Chief residents (CRs) play a crucial role in training residents and students but may have limited geriatrics training or formal preparation for their CR role. A 2-day off-site chief resident immersion training (CRIT) addressed these challenges. Objectives were to foster collaboration between disciplines in the management of complex older patients, increase knowledge of geriatrics principles to incorporate into teaching, enhance leadership skills, and help CRs develop an achievable project for implementation in their CR year. Three cohorts totaling 47 trainees and 18 faculty mentors from 13 medical and surgical disciplines participated over 3 successive years. The curriculum, developed and taught by a multidisciplinary team, featured an interactive surgical case, mini-lectures on geriatrics topics, seminars to enhance teaching and leadership skills, and one-on-one mentoring to develop a project in geriatric care or education. Evaluation included pre- and postprogram tests and self-report surveys and two follow-up surveys or interviews. In 2006 and 2007, scores on a 12-item objective knowledge test increased significantly (P<.001) from before to immediately after CRIT. Self-report knowledge and confidence in teaching geriatrics also increased significantly (P<.05) in all formally covered topics. Mean enhancement of CR skills was 4.3 (1=not at all, 5=very much). Eleven months after CRIT, all but five CRs had implemented at least part of their action projects. CRs reported improved care of older patients, better leadership skills, more and better geriatrics teaching, and more collaboration between disciplines. A 2-day interactive program for CRs can increase institutional capacity regarding geriatrics teaching and care of elderly patients across medical specialties.

Background: Dual practice and multiple job holding are widespread among health workers throughout the world. Although dual practice can help the financially strained public sector retain skilled workers, there are also potential negative consequences if it is not regulated. In Cambodia, there is substantial anecdotal evidence of dual practice among physicians but there is very little data on the extent and prevalence of the practice. This study was conducted by the University of Health Sciences (UHS) to gain insight in to the employment practices of UHS alumni. Results from this survey may help to inform policymakers in rational planning for future health system development related to capacity building and regulation of human resources for health. Methods: Data were collected from a self-administered survey of UHS graduates who graduated between 1999 and 2012. A total of 162 medical graduates were randomly sampled from a total of 1867 medical graduates between 1999 and 2012. Contacted individuals were asked to complete a written structured questionnaire regarding demographic characteristics, current employment and types of employment, compensation, and job satisfaction. The response rate of graduates sampled was 49% (79 completed questionnaires). The low response rate was primarily due to the difficulty in locating individuals. Results: Of 79 respondents, 96% were currently employed at the time of the survey. However, only 63 of the respondents (80%) were working in the healthcare sector. The 16 respondents (20%) not working in healthcare were excluded from further analyses since they are not relevant to dual practice analysis. The vast majority (87%) of respondents are public sector employees (61.9% in public sector only and 25.4% in both public and private sector). 12.7% of respondents only work in the private sector. Almost half (47.6%) of respondents hold more than one job. For income satisfaction, physicians employed in both sectors have higher satisfaction than physicians employed in the public sector only. Conclusions: As policymakers in Cambodia consider new approaches to regulation of the practice, it is important to know the context of the practice, the benefits to the healthcare system, and the costs. Recognizing the high prevalence of multiple job holding in Cambodia, as evidenced in our survey of UHS medical graduates, contributes to the discussion as important information that can be used toward meaningful reform.

report, a presenter will share an interesting patient case that is open for both groups of residents to discuss and work through. Outcomes & Evaluation: In this setting, Haitian residents can learn about the diagnostic and therapeutic process in patients who have often been referred from outside hospitals for higher level tertiary care. During the Haiti resident cases, Dartmouth-Hitchcock residents can learn the value of more basic investigative practices and what the best diagnostic and treatment strategies are when resources are scarce. Both parties can learn a great deal from each other in recognizing the vast differences in medical systems and how geo-political and socioeconomical factors play large roles in healthcare delivery. However, perhaps one of the most valuable lessons gained from these conferences is that despite so many differences in our backgrounds and resources, there are countless aspects of good patient care that are universal to all healthcare providers. Going Forward: This pilot project has had to withstand several challenges in its early years of development. The language barrier between residents was an initial concern and hindered the free flow of discussion between groups. Having bilingual presentation slides and a Funding: There is currently no funding required for this initiative.

organizations and several new grants and awards. Each of these linkages have contributed to improving and increasing training, and locally relevant research. Drawing on PRIME-K's experience, there are four key lessons from these MEPI-enabled partnerships: establishing strong foundations can lead to new collaborations; infusing existing partnerships with resources enables innovative and sustainable solutions to long term problems; connecting new partners with different strengths can expand their scope of impact; and providing opportunities to search for local solutions within Kenya and Sub-Sahran Africa strengthens South-South collaborations. Going Forward: Partnerships have been integral to meeting the goals of MEPI in Kenya by enhancing quality of trainings and expanding medical education and research opportunities. The lessons learned from PRIME-K's partnerships are important to future large scale collaborative interventions addressing health system needs in low resource settings.