Talking SMEC

Thu, 23 July 2009

7-23-09 S.M.E.C. Executive committee meeting

Filed under: Minutes — bpb5d @ 20:26 UTC

July 23, 2009 S.M.E.C. Executive Committee minutes.

In attendace: Travis Moss, Jon Hemler, Nicole White, Maureen Dale, Emily Binns, Laura Page and Brad Bradenham


1) Follow up of curricular retreat. Evan Lapinsky has agreed to author the S.M.E.C.’s official report from these two meetings. This draft will be jointly proofread by Brad and either Andrew Pfeffer or a third year representative before it is posted in its final form.

– We all agreed that the S.M.E.C. does not need to vote separately on the same issues discussed at the retreat.

2) Geriatrics/ Acute Care clerkship (Nicole and Laura):
Following student working group on geriatrics/ acute care meetings, Nicole and Laura have been able to meet with Dr. Plautz. More student/ resident pairing and student/ nurse pairing is currently being experimented with and we have anectdotally received very positive feedback from this intervention. Dr. Plautz has been very responsive to student feedback and is more than willing to work within the framework of the clerkship.
Perhaps in the coming months, the framework and overall goals of the rotation could be discussed in a more formal way in an effort to overcome major barriers to what could be a truly exceptional educational experience.

Triage- operating within the existing framework. Dr. plautz’s idea of having a student follow a patient from triage all the way through their ER visit was universally well received at today’s meeting. It is the best and possibly only view a student will ever get at seeing what a patient goes through while in the ED. Additionally it stays in line with the goals of the clerkship as the student could function as the patient’s nurse, taking their vitals, putting in IVs, foley catheters, getting a EKG, etc.

Geriatrics- it is also very apparent that the geriatrics clerkship is responding very well to student feedback. We will continue to closely follow this clerkship as it evolves.

3) Class of 2013 rep/ SACs. Evan Lapinsky will be principal contact person. Will get in touch with Allison Innes with regard to orientation time allotted to S.M.E.C. / Mulholland introductions. As we’ve done in previous years the presentation will be an intro to what the SMEC is and how to get involved. Additionally this year, we talked about briefly addressing professionalism during orientation.

4) Curricular update:

WGoCSE: Working hard to provide a clinical framework for the entire curriculum.

Individual Systems: MCM (Molecular and cellular medicine) will likely be leading the way in constructing a more detailed day to day plan outlining its learning objectives and lecture topics. Once this has been done, other systems will be able to work with MCM to identify issues that are better left to systems or alternatively, are better suited for MCM. This will be a big step in moving things forward. Brad needs to work harder to make sure students are in place with every system. (We have now have students with renal, GI, hematology and MCM, with a possible student interested in endocrinology). Still need students for reproductive, CV, Respiratory, several for brain and behavior and one for the bugs and drugs section.

5) SMEC structure changing with the new curriculum. Our structure could mimic the two committees that will replace the POM committee: systems community and thread/ content director community. Consider the second year rep chairing one of the two and one of the two third year representatives chairing the other. Likely recommend that the second year rep chair the systems community and the third year rep chair the content thread community as this community will likely have a more longitudinal appreciation of the curriculum, which would like to have the direct input of a student who has experienced/ is experiencing the clerkships. Alternatively, our current structure could be adapted to have SACS for each block.

6) Mulholland Clerkship report:

Congratulations to Jason Woods, who has been elected chief editor of the Mulholland Clerkship report by the Mulholland society.
His rough timeline is on a much more accelerated pace than previous years: September 1 is when the deadline by data will be fully mined by Dr. Short’s office and sent to section writers. Jason’s preliminary goal is for section drafts to be completed by Nov 1 (before interview season). He will get the draft back to section writers as soon as possible and ideally allot them 4-6 weeks to get the final drafts in. Additionally, a hope is to beef up the executive summary a bit and have all the final drafts from section editors by January 1, with a final draft from Jason being submitted to Dr. Short by February 1.

The more traditional timeline is as follows:
Students get data from Jerry Short’s office in October/November. The editor will be provided with a copy of this year’s report so that he/ she can make sure us section editors keep the same format. Section writers should have a rough draft to the chief editor by early January. The chief editor will then get the individual reports back to the section editors by mid-January, which allows us section editors 4-6 weeks to meet with the clerkship directors, after which the clerkship director can write a response, which will be incorporated into the report. After all of this is given back to the chief editor, a final read is done, and the final draft is submitted to Jerry Short by early-mid March. Final report usually comes out between late April and mid- May.

Mon, 01 June 2009

S.M.E.C. Curricular retreat- part 2: May 31, 2009

Filed under: Uncategorized — bpb5d @ 0:44 UTC

S.M.E.C. Curricular retreat: Part 2 Sunday 5/31/2009

In attendance:

From Mulholland/ S.M.E.C.: Brad Bradenham, Lisa Herman, Laura Page , Maureen Dale , Tyler Harris, Nicole White, Andrew Pfeffer, Evan Lapinsky, Tina Ho, Jon Ableson, and Patti Frost.
Dual Degree Students: Adam Meuller
Students from open forum: none in attendance.


∑ Discussion of previous SMEC meeting- 6 pointed issues.
o Minutes sent to professors/course directors/clerkship directors
ß Feedback thus far has been minimal secondary to the minutes just having been made public, but it has been resoundingly positive.

∑ Today: discussing issues and voting to come to a consensus. By the end of this meeting we will have voted on all 6 major issues by ballot. These ballots will be tallied after the meeting and will be included in a position paper generated by those in attendance. Evan Lapkinsy’s name was mentioned as the possible chief author of this position paper.

∑ Issue #1: Autonomics in the new Curriculum:
o Have an autonomics component in Molecular and Cellular Medicine (MCM)
ß Anatomy ,neuroscience, phys, pharm. Faculty would al co-teach this “thread” through MCM. The gaol would be to teach this thread in , 30 class hours.
ß Separate, but similar pharmacology related discussion: Include anti-neoplastic drugs in MCM alongside biochemistry and genetics? Learning about the drugs that disrupt microtubule/ spindle formation as you’re learning about mitosis.

ß Discussion: agree with autonomics, maybe not for anti-neoplastics?
∑ Preliminary thoughts: beginning of first year might be too early for anti-neoplastics (won’t stick, too far away from boards)
∑ More general discussion on whether moving more global drug classes up into the MCM course (such drug classes include NSAIDS/ other DMARDS/ anti- inflammatory drugs)
ß Vote on autonomics ,
∑ The issue of anit-neoplastic and anti-inflamm drugs being introduced in the MCM course was tabled for now to be dealt with by the SMEC at a later date.

∑ (1st VOTE): for or against an Anatomy, neuro, phys, pharm co-taught 20-30 hr, Autonomics thread in MCM.

o Issue #2: Immunology and microbiology/ parasites/ Antibiotics:

ß Immunology in MCM

ß Micro should not be dismantled throughout the systems
∑ Faculty are currently moving in this direction. It is hugely important that students do all they can to prevent this from happening as it would undoubtedly be detrimental to the education of our future peers.

∑ As of right now, there is also no talk about, or plans for including an infectious disease block/ system in the systems curriculum.

∑ Andrew Pfeffer brought up an interested question: how do other schools that teach in a systems format handle the issue of infectious disease/ microbiology? Answer from Brad: Many schools (Vanderbilt for sure, maybe UPenn+ Hopkins as well): all teach a micro equivalent early on what would be considered the ‘pre- systems’ stage of their curricula.

∑ School of thought 1 vs. 2 (see previous minutes from 5/3 meeting)
o The current Microbiology course experimented with school of thought number 2 with SMD11 (se 5/3 minutes). To put it mildly, it was a failure in the eyes of most students. This is evidenced by microbiology receiving the poorest set of student evaluations it has received in years. Why was this received so poorly? A potential logic is described in the 5/3 meeting minutes…but simply put… With so many guest/ clinician lecturers being responsible for delivering core material to students in a relatively directionless format…the necessary information simply didn’t get delivered. Perhaps this format would be more successful if lecturers were held to a much more rigorous standard and were required to teach students a certain set of predetermines learning objectives. As it is, most of the times, lecturers simply regurgitate the same lectures they give to residents, which at best are inappropriate for second year medical students and are at worst a huge waste of their time as they lack any clinical experience/ context for such a lecture.

∑ Middle road solution (also in previous minutes)
o Option #1. Infectious disease system (first system taught following MCM) Very micro for micro- sake style: lecture topics are organized by organisms. Every day is diff bug- you are still taught the associated diseases, but for the most part, this approach would target the biggest 15- 20 bacteriological infections, major parasites, fungi, viruses and antibiotics in as holistic a manner as possible. (estimated that this system would take between 4-7 weeks to teach properly
ß Each organ system at their own discretion could then be free to target infections that are pertinent to their system in amore clinically oriented approach that outlines in the infectious disease section.
ß Pros: Early intro to infection…build on knowledge of infection/ treating infection throughout second year. Infection pops up in every system. This is a hugely important topic. All we need to understand the topic is an understanding of immunology…which we will have already had by this time.
ß Cons: For Dr. Turner, she may consider this a step back. She and many of the micro bio/ ID faculty have been working tirelessly to make the course more clinically oriented. Past classes have clamored about how irrelevant micro is to doctors…she’s spent the past several year trying to make it more clinically relevant….and now, we’re clamoring about how we don’t understand the clinical concepts being presented to us b/c we don’t have enough background micro/ clinical knowledge to make sense of highly clinical topics. Basically…if we were her…we’d be pretty frustrated at this point. Again…the middle road will hopefully turn out to be a productive solution.

o Option #2. (3 parts) Nuts and bolts micro in MCM, after immune, then clinical spread out in the systems, then final system is infect disease
ß (Part 1) Formal handling of bacteriology, virology, mycology, parasitology and antibiotics in MCM. Would likely have to extend MCM into January to accommodate what would likely be between 4-7 weeks worth of material.
ß (part 2 ) System by system handling of infectious disease is where more clinical / differential- minded thinking would come in.
ß ( Part 3) Last system is infectious disease (prob short), brings everything together (or maybe have clinical correlations here too), global disease processes.
ß ***Note: the only really differences between option #1 and #2 have to do with semantics/ under what course title what is going to be taught and what exactly should be taught under a system entitled infectious disease? Should you be taught all of micro/ antibiotics in an ID system, or should you have an ID system that really tried to get you thinking like an ID doctor? Difficult question to answer.
ß Pros: having s short infectious disease system at the end dealing with global infectious processes (sepsis/ septic shock etc.) would be a great time to sit back and really give students a chance to synthesize a lot fo what they’ve spent the past few months learning.
ß Cons: risks reviewing too many things that don’t need formal rehash at end. Discrete time for this type of “Synthesis” built into the curriculum could open the door to a substance-less waste of time. At the end of the year, if not taught with a lot of enthusiasm, students may respond poorly. If topics are revisited, again student just might choose to go play golf instead of going to lecture (“I’ve already had that before- this is a waste of my time.”). Rather, our BS4C and DxRx have afforded us the chance to synthesize our educations at an even more appropriate juncture- between third
ß year and fourth year.

ß Issue 2 vote (2nd VOTE): choosing Option #1 or #2 above

o Issue #3: Core clerkship issue: What defines a core clerkship?

ß Previous meeting minutes: core is different for everyone, but some things you NEED to have. After the last meeting, we all came to the conclusion that perhaps the best stance to take is that perhaps you can “customizing your core.”

∑ Andrew Pfeffer on” how to think about core clerkships” What medical services does a community hospital have to have in order for it to be a fully functional hospital? : medicine, general surgery, pediatrics, OBGYN, ER, acute psychiatry ward (might be able to get away with not having neurology….not unlike many smaller hospitals…could maybe get OSH consults.

∑ Another way of looking at it: There is some degree of background knowledge every doctor should have. – scenario- your on a plane…someone has a heart attack…is in labor…is having a stroke….

∑ Bottom line; This group agrees idealogically with every “core clerkship” that exists in the 2011 curriculum (note: two- 2 week surgery electives are not considered core clerkships).
∑ We all agreed that geriatrics is important enough to merit consideration for being a core clerkship- as is critical care/ anesthesia experience.
∑ However…what has not gone unnoticed to us as students is that they added 4 weeks of graduation requirements and taken away 2 months of fourth year time without providing us with any additional flexibility in our schedules to accommodate with a dramatic shift in the third/ fourth year dynamic.

o Maybe we just want more flexibility?:

o Option #1: 8 weeks into four- 2 week block experiences: simply choose from existing selectives, and any others interested in providing brand new third year student with a 2 week experience (eg: radiology, pathology , anesthesia, dermatology).
ß It is implicit that any department that wants to have a selective available to third year student would have to be willing to take green 3rd year med students and provide them with an ORGANIZED, MEANINFUL experience.
ß Pro: 3rd year is long, having some blocks like this would invigorate students to get a taste of 4th year style
ß Would still have to do acute care and geriatrics before graduation, but it could be in 4th year.

∑ Important note/ digression: preliminary/ anecdotal reports from SMEC clerkship committee suggest that the geriatrics core clerkship experience is highly variable between students secondary to issues with continuity of experiences/ preceptors, lack of responsibility, lack of patient volume, lack of workload and highly variable demands on preceptors that inherently dictate the amount of time they can dedicate to teaching. The S.M.E.C. is in the process of forming a working group made up of third and fourth year students to help trouble-shoot this new core clerkship as best we can.
ß Cons: doing selectives first would be less valuable w/o having had 3rd year experience. Selectives are generally poorly organized- fourth years are given a fair amount of autonomy and told to try to get as much out of the experience as they can. Third years don’t quite know how to handle such autonomy yet…they need more structure….as such…any department wanting to have their selective populated by third year student would have to make create a structured 2 week curriculum for third year students. Again, preliminary reports from the SMEC’s clerkship committee reveal that the lack of organization amongst nearly all surgical selectives is detrimental to the new third years’ experiences. Selectives have evolved over the years into slightly less formal, enjoyable fourth year learning experiences in which fourth year students are appropriately given a fair amount of autonomy…the same level of autonomy is now being given to third year students….inappropriately so.

ß Option #2: radiology (4 weeks) and ER/anesthesia/ critical care (4 weeks)
∑ move 2 week geriatrics req .to 4th year.
∑ ER and anesthesia are consistently among the most sought after residencies by UVA students( we send roughly 15- 20 students/ year to each)…in addition, we send between 5- 10 students into radiology / year …they are all beginning to sound pretty “core” to us…and may very well need representation in the core clerkships.
∑ Pros: Don’t have to have wards experience to get a great experience out of either radiology or ER/ critical care/ anesthesia.
∑ ER, in particular, could be done at UVA, Culpepper, Roanoke, etc.
∑ Radiology has a fantastic core curriculum in place for fourth year students that could easily be taught to third year students as well.
∑ Emergency medicine also has a 4 week curriculum for med students…this curriculum would have to be combined with the existing 2 week critical care experience…but is a great start.
∑ Cons: as always…could these departments handle this many students?….we believe radiology could as they have the luxury or a huge, well organized department that could seemingly take on a large volume of students with relative ease. Their intradepartmental setup seems like it could be perfect for this. ER…might be trickier…may run into learner/ team caps as we have with internal medicine/ OBGyn/ peds.

ß 3rd VOTE:
o A: 4 two week block selectives (as described above)
o B: Radiology and ER/Anesthesia/Critical Care each for one month

o Issue #4- Individualized med school “experience”:

ß Would be SIM, changing it to exploratory (research, global health, community organizations, etc. (listed out in previous minutes)
∑ Three 10 hr experiences selected by each student (one would have to be community service oriented)
∑ Students would have a large say in the selection process…( not unlike they technically do now…an important digression: despite the preliminary survey taken over the summer before arriving, based on anlarge volume anecdotal evidence, very few students feel like they have much of any say in where they end up being placed for SIM… )

o Arguement to keep current SIM structure(hypothetical arguement)…sometimes isn’t it better to have students just have an interesting life experience? To try something they otherwise never would have seen/ done/ even heard of? ….To that, this group agrees..but humbly suggests that thanks to a diversity of students interests, it may be more valuablefor community groups and students alike to let people choose their own path. That way, community placements are getting energetic, enthusiastic students to work with (students that want to be there). Additionally, by having the requirement that one of the three- 10 hour sessions be community service related…UVA SOM is providing many students with “ that experience” that they otherwise would not have had. Bottom line….we’d have the best of both worlds.

∑ Important: Not a graduation requirement to have completed some big thesis- like project….all we would as of student is to give a 5-10 min report to POM or SIM group on their experience: did they like it, why/ why not…even if they didn’t like it…they could leave a record of their experience somewhere along with a few ideas for future projects for those that will follow In their footsteps.

∑ These experiences would be done in preclinical years. Make no mistake…SIM/ exploratory in its current for would be dismantled and re-shapen into this new entity…( by the way…this would be a pretty manageable dismantling and reshaping from what we can tell…)
∑ maybe have 3 presentation sessions set throughout the 1st 2 years to prevent procrastinating until very end- students trying to squeeze in all three experiences just under the wire.

∑ SIM lectures and small group would remain- they are the perfect vehicle to introduce important societal topics in into the UVA SOM: eg: LGBT issues, swine flu epidemic etc…
∑ Note: basic science/ clinical research experiences can be included as a 10 hr experience, provided that the researcher can readily and formally explain how their research has societal relevance.

ß VOTE 4: Do we support the above? (3Three 10hr experiences, 5 min presentation for each, community component for one of them, all projects must have social link)

o Issue #5- Testing:
ß Do not want more frequent testing, we like current approach- it is conducive to as good a quality of life as one can expect during medical school.
ß Testing format: holistic/system testing… or broken down by discipline as we do now…phys/pharm. etc.?
ß Should we test after each system?
∑ Pros: just one test, similar to format of third year clerkships.
∑ Cons: more frequent tests than we currently have.
ß Should the test questions look like boards?
ß Should things be re-tested over and over again?
∑ YES, there are certain things that should be re-tested (like antibiotics, autonomic concepts, anti-inflammatory drugs etc…)

ß 5th VOTE:
∑ 1. Single integrated test after each system
∑ 2. Less frequent tests- at end of every few systems…have week of tests broken down by discipline (kind of like now).
∑ 3. Integrated test but for 2-3 systems ( after every few systems, have a week where each system is tested individually)

o Issue #6- Preclinical treatment of pediatrics, oncology, and other surgical disciplines:

ß Pediatrics, oncology, and surgical threads throughout the preclinical years.
∑ Large scale: Have a pediatrics, an oncology and a surgery thread/ content director for the entire curriculum.
∑ Smaller scale: have a pediatrics, oncological, and surgical content director in each system community (pretty much already in place)
ß Unanimous vote in session: approved the above.

Soon to come:

1) Votes on all issues were tallied and recorded at the conclusion of the meeting. Those votes, along with detailed descriptions of this group’s position on the above 6 issues will be made available by the end of June in the form of a formal position paper. This paper will be made available for all to see.

2) Additionally, the S.M.E.C. will take the positions of this group, along with several other factors into consideration as it attempts to determine the student body’s stance on these and several other critical curricular issues. A timeline for the production of the formal position of the student body regarding curricular issues has not yet been established.

Thu, 28 May 2009

S.M.E.C. Curricular Retreat: part 1- Sunday 5/3/2009

Filed under: Uncategorized — bpb5d @ 23:20 UTC

SMEC Curricular retreat- part 1 Sunday 5/3/09

In attendance:

S.M.E.C. Mulholland: John Ableson, Pattie Frost, Evan Lapinski, Maureen Dale, John Hemler, Emily Binns, Nosheen Reza, Jason Woods, Laura Page, Nicole White, Andrew Pfeffer, Tom Hardka
Dual Degree Students: Adam Meuller, Jon Overdevest
Students from curricular forum: None in attendance
Moderator: Brad Bradenham (S.M.E.C./ Mulholland)

Agenda: Brad presented in broad strokes what the “Next generation” curriculum will look like- planned to effect for the class of 2014. This took roughly 20 minutes. At that point the meeting shifted focus to six issues that the S.M.E.C. had previously identified as issues where student input could be beneficial.

1. Autonomic pharmacology in the new curriculum: have an “autonomics thread”

1) We almost unanimously agreed that student would greatly benefit from keeping autonomic pharmacology early on in the curriculum (which is where it is currently placed). The main issue was how to prepare students to understand autonomic pharmacology. Currently, students have a full course of systems physiology before we are taught autonomics. This is ideal as autonomics interact with almost every system in the body; however, we came to the conclusion that it wasn’t entirely necessary. If anatomy, physiology and pharmacology worked together to create an ” automonics thread” taught in the foundations/S1: Molecular and cellular medicine section of the curriculum, we believe that would be enough. We don’t need an entire systems physiology course to understand autonomics. We just need to basics up front. Autonomic pharmacology will be revisited again and again throughout the curriculum and as it does, our understanding of those drugs and their physiology will only improve. However, initially, as with many subjects, a comprehensive understanding may not be what is called for. So, with anatomy professors teaching us the organization of the autonomic nervous system and physiology/ pharmacology teaching us what we need to know to have a basic understanding of what autonomic drugs are all about, we believe the result could be great for future students.

2. Immunology and Microbiology:

1) Immunology has found a home within the foundations/ S1: Molecular and Cellular Medicine section of the new curriculum.

2) Microbiology/ virology/ mycology/ parasites/ antibiotics = a different story. This will likely be one of the more difficult issues to handle in the new curriculum. There are two schools of thought; however we ultimately agreed that the middle way was the best way.

i. School of thought #1: “understanding micro for the sake of micro- ie: our current approach.” Brad used the following example from his wards experience. When thinking about an infection, what pops up in his head is an organizational scheme of gram positive bugs and gram negative bugs. You’ve got the spore forming gram positives, the enteric gram negatives etc…they are all grouped together by what they have in common on a microbiological level. For a student with minimal to no clinical experience, we all agreed that this was really the only way we can conceptualize infection. The only way we can understand infection in any organized fashion is to have some sort of organizational scheme that makes sense to us for where we are in our education (ie: we haven’t seen any sick people yet…all we’ve seen are charts of bugs grouped by common microbiologic characteristics- ie: gram positive/ gram negatives/. Growing in clusters

ii. School of thought #2: Understanding bugs from a clinical perspective: Many more experienced clinicians see infection from a purely clinical standpoint. Eg: when someone has infectious endocarditis, the have a list in their head of bugs that they have grouped together as likely culprits of that infection. This is a differential that has been assembled in their own heads from years of clinical experience. They have likely had a several patients that they can remember that had each bug growing on that heart valve. However, students don’t have that context to draw from. We haven’t seen any patients yet. While at one point this is where we all want to be and is how we all want to be able to think about infection, for our educational levels, it is not an appropriate expectation for us to be able to think this way. To make it clear, this is what would be asked of students if the microbiology course was spread apart all of the systems. We fear that we would never truly grasp the concepts that bring various bugs together and those characteristics that we use to differentiate one bug from the other. These would be links that we couldn’t make as we wouldn’t be learning about the bugs side by side- allowing us to compare them with one another.

iii. The middle road- “a little bit of both”. Multiple ways to do it….In curriculum speak- having both an infectious disease system and an infectious disease thread/ content director.

1. We thought that having an infectious disease system early on in the new curriculum where for 3-4 weeks, a very “nuts and bolts” approach to micro was presented to students. It would not be necessary to give students the full picture at this point. You could leave that to the systems. Pertinent infections to each system would be revisited in amore clinical context in each system. We could be briefly reminded of the “nuts and bolts” micro and the majority for the time in the systems could be spent talking about more clinical aspects surrounding infectious agents pertinent to that system.

2. Have a “nuts and bolts micro” course taught within the foundations/ S1: Molecular and Cellular medicine course- as described above. Again, as above, we could have some clinical micro addressed within each system as it is pertinent. However, what differentiates this “middle way” approach from the above approach is that we could include an infectious disease section as the last section of the curriculum. After having been exposed to all the systems, a soon to be 3rd year student could be spending their last weeks in second year thinking about truly global infectious processes that involve every system. By the way, this would not be much different from how POM2 is currently set up with infectious disease at the end.

3. Core Clerkships:

Somewhere along the line, we have lost what defines a core clerkship. It is a complicated issue- what is a core clerkship. We preliminarily concluded that the definition varies widely depending on who you talk to; however, perhaps what is core for one student may not be “core” for another. For a student interested in neurosurgery, having a two week neurosurgery experience during the third year is very much a core part of their education; however, for a student interested in pediatrics nephrology, this may not be the case. In essence, what makes up the “core” clerkship experience could differ slightly from person to person.

1) 4 weeks of surgery selectives in the third year. While this seemed a bit arbitrary, students have largely responded well to this for the following reasons. For those interested in competitive subspecialties, it is a big advantage to be able to gain exposure to their field of interest earlier as opposed to later. First and second year student voiced concern about making a poor impression on a surgical subspecialty clerkship early on in their medical training and preemptively “closing the door” on their future carre before they even got a chance at it. Fourth year students in attendance responded with the following. Basically, as a third year student- expectations are going to lower- after all surgical subspecialties made the sacrifice when they moved into the third year- they decided that they would be willing to take brand new third year students. Secondly, if you’re interested in something, you’ll be doing a few fourth year rotations in that field. This will be when your performance will determine your future/ ability to get letters of recommendation. Basically, these two weeks of selective just function as a taste of a field…nothing more. Some students voiced discontent that they only had surgical selectives to chose from as opposed to psychiatry selectives or OPB/ Gyn selectives or medicine selectives. In a perfect world, that would of course be preferable; however, given how competitive some of the surgical subspecialties have become, in fairness to our colleagues that are interested in those fields, perhaps it is more important to make sure they get the early exposure they need to ensure they’re making the right decision for themselves.

2) Should we trim down AIM/Family Med? What’s its overlap with geriatrics?
This has been a topic thrown around by students for years. Is redundancy/ overlap between family medicine/ AIM worthwhile/ necessary. It provides such a unique learning experience, but do we really need 8 weeks of it in the core clerkships…? Again…the important question: What should be considered “core”. Very difficult to answer at this time. The group did discuss the concept of moving AIM in it’s current state into the “new 6th core clerkship block, accompanying critical care/ geriatrics. This would allow the internal medicine clerkship to dramatically increase student exposure to the inpatient setting. Additionally, a dismantling of AIM, in its current form, was discussed in favor of having 2 weeks of AIM in the core internal medicine clerkship and 2 weeks paired with geriatrics in the “ new sixth block”. Such an arrangement was generally viewed as not only appealing, but more favorable than the current setup. Some of those present cited examples of having inadequate mentoring/ poor experiences on their AIM/ family medicine type rotations and by splitting up the experience…one would only be made to suffer through 2 weeks of a mediocre learning experience as opposed to a full four weeks. After all…a full 4 weeks of a mediocre learning experience during the core clerkships is a lot to swallow for students.

3) What about a Primary Care block or Outpatient Block ‡ this could include AIM, family, outpatient ob/ GYN, pediatrics/ psychiatry. Very feasible with our current setup of selectives…simply emphasize primary care more. Again, this would involve dismantling AIM in it’s current for in favor of a more flexible form. In this structure, it was duiscussed that AIM would essentially remain the same except for the fact that it would be offered in 2 week increments and students could have a lot more flexibility in scheduling these incremements (students may be able to choose between having their “AIM selective” in one of several locations) . In addition, it was noted that geriatrics will be an AIMish experience, emphasizing skilled nursing facility care/ palliative care etc…however, it will still predominantly be an adult internal medicine type experience. So, instead of 8 weeks of outpatient medicine, we currently have 10 weeks of it. The question was raised: are we bordering on excess? It was agreed that geriatric medicine should be a focus in our curriculum, as should primary care as both are in high demand in our current socio-medical environment…however, as student, perhaps a little more give and take is appropriate. While we were largely ok with it, it did not go unnoticed that an additional month of graduation requirements were pushed upon us. Again, would a little more give and take be out of the question?

4) Proposal: “new sixth block” be purely selectives ( four 2 week experiences, or one 4 week, and two 2 week experiences), including perhaps include a month of elective for select student interested in things that would afford such an opportunity eg: pathology, radiology, anesthesiology, dermatology etc.

5) 6th block = 4 two week blocks distributed out across all specialties

i. Or, make these requirements for 4th year…timing is important…couldn’t we just call the new 2 week geriatrics and critical care experiences “selectives” that could be done during third year, but are required to be done during fourth year, just like our current selectives?

4. Individualized Medical School experience:

1) Thesis? We are a professional school, not a graduate school. The word/ idea of a thesis was received extremely poorly by the group as a whole- nearly unanimously people hated it. However, the idea of an “ experience” was very appealing to everyone at the meeting. If students were given access to a database that had lists/ descriptions of all/ any medically/ community related projects o at UVA and were told to go out and try a few, the group unanimously agreed it would be a success. Emphasis would be on having an experience…if the experience inspired you to take on a project of your own, get published, present something…great…but there would be no formal pressure to do so. What would be required is a forum to very informally talk about your experience/ what you learned from your experience. (eg: 5 minute presentation to a SIM/ POM small group).

i. A comprehensive list of possible experiences/ projects students could pursue would have to include: medical research opportunities (clinical and basic science), community service programs/ specific projects, global health projects, interdisciplinary projects (business school, law school, education school, school of arts and sciences, school of public health, school of engineering, school of architecture).

Other issues/ specific questions we had regarding this topic:

– we discussed the current Preceptor program in POM1, and its evolution- Brad discussed what it used to be….a weeklong one on one experience in the community with a doc during Spring break of first year.

– Everyone has their own Experience spread across for 4 years

– Advisor/mentorship office ‡ mirror the MSSRP format- but again… across al 4 years…

5. Testing:

1) We need to be competitive as a school ‡ need prep for the Boards, but no teacher in their right mind wants to teach to a test…one word for those familiar with Va. Public schools: SOLs…

2) Objective truth: The way you learn is driven by the way you are evaluated

3) One big exam at the end of the pre- clinical years vs current structure-we’re a bit skiddish over the idea of one big test ant the end of the preclinical years….once of those is plenty…boards suffices…

4) Breaking down notes ‡ path/pharm/anatomy; will it be tested each way- subject based testing? System- based testing. What are going to do?
Big organizational question….are we gong to get a few big packets of notes at the beginning of the course entitled: molecular and cellular medicine, repiratory, cardiovascualr… – or- are we gong to get the same big packets of notes we get currently – organized by disciplines….- or…are we going to get something else entirely?

Bottom line….we do want you to give us something…don’t do away with handouts….that’s just mean…at least we think it’s mean. Just think about how you want us to learn the info/ in what context you want us to learn it…and present the info in a manner best suited to learning what you want us to learn.

5) Important to get broken down feedback from each exam- if we do have “systems based testing”- we would eed a breakdown of what disciplines we’re testing wel in, poorly in, withn a given system.
Having thought about this a priori will be useful when constructing tests…we need to be able to identify our weaknesses in this type of learning environment…it can be difficult at times for us to do it on our own in a reliable fashion.

6) Do we test by thread, or by block…big question…

7) CRITICAL: we cannot increase the frequency at which we have tests…this was unanimously agreed upon. UVA has got it right! Having significant blocks of testing roughly every 10 weeks during the preclinical years is perfect. Testing less frequently is possible, but should be done cautiously….testing more frequently would significantly decrease the quality of life of students here at UVA. In our current structure, the group unanimously agreed that UVA’s testing structure is well thought out- we are not perpetually going into a block of testing/ coming out of a block of testing. The group viewed this as critical to the learning process. When you’re being taught new material as your going into a testing block, a student is only but so engaged in the new material being taught if it isn’t going to be on the upcoming test. Similarly, immediately following a test, students are generally less engaged and need to take a little mental break before buckling down again.

6. Oncology and Pediatrics:

1) There are several highly clinical topics that students feel are grossly underrepresented in the pre- clinical years. These are two of the big ones… (OB/ GYN also falls into this category in many ways…although it does not lend itself to the following recommendations as readily as peds or oncology as it does not span the systems as widely.)

i. Present in every system ‡ needs more attention that currently receives in POM2

ii. Throw it into the systems with an increased emphasis, maybe a few devoted days

iii. Could they each be a thread
iv. *** In hindsight, the author of these minutes feels that Surgery could also be included in this list…not just general surgery, but all surgical disciplines receive a cursory if not nonexistent treatment in the preclinical years. This will likely change in the new curriculum with many clinicians from surgical subspecialties.

*** a structure for better integrating basic sciences into the third year needs to be developed. If this group does not have any ideas for such a structure, the S.M.E.C. as an independent organization will address it in a timely fashion.

Sun, 26 April 2009

4/22/09 Executive com. meeting

Filed under: Minutes — bpb5d @ 14:17 UTC

4/22/ 09
SMEC executive Committee meeting

Attendnace: Tina Ho, Evan Lapinsky and Brad Bradenham
( Meeting did not meet quarum)


1) Briefly discuss student survey:
a. Both Evan and Tina had excellent suggestions, especially with regard to improving the answer choices in the preclinical years.
b. Included an ‘independent learner’ answer choice etc…

2) Went over what to expect at May 3rd meeting.
a. We will be inviting all of Mulholland society, select members of the dual degree community and all those newly crowned second year students who came to the curricular forum earlier this month.
b. At the May 3rd meeting, Brad will briefly go over the aspects of the new curriculum that hav already been set in place and will discuss areas of focus within the curriculum that could benefit from SMEC input. 4 areas have already been identified
i. Autonomic physiology/ intro to systems physiology in the new curriculum. We now learn autonomic physiology right when students get back from summer vacation. It is perfectly placed there principally because they are some of the most important drugs we use and as they are constantly being revisited in the systems, it was deemed critical that we get a formal introduction to them early on in second year. The only reason we can get this early introduction to them is that we have already taken physiology and have a good foundation in systems physiology. In the new curriculum, we may not have that luxury as there are talks of physiology being taught entirely within the systems. Is this a good idea? Students at the forum we heald earlier this month expressed concern about only seeing information once during the preclinical years. Physiology and pharmacology currently complement each other in that all the pertinent physiology learned in the first year gets reinforced by pharmacology in the second year.
ii. Immunology and microbiology in the new curriculum- Do we need an infectious disease system? How do we want to teach micro? Immunology has pretty much found a home within the’foundations’ course; however micro is still trying to figure out whether it should be tought in an infectious disease section, or parceled throughout the systems. Perhaos a little bit of both wouldn’t be a bad idea?
iii. What should be considered a “core clerkship” in the new curriculum. Are surgical selectives really part of the core curriculum that every student needs to experience in the third year? For that matter, is the new critical care and geriatrics experience an experience that needs to be in the third year for every student? It is agreed that as a school, we need to move to a six ‘block ‘ paradignm; however, perhaps we need to take a step back and really look at what a core experience really is. It is very possible that with inherent restrictions, this 6th block could be a block that a student tailors to their own educational desires.
iv. How to allow students to tailor their education to their own interests and passions.

c. After presenting these topics, have students think about it for a week. The the group will ajourn again and discuss possible positions. At this time, the S.M.E.C. will vote on what we want our official position to be. Lisa Herman has volunteered to moderate this second meeting.

Mon, 30 March 2009

SMEC Transition Meeting

Filed under: Minutes — bpb5d @ 23:58 UTC

3/ 26/ 09

SMEC Executive Committee- Transition Meeting:

In attendance: Evan Lapinsky, Tina Ho, Nicole White, Maureen Dale, Emily Binns, Laura Page, Tyler Harris, Andrew Pfeffer, Jason Woods, Lisa Herman, Animesh Jain and Brad Bradenham

Old Officers >>>> New Officers
1st year class pres: Tina Ho >>>> elected in the fall.
2nd year class pres: Maureen Dale >>> Tina Ho
3rd year class pres: Andrew Pfeffer >>> Maureen Dale
4th year class pre: Doug Clark >>>> Andrew Pfeffer
Mulholland President/ vice presidents:
Jason Franasiak >>> Lisa Herman
Lisa Herman >>> Emily Binns
Jason Woods >>>John Hemler
1st year SMEC rep.: Evan Lapinski >>> elected in the fall
2nd year rep. Kira Mayo >>>> Evan Lapinksy.
3rd Year reps: Armin Razavi and Brad Bradenham >>>> Laura Page and Nicole White
Electives Committee rep: Keiko Greenberg >>>> Tyler Harris
SMEC Chair (4th year rep.): Animesh Jain >>>> Brad Bradenham.

Future advisors to SMEC- Travis Moss, Jason Woods.


A year in review- presented by Animesh Jain. Went over what we’ve accomplished over the past year.
– reviewed, edited and ratified the SMEC constitution.
– We clarified relationship between SMEC and Mulholland. SMEC is the Mulholland subcommittee that deals exclusively with curricular issues. SMEC does not require the permission of the Mulholland to take a given stance on curricular issues. In the same vein, the SMEC cannot speak for the Mulholland society as a whole. We function as an independent advisory committee for the mulholland society.
– First year orientation: had a 5 minute intro to SMEC, had an activities fair poster and were able to put our a textbook guide to first years.
– Second year- “Sac of Sacs meeting” – were able to orient all second year SAC members in a single meeting.
– Website- were able to post minutes on website.
– Overall we had better communication with SACs- we had several SACs come to SMEC executive committee meetings.
– BS4C- were able to create an advisory committee- shortened to course from 3 weeks, to 4 days. This gave the class over a week of extra break. It eliminated the large group lectures. Subjectively was very well received.
– DxRx: created a focus group with course leaders- were able to have several more small group discussion sections. Reduced the amount of traditional lecture time, added a film, changed the prompt for the final paper, added 4th year TA’s as group leaders. (4th years were able to do this for credit.) Significantly revised content.
– Student voce was heard- we have been able to establish consistent student presence on the following committees: Curriculum committee, Principles of medicine committee, Clinical Medicine Committee, Working Group on Clinical Skills Education. In addition, we have given presentations at the Joint Clerkship Directors meeting, and at this year’s curricular retreat (fall ’08).
– Board Review Course- greatly improved content- 3rd and fourth years reviewed almost every presentation. The time scale of the review was also changed. We decided to make sure the review was finished by the end of January. Attendance still dropped off over the course of the review. Note to perhaps have more students teaching towards the end of the review.**However, overall….attendance was better. Almost half of this year’s reviews were taught by students. We are in the process of gathering data to determine how effective the review has been in accomplishing its initial aims. Hopefully this data will help maintain faculty support. We like the idea of a joint student/ faculty review.
– Anatomy SAC worked well in real time to make improvements in the course throughout the year.
– Third Year Grading survey- will go out in the next few weeks. Aim is to try to ascertain the ways in which students feel they can be best evaluated throughout the clerkships.
– Basic Science Review Elective- 25 fourth year students were able to help evaluate the basic science curriculum for credit.
– We presented a poster at he AAMC that highlighted this basic science review elective. UVA is quite unique to the degree to which fourth years involve themselves in evaluating and trying to improve the basic science curriculum.
– Furthermore….SMEC still exists!…Go us….in addition, we had a great new batch of reps and members and are looking forward to a great year.

– New chair welcomed all of the old and new SMEC folks and gave a brief review of SMEC’s infrastructure for the benefit of any new folks that might not be familiar with it.

– The remainder of the meeting was spent going over the logistics of our first major project. The SMEC curriculum project is our first and likely most important project of the year. We will work within the existing/ expected framework of the 2010 curriculum that is beginning to take shape and try to establish one or two examples of a student endorsed curriculum. We discussed mechanisms by which we could include the student body in the process.
– A few examples of the themes to focus on- mentorship, integration of basic sciences in the clerkships, promoting a learner focused approach, and making sure the new curriculum is still friendly to multiple learning styles/ emphasizes autonomous learning and student responsibility.
– We will likely hold an open forum in the near future for students to learn about the new curriculum and make productive suggestions if they have them.

Wed, 25 March 2009

2008-2009 Wrapup

Filed under: Uncategorized — flack1515 @ 22:28 UTC

Congratulations to all the new SMEC representatives: Evan, Laura, Nicole, Brad!

Outgoing representatives – thank you all for your hard work this past year. It was a very productive and fun year!

~Animesh, SMD 09

Executive Committee Meeting 3/12/09

Filed under: Minutes — flack1515 @ 22:20 UTC

Minutes for 3/12/09

• SAC Update: Phsyiology SAC Representatives
o SAC has met with Dr. Kutchai several times who is very receptive. Have discussed several ideas including adding quizzes to help students gauge their comprehension of the material. They are also working on coordinating with other courses to reduce unnecessary overlap.

Old Business
• Basic Science Review Results
o Reviewed results at the meeting. Seem encouraging.
o Will have two more surveys – after boards and after board scores.
• 3rd Year Orientation
o Monday – at 10:45AM – tips for 3rd year
o Friday – student panel, each clerkship rep will prepare 5 mins on their clerkship
o Feedback on handouts – will send some feedback to Darci
• 3rd Year Grading Survey
o Survey is ready. However, we will wait until students get grades from their last clerkship – likely mid-april.
o Will plan on sending survey to SMD09, but will keep the results separate.
• Professionalism Followup
o Lunch meeting seems unlikely at this point.
o Still considering email – may mention “promotions committee”
o Ideas for upcoming year: brief mention at orientation, parody video for orientation

New Business
• Joint Degree Representation on SMEC
o Consensus: good idea. Will allow multiple students be a part of SMEC, ideally one per joint degree program based on student interest. The joint degree representatives will get one vote on the SMEC executive committee.
• 2nd Year Exam Scheduling
o Need one year advance notice for scheduling.
o Discussed the tentative schedules at meeting today.
o Evan will email Darci with the preferred scheduling.
• Joint Clerkship Directors Meeting – Wed 3/25/09
o Possible topics: 3rd year grading survey, 3rd year orientation, SMEC activities this past year
o I will try to get a SMEC slot that works with the DxRx schedule
• Mulholland Report
o Need to discuss with James Click, Dr. Short and new editor.

• 1st Year: Going well. They enjoyed spring break and are looking forward to their first EBSP.
• 2nd Year: Taking exams. Good luck! See you at EBSP.
• 3rd Year:
o Haven’t gotten OASIS evaluations but it would be very helpful for 3rd year SMEC reps. Will do some digging into this.
o 3rd year SMEC reps can’t get a lot of “real-time” feedback without OASIS evals and basically end up doing 1-2 major curriculum projects per year (e.g., – 3rd yr grading survey). Would be helpful to have 3rd year SMEC reps not take on a clerkship if possible.
• 4th Year:
o Will discuss ideas on 4th yr scheduling with Dr. Keeley.
o Ongoing discussion of current SMEC course evaluation electives with Dr. Keeley and Dr. Bloodgood.

Future Business/Year Long Goals
• New Curriculum – Curriculum Committee
• WGCSE is still meeting – see “Old Business” above. Working with curriculum committee on future curriculum changes.
• USMLE Step 1: UVA is proceeding with a practice exam at end of 1st year. Future of Board Review Course as Step 1 changes?

Executive Committee Minutes for 2/19/09

Filed under: Minutes — flack1515 @ 22:19 UTC

Minutes for 2/19/09

Old Business:
• Anatomy Update
o Evan has been in touch with Dr. Gay who is aware of the need for refining the radiology portion. Evan still needs to get in touch with Dr. McCollum.

• Board Review Course
o General consensus is that there has been great attendance and the Review Course has been well received. Brad probably has the most up to date info so we will anticipate an update from Brad.
• SACs
o Dr. Peterson is working on setting up a SAC for Cells to Society that includes representatives from all classes.

• SMEC involvement in Calendar planning
o Tina is in touch with Darci about this

New Business
• Orientation to 3rd Year
o Darci has confirmed that we will have 1hr 15min block (either on Mon or Tues) and a 1hr block on Friday. Andrew Pfeffer will confirm that dates but the time (1hr 15min followed by 1hr block) is certain. We will need to finalize plans during our March meeting (or a meeting among the 3rd and 4th year SMEC members separately).

• 3rd Year Grading Survey
o Feedback is in from all clerkship directors and Dean Pearson. John Jackson has the survey and will debut it at the final Clinical Connections next week. He will likely keep it open through DxRx. Andrew Pfeffer will have access to who has yet to complete the survey so that he can contact those people individually and increase participation. There was some discussion regarding turning this into a larger project that Andrew, Armin, Brad and Lisa might be able to take on as 2 week research elective and potentially have the results published. This is still just an idea but something work mentioning. Additionally, we were wondering if it would be useful try and receive the 4th year class’ input to increase participation and possibly increase statistical significance/power.
o This can continue to be discussed in March meeting.

• Including Joint Degree Students in SMEC
o We agreed that this would be beneficial and will plan to discuss logistics of incorporating Joint Degree Students in SMEC at the March Meeting.

Executive Committee Minutes for 1/15/09

Filed under: Minutes — flack1515 @ 22:18 UTC

Minutes for 1/15/09

• SAC Updates: CTS SAC Representative
o Discussed number of practice questions on website and recommendation to increase number of questions on quizzes – course directors did this and it seemed to help.
o Would like to see course have more clinical correlation
o Summary report submitted to Dr. Bloodgood

Old Business
• Anatomy Update (Evan) – Meeting with Dr. Gay
o Went well. Discussion focused on pros and cons of radiology component. Areas for future improvement included evaluation/grading and coordination between anatomy and radiology course directors.
• Board Review Course (Kira)
o Started this month – going well. Good attendance so far. Will start to do more formal head counts.
o Initial survey sent to SMD 11 – discussed results. As expected, Step1 is a major source of stress and students like the idea of a board review.
• Curriculum Committee
o Continuing to discuss new curriculum, starting to take shape
o Working with curriculum committee. Major goals:
 Clinical skills course and goals of clinical skills
 Mentorship

New Business
• Orientation to 3rd Year: SMEC Panel and your lecture
o We will do a student panel and 3rd year “survival” skills lecture, similar to last year. Hopefully back to back depending on schedule.

• 3rd Year Grading Survey
o First draft sent to clerkship directors. Positive feedback from several clerkship directors so far. Will be sent to students next month?

• SMEC involvement in calendar planning
o Scheduling committee has offered to have a couple of students give input on when to schedule exams for next year’s second year class. Evan and Tina will attend this meeting (with guidance from current 2nd years).

• 4th Year Elective Scheduling
o Animesh will get input from 3rd and 4th years and discuss with Dr. Keeley.

• Professionalism Followup
o There have been several unprofessional emails/comments sent to faculty members. We should address this as a student body – ideas include email, open forum. Andrew will meet with Dean Pearson to get his input.

• 1st Year: Strong interest in SACs this year.
• 2nd Year: Board review course above
• 3rd Year: Updates from 3rd year clerkship reps? Clinical connections?
• 4th Year: See Elective scheduling above.

Future Business/Year Long Goals
• New Curriculum – Curriculum Committee
• WGCSE is still meeting – see “Old Business” above. Working with curriculum committee on future curriculum changes.
• USMLE Step 1: UVA is proceeding with a practice exam at end of 1st year. Future of Board Review Course as Step 1 changes?

Final Third year meeting (’08-’09)

Filed under: ThirdYear — bpb5d @ 0:26 UTC

3/ 23/ 09

Third Year SMEC meeting

Attendance: Armin Razavi, Brittany Holt, Jose Matos, Keenan Yount, Matt Hubbard, Brad Bradenham, Sarah Schmidt, Andrew Pfeffer and Animesh Jain.


I. Ideas that began with this committee that have become a reality:
a. Clerkship grading survey- taking an objective look at how students feel they can be best evaluated- many thanks to Andrew Pfeffer and Lisa Herman for getting this project off the ground.
b. Transition week- SMEC has been given 2 hours during transition week to provide a structured format for student to student advice regarding the clerkships- again tanks you Andrew for you hard work with this project and working with darci to make this a reality.
i. Handouts- We are in the process of revising and adding to handouts. Need to include notes from Animesh’s lecture in the handouts.
ii. We did receive this handout last year…few of us remember llooking at it- perhaps emphasize to this year’s class that this handout was constructed by both faculty and students.
iii. Make agendas for each clerkship to go over during the panel discussion.

II. Goals for this year- did we meet them?
a. Goal #1- Meeting with Clerkship Directors, face to face, at least 3 times over the course of the year?

Brad-Internal Medicine: 1/3- will meet again soon
Armin- OB/ GYN: 2/3- will meet again soon
Liz- Clinical Connections: N/A informal feedback throughout the day.
Brittany- Family Medicine: 1/3- will meet again soon
Keenan- Neurology: 1/3- will meet again soon
Matt- Psychiatry:1/3 ( could not get a response from WS clerkship director)
Jose-Surgery: 1/3- will try for a second
Sarah- AIM: 2/3
Andrew- Pediatrics: 0/3.

– In hindsight, we did not feel as though meeting with the clerkship directors three times over the course of the year was entirely necessary. Given out current capabilities it would not have made for a more productive year. Even if we were able to meet with clerkship directors, the meetings would likely not benefit directors or students, as we ourselves are ill equipped to gather feedback with a sufficient enough” n” to merit any attention.
– see recommendation section

b. Goal #2: Have SMEC Clerkship committee meetings once/ month. – we met 5 times over the course of the year- including this final meeting. Haven’t met in a few months. We attempted to have one “online meeting”- unfortunately that was a failed venture.
i. Did we need to meet every month?- No not necessarily- given this committee’s current capabilities, we believe we met a sufficient number of times and were able to use that time productively. We came away with two projects that will hopefully benefit future classes and clerkship directors.

c. Goal #3: Targeting issues that we can meaningully contribute towards: See agenda item #1….I’d say we were successful!…go us….

Other issues:

1) Did the class know who we were?
a. Our sentiment: Probably not…regardless, we gave them sufficient opportunity to know who we were. We sent several emails at the beginning of the year before every clinical connections making them aware of who we, our purpose, ad how they could get in contact with us.
i. Invite student participation at the beginning of SMEC meetings.
ii. Ideas for improving our visability- Sarah Schmidt (AIM rep.) wsa able to get her name in the syllabus of the clerkship. Over the course of the year she received several emails as a result of it.
2) Clinical Connections-
random thoughts- Unfortunate reality is that it, as a program, has many things working against it-
– in a short clerkship- it can potentially take a big bite out of clerkship time.
– Overall, many were well received by the class- such as the acute coronary syndromes wksp and emergency/ disaster preparedness workshop.
– All clearly spend a lot of time revising/ revamping and making their respective workshop the best it can possibly be. As such they deserve a lot of credit for what they do. This doesn’t change the fact that many topics are simply doomed from the start with respect to global student opinion whether that is from past student experience with the workshop or simply from the topic alone.

III. Recommendations:
– Making goals for email contact rather than focus on face to face meetings. Three face to face meetings is likley excessive. It is important to have a face to face meeting initially, but perhaps much of the relationship you have with a clerkshi director after that is via email.
– Be cognizant of the fact that clerkships will be received by students differently depending on what stage of their training students are at. (eg- students in a clerkship at the end of third year will see the clerkship ina very differnt light than those who had the same clerkship to start their third year experience.
– Idea- logistically demanding- but an idea for improving SMEC clerkship rep. exposure to feedback > Clerkship reps trying to make it to exit interviews.
– Potentially- a huge leap forward…
o If we were given Access to Oasis clerkship evaluations we could potentially serve a much more useful function to our class and to clerkship directors by acting as sounding boards for new ideas in the light of new student feedback. In reality the only useful thing we could obtain would be the narrative sections of the global clerkship evaluations. The data from each clerkship is not analyzes block by block- rather it s analyzed as a whole at the end of the year. Still, even with only the narrative sections of the evaluations, we feel like we could better accomplish the initial aims of this committee much better than we are currently capable of doing.
ß Privacy issues- are legitimate- possible solution is to take out last sections of evals if privacy issues are the chief barrier. OR…perhaps we could just sign a type of disclaimer saying that we wont talk about what we see on the evals…after all a few months later we’ll be seeing everything anyway as we are the ones who are going to be writing the Mulholland clerkship report.
ß Important to note that it probably isn’t necessary to look at professionalism issues as we are not the Student Advocacy Committee. Our ends are purely in the realm of curricular improvement.
ß Generally we will not be looking at evaluations of particular individuals. The exception to this would have to be the AIM and family medicine clerkships in which the evals of these individuals will have a huge impact on how the clerkship is received.
ß Overall- we as a body do not think asking future clerkship reps to take on the responsibility of looking at evals is too much of a time commitment or burden. The only consideration that we had was to prevent having to do a significant amount of eval review while we ourselves are in the midst of studying for a shelf. We feel this can be avoided- and while this is a time sensitive process in some regard. Anything we are able to do will be faster than it takes for the Mulholland Clerkship report to come out.

– We also recommend that the elected third year SMEC reps take a strong look at whether or not they should take on a clerkship of their own. (ie: serve as a clerkship rep.) By not being a clerkship rep, he or she would be more able to spearhead whatever issues the committee choses to target.
– Recommend that by the third- fourth meeting, the committee should have shaped a clear focus for what projects they want to tackle.
– Recommend that whoever serve as clerkship reps be people who will be experiencing his or her clerkship early on in the year- there is not substitute for having experienced a clerkship for yourself..

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