 pm - Reply

    This confirms what I’ve long suspected, Bob…you really never sleep, do you?

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About the Author:

Robert M. Wachter, MD is Professor and Interim Chairman of the Department of Medicine at the University of California, San Francisco, where he holds the Lynne and Marc Benioff Endowed Chair in Hospital Medicine. He is also Chief of the Division of Hospital Medicine. He has published 250 articles and 6 books in the fields of quality, safety, and health policy. He coined the term hospitalist” in a 1996 New England Journal of Medicine article and is past-president of the Society of Hospital Medicine. He is generally considered the academic leader of the hospitalist movement, the fastest growing specialty in the history of modern medicine. He is also a national leader in the fields of patient safety and healthcare quality. He is editor of AHRQ WebM&M, a case-based patient safety journal on the Web, and AHRQ Patient Safety Network, the leading federal patient safety portal. Together, the sites receive nearly one million unique visits each year. He received one of the 2004 John M. Eisenberg Awards, the nation’s top honor in patient safety and quality. He has been selected as one of the 50 most influential physician-executives in the U.S. by Modern Healthcare magazine for the past eight years, the only academic physician to achieve this distinction; in 2015 he was #1 on the list. He is a former chair of the American Board of Internal Medicine, and has served on the healthcare advisory boards of several companies, including Google. His 2015 book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, was a New York Times science bestseller.


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