KBIM in 2022: Year in Review

It’s hard to believe how quickly 2022 has flown by and that we are in 2023 already!

I want to take a moment to thank every single resident, faculty member, and administrative assistant in our program for their incredible work.

I want to especially thank members of our residency program committee including all of our site coordinators, subcommittee heads, our leads, and our fantastic chief residents, both the outgoing and incoming ones. Without their talent, creativity, and dedication, the program wouldn’t be where it is today.

What We Accomplished in 2022

As we turn to a new page, let’s take a look back at some of what we managed to get done over the previous year and reflect on it.

Implementation of Competence by Design (CBD) and Entrustable Professional Activities (EPAs) assessments. This is a critical step towards accreditation and the culmination of over a year of hard work until it was launched officially in October 2022. Every site coordinator, tutor, and resident helped us get to this point.

Dr. Hussa Al-Oudah, the Junior’s Chief Resident, showed great leadership by setting a great example to other residents and helping them understand and adapt to the requirements.

Establishment of the Competence Committee with Dr. Ammar Alkhateeb as the head of the committee and membership of Drs. Naela Al-Mazeedi, Hebah Al Wayel, Yousef Behbehani, Ahmad Alshatti, and Ahmed Abdelalim. This committee is responsible for reviewing all resident profiles, looking at the completed EPAs, and making sure that every resident is progressing well in the program.

Refreshing our curriculum map. Assistant Program Directors Drs. Sundus Alduaij and Abeer Almutawa mapped every academic lecture. Drs. Hawra Al-Matrouk, Maryam Al-Sarraji, and Ammar Alkhateeb meticulously mapped every rotation, making sure that for the first time in our program we have a complete curriculum map.

Our curriculum map can be accessed on our website here: http://kbim.app/im/curriculum/.

Several Improvements to Rotations in Specialized Centers were made through the hard work of our Assistant Program Director and Off-Site Rotations Coordinator Dr. Abeer Almutawa. They include adding a dedicated Hematological Oncology rotation, incorporating Palliative Care into our oncology rotations, and moving dermatology to Adan Hospital with much higher yield cases.

Weekly site-based lectures on the most important topics of Internal Medicine are now happening at all major sites. This supplements our Academic Day lectures.

Jaber Hospital is now an official site with two MTUs and two subspecialty rotations are now part of the program, with Dr. Ebtehal Aljamaan as the site coordinator.

Armed Forces Hospital is now our Community Medicine site allowing our residents to experience medicine in a different context, thanks to the leadership of Dr. Ahmad Al-Ansari.

Developed and implemented a unified KBIM leave policy which greatly reduced the uncertainty and variability of applying leave rules across different sites. This effort was led by Dr. Hawra Al-Matrouk with significant consultation with site coordinators, tutors, and residents.

Launched our online platform at KBIM.app, significantly reducing the administrative burden of running the program, facilitating access to information across the program, and improving the quality and quantity of information collected.

Development of new rotation and tutor evaluation forms, led by Dr. Maryam Al-Sarraji in consultation with other clinical tutors and our chief residents. The forms are the first step in a comprehensive plan for continuous program evaluation and improvement, being developed by Dr. Maryam Al-Sarraji.

A new research curriculum has been developed by our new Research Lead, Dr. Mohammad Shehab. It combines theoretical teaching and a practical, project-based experience in a structured, longitudinal curriculum in the R3 year.

A new Quality Improvement & Patient Safety (QI & PS) curriculum was developed with significant help from Dr. Mohammad Behbehani, who is a Ph.D. candidate in Public Health with extensive experience in the field of QI and PS. Similar to the research curriculum, it combines theory with a real-world QI project.

Dr. Farah Al-Yaseen, our Senior Chief Resident, was instrumental in getting our research and QI curricula organized.

Welcomed our first Resident Safety & Wellness Lead. Dr. Nawal Al-Otaibi has extensive experience in wellness and is trained in one-to-one support of residents. She’s breaking ground in this area starting a new mysterious item on our Academic Day agenda titled “Ice Cream Rounds”.

Our site coordinators were involved in every one of those changes. They are on the ground every day, making sure that all our ideas and plans get implemented to the highest standards. Without their dedication, wisdom, and attention to detail, none of our plans would have been successful.

Let's give them a big thank you!

• Amiri Hospital: Drs. Hawra Al-Matrouk and Ahmad Mahdy.
• Adan Hospital: Drs. Eissa Almaraghy and Khaled AlJenaee.
• Farwaniya Hospital: Drs. Ammar Alkhateeb, Marwan Alwagayan, and Abdulrahman Aljasem
• Mubarak Alkabeer Hospital: Drs. Mohammad Alharban, Khalid Alhasawi, and Maryam Al-Sarraji.
• Jahra Hospital: Drs. Nasser Alherz, Mohammad Alhajri, and Nadia Alrashidi
• Jaber Hospital: Dr. Ebtial Aljamaan

And last but not least, our In-Training (Part 1) Exam Committee headed by Dr. Ahmad Al-Ansari with members Drs. Nada Alhasan, Abdulaziz Almutawa, Abdulrahman Aljasem, Maryam Al-Sarraji, and Mariam Alserri. They continue to work very hard, week after week, to make sure we have a constant supply of fresh, high-quality, and up-to-date MCQ exams.

What to Expect in 2023

In terms of what we want to accomplish in 2023, we can think of them as falling under three main categories:

1. We want to continue to refine and improve all the new projects we started in 2022, listed in the previous section.
2. We have some remaining projects that we’re working on and are expecting to launch in 2023. I’ve listed those projects in this section.
3. Perhaps most critically, we want to restructure the program so it’s capable of handling the expected increase in the number of residents. I describe our expansion strategy in the next section.

Here’s the list of new projects that are under work and expected to launch in 2023:

The first KBIM Faculty Development Day is being planned around March 2023 and will consist of lectures and workshops targeted at our Clinical Tutors on topics such as effective teaching, giving feedback, coaching, and other topics you find most useful. Stay tuned for more details!

Rotations and tutors will start getting feedback reports based on the evaluations filled out by residents. The reports will contain summaries of evaluations done over 6 to 12 months, to maintain resident anonymity.

Longitudinal resident internal medicine clinics are scheduled to launch in April 2023, an effort that's been led by Dr. Ebtihal Aljamaan. Each resident will be assigned a weekly clinic at a fixed site and a fixed day of the week. They will be paired with a supervisor who'll review their cases with them and provide them with feedback on how to run the clinic. Residents will not only learn the medical aspects of outpatient care, but also the managerial and leadership aspects of being responsible for their own patients.

A new Point of Care Ultrasound and Procedures Simulation curriculum is being developed by Dr. Abdullah Alawadhi.

Access to Institute of Health Improvement (IHI) online modules on topics such as Quality Improvement, Patient Safety, and Leadership is now available to our residents and tutors. Details on how to access them and the required modules for residents will be sent out soon.

Introduction of a few more resident assessment tools including multi-source feedback assessments in which we collect feedback on residents from not just a supervisor but other members of the healthcare team such as nursing, as well as patient assessment of residents. The additional tools will supplement our existing assessments and give residents a more holistic view of their performance to better help them improve it.

A new leadership workshop and curriculum for R5s is being developed by Drs. Hawra Al-Matrouk, Sumoud, and Fatima Al-Sarraf.

Continued improvements to our Academic Day curriculum and preparing to divide the curriculum so that there’s a dedicated curriculum for each academic year in the program.

Continued collaboration with specialized centers to find high-yield training opportunities through Dr. Abeer Almutawa’s excellent initiative and connections, such as high-volume clinics in respiratory conditions which are less commonly seen in general hospitals.

Continued improvements to the electronic platform to make it easier to use and increase its capabilities based on the feedback we’re getting from residents and tutors.

Finally, all of this work will help us meet and exceed the accreditation standards of the Royal College of Physicians of Canada. While this is not something that we can have a clear timeline for, I can assure you that it is a top priority for everyone in the program’s leadership.

Our Expansion Strategy

We are very fortunate this year to have received approximately double the number of interested applicants for the 2023/2024 academic year. While our acceptance criteria remain unchanged, the number of high-quality candidates has gone up.

With that increase, the demand for our high-quality residents has also been going up and the number of educational opportunities is growing rapidly.

Both our general medical units and subspecialty units have been increasing their reliance on our residents. More and more units and entire new sites are approaching us, wanting to participate in our program.

That leaves us with the organizational challenge. We believe we have a strong strategy that will enable us to achieve this expansion to the program without compromising the quality of training or the safety and quality of patient care.

Our expansion strategy stands on three pillars: digitization, decentralization, and standardization.

• Digitization- our online platform has already proven to be an excellent way to reduce administrative overhead. We will continue to improve the platform and add more features, tools, dashboards, and notification systems to allow most routine tasks to be done automatically with minimal human intervention while also detecting major issues that require immediate human intervention.
• Decentralization- instead of keeping all decisions in the hands of the Program Director, we want to empower our RPC members to take the initiative, make decisions locally, and have a larger leadership role in the program.
• Standardization- to maintain high-quality training, ensure fairness to residents and faculty, and keep the program cohesive and well-integrated, we will be developing a set of standards and processes for all aspects of program management.

How you can help

As we continue to improve and expand the program, we’re constantly looking for skilled and enthusiastic clinical tutors, educators, as well as collaborators to join our leadership team.

If you’d like to help, please approach your site coordinators or the leads responsible for the areas you’re interested in. If you’re not sure who to contact, please contact me and I’d be happy to direct and work with you.

You can always find the list of our leadership team, including all site coordinators, as well as all of our faculty across all sites, on the Faculty page of our website here: http://kbim.app/im/faculty/.

Finally, I want to again thank every resident, clinical tutor, and member of our incredible leadership for their hard work over the last year. With you, our program is heading to great success.

I can't wait to see what we will accomplish together in 2023!

Sincerely,

Dr. Ahmad Alhashemi
MBBCh, ABIM, FRCPC, MScCH (HPTE), MScCS
Program Director - KBIM