University of Virginia School of Medicine
Surgery Conference Room, 4:00 p.m.
Present (underlined) were: Reid Adams, Gretchen Arnold, Eve Bargmann, Daniel Becker, Robert Bloodgood, Gene Corbett, Wendy Golden, Donald Innes (Chair), Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill Wilson, Devin Mackay, Kavita Sharma, Brad Bradenham, Debra Reed (secretary) Guests: Edward Nemergut, George Rich
- Anesthesiology Component of the Curriculum. Edward Nemergut and George Rich from the Department of Anesthesiology met with the Curriculum Committee to discuss Anesthesiology's placement in the Curriculum. At the present time, Anesthesiology is a three day part of the Surgery Core Clerkship. Surgery clerkship directors find this three day period disruptive. When the Surgery clerkship was 12 weeks, Anesthesiology was a one week rotation in the period. Now that the Surgery Core Clerkship is eight weeks, Anesthesia is allotted 3 days.
Dr. Nemergut outlined the goal of the rotation: To experience and learn about the preoperative, intraoperative and postoperative case of the adult and pediatric surgical patient.
He also explained the relevance of the rotation. Primary care physicians are often consulted regarding the medical preparation of their patients for surgery. However, this area is not traditionally covered in medical, pediatric, or surgical rotations either for medical students or residents. While there is some exposure to perioperative consultation on such medical specialties as cardiology, these individuals may not possess a specific knowledge of the perioperative concerns represented in these consultations. Furthermore, as primary care physicians become the gatekeepers to surgical interventions, it is critically important that they are familiar with the entire perioperative period. Students planning a career in one of the surgical specialties may benefit from an approach to the patient that is a bit different from that usually taken on a surgical rotation.
Dr. Nemergut outlined the objectives of the course which include, preanesthetic patient evaluation and anesthetic planning, management of the airway, use of equipment to ensure airway patency, and patient ventilation, intraoperative anesthetic management and anesthetic pharmacology, and postoperative anesthetic management and pain control.
Procedures done by the medical student on anesthesiology rotation include endotracheal intubations, peripheral IV's placed, LMA insertions, insertion of arterial lines and performance of a spinal anesthetic.
Dr. Nemergut did an informal poll of other various other medicals schools to see how anesthesiology is taught in other venues. He found that time devoted to anesthesiology is variable and often is a one or two week block as part of the surgery clerkship or in a acute care rotation. In some instances it was a stand alone clerkship experience.
Student evaluations of the anesthesia portion of the surgery clerkship have been very positive. Most thought that skills taught during this rotation were unique and not actually taught anywhere else in the curriculum.
The Committee discussed whether it was feasible to make the anesthesiology rotation a selective in the fourth year and since only one week is required for anesthesiology a joint session with another subspecialty would be required. The possibility of developing an acute care selective and incorporating anesthesiology into that was raised. The problem with selectives is they are not required so not all students would have the anesthesiology experience. Dr. Nemergut and Dr. Rich noted that four students assigned to Anesthesiology in any given week would be optimal but six could probably be accommodated. This number would need to include students who take an anesthesiology elective in their fourth year.
The possibility of incorporating some of the clinical skills taught in the Anesthesiology rotation into the transitional course before clerkships was discussed. At the November 2, 2000 meeting of the Curriculum Committee, Jennifer O'Flaherty from Anesthesiology presented ideas for an introductory basic interventional skills (IBIS) program for medical students.
An assessment of time devoted to acute care, pain management, airway management, etc. and a determination of the best placement of such topics is needed. Data will be collected from students, residents, and faculty and other schools. This subject will be discussed again at a future meeting before a decision is made.
2006 National Board Scores for USMLE Step 1. Performance data for the students taking USMLE Step 1 for the first time in 2006 were distributed to the Committee. Out of 144 students taking the test, 138 passed on the first attempt. The mean was above the national average. See http://www.med-ed.virginia.edu/handbook/academics/licensure-page
- Epidemiology Course Director. Dr. Robert Reynolds has nominated Denise Bonds, M.D., M.P.H. for the position of Epidemiology Course Director. Dr. Bonds is an Associate Professor in the Department of Public Health Sciences. The Committee reviewed her CV and voted to endorse this nomination. Dr. Bonds will be the new Course Director for Epidemiology.
Practice of Medicine (PoM1) Course Director. A search committee (Christine Peterson, Walt Davis, and John Gazewood) recently met with eight excellent well-qualified candidates for this position. The Search Committee recommends that the position be offered to Dr. Seki Balogun, M.D., FACP, Assistant Professor of Internal Medicine, Division of Geriatrics and General Medicine. Dr. Balogun has extensive medical education experience with a concentration in curriculum development. She is a geriatrician and devotes much of her professional time to education and educational research. The Committee reviewed her CV and voted to endorse this nomination. Dr. Balogun will be the new Course Co-Director for PoM1.
Isabel. The Committee agreed that Isabel is an excellent tool to have available to the medical students. The Committee will invite Brian Wispelwey and Steve Borowit to a future meeting to discuss how the system might be incorporated into PoM2. The possibility of setting up training for faculty, in particular PoM2 mentors, was discussed. Dr. Joseph Britto, one of the developers of Isabel, is very interested in visiting UVA and would be available to speak to both faculty and students. The possibility of incorporating something of this nature into the second year orientation was discussed.
Cultural Competency. Don Innes has met with Dr. Fern Hauck and she will be leading a group to determine how cultural competency is taught in the School of Medicine, how to perhaps this issue in the curriculum and how to measure student competency.