Our nation is home to many of the best postgraduate medical training programs in the world, but one area of medical training that has been largely ignored for students in the healthcare profession is the preparation for their transition from academia to practice.
 
With the Bureau of Labor Statistics projecting that employment of physicians and surgeons will grow by 24 percent between 2010 and 2020, graduates face an ever-growing demand for their skills. Unfortunately, nearly a third of physicians leave their position in the first five years. Due to these contradicting circumstances, significant resources need to move beyond teaching trainees how to find a job and instead allocate resources to help trainees determine the right job for their lifestyle, culture and skills.
 
Designed to assist allied health students, residents and fellows, Sheridan Healthcare’s Education Outreach Program developed a complimentary, unbiased lecture series examining transition to practice. The goal of the Education Outreach Program is to give trainees some indicators as to what to consider when transitioning to practice, rather than solely relying on financial comparisons to assess job offers:
 
• Crafting CVs and interviewing strategies: As in any field, the importance of a solid CV and interview skills to get in the door of a potential employer are the first steps to securing employment. Sheridan uses seminars to give each trainee the knowledge needed to position oneself appropriately in the medical arena. 
 
• Lifestyle balance: Many physicians leave their position in the first couple years due to lifestyle conflicts, including stress and pressure, incompatible work hours and a lack of assimilation into the work culture. Job candidates must learn how to evaluate the culture of potential employers before responding to an offer.
 
• Interviewing the interviewer: We advise trainees when considering employment with a facility to discuss the work schedule, turn-over rates, career paths and leadership opportunities. We also encourage talking to physicians, mid-level providers and supervisors already on staff.
 
• Different types of practices and facilities: New graduates face a dizzying array of options as to what practice and facility type they should join. Many times, this type of decision can be evaluated by one’s own personality and interests. For example, someone who thrives in a fast-paced, high acuity work environment may prefer working at a tertiary care facility rather than a small community hospital.
 
• Staffing models: From independent practices and contract management groups to hospital employment or locum tenens positions, each offers various advantages and requires different obligations of its employees. Here, it is important to understand the different models, which vary in terms of compensation, benefits, and work environment.
 
• Compensation and benefits: Before accepting a position, trainees must understand how they are being paid. For instance, Is it productivity-based? Is it salaried? Is it salaried plus incentives? Is it equal distribution? Also, trainees should know what benefits they are being offered.
 
• Malpractice insurance: Since a thorough understanding of malpractice insurance coverage is essential, trainees need to know what type of malpractice insurance is offered and what costs they may incur.
 
• Contracts: We recommend reviewing any contract prior to signing for restrictive covenants and needed amendments. At times, trainees may even wish to seek a contract attorney.
 
Just as healthcare professionals in training learn to treat future patients, they must learn how to take care of their careers to enjoy a long and healthy professional life.


As the business of health care has become increasingly complex, physicians and other professionals have been turning to the University of Miami School of Business Administration in order to gain the skills they need to navigate the evolving industry. More than 800 industry professionals have earned their MBA degrees through the School’s Executive MBA in Health Sector Management and Policy program since the program was started more than 30 years ago. The School now counts some of the region’s most distinguished health care leaders among its alumni.
 
“One of the greatest assets of having gone through the program was the networking opportunity,” says Steven Sonenreich, MBA, president and CEO of Mount Sinai Medical Center and a 1990 graduate of the program. “Having been able to develop relationships and maintain regular contact with those who went through the program with me has helped create opportunities for collaboration,” which, according to Sonenreich, is one of the most important aspects of health care today.
 
In 2012, UM’s Executive MBA program was ranked the No. 2 MBA program for physician-executives in the United States by Modern Healthcare magazine. The program continues to grow as demand for those with advanced business knowledge and management skills grows in the health sector.
 
“As the Affordable Care Act moves into full implementation, the kind of business skills developed in the MBA program can be more valuable than ever to those working within the health care industry,” said Steven Ullmann, director of the School’s programs in health sector management and policy. “Delivering on the promise of improved quality and efficiency, while controlling costs, requires the highly-trained managers and executives we see taking part in and graduating from this program.”
 
The University of Miami program is the only health sector MBA program in Florida to be accredited by the Commission on Accreditation of Healthcare Management Education (CAHME), the premier accrediting body for health care management programs. The program begins in January each year, with classes meeting one weekend each month for 23 months. Participants include physicians, nurses, mid-to-high level executives and other highly experienced health care professionals working in group practices, hospitals, government agencies, biotechnology and pharmaceutical firms, insurance companies, managed care organizations, and medical device companies.
 
Grisel Fernandez Bravo, ARNP, MBA, NEA-BC, DNP, chief nursing officer at Memorial Hospital West, is among the many executives who have graduated from the program. She began her medical career as an RN at Miami Children’s Hospital, then known as Variety Children’s Hospital, and went on to serve as CNO of Hialeah Hospital, Palmetto General Hospital and Memorial Hospital Miramar before joining Memorial West.
 
“I needed an MBA to understand the business aspect of nursing,” says Fernandez Bravo, who was steered toward the Executive MBA program by colleagues who had graduated from the program. After earning her MBA from UM in 2005, Fernandez Bravo earned her DNP from the University of Miami School of Nursing and Health Studies, a decision that was heavily influenced by the high caliber of professors who taught courses for the Executive MBA program.
 
“This was an excellent program for someone without any business experience, especially in health care, which is so intricate,” she says.
 
The School of Business also offers a joint MD/MBA program with the University’s Miller School of Medicine, as well as an undergraduate major and minor in health sector management and policy.
 
A Center for Health Sector Management and Policy was established in 2010 to serve as a resource for the health care and business communities. The center promotes and conducts research, provides training for those in the health sector through customizable executive education programs, and features a consult practice to help organizations tackle challenges facing health care, such as cost-effectiveness analysis, Lean Six Sigma, process improvement, management and leadership, ethics and compliance, health care technology, and international health care policy. Through the center’s experts bureau, leading authorities in health sector management and policy and professors of the School are also available to provide expertise to legislative bodies, government agencies, news media and various organizations.


The Department of Veterans Affairs has a proven record of delivering Health Promotion Disease Prevention services to Veterans at a higher overall rate than that of non-VA health care entities. Many of these services are well-incorporated in VA facilities because of an established Health Promotion Disease Prevention Program (HPDP) that implements performance measures and reminders that prompt staff to discuss prevention along with discussing behavior change and setting goals with Veterans.
 
To encourage Veterans to choose healthy living behaviors and goals, VA’s across the country implemented nine key evidence based healthy living messages. These messages cover core prevention areas including nutrition, physical activity, weight management, smoking, alcohol use, stress management, clinical preventive services, safety, and health care communication. These topics were chosen because of their importance for reducing chronic disease morbidity and mortality and improving quality of life.
 
West Palm Beach VA Health Promotion Disease Prevention Program trains Primary Care staff to utilize effective brief interventions for weight management, tobacco cessation and other patient education topics for Veterans. Helping patients achieve weight loss and make dietary and physical activity improvements is difficult; some patients need more intense behavioral counseling. A review of behavioral counseling interventions for healthy diet, physical activity, or a combined lifestyle can result in small but significant improvements in the amount of salt, fat, fruits/vegetables, and calories; minutes of physical activity per week, and physiologic measures of body mass index, blood pressure and cholesterol.
 
The National Center for Health Promotion Disease Prevention suggests that establishing a strong relationship with patients and using communication techniques such as motivational interviewing, health coaching, and shared decision making can help patients make better choices around behaviors that can impact health, such as physical activity, eating habits, tobacco cessation, and alcohol misuse.
 
The premise of this approach, which is termed patient-centered care, is to elicit the patient’s priorities and goals, rather than telling the patient what those priorities should be. This approach allows patients to prioritize and decide what they are ready to change and has been shown to be effective in promoting behavior change. With practice, these types of conversations can be conducted efficiently and effectively.
 
Training staff in patient-centered communication skills have proven successful in promoting and supporting tobacco cessation and can be expanded to address physical activity and diet choices. Staff are able to emphasize the importance of these behaviors in preventing and managing chronic diseases and to offer more information on such topics if the Veteran expresses interest.
 
HPDP Program Managers and Health Behavior Coordinators (HBCs), in collaboration with Veterans Health Education Coordinators, play a critical role in training staff in effective communication strategies to promote prevention through health behavior change. The first of the two courses is TEACH for Success. TEACH guides clinicians in how to use evidence-based health education, counseling, and communication skills with patients and their family members.
 
The second course covers motivational interviewing. Derived from work with patients with substance abuse issues, motivational interviewing is now being widely used in the general health care setting. The philosophy of the motivational communication approach is to assume that it is natural for people to have mixed feelings (ambivalence) about making changes in their health-related behaviors. To successfully assist patients in making healthy lifestyle changes, health care staff establish a collaborative, empathetic relationship with their clients. The approach helps patients explore their ambivalence about health issues and change by teaching skills to resist lecturing, exploring patient motivations, partnering with patients through effective listening, and empowering patients by helping them explore how they can make a difference in their own health.


The Lake Erie College of Osteopathic Medicine marks its 20th anniversary with the opening of the LECOM School of Dental Medicine in Bradenton, FL. The first class of 100 students arrived in mid-July and began using the $52 million state-of-the-art building constructed just north of the original 5000 Lakewood Ranch Boulevard campus.
 
With LECOM’s commitment to quality education at an affordable cost, LECOM is determined to prepare dentists who can deliver the best health care. Students and faculty will work with the Bradenton community to provide care to residents who face challenges in obtaining needed dental care by serving them at an on-campus patient clinic and in the future at community-based, primary care dental clinics.
 
LECOM’s unique Problem Based Learning (PBL) Pathway will bring together medical and dental students. Using actual patient-cases, this small-group learning approach teaches critical thinking, reasoning and diagnostic skills that makes an adept physician and dentist. PBL graduates have a proven track record of success and rank at the top of the pass rates for national licensing board exams.


Commission Members Vote Unanimously for Broward’s Initial Accreditation
 
Dr. Linda Washington-Brown, associate dean of Broward College’s Bachelor of Science program in nursing, has spent a considerable amount of time as a competitive tennis player, but over the past few years, she’s felt more like a sprinter.
 
Finally she’s reached a finish line with notification that Broward College’s RN to BSN program has received initial accreditation from the National League for Nursing Accrediting Commission. The letter informing her of accreditation arrived in the last week of March.
 
It’s been an exhaustive experience, she says. In December 2009, the program’s curricular outline was assembled and approved by the Florida Department of Education and by the Broward College District Board of Trustees. The program was unique, designed for nurses working in the field and capable of being completed in a year.
 
When Washington-Brown was hired, she needed to hit the ground running, hiring faculty and staff. The curriculum needed to be fleshed out, the Southern Association of Colleges and Schools needed to be notified of the program’s start and the NLNAC needed to be petitioned for candidacy. Washington-Brown and her hard-charging staff got it all done.
 
“It was a lot of work and it was a tight schedule, but we did it,” Washington-Brown said. The college welcomed its first class early in 2011.
 
Members of the class came from a variety of backgrounds and were employed in hospitals, emergency rooms, hospices, pediatrics, geriatrics, critical care, and more. Several were recent graduates; others had up to 20 years of experience. What they all shared was a desire to take their education and career to another level and to earn a bachelor’s degree in nursing.
In December of that year, the first class – 22 students – graduated. “Actually 30 successfully completed the program,” Washington-Brown said. “A few had some general education requirements yet to complete.”
 
The accreditation process, though focused and intense, did result in a few nice surprises, Washington-Brown said. First, the vote for accreditation was unanimous, 18-0.
 
“Not only did we go unblemished, we got accolades for how well the program was organized and put forward,” she said. “It was even recommended that we publish our conceptual model and curricular framework in a peer-reviewed, academic journal. We plan to do that.”
 
The accreditation caps off the program’s start and now Washington-Brown gets a little time to kick back, take a deep breath and look at what she and her team created.
 
“It was totally a team effort,” she says. “My faculty and staff knew what they had to do. They didn’t murmur, mumble or complain; they just did it.”