Highlighted Meeting Dates
- Boot Camp: Drs. Adam Tobias and Anna Donovan gave an update on our required MS4 bootcamp to help learners transition to residency. The experience takes place in May (Period 12.5) just prior to graduation, and students participate in core sessions plus seven specialty-specific tracks, with hybrid and alternative versions based on student need. Content is heavy on simulation (human and non-human based), with practical and clinically relevant topics predominating over the 2.5 weeks of compressed curriculum (in 2022, from 4/24 to 5/10). This year will integrate surgery into the other tracks, with everyone receiving ACLS at the same time. Last year’s version was well-received by students, with 90% or more saying it was well-organized, relevant, and an overall positive experience.
- OB/GYN Clerkship Report: Dr. Emily Cunningham shared information about her required four-week clerkship, with important clinical experiences on labor and delivery, in the operating room, and in ambulatory sites. Grades derive from clinical work (55%), a Shelf exam (20%), as well as small group work, an essay, and general professionalism—55% of learners received Honors last year. LCME process measures (e.g., midcourse feedback) is 100%, and feedback in particular has improved (with 78% of learners now saying that they received helpful feedback on the rotation, up from 50% two years ago). The clerkship continues to work on learning environment issues and trying to improve Shelf scores. Dr. Cunningham shared that she will be stepping down in February 2023; a successor is being sought.
- External Resources: To follow-up on the recent MS2 curriculum report, the Committee discussed issues related to external learning resources (e.g., ANKI, Boards and Beyond, etc.) and how we integrate them into the curriculum, both now and for the future. Many perspectives were shared by students, staff, and faculty present, but all agreed that this is a complex issue. Most felt that we should continue to offer a few expensive, high-yield resources to all learners, and then make curated suggestions for other resources based on curricular content and availability/quality of options. Promoting library offerings may help.
- Specialty Care Clerkship: Dr. Stephanie Gonzalez, clerkship director, presented her annual report on the state of SCC, which combines adult emergency medicine, ophthalmology, otolaryngology, and oral health. That latter component has been significantly altered based on student feedback, with more focus on oral maxillofacial surgery, the language of dentistry, and the approach to referral. Didactics have shifted more towards asynchronous learning. The clerkship has struggled with organizing the disparate components, and students this year have a higher than expected exam failure rate. The clerkship is trying to consolidate schedules to be more organized, using mock exams to better prepare for the final assessment.
- Curriculum Reform: Quarterly Report on Phase 3: The task force leadership shared a brief update on Phase 3, including the activity of the 17-member steering committee and the various working groups. A yearly calendar has been finalized, as well as a structured weekly schedule. Job descriptions and selection processes have been developed for longitudinal educators and content leads. The task force is actively working on case development, assessment protocols, and educational technology platforms to optimize the new curriculum. Their final report to the Curriculum Committee will take place in late March or early April.
- MS2 Curriculum Committee Student Representatives Report: Student reps surveyed their classmates about their experiences in the second year of curriculum. Twenty-seven respondents appreciated organ systems, the hybrid ICS delivery, and small group learning. Most felt prepared for clerkships although wanted more practice with note-writing and oral presentations. Closed book exams would help students be better prepared for Step 1. Suggestions were made around exam reviews and item coding. The Executive Subcommittee will be acting on these recommendations.
- Family Medicine Clerkship: Dr. Robin Maier gave her clerkship report, welcoming Dr. Jonny Yadlosky to her leadership team. FM remains a very successful a popular clerkship experience, with high levels of overall student satisfaction and successful process measures on LCME outcomes. NBME shelf exam scores remain above the national average. The clerkship had several student suggestions, including ways to improve site selection, and they made changes that students felt were helpful.
- AAMC Review: Several UPSOM individuals attended the recent AAMC annual meeting and reported back on national trends in medical education, notably increased attention to the UME/GME transition, models for coaching, climate change in health environments and curricula, and the development of standard core competencies in undergraduate medical education. Schools that had moved their Shelf exams to post-clerkship have been moving back to preclerkship; some schools that had tried pass/fail clerkship grading have been moving back towards tiered grading to help students stay motivated and distinguish themselves. Attendance for preclerkship didactic sessions remains a national problem.
- Admissions Update: Dr. Beth Piraino gave an update on the admissions season and our current prerequisites. UPSOM has a record number of applicants and interviews this year; almost 30% of interviews are for candidates who are underrepresented in medicine. The GPA for interviewees is 3.83—an amazing group of candidates. The committee reviewed our current prerequisites (biology, chemistry, physics, statistics, etc.) and decided that no changes were needed at this time, but it should be reevaluated after the start of the new curriculum.
- MS1-2 Segment Report: Dr. Cynthia Lance-Jones gave the report on the Foundations phase of the curriculum. Although there were dips in perceived course quality during the pandemic, this past year (AY22) saw a return to normal: block quality ranged from 4.0 to 4.3 (out of 5). Two courses with significant improvements were Skin-MSK and Intro to the Physical Exam. GQ data confirm increases for all foundational science areas in how well students felt the content prepared them for clerkships; almost all of 13 areas are now above the national average. Students are concerned about clinical relevance, intergroup consistency, how to use external resources, and practice questions for content. The committee also reviewed data on diversity and social medicine in the curricular segment, and ways to better integrate such content.
- Breast Problems Added as a Required Clinical Condition: Dr. Rani Schuchert proposed that breast conditions be added to our list of 44 required clinical conditions that every student must encounter prior to graduation. It has been recommended by several national organizations, and our students should be able to meet this expectation. The committee approved the addition, to take effect with the Class of 2025.
- MSTP Student Report: Student CC representatives shared their overview of curricular issues in the MSTP program, with Dr. Richard Steinman present in his role as MSTP director. In July, our program secured its renewal as a T32 training opportunity, securing $8.3 million in funding to support an expansion from 23 to 31 trainees. The students discussed integration of MSTP with the new Three Rivers Curriculum, and possible challenge points. They have done work on mapping competencies to courses/training, with a focus on skills needed by physician-scientists (e.g., grantsmanship). Some data has suggested gender differences in outcomes, although the program is aware and has made progress on mitigating. MSTP will continue their strategic planning and work with the Curriculum Reform Task Force on key issues.
- Academic Remediation Policy: The Curriculum Committee reviewed a proposed revision to the school’s academic remediation policy, focused on Foundations curriculum in MS1-2 years. This revision was prompted by alterations in grading for incoming MS1s, part of a pilot for the Three Rivers Curriculum rollout. MS1s have moved from normative, section grading to criterion-based, course grading (where students have to pass every course to progress). The new policy defines remediation practice, timing, and expectations. Students will have two chances at remediation, not just one; remediation must be completed before the start of the next academic year; and the Committee on Student Promotions is expected to only review outcomes in courses not yet passed, rather than doing a global review of student progress, to avoid bias/stigma.
- New Electives Approved: Two new electives were approved today. The first is “Introduction to Health Systems Science,” led by Dr. Andrew Wickerham. This primarily asynchronous and virtual elective will take place during December/January, to allow MS4s to maintain academic progression while interviewing for residency. They will do online modules, develop interview questions, and review/discuss key literature related to HSS—grading will be pass/fail. The second elective is “Medical Education: Teaching Foundational Sciences,” led by Drs. Jason Rosenstock and Cynthia Lance-Jones. Senior students will serve as an embedded TA in a foundational science course, learning how to teach and providing key content help for courses.
- Social Medicine Thread Report: Drs. Eloho Ufomata and Thuy Bui presented a comprehensive update on the social medicine thread. The thread grew out of a need to better fulfill educational program objectives (e.g., EPO-21, which states that students should learn how to mitigate bias/racism and work to achieve health equity). Many courses/clerkships and other activities support this thread, including the IPC and PPS blocks, diversity orientation, the new neighborhood walk program, activities in courses like immunology and skin/MSK, and the longitudinal alliance program. New activities include the addition of environmental justice content to the Population Health course, for instance. The thread is seeking to expand faculty development efforts and coordinate better across the clerkship phase.
- Mapping/Integration Subcommittee Report: Drs. Marie DeFrances and Will Walker shared results of their group’s review of eight key topics. Four were deemed very well-supported in the curriculum (dermatology, EBM, oncology, and women’s health); three were adequately supported (adolescent medicine, emergency medicine, and continuity of care). One area, community health, was felt to need improvement, particularly around community partnerships and community-informed research. The new Three Rivers Curriculum, currently being designed, is seeking to address this deficiency. Course/clerkship directors will be reviewing other identified gaps in these areas to determine the best way to respond.
- Course Evaluation Subcommittee Report: Dr. Cynthia Lance-Jones shared the work from the past year from her group, which reviews course evaluations and meets with course directors in the Foundations phase, for all 28 courses. Themes this year include an increased focus on justice and diversity (especially faculty development efforts), improved board/ward relevance, more active learning, and streamlining material to reduce unnecessary content. Examples, for instance, of recent efforts to enhance board relevance include initiatives to expand board-style practice/exam questions, to integrate better with external resources, and to improve content retention through more frequent assessment.
- Social Medicine Thread Activities: Dr. Thuy Bui, who leads the social medicine thread, shared updates about thread activities in the MS1-2 segment of curriculum, particularly MS2 courses. Clinical Experiences (CE) held a book club on “Medical Apartheid,” including a discussion of recent family experiences at UPMC, reflections about content and changes needed, and a mindfulness activity to support anti-racist work. Racism in Medicine followed CE with a six-week exploration of how issues around race play out in medicine, health, and society; switching the academic schedule to do this course earlier has helped allow student to pay more attention and participate better. Finally, MS1s will have a required session in October on Refugee and Immigrant Health, which will include sessions on working with patients who have limited English proficiency.
- Otolaryngology Acting Internship: The ENT AI has counted as an official AI, to help students meet graduation requirements. However, it appears that residencies in the field are expecting/demanding that such students also complete a Surgery AI, which makes it counterproductive for students to ONLY do the ENT AI. The Curriculum Committee voted to trim this AI from the list of eligible AI’s, beginning with the Class of 2024.
- Evidence and Discovery Block Report: Dr. Peter Drain presented an overview of the block, including a description of innovations and activities across the courses. Overall quality and faculty ratings are high or increasing. The social determinants enrichment of the summer research program has been a success, as has the introduction of a module on artificial intelligence (in response to a school task force’s recommendations). UPSOM students have produced 346 peer-reviewed publications, given 397 oral presentations, and won 59 national awards related to their work on the scholarly project.
- Anesthesiology Clerkship Report: Dr. Bill McIvor, clerkship director, gave an overview of the experience. Students are required to complete two weeks, one focused on didactics/simulation (mainly at WISER), and one at one of seven clinical sites. Students take a home-grown test at the end that comprises half of the final evaluation, with clinical evaluations the other half. The clerkship's strengths include emphasis on pharmacology, physiology, and crisis management. Challenges include feedback/assessment quality and capacity issues.
- Social Medicine Thread: Neighborhood Walk: Dr. Thuy Bui shared the success of a new component of orientation for MS1s: the Neighborhood Walk, where students went out in groups to important areas of the city to better understand the strengths and challenges of those communities, debriefing with faculty afterwards. This was very well received and will be repeated in the future.
- Clerkship Directors Subcommittee Report: Dr. Raquel Buranosky reviewed the work of the subcommittee over the past year or so, highlighting key initiatives around grading/feedback, bias mitigation, COVID management, basic science integration, learning environment, and transition to GME. Progress on grading has included better alignment between learning objectives and assessment, clearer information on Navigator, gradual shift more towards competency-based education, more consistency across clerkships on measures, better validity checks, incorporation of best practices, and more.
- MS1 Class Report: The new MS2 student representatives shared their final report on the 1st year of curriculum. Almost three-quarters of students felt satisfied or very satisfied with overall quality, liked the mix of required activities, and felt they had time for self-care. Students appreciated opportunities to give feedback to administration. Students had several recommendations related to specific courses, and in general were worried about Step 1, hoping that the curriculum will help them prepare.
- Curriculum Reform: Phase 3 of the Task Force will have their kickoff 8/23 7a in Scaife 1105, consisting of 29 working groups and 130 faculty, staff, and students. At a recent faculty vote, 83% of faculty approved of the Phase 2 final report and the blueprint for the new Three Rivers Curriculum.
- Survey Results: Graduation Questionnaire results just came back from the Class of 2022, demonstrating improved satisfaction in multiple areas. 92% of students are satisfied or very satisfied with their UPSOM experience, above the national average of 88%. Six of our eight evaluated clerkships were rated higher than last year and greater than the national average (five are in the 75th percentile or above). Students felt much better at handling social determinants of health, with 91% rating that item positively, up from 83% in the past year (and also above the national average). More to come.
- Social Medicine Thread: Dr. Eloho Ufomata shared results from a recent survey of course directors around how they teach social medicine topics within their courses. Increasing numbers of course directors are incorporating or planning to incorporate key topics like race as a social construct, visual equity, and highlighting disparities better. Every course director committed to at least one action for the coming year, and they reported things like improved faculty development, getting clinical preceptors to focus more on social determinants, and increasing family involvement in teaching.
- Learning Environment: Dr. Evelyn Reis presented a report from her office about the state of the learning environment, and improvements from 2017 until now—student awareness and comfort in reporting, actions taken to improve faculty teaching, work to improve the overall culture. Although we still have much work to do (especially around race-related bias/mistreatment), we’ve made much progress in building community and trust.
- New Elective: Comics and Medicine: The committee approved a new elective for the fall (Period 7), created by Dr. Jason Bitterman (PM+R), for up to 15 students to learn how to use comic illustration to foster patient education. The elective will include studio work, field trips, and summative comics that will be displayed to the community. This flexible elective will take place during “interview season,” giving students another option during an otherwise very busy time. Some asynchronous or remote electives are also in development for interview season.
- Mapping Follow-Up: AI and Disaster Medicine: We followed up on two key topics from past discussions: Artificial Intelligence/Machine Learning, and Bioterrorism/Disaster Medicine. Previous task forces or subcommittees had recommended enhancements in these areas. AI/ML content has been rolled out in the Evidence and Discovery block, with good acceptance by students and demonstration of successful learning. Bias was explicitly addressed. A further review of bioterrorism/disaster mapping showed additional content not previously mapped; additional content will still be added, including cases and activities in the surgery and specialty care clerkships, as well a “Stop the Bleed” workshop for incoming MS1s.
- Patient, Physician, and Society Block Report: PPS presented on the five courses in their block, which have been very successful and popular overall. Racism in Medicine faced some controversy this past year related to student comments about the course; we will be flipping the timing of RiM and Population Health so MS2s get RiM earlier, when they can focus better on its content. A new initiative to compensate community educators will help multiple courses better recruit patients/family members and other community individuals who teach in the curriculum.
- Grading Proposal for MS1s: Pass Every Course, Above a Threshold: Dr. Cynthia Lance-Jones presented a plan to improve student success by shifting away from block section grading towards course grading—where students have to pass every component to progress (our current system does not require this). By shifting from normative grading to criterion-based, students will have a clear line to demonstrate mastery of the material, and will be given academic counseling resources and multiple remediation opportunities to help with learning. Based on recent data, we expect students to be better prepared for Step 1 under this plan—which applies only to the Class of 2026 (moving forward). Promotions Committee criteria will need to be altered/adjusted under the new model.
- Curriculum Reform: Phase 2 recommendations approved: After lengthy review and discussion, the Curriculum Committee voted today 22-4 to approve the Curriculum Reform Task Force's recommendations for the new Three Rivers Curriculum. The new curriculum will feature a condensed foundations phase with dedicated educators teaching in small group formats, using cases that tie together key threads like social medicine and interprofessionalism, setting up an integrated organ systems block with an early start to clinical rotations. Expanded surgery and OB/GYN clerkships will highlight the clerkship phase, along with more elective flexibility, longitudinal clinical experiences, and a parallel diagnostics course. We will be piloting an accelerated 3-year MD degree for students entering primary care specialties. The task force now moves to Phase 3, to plan out the specifics of the approved blueprint, with a planned rollout of Fall 2023.
- Foundations of Medicine: The committee received follow-up from FOM leadership about its plans to enhance grading consistency across its courses, and specific strategies to improve the quality of assessment more generally.
- Social Medicine: Bias Against Larger Sizese: Drs. Eloho Ufomata and Thuy Bui presented information from a student-driven initiative to improve teaching around overweight/obesity, and avoiding language/images that might promote stigma. Course directors have been asked to review materials including slides and syllabus sections to try to use “people first” language, removing negative pictures of larger size individuals, and seeking to mitigate implicit bias against students of larger size.
- Leave of Absence Policy: The committee discussed new language being considered for an addition to our LOA policy, prohibiting leaves during the Foundations phase, and requiring students to take Step 1 prior to beginning research leaves.
- Adult Outpatient Medicine Clerkship: Dr. Amar Kohli shared an annual report on his clerkship, AOMC, which has performed admirably since its creation two years ago. Student satisfaction was around 90% for overall quality, organization, and providing sufficient feedback. Dr. Kohli has added material on social determinants and weight management, and will be adding back tobacco cessation skills sessions in the future. Two innovations have been expanding student access to the electronic medical record, and employing focused feedback forms for specific skill development. Dr. Kohli will be leaving the leadership role in AOMC, becoming the new clerkship director for Adult Inpatient Medicine effective 7/1/22.
- MS4 Student Report: The four student representatives to the Curriculum Committee from the Class of 2022 summarized the impressions of their class with respect to the 4th year curriculum. They particularly valued acting internships; 73% felt the bootcamp was helpful; and about 90% feel well-prepared to start residency. There were concerns about the breadth and consistency of the ILS courses, and a desire for more asynchronous/remote electives that students can take during interviewing season (particularly around health systems science topics). We will solicit proposals for such an elective.
- EPO-20: Culturally Competent Care: A working group revised our Educational Program Objective around how to deliver culturally competent care, shifting the language away from competence and more towards humility; increasing emphasis on language/interpretation skills; and adding an aspirational goal on working with communities through partnership and advocacy. The new EPO was approved.
- OB/GYN Grading Change: For the coming academic year, OB will be making a minor assessment change, reducing the value of PBL sessions from 15% to 10%, and adding a new component of professionalism (5%), which brings it in line with other clerkships and reflects a decrease in time for PBLs.
- Practice Based Assessment Subcommittee_CCAs: Dr. Reed Van Deusen outlined his subcommittee’s approach to the Clinical Competency Assessment (CCA), which is being revamped in the post-Step-2CS environment. MS3s will be asked this year to take a six-station screening OSCE around Assessment Week (April/May); learners who don’t achieve competency will be given skill guidance and then asked to do a more rigorous 10-station OSCE in the fall. Successful completion of the CCA will be a graduation requirement. The team will work to improve grading turnaround and reliability of student notes, giving them more completion time and more guidance for preparation.
- Clerkship Reports_Psychiatry and Neurology: Both clerkship presented annual reports today. Psychiatry demonstrated excellence in overall quality and organization, over 95% in student satisfaction, with rapid grade submission and above average Shelf exam scores. There were duty hour and learning environment reports that still need to be followed up on, and the clerkship director was going to return to the group to provide an overview on actions taken. Neurology improved its scores on feedback, making plans for more transparency in evaluation, and creating innovative learning experiences around lumbar puncture procedural skill and social determinants of health (with an enhanced interprofessional education component).
- MS4 Segment Review: Dr. Laurie Knepper, MS4 Subcommittee chair, provided an annual review of the 4th year segment of curriculum. We now have over 250 electives; the most popular last year were Quality and Patient Safety, Emergency Med, Radiology, and Critical Care. We expanded ILS and Bootcamp options, adding surgery bootcamp slots and integrating surgical subspecialties into that track. We’ve added MOUD as a graduation requirement (Medication for Opioid Use Disorder). Outcomes look positive, with 95% of students saying that they feel they have the clinical skills necessary to begin residency (higher than the national average of 92%). Our match results are strong, and PGY-I data suggest that our graduates have the same or better skills compared to their peers.
- Mapping/Integration Subcommittee Report: Drs. Will Walker and Marie DeFrances, who lead this subcommittee, presenting their mapping data and recommendations on nine content areas reviewed by content champions. Three areas were deemed strong (imaging, disparities, and humanities), three were adequate (geriatrics, genetics, palliative care), and three needed further development (bioterrorism, disaster medicine, environmental health). Environmental health will be rolled in to the social medicine thread, and the other two will be taken up by the CC Executive Subcommittee, to enacted recommended ways to improve content coverage and vertical integration.
- Pediatrics Clerkship Report: The leadership of this clerkship shared their annual report. PC supports 29 of our 34 educational program objectives. Grading components are mainly clinical skills (60%) and SHELF (30%); the grade distribution has shifted from two-thirds Honors to two-thirds High Pass, which was a goal. The clerkship meets LCME standards; 96% of students felt that the learning environment was good, and 90% felt they were getting good feedback. SHELF scores have gone up to 80 in the combined eight-week clerkship (above the national average of 76). Peds has innovated with an antiracism workshop and social justice rounds, and they will be adding a formative simulation component next year (focused on initial management of febrile seizures).
- EPO-20: Continuing our routine review of educational program objectives, the group tackled EPO-20, which lays out knowledge, skills, and attitudes related to cultural competence. The committee felt that a shift more to a cultural humility model would be more helpful, along with additional attention to disability education, language/English proficiency, and religion/spirituality. The social medicine thread, led by Dr. Eloho Ufomata (the new Assistant Dean for Equity and Justice and the Curriculum), will tackle a rewrite of this objective, with faculty and student input.
- Clerkship Segment Report: Dr. Raquel Buranosky presented a review of our clerkship phase, sharing data on student satisfaction, test scores, match results, and other outcomes. Although GQ data has shown a dip in clerkship satisfaction over the past year, the five-year trend is much more positive, and other surveys show that >90% of current MS3s are satisfied with clerkships. There has been particular attention to feedback sufficiency, with improvements thanks to evaluation transparency and benchmarking during midcourse feedback. We achieve 100% on key LCME measures like grade turnaround, and our assessment process overall has shown improvements in clarity and connection to learning objectives. Our NBME scores are at or above national averages in almost every clerkship, unaffected by COVID, and our 2CK pass rate is 99%. Our match success remains outstanding, 95%, to top programs and competitive specialties. And new data shows that PGY-I residents from UPSOM perform at or above their peers on milestone ratings, in all areas. There are also some important areas for development, including better integration of basic science. Most notably, our learning environment measures leave significant room for improvement, as we try to stamp out the hidden curriculum and mistreatment (e.g., public humiliation)—which will be a key focus in the coming year, partnering with departments and clinical affiliates.
Collaborative Based Learning: Students Nathalie Chen and Susheel Khetarpal presented their innovative pilot on peer study groups, which grew out of a “Big Idea Competition” proposal for curriculum reform. In an effort to pilot some of those ideas, the student leaders rolled out their CBL effort in Genetics (MS1) and Cardiology (MS2), with upwards of one-third of each class participating in the 2-hour weekly sessions. Students prepared learning objectives linking internal/external resources, and taught peers concepts (e.g., physiology) in a way that supplemented course delivery. Almost 70% of students who participated found it helpful in improving understanding, and the students are planning to try it again in Neuroscience, and then to study outcomes prior to a more formal dissemination across other courses.
Foundations of Medicine Block Report: The block directors presented to the committee on the performance of courses in AY21. We saw improvements in some of the courses that had organizational or other issues, and students commented on appropriate threading of social medicine through the seven courses, along with good clinical relevance. The experiment with open book exams, necessitated by the pandemic, allowed appropriate academic progression but was characterized by higher course means and lower reliability on assessments. The increasing use of external resources has caused tension in some courses, due to differing organizational approaches. The committee asked FOM to address two assessment issues going forward: improving course director support for quizzes/exams (e.g., peer review of questions), and heightening consistency in student evaluation overall (e.g., ranges for different grade components, frequency of assessments, etc.).
- New Electives Approved: Two new electives were approved for select PittMed student populations--an experience in POCUS for students in the certificate program, and a clinical refresher course for students returning from lengthy leaves of absence.
- Policies Approved: Several policies were discussed and approved, including a revision to the Absence/Attendance policy, guidance about SHELF make-up exams, and restrictions on Medical Student Involvement in clinical care experiences where there are inappropriate conflicts.
- Surgery Clerkship Reviewed: In an extensive report to the committee, Surgery Clerkship director Dr. Rani Schuchert shared information about the rotation, including improvements from the past year (new grading procedures, shortened work week, and enhanced coverage of social determinants of health. Ratings of the clerkship have risen, including student satisfaction with organization, grading, and learning objectives.