Minutes 11/14/07

Minutes 11/14/07

University of Virginia School of Medicine
Principles of Medicine Committee

  1. Lobby Notification System:  John Jackson described the equipment that he was planning to install in the 1st year and 2nd year auditoriums in Jordan Hall that would allow instructors to notify medical students in the lobby when instruction was resuming in one of the lecture halls.  This will involve both visual and auditory clues and be controlled from the speaker=s consol.  It is hoped that this technology will be installed in Jordan Hall in time for the Spring 08 semester.

  2. USMLE Part I review course for 2nd year medical students. Brad Bradenham presented a detailed proposal for a USMLE Part I review course being organized by himself, Ann Falor and Sixtine Valdelievre. While the cumulative exams in the 2nd year courses provide a useful tool for preparing for 2nd year material on USMLE Part I, the medical students felt that something was needed for reviewing the 1st year material.

    In terms of assessing need, 3rd and 4th year students were polled on two questions:
    a.         Is current USMLE Step I preparation adequate?
    46% Yes; 53% No; 1% Maybe
    b.         Is this plan for a review course a good idea?
    73% Yes; 22% No; 4% maybe
    In cross-correlating these two questions:
    50% Prep not adequate/course a good idea
    15% Prep is adequate/course a good idea
    33% Prep is adequate/course is a bad idea
    4%   Prep is not adequate/course is bad idea

    Basically, course is designed to serve that population of 2nd year students who would agree with those students who felt their preparation was inadequate and the course is a good idea.

    Course Proposal: Over a period of eight weeks, conduct 16 sessions (2/week) for 45 minutes/session during the Noon hour.  A trial session will be conducted by Dr. Howard Kutchai on November 27th on the subject of renal physiology in order to gauge student response. Idea is to use a large room in the library or an auditorium in Jordan Hall.

    The proposed format for each session: 15 clinical vignettes or questions, each to be followed by 1-3 Powerpoint slides with relevant basic science information. The students will select the questions and provide them to the appropriate faculty members, who will select the appropriate basic science content.

    Howard Kutchai suggested that physicians and 4th year students be consulted when selecting the clinical scenarios.

    Melanie McCollum felt that the deficit experienced by our medical students was in problem-solving skills and not in science content.

    Darci Lieb was concerned about impact of the review sessions on PoM2 small group meetings, which start at 1:00 PM in the small group rooms in the HSL.  There was a concern that the students might show up late for PoM2 small groups.  She also pointed out that the library rooms were too small for this review session and, in any event, they were needed for PoM2.  It was also pointed out that the availability of the clicker technology was another reason favoring one of the Jordan Hall auditoriums as the preferred location for the review sessions.

    Melanie McCollum pointed out that, in the past, when Gross Anatomy gave board review sessions at the end of 2nd year, student attendance rapidly petered out after the initial day.

    Jerry Short suggested that courses work to present their course exam questions in USMLE question format.

    The medical students leading this project will soon distribute the detailed schedule; questions for each session will be distributed 2 weeks ahead of time.

  3. Changes in the USMLE exam program:

    Don Innes reported on the meetings he attended at the AAMC annual meeting that related to the proposed change in the USMLE exam program that would combine Step I and Step II and give the combined exam at the end of the Clerkship period. One of the arguments in favor of this change is that separation of basic science and clinical science in Step I and Step II adversely affects medical schools= ability to develop an integrated curriculum model.  There is currently no consensus as to whether to go to P/F or continue using a score for the USMLE exam(s).  The AAMC indicated the following timeline: 1) Currently, taking public comments, 2) Their study committee will deliver recommendations in early 2008, 3) State licensure boards have a vested interest and some may have to rewrite current state rules, 4) Full review by Spring 2009, 5) It would take two more years to implement (probably in Spring 2011).

    The Principles of Medicine Committee had a lively but brief discussion of this issue.  Some of the issues that came up: 1) Will this change devalue the basic sciences? 2) Will it change student behavior, in terms of spending less effort on learning the basic sciences? 3) Will this change free the basic sciences faculty from having to Ateach to the test@?, 4) Will the change open up opportunities for further integrating the basic sciences and clinical sciences? 5) Will it solve our 2nd year lecture attendance problem? 6) Would the new Part I have to be moved up in time to ensure its availability for Residency selection decisions or would residency programs be faced with the possibility of having no USMLE results at time of making residency selection decisions?  Don Innes pointed out that we could choose to utilize another NBME instrument (tailored basic science examination) at the same time in the curriculum when the old USMLE Step I was administered.

    It appears that the possibility of losing the old USMLE Part I has generated a lot of national concern among professional societies [American Physiological Society; American Society of Pharmacology and Experimental Therapeutics; the Association of Medical School Neuroscience Department Chairs] representing areas of the basic sciences, as well as the National Association of MD-PhD Programs.  See attached two letters that have been sent by the American Physiological Society and the National Association of MD-PhD Programs to the AAMC.  Individuals can provide input on the proposed changes to the USMLE at the following web site:


    The discussion of this topic will be continued at the next meeting of the Principles of Medicine Committee, which will be held on Wednesday, December 12th at 2;00 PM.