Minutes 09.27.07

Minutes 09.27.07

University of Virginia School of  Medicine
Curriculum Committee

Pediatric Conference Room, 4:00 p.m.                       

Present (underlined) were: Reid Adams, Gretchen Arnold, Eve Bargmann, Dan Becker, Robert Bloodgood, Brad Bradenham, Gene Corbett, Wendy Golden, Donald Innes (Chair),  Howard Kutchai, Marcus Martin, Chris Peterson, Jerry Short, Bill Wilson, Emily Clarke, Sixtine Valdelievre, Debra Reed (secretary) 

  1. Response regarding ACLS and electives. An e-mail comment from Meg Keeley (Electives Director) regarding ACLS was read to the Committee.

    "Re: the ACLS discussion: ACLS is offered almost monthly and PALS is offered 5 times a year. Students are not allowed to take these courses during selectives or during an ACE. They must get permission from their primary elective supervisor to the course (the supervisor of course may not grant permission or the student may need to be instructed to make up the time). Students should miss only 2 days for the course. We could consider not offering concurrent credit for these courses but many students take advantage of this opportunity and use it for an extra one credit for whatever reason they may need it."

  2. An article entitled "Breathing Life in the Lecture Hall" from the Washington Post (9/24/07) was distributed to the Committee.

  3. Class Size and the Commission on the Future of the University. The Committee continued their discussion of the class size issue. A recent report from the AAMC entitled "Recent Studies and Reports on Physician Shortages in the U.S." was distributed to the Committee.

    As Dr. Short was unable to attend the meeting, his e-mailed comments were read to the Committee.
    "My current thought about class size is that the 160 goal is feasible and socially responsible, especially if it brings additional funds to strengthen the clerkship experience of students. My reading of the AAMC 2008 GQ Weaknesses is that our current away sites are not up to the quality of UVa sites. Perhaps the need to accommodate more students will give us the opportunity and funds to rethink and remodel the activities for students in the third year. I'm sorry I'll miss the discussion."

    While the School of Medicine's primary function is to competently educate medical students, increasing the student body to a point where the resources (faculty, space, etc.) are found lacking is neither socially, ethically or professionally responsible.

    Residency Program rules such as the 8-member team limit for Internal Medicine restrict the number of medical students that can be placed on a service. as well as the lack of nearby outside facilities for clerkship placement were discussed.

    In that the major problem is geography - our rural area - we could work it to our advantage. As an alternative to placing 20 more people intoCharlottesville a separate rural based medicine tract sponsored by UVA with much of the first two years taught by telemedicine/web-based learning and the clerkship/elective years spent in a rural setting was discussed.

    One way we could increase class size would be to start a rural medicine track, as others University of Washington) have done -- UVA at Wise or Harrisonburg. A small dedicated faculty at the clinical/education site, with much of the preclinical curriculum being web based with faculty-led small groups, and several one-month stints in Charlottesville for anatomy prosection, etc. Students could have continuity clinics from day one, do many rotations on site, and do electives in Charlottesville. 

    A study is being done now in the Dean's office to determine the financial costs of an increase in class size to the School of Medicine and whether the increased tuition would adequately cover these costs.

    The Committee agreed that the infrastructure must be able to support an increased class size before the class size is expanded.  Local area hospitals have no residency programs in place nor have been inclined to accept medical students in the past.

    A letter will be drafted to the members of the Commission on the Future of the University and circulated to the Committee for comment.  To maintain the quality of education the School of Medicine provides now, the Curriculum Committee unanimously agreed that an increase in class size is unrealistic with the current resources or even with resources we can reasonably foresee in the near future.

    Ultimately, five issues must be addressed:

    1.  Number of faculty required for teaching, both basic science and clinical
    2.  Classroom/laboratory space
    3.  Sufficient clinical experiences with patients
    4.  Support costs (staff issues)
    5.  Quality of education outcomes

  4. The next meeting of the Curriculum Committee will be 10/4/07. Eugene Corbett will update the Committee on the progress of the Clinical Skills program.  The latest AAMC student questionnaire will also be reviewed on 10/4. On 10/11 Debra Perina will meet with the Committee to discuss plans for the Basic Science for Careers course.  Also, coming up in October, Linda Wells from Anesthesiology will meet with the Committee to discuss a pain management curriculum and Fern Hauck will be invited to apprise the Committee of her work with cultural competency.