University of Virginia School of Medicine
Principles of Medicine Committee
Minutes
09.12.07

1. Review of 2006-2007 course reports and attempt to identify trends
   
   The annual course reports are available on the Principles of Medicine web site at:
   http://www.medicine.virginia.edu/resolveuid/e1f93ccd3948c5cef03d49ad6ff2d115
   
   Trends in the 2006-2007 curriculum (Foundations of Medicine and Core Systems) include:
   
   

   Continued decline in self-reported attendance in Core Systems Concerns of declining course performance in Core Systems (clear decline in PoM2) Changes in Social Issues in Medicine course (SIM): introduction of more pedagogical material; making the service component optional for the Fall semester of 1st year. Changes in Gross Anatomy Scheduling (3 days/week instead of 4 days/week) Introduction of Audience Response System (ARS) - some shakedown problems have been encountered, especially with the MAC version Continuing Cadaver Problems in Gross Anatomy Increased number of failures in Physiology/CTS Increasing use of Student Advisory Committees (SACs)

   Compiled data on the student evaluations of courses and the student performance in courses were presented and discussed:
   
   
   
   
   
   There was some discussion of the issue of medical student attendance at lectures and whether there was any correlation between lecture attendance and academic performance. The self-reported data collected from the medical class has shown a steady decline in attendance in the Core Systems section of the curriculum.  Julie Turner has been collecting detailed attendance data in the Medical Microbiology course for a number of years and is attempting to correlate these data with performance measures. Don Innes has looked at academic performance and attendance in Pathology and sees some correlation (if one eliminates the top and bottom ends of the distribution). Bob Bloodgood will prepare a web survey about lecture attendance (to be administered to the 3^rd year class each year) and will send it out to the Principles of Medicine Committee and the Curriculum Committee for review.  The discussion of attendance issues will be continued at the next meeting of the Principles of Medicine Committee.
   
   
2. Oasis On-Line Schedule:   John Jackson (Office of Medical Education) gave a demonstration of the new Oasis scheduling system that is now available at:
   
   https://oasis.med.virginia.edu/index.html
   
   Each faculty member who wants to use the Oasis scheduling tool needs to first obtain a password. In the yellow field, enter your computing ID or full e-mail address and submit.  You will receive a password by e-mail.  Then go back in and enter your username (computing ID) and password and click "login". You can then reset your password or enter "Calendar". You will see quite a jumble of both 1st and 2nd year schedules at first.  Click on "View" at the upper left and you get a pull-down menu where you can select just the Foundations of Medicine schedule or just the Core Systems schedule or you can click "show my events" which will only show the events for which you are the instructor. You can edit a particular page using the "Page Filter" drop-down menu. You can print a page using the "Print" button.  There are black arrows for moving forward and backwards in the weeks and a small menu icon for navigation.
   
   
3. Medical school Class Size:
   
   In the draft report of the Commission on the Future of the University=s Committee on Schools and the Medical Center, the School Plan Summary from the School of Medicine states: AWhen the [Claude Moore Medical Education Building] opens, class size will increase by approximately 20 students (15%) from 142-162 per year.@
   
   There are many obstacles to increasing medical school class size without compromising the quality of the medical  education that each one of our students receives. Among the limitations to increasing class size are:
   

   Lmited patient availability, which already limits the amount of direct patient contact our students receive and the amount of clinical skills education that we can deliver. There are currently concerns about availability, quality and consistency of away training sites. The new medical school being created by Carilion and Virginia Tech may reduce the capacity for training our students in Roanoke. There are already concerns about the quality of resident education provided in Roanoke. We were cited in the recent LCME reaccreditation report. (noncompliance Item 1 in Feb 28, 2007, letter from the LCME to President Casteen) in terms of comparability of experience at various sites. There is already a limitation in available sites for students in the AIM clerkship and the Social Issues in Medicine (SIM) course. We are already stretching our clinical faculty too thin in terms of staffing small group teaching in PoM1, PoM2, Clerkships, Cells to Society, etc. and we are about to introduce the new Basic Science for Careers course which will increase the need for small group instructors. The draft report of the Medical School section of the report of the Commission on the Future of the University states: AOver the past several years, economic pressures have led to fewer faculty who are willing to teach.@ Coupled with a dearth of small group instructors is a dearth of small group teaching rooms. There is a lack of room for expanding the laboratory teaching that currently occurs in the Gross Anatomy dissection labs and the 2nd floor Jordan Hall medical students teaching labs (which has a fixed capacity of 147 students). Expanding class numbers would demand additional basic science lab instructors at a time that basic science faculty are under pressure to maintain research grant income productivity in the face of a very tight funding situation at NIH.

   While the state of Virginia may currently need an increase in the numbers of physicians, the state will soon be served by 5 medical/osteopathic schools and collectively these institutions will be dramatically increasing the yearly production of medical graduates in the state: 1) VCU School of Medicine in Richmond plans to increase its medical class size from the current 184 to 250 per year, 2) The Virginia College of Osteopathic Medicine (VCOM) in Blacksburg has just graduated its first class (Class of 2007) of 139 graduates, 3) The new Carilion-Virginia Tech Medical School will admit its first class in 2009 or 2010 and will graduate 40 physicians/year.
   
   After a thorough discussion, it was the consensus of the members of the Principles of Medicine Committee present to go on record as opposing any increase in the medical school class size at UVa.  It was decided to prepare a proposal and send it out for an e-mail vote of the entire committee.  The proposal is on the committee web site at:
   
   http://www.medicine.virginia.edu/resolveuid/28f05f14b06820baab74fd71e1e37cbd
   
   The result of the e-mail vote was that the Principles of Committee voted 25-1 that the UVa School of Medicine NOT increase the medical student class size beyond the current level of 142 students per year.  These 26 votes represent course directors from all courses in both the Foundations of Medicine (10 courses) and Core Systems (6 courses) portions of the medical curriculum, as well as 4 medical student representatives to the committee.  Reasons for this recommendation are discussed below.  The vote and detailed justification statement were sent as a recommendation to Don Innes and the Medical Curriculum Committee.
   
   
4. Reminder that all courses need to organize and utilize a Student Advisory Committee (SAC)
   
   
5. The next meeting of the Principles of Medicine Committee will be held on Wednesday, October 10, 2007, at 2:00 PM.