Minutes 04.10.08

Minutes 04.10.08

University of Virginia School of  Medicine
Curriculum Committee

Pediatric Conference Room, 4:00 p.m.                       

Present (underlined) were: Gretchen Arnold, Eve Bargmann, Dan Becker, Robert Bloodgood, Thomas Gampper, Wendy Golden, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Mohan Nadkarni, Chris Peterson, Jerry Short, Bill Wilson, Kira Mayo, Jason Franasiak Debra Reed (secretary)

  1. USMLE Response to Pathology Chairs.  Portions of a letter from Peter Scoles of the USMLE in response to inquiries made by a group of Pathology Chairs regarding the future of the Step 1 and Step 2 examinations were read.
    There is a misconception that the recommendations under consideration involve either the elimination of Step 1, or the combination of the current Step 1 and Step 2 examinations into a single one day test, and the subsequent administration of the current Step 3 examination.  This is not the case. Instead, we anticipate building new test items that measure not only mastery of clinically relevant basic science information, but also the ability to deal with emerging concepts which may have relevance in the future for the practice of medicine.  Both "gateways" in the new examination would contain these materials. Conjunctive scoring models could be applied, with minimum requirements in basic sciences and clinical materials in both gateways as a condition of passage. Although some current USMLE test materials may be appropriate for the purpose, it is certain that new blueprints, test materials, and test formats will be required.

    One of the more disconcerting findings has been that curriculum officers at nearly all US medical schools report that students engage in "binge and purge" behavior with regard to basic science knowledge in the several months surrounding the transition from preclinical studies to clinical rotations, regardless of the nature of the curriculum at their medical schools. Most believe that Step 1 of the USMLE interferes with their ability to achieve horizontal and vertical integration of basic science across the curriculum, and encourages this approach on the part of students. NBME basic science retention studies are not encouraging, and frankly, the popularity of USMLE review courses and the volume of sales of USMLE Step 1 preparation books support these conclusions.

  2. Combined Degree Program:  M.D./M.B.A.  A proposal for a combined M.D. and M.B.A. degree program was submitted to the Curriculum Committee for approval.  After discussion, the Committee voted to approve the proposal.

    Proposal: Combined Degree Program:  M.D./M.B.A

    Students must be admitted to each career/degree program (M.D. and M.B.A.) by the respective schools, the School of Medicine and Darden).  Admission is first to the M.D. program and then to the M.B.A.

    Enrollment, Tuition and Financial Aid
    A student enrolled in the M.D./M.B.A. degree program will have access to the financial aid office in the school of enrollment. The student will spend the first 3 years in the School of Medicine, the fourth year in Darden, the subsequent summer semester in the School of Medicine, and the final year registered in Darden.  In total the student will pay a total of 7 semesters of tuition to the School of Medicine 4 semester to Darden.  Darden will reimburse the School of Medicine for 0.5 semester of tuition for the Spring Semester of the final year. Registration, tuition and fees will be as follows:

    Year 1  SOM Fall and Spring
    Year 2  SOM Fall and Spring
    Year 3  SOM Fall and Spring
    Year 4  Darden Fall and Spring; SOM Summer Session
    Year 5  Darden Fall and Spring (tuition to be divided evenly with the SOM)

    Students will be required to meet the degree requirements of the School of Medicine with the exception that the total number of elective credits will be reduced by 8 provided that they successfully complete four quarter long health-related courses in Darden to be designated by the Darden faculty.

    Tracking Credit
    Documentation of successful completion of the 4 Darden courses will be required from Darden in order for students to receive the M.D. degree.  Documentation must be received at least 3 weeks before the graduation date.

    Effect on the Transcript
    The UVA academic transcript will include separate entries for each career/School (Medicine/Darden-).  Credits or coursework taken while enrolled within a particular career will appear on the page of the transcript affiliated with that career.  The following courses will have to be manually entered by the School of Medicine:
    MED 665 Selectives Program
    MED 670 Electives Program
    MED 680 DxRx: Health Care Policy
    MED 682 Basic Science for Careers

    Awarding of Degrees
    Both the M.D. and M.B.A. degrees, providing requirements have been met for both career plans, can be awarded on a UVA graduation date.

  3. Cultural Competency.  The Committee agreed to ask the PoM-2 course director to revise two of the tutorial cases to include a component of cultural sensitivity [competency] for 2008-09.  Guidance in revising the cases may be available through Fern Hauck and the Cultural Competency Committee. 

  4. CPX and Cultural Competency. The Committee requests that beginning in 2009 the CPX include at least one case evaluating the student's ability to work with a patient in a competent, culturally sensitive way.

  5. Anatomy Course Review.  The Curriculum Committee discussed the Anatomy Course Review of 4/3/08.  The Committee began the review and will recommend that more image analysis be integrated into the course.  The discussion will continue at the April 24th meeting.

  6. Cumulative End of First Year USMLE Examination.    The Committee began exploration of a summative examination after the first year.  The Committee had a lengthy discussion on whether such an exam is a good learning tool, whether it is good preparation for the case based questions of Step 1, timing of exam, whether there would be increased stress to students with addition of the exam, appropriateness of questions on the exam and difficulties course directors face in not knowing what topics are covered on the exam. Input is requested from the Principles of Medicine Committee. Medical Education is investigating the nature and composition of an examination containing a specific subset of questions concentrating on our first year courses. 

Donald Innes