University of Virginia
Clinical Medicine Committee
February 15, 2010
Attending: Drs. Heald, Ham, Plautz, Chapin, Herrington, Pearson, Wilson; Mr. Hemler; Ms. Berghuis.
The meeting was called to order at 5:05 PM.
The clerkship directors were reminded to confirm the schedules of their portions of the upcoming Basic Sciences for Careers sessions with the individual presenters, and to notify Darci Lieb of these confirmations.
The new time requirements for the NBME shelf exam were discussed. Students may be allowed 2 hours 30 minutes for the shelf exam, which is an increase from 2 hours 10 minutes. This change will be in effect with the first test administration of the upcoming clerkship year.
Ms. Chapin discussed the plans for the 2010 CPX exam. She would like to reduce the number of cases from 7 to 6, and explained the rationale for doing this, which includes a loss of space and the addition of standardized patient experiences to Family Medicine and Geriatrics. The addition of these other standardized patient experiences helps with the "practice effect" for our students as they prepare for the USMLE Step 2 Clinical Skills exam. It was felt that her plans for the 2010 CPX exam were reasonable. Ms. Chapin also mentioned that UVA has joined a regional consortium of medical schools who will be using similar cases with their students.
The issue of when to make-up required clerkship workshops was discussed. Several of the clerkships have required workshops, and occasionally students miss them (illness, unanticipated absence, etc.). These workshops are usually scheduled on fixed dates. Currently students usually make up the workshops during the early clerkships of the following clerkship year, but some are concerned that they won't have a grade for that clerkship in time to use that information to help make residency decisions. After discussion, it was felt that there isn't a better solution at this time, but that an unofficial clerkship grade might be given to the student, pending the completion of all of the requirements. (Workshops are usually not graded but attendance and participation are required).
The "10 hour rule" was discussed. Several years ago it was decided that med students' work hour requirements, etc., should not be more than those of the residents. An issue has arisen when a student complained that the student, who was "on call" on an inpatient service", was not given 10 hours between shifts. The language of the LCME requirement was reviewed, and makes no mention of specific duty hour restrictions for students or of correlating student duty requirements with those of the residents. The ACGME language was also reviewed; it does mention a 10 hour break between shifts, but also describes a 30 hour in-house call period, with the resident leaving at the end of that 30 hours. It was felt that "on call" for students on inpatient services could be either in-house or taken from home, and that the 30 hour total limit should be the guiding metric.
Dr. Pearson mentioned a concern that has been raised by students regarding student safety and early reporting for rounds. Some services have students reporting at 5:30 AM or earlier, and the usual campus busses are not running at that time. Various solutions to this issue are being explored.
A change in the wording of the uniform student evaluation form was discussed. The current form has five levels: unacceptable, marginal (needs improvement), typical of a UVA student, excellent, and honors. It was proposed that the wording be changed to "unacceptable, acceptable, good, excellent, and honors.". The rationale was that a truly "marginal" performance in need of improvement should not be considered acceptable. It was also mentioned that the term "typical" is viewed as a pejorative term by some students. The proposed changes will be presented to the Curriculum Committee.
The meeting was adjourned at 6:05 PM. The attendees were thanked for braving the winter weather to attend.
William G. Wilson, MD
Chair, Clinical Medicine Committee