Minutes 06.15.06

Minutes 06.15.06

University of Virginia School of Medicine
Curriculum Committee

Minutes
06.15.06

Surgery Conference Room, 4:00 p.m.                       

Present (underlined) were: Reid Adams, Gretchen Arnold, Eve BargmannDaniel Becker, Robert BloodgoodGene Corbett, John Gazewood, Jennifer Harvey, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill WilsonDevin Mackay, Kavita  SharmaDebra Reed (secretary) Guest: Debra Perina

  1. Basic Science for Careers. Debra Perina outlined the plans for the Basic Science for Careers program.  The course following the 3rd year clerkships is designed to review, expand, and focus on basic sciences as applied to a particular discipline. The course will be taught by basic scientists and clinicians over a three week period followed by the Rx/Dx course.  BS4C has three components - General sessions, Specialty sessions, and Applied sessions. In the General sessions a clinician will present a case and a basic scientist will discuss relevant concepts in context of the presented case.  Students are required to attend the General sessions (approximately 18 hours per student).  These sessions have universal relevance over all specialties.  Some suggested topics include: Fluid and Electrolyte Balance and Acid Base Disorders; Diabetes; Cardiovascular Disorders; Cancer; Lower Respiratory Track Disorders and Preventive Medicine.  BS4C includes 14 Specialty sessions focused on particular specialty careers, each ~3 hours. Students must select 7 sessions, but may attend more.  There are also Applied Sessions in which students will receive cases developed from specialties sessions in advance.  They will manage the case using concepts learned from general and specialties sessions and receive immediate feedback from faculty.  Groups of 5-10 students will be offered 9 sessions approximately 3 hours each and must attend 5 sessions, but may attend more. 

    Jerry Short has expressed concern that it may be difficult to find large lecture hall space in the mornings for the general sessions.  Dr. Perina responded that these sessions could be moved to the afternoon.  While small group space is sometimes a problem, it can usually be found.  The Committee reiterated that lack of space should not drive the curriculum. 

    Bob Bloodgood suggested that the list of suggested specialties sessions which included Clinical and Basic Science departments might better be classified by topics such as protein structure/function; transcription, gene regulation, secretory pathway cells, cell adhesion and migration and intermediary metabolism.

    The Curriculum Committee enthusiastically supports Debra Perina's plans for the Basic Science for Careers program.  The next step toward implementation of the course is to pilot a segment in the Spring of 2007 as an elective and measure the impact of the course by surveying participating students.  Dr. Perina was asked to work with Jerry Short to develop an optimal pilot, evaluation, and funding process. 

  2. Focus Group for Clerkship Discussion.  Jerry Short will schedule a "town meeting" for the Curriculum Committee and other interested faculty to meet with students who recently completed their clerkships.  The Committee will be notified by e-mail of the date, time and location.   Student have expressed concern that they lack sufficient practice/training in procedures such as insertion of IVs,  NG tubes, and Foley's, and blood drawing and blood gasses.  The Committee discussed ways of remedying this such as elective time with the phlebotomy team, ICU or ER staff.  The level of procedural competency a student should achieve by the end of the third year or even the fourth year and how much experience is necessary for this level of competency should be delineated. It was suggested that residents in departments such as Medicine, Pediatrics, and Surgery departments might be asked "what do you wish you'd know how to do when you started your residency?"  

    Note: The [OB/GYN clerkship] faculty and residents have responded to this [request for more procedures] by making a concerted effort to engage students in procedures with the result that in the last period students were involved in 17 vaginal deliveries, 130 speculum examinations, 91 PAP smears, 114 bimanual exams, 5 endometrial biopsies, 1 vulvar biopsy, 59 cervical DNA probes, 34 rectovaginal exams, 49 breast exams, 35 placental deliveries, and 1 circumcision.  This is a most positive development.  - May 18, 2006 minutes of Curriculum Committee

  3. Internal Medicine Clerkship.  Michael Rein has informed the Curriculum Committee about a problem recently surfacing in the Internal Medicine Clerkship.  The Accreditation Council for Graduate Medical Education (ACGME) has recently put UVA on institutional probation, and the program will be reviewed again in about two months.  Working through its Internal Medicine Residency Review Committee, the ACGME has decreed that an Internal Medicine Service can have no more than eight learners per attending physician.  This does not apply to any other specialty.  Learners include both residents and medical students.  Dr. Rein has recently learned that it is not possible to simply add a second attending to a team.  The major problem is that under these guidelines, only two students at a time may be assigned to the MICU and one student at a time to the CCU. To address this mandate, the Internal Medicine Clerkship will now make the MICU rotation two weeks long rather than four weeks.  Medicine would like to continue to provide at least some exposure to all students wanting this highly popular rotation, and students will now be doing the MICU following the core clerkships, rather than as 3rd year students, which may make it easier to get acclimated to this intense environment.  Students who have signed up for a  MICU rotation in periods 1,2,3,4,5,7,8,or 9, will be assigned  to another selective for two of those weeks.   If students have signed up for the CCU in period 2b or 6a, it may be necessary to reassign them also.  Students will be allowed to choose which other selective(s) they would like to participate in for the remaining two weeks.  Options include Acute Cardiology, Geriatrics, Hematology/Oncology, Infectious Diseases, Pulmonary Medicine or Digestive Health. The Committee will monitor this change and it's effect on the students' medical education.

  4. Introduction to Psychiatric Medicine. Bruce Cohen, Course Director, has proposed that the weekly interview sessions be reduced from 8 to 6 per student for the 2006-2007 year and that if it is unsuccessful, they have the option to revert to 8 the following year. In addition to the 8 sessions, there are two online sessions. The Committee endorsed this proposal and requests evaluation/assessment data on the change.

Donald Innes
dmr