Highlighted Meeting Dates
- Membership: Newly elected members Drs. Brielle Spataro and Bob Arnold were introduced to the committee, In the last election, in 2021, Drs. Andrew McCormick and Orquidia Torres joined the committee. Now that their two-year terms have ended, they will be appointed to ongoing service on the committee, contingent on ongoing active participation. We also created another appointment slot for one more voting position, our final, which will be a shared position in the Department of Neurological Surgery, by Drs. Michael McDowell and Nitin Agarwal.
- Assessment in the Introduction to Being a Physician Course: We approved a grading plan for IBP in the new curriculum, pass/fail based on attendance.
- Learning Environment: Update: Drs. Raquel Buranosky and Evelyn Reis provided an update on efforts to improve the learning environment. While we have more awareness of policies, and more reporting, we still have higher than desired rates of “hidden curriculum” and mistreatment incidents, particularly in the clerkship phase of the curriculum. The Offices of Clinical Education and Learning Environment are working to identify the issues, better reward all faculty, partner with departmental leaders around faculty development, and improve remediation/coaching plans.
- 3RC: An Interim Update: Greg Null, Dr. Allison Serra, MS1 Abigail Yohannes, and Drs. Lisa Borghesi and Martin Schmidt shared an update on the rollout of the new curriculum, now that the first semester has ended. Keystone Fundamentals (KF) is complete, Organ Systems is beginning in January. 3RC broke down siloes, integrating knowledge and consolidating content spirally over time, shifting from lecture to small group active learning using a case-based approach. Weekly formative and chunked summative assessments use NBME-style questions with a flexible remediation approach. The teaching format improves critical thinking, mentorship, and teamwork; the curricular map and assessment plan both facilitate long-term retention through spaced repetition and interleaving. There were many challenges during the rollout, particularly around timeliness, quality/consistency, communication/transparency, and new program expectations. The program evaluation core, with Feedback Fridays, surveys, and “closing the loop” efforts, helped improve curricular quality in close to real time. Successes have included flex weeks, improved assessment and program evaluation quality, the Patient-Centered Care block, faculty/staff dedication, and new space/technology.
- New Elective: Clinical Informatics: Dr. Kevin Kindler and other faculty developed an innovative new elective on clinical informatics, which offers and individualized interdisciplinary hybrid learning experience to students who want to learn how to use information technology to facilitate patient care, education, and research. The elective will include coverage of artificial intelligence and machine learning, as well as applications in fields like radiology and pathology. The elective was approved unanimously.
- Policy Revision: USMLE: Dr. Alda Gonzaga proposed a small revision to our current USMLE Policy, making explicit what our practice has been around Step 1: if a student uses their two vacation months to study and still has not been able to successfully take the exam, they will be placed on a leave of absence for the remainder of the year. This will help improve scheduling and bring clarity to the process for our learners. The revision was approved unanimously.
- 3RC in Clerkships/Bridges: Dr. Jason Rosenstock provided an update on work going on related to the new curriculum’s rollout in the Clerkships and Bridges segments. Preclerkship, Surgery, and OB/GYN are expanding; Optho/ENT and thread content is being integrated; longitudinal experiences like the Diagnostics course and the Longitudinal Clinical Experience (LCE) are being planned; and major faculty leads will move to our model where the School of Medicine pays their salary directly for their specific teaching role. The calendar needs to be adjusted significantly, particularly around the overlap issue with the legacy class.
- Foundations Phase Grade Components: The Curriculum Committee is taking on more oversight over specific changes related to grade components in Foundations phase courses. Grade weightings that had previously been course-level decisions will now require full approval by the Curriculum Committee, to bring more transparency to the process. A recent change involves Legacy Organ System courses (Skin-MSK and Hematology) where grade weighting for attendance was being removed and shifted back to MCQ assessments. Although the timing of a recent electronic vote was messy, in the future the Committee will ensure that such requests are considered and voted on well before courses begin.
- AAMC Annual Meeting: Several staff and faculty from UPSOM attended the annual Learn Serve Lead conference organized by AAMC, the national organization of academic medical colleges. Highlights were shared today, including information about accreditation and staffing, particularly around changes the LCME will be incorporating to better and more fairly accredit medical schools. Subsequent updates will be forthcoming on various other topics.
- MD-MBA Joint Degree Program: Several students helped galvanize conversations between Pitt’s medical and business schools to help develop a joint degree program. A full proposal was reviewed today: up to five students would be admitted to the program beginning in Fall 2024; they would take two years of the MD curriculum, then a year at the Katz business school; then back to SOM to complete their training. After brief discussion, the Curriculum Committee approved this proposal, which will now go to the Pitt Provost for consideration.
- Evidence and Discovery Block Report: Dr. Peter Drain presented an update on courses in the block, both in the legacy and in the new curricula. Facilitator recruitment has improved with the hiring of longitudinal educators, although curriculum development and faculty training remain ongoing issues. The Investigation and Discovery course has been removed from 3RC; goals of that course will be met elsewhere. Student scholarly activity has been impressive, with the Class of 2023 reporting 311 published manuscripts, 389 presentations, 59 national and state awards, and more—in large part supported by this curricular block.
- MS3 Student Report: The current MS4 Curriculum Committee student representatives shared their observations about the clerkship phase of the curriculum, leading in to the 4th year, based in part on a survey of 28 of their classmates. Students generally were pleased with the quality of the clinical rotations and felt prepared for acting internships; simulation training has been particularly helpful. They suggested more timely schedule releases, better support for exam prep and transportation, and more transparent and consistent assessment. The Clerkship Directors Subcommittee and CCES will be following up on this report.
- New Elective: Diversity in SOGIE Experiential Elective: Drs. Eloho Ufomata, Kristen Eckstrand, and Sarah Lim have developed a new elective to give medical students experience with health care for sexual minorities, focused on sexual orientation and gender identity. Up to two students monthly will be able to attend a variety of clinics to get experience with LGBTQ+ health care, including gender-affirming care. Students will have weekly didactics, learning modules, and direct clinical experiences, along with some reflective writing. The Curriculum Committee approved this new elective.
- Content Change: Assessment Week Renamed: To better align this clinical focus course with its main goal, Dr. Ruth Preisner suggested renaming the experience as “Clinical Skills Enhancement Week,” de-emphasizing the Step 2CK preparation (which is generally done separately) and aligning learning objectives more towards existing and important clinical skills—derm, EKG-reading, radiology, etc. Placement of the Clinical Competency Assessment (CCA) is being fine-tuned as well for this course, which will continue in the legacy curriculum (but not in 3RC).
- Block Report: Patient, Physician and Society (PPS): Dr. Julie Childers shared information about the block and how it supports educational program objectives. In the new curriculum, PPS will switch from a block to a course, with Introduction to Being a Physician breaking off as a separate course. Behavioral Medicine content is being integrated into Wednesday Workshops, the Psychiatry course, and Patient-Centered Care block. Students felt that this content was important and well-taught.
- Class Report: MS2 Curriculum: Current MS3 student curriculum representatives shared their observations about the second-year curriculum, based in part on a survey of their classmates (n=26) that found 72% of students would recommend PittMed’s curriculum to others. They valued the organ systems learning in particular and felt adequately prepared for both Step 1 and clerkships. They liked question reviews, NBME exams, workshops, and alignment of material with Step 1 needs.
- Curriculum Review: The Program Evaluation cluster, led by Dr. Allison Serra and Greg Null, led a discussion of core outcome metrics to help the group determine how well our curriculum is performing as a whole. Members reviewed data in advance and rated concern; at the meeting discussion took place about next steps to address areas for development. Our strengths remain the Clerkship and Bridges phases, with students doing well on Step 2CK and 3 exams and in the match, and highly rating their residency readiness. We’ve made improvements in learning environment and clinical relevance of foundational science. We have room for improvement in Step 1 performance, grade turnaround, learning environment, learning log audits and curriculum mapping. Various work groups were charged with some tasks, and the committee will have further discussion in future meetings. But members unanimously voted that our curriculum is meeting its overall objectives at this point.
- Surgery Clerkship Report: Dr. Rani Schuchert reviewed the status of our current Surgery Clerkship, which includes two three-week rotations on general surgery and surgical subspecialty services. Synchronous didactics have been virtually eliminated but students have content resources for study. A “Back to Basics” workshop was hailed as a model of basic science integration on clinical rotations. Shelf outcomes are approximately at the national average. Recent innovations have includes a social determinants case report, flash feedback, padlet (for student-to-student tips), and a mentorship program (utilizing MS4 peers). Orthopedic surgery has been added as a rotation site, and the clerkship has increased the number of mid-rotation check-ins. Several student satisfaction measures have improved over the past three years, including adequacy of feedback and assessment validity. The “Back to Basics” model will be explored as a best practice for other clerkships, and at the next clerkship report, Surgery will present their plans for expansion in the new curriculum.
- Introduction to Patient Care (IPC) Block Report: Dr. Reed Van Deusen presented the block report, discussing core content areas of medical interviewing, physical exam, clinical procedures, and other clinical skills (oral presentations, clinical reasoning, documentation). Individual courses in IPC have received high ratings from students, although numerous challenges have been faced: faculty recruitment, complex scheduling, and patient availability. IPC is becoming the Patient Centered Care (PCC) block in the new curriculum, with one coordinator, taught by designed Clinical Skills Preceptors (CSPs), with some changes to where and how material is taught.
- MS1-2 Course Evaluation Subcommittee: Curriculum Committee member Dr. Brighid O’Donnell was approved as the next chair.
- Board Study Elective Expanded: MSELCT 5300 is currently a one-month elective for students who need additional time to study for Step 1, if approved by the Academic Success Team. Because external study courses require at least six weeks of time, the course director (Dr. Gonzaga) is requesting that the elective be expanded to allow students who need an external study course to get two months of credit for their efforts, retroactive to May for the Class of 2024. The Curriculum Committee approved this change.
- Bootcamp as a Graduation Requirement: The “Getting Ready for Residency” bootcamp for MS4s is currently a graduation requirement. The Committee voted to continue this as a requirement for Three Rivers Curriculum students as well.
- Clinical Focus Courses: Course directors shared updates on three intersession courses: Preclerkship Week (Dr. Suyama), Interprofessional-Geriatric Week (Drs. Cheng and Shulman), and Assessment Week (Dr. Preisner). These courses have been well-received and will continue in the legacy curriculum as is; Preclerkship will expand to two weeks for 3RC students, and IP-Geri and Assessment Week content will be distributed to other components of the curriculum. For the next two iterations of Assessment Week, the course is hoping to shift focus from Step 2CK prep towards clinical skill building; a new proposal will be submitted to Curriculum Committee to finalize specifics.
- Academic Remediation Policy Approved: Dr. Lisa Borghesi presented an updated academic remediation policy for 3RC students in Foundations, with specifics around referral to the Committee on Student Promotions as well as more detail on deadlines. The revised policy was approved.
- CCES Membership: Dr. Rani Schuchert was approved as a faculty-at-large member of the Executive Subcommittee.
- Curriculum Review: CCQI and the Program Evaluation core will be leading a “whole curriculum” review at the October 2 meeting. Two weeks in advance, members will receive data related to curricular outcomes: USMLE, grades, process measures, student satisfaction, residency readiness, etc. At the meeting, we will discuss areas for improvement and develop appropriate action plans.
- Research on Medical Students (ROMS): Dr. Bill Yates updated the group on the work of the ROMS subcommittee, which vets research studies specifically targeting medical students as a subject group. Such studies need ROMS approval before moving to IRB. Quality improvement projects do not require such vetting. Investigators should contact Dr. Yates to discuss their planned research.
- Policy: Test Punctuality: We reviewed a new policy laying out what should happen if a student arrives late to an assessment. For in-house assessments, they will be able to sit but won’t get any additional time. For Shelf/NBME exams, they will be allowed to test if they arrive within 15 minutes of the scheduled time but otherwise would have to reschedule. For SP-related assessments, they would lose out on the first rotation but can join after that. There may be academic or professionalism consequences depending on the situation. After much discussion, the Curriculum Committee approved this new policy.
- Help Needed: Curriculum Committee seeks faculty and student members for two important bodies, the CC Executive Subcommittee and the 3RC Course Approval Task Force. Anyone interested in more information should contact Dr. Rosenstock.
- New Policies: Dr. Lisa Borghesi presented four policies for discussion, with two approved and two tabled for further revision. The approved policies were revisions of existing policies related to transportation to clinical sites and site assignment requests, bringing these up-to-date for the new curriculum. Specifically, the transportation policy should apply to travel in any phase of the curriculum (with students being responsible)—this includes CAP/LAP, PCC block activities, and clerkships/electives. Students can request a change to a site assignment if they wish but must follow deadlines, otherwise site assignment is final. Policies on test punctuality and academic remediation were tabled and will be reviewed later.
- Foundations of Medicine (FOM) Block Report: Drs. Cynthia Lance-Jones and Martin Schmidt shared a review of the FOM block, seven basic science courses in the legacy curriculum with an overall course quality rating of slightly above 4.0 (5=best). Course directors made many improvements last year, particularly highlighting Step 1 relevance, streamlining syllabi, improving clinical relevance and coverage of social justice issues, and strengthening academic expectations (“pass-every-course” and criterion-based passing thresholds). Class means were about the same and there were fewer course failures per course. Student suggestions are being used to improve the new Keystone Fundamentals (KF) block in 3RC, which replaces FOM—students want a focus on high-yield learning objectives, more practice questions, a fewer number of high-quality educators, and even more clinical relevance and social medicine tie-ins. The shift away from lectures to case-based active learning in small groups, and the elimination of course “silos” and lectures, should also help. The Committee approved the report.
- New Instructional Designer: Katherine Senko introduced herself as the new instructional designer, someone who can help educators with curriculum design and delivery to maximize quality and enhance consistency. Kathy has a lot of experience with active learning and other classroom teaching strategies, and she introduced the concept of cognitive load. Faculty in any part of the curriculum can reach out to her directly to discuss needs.
- Step 2CK Study Elective: A proposal was introduced to create a 2CK study elective for students taking the exam beginning in 2024. Modeled on the Step 1 study elective, this pass/fail experience would allow for self-assessment and self-regulated study culminating in exam administration. Students don’t have to take it, and are only eligible for taking this once. This will make it easier for students to focus on studying for this increasingly important assessment. The Curriculum Committee approved the elective.
- Adult Outpatient Medicine Clerkship: Dr. Jillian Kyle presented on the clerkship she directs, where students participate in ambulatory care at general internal medicine and specialty sites. A new site is the Pitt Vaccination Hub. Dr. Kyle and her team are developing new didactic content on LGBTQ+ health, addiction medicine, and bias in medical writing. Grading is based on clinical (50%), OSCE (25%), and Shelf exam (25%) with no minimum passing scores for the latter two elements. Shelf performance is around national average and 85% of student achieve Honors level performance. Dr. Kyle has worked to improve reliability of OSCE grading, and she is seeking to address site comparability and improve midrotation feedback for the coming year. 92% of students are satisfied with the overall quality of the rotation.
- Neurology Clerkship: Dr. Laurie Knepper presented on the clerkship she directs. She and her team have been working on improving the transparency of clinical evaluations, which comprise 50% of the grade. Shelf scores have been slightly below national average. About 40% of students achieve Honors. Neurology emphasizes EPA and competency development, successfully covering key clinical conditions. Dr. Knepper raised a concern about an increase in the number of visiting students, and how that might impact clerkship students if the trend continues—this will be further reviewed in the MS4 subcommittee. 91% of students are satisfied with the overall quality of the rotation.
- Academic Remediation Policy: A revised academic remediation policy was introduced, which lays out plans for remediation in the new curriculum. Students would get three chances to successfully pass summative exams; students must pass all three summatives in Keystone Fundamentals before moving on to Organ Systems. Remediations should occur as soon as possible, either during flex weeks or on breaks. We reviewed when Promotions Committee would be notified and what outcomes might be based on student performance. The policy will be edited based on committee feedback and resubmitted for final approval.
- Clerkship News:
- Neurology presented a novel approach to integrating structural competency and interprofessional education into a clerkship experience, with students assisting with discharge planning and writing reflectively about the issues faced.
- Surgery and Neurology will be changing their grading procedures to allow for a High Pass grade even if the initial Shelf exam was not passed (previously those students could only get a Pass).
- Pediatrics shared their annual report with the group, highlighting their inpatient and outpatient months, with subspecialty exposure, didactics, and cases. Clinical performance counts for 60% of a student’s grade (weighted by time spent), 30% for Shelf exam (52 as passing score), and 10% for professionalism. Students felt that the clerkship was well-organized (89%) and highly focused on giving students useful feedback (88%). The clerkship requested (and the Committee approved) a 3-hour reduction in didactic time to allow students to spend more time in clinical settings; the ethics content previously covered will continue to be addressed clinically (and on other clerkships).
- New Acting Internship Approved: Pediatrics proposed a new AI in the Neonatal ICU setting, led by Dr. Danielle Browning—50hpw, no call, 1 student per period year-round. This will help address capacity, as an increasing number of students are interested in pediatrics AI’s. Residencies see NICU and inpatient experiences as equivalent. The Committee approved this new experience effective immediately.
- MS4 Class Report: Our Class of 2023 student representatives shared an update about the 4th year curriculum. Students were pleased with the flexibility and support, the completion of the new West Wing, and the quality of the Bootcamp experience. They suggested formalizing a Step 2CK study month, adding content on financial planning and CV development, improving advising around residency applications, and providing more information about remote/asynchronous electives.
- Students With Disabilities: A panel of four students led a discussion about how to best serve students with disabilities. Such students appear to be underrepresented, especially those with mobility and sensory impairments. Mental health and attentional disabilities predominate, and accommodations may be necessary to help students succeed. The panel argued that such students should be integrated into a school’s diversity programming and tracking, with a separate webpage discussing services, and attention to language and technical standards in an effort to be more inclusive.
- Adult Inpatient Medicine Clerkship: Dr. Amar Kohli reviewed the AIMC experience for its annual report. The clerkship continues to be very successful, with 91% of students saying they were satisfied with its overall quality; 96% felt it was well-organized, 94% felt they got appropriate feedback. It’s one of the top clerkships in these and other categories. AIMC is looking at learning environment, increasing faculty development around the topic. They are also hoping to add more planetary health content.
- Curriculum Committee Mandate and Process: We discussed a proposal to alter the committee’s mandate to encourage “cycling” of leadership and membership more frequently. Members felt that this may not be the best time to change committee structure, with the new curriculum rolling out and the need for more stable leadership in particular. The proposal was tabled for now. We also discussed how to maintain a safe environment for conversation, particularly the need to be mindful of comments that might be hurtful or inappropriate. We decided to pull together some tenets of participation and do more frequent reminders.
- Clerkship Content Changes Approved: Three clerkships requested changes for the 2024 academic year. Family Medicine is altering didactics to enhance musculoskeletal and mind-body teaching, eliminating an ethics discussion. OB/GYN is revising their learning objectives, notably adding an item on leadership and advocacy; they are also eliminating PBL experiences and shifting the 10% grade weight towards two other components (overall clinical evaluations now 60%, and a required knowledge quiz will now count for 5% if completed). Surgery is changing its Shelf exam policy to allow students who don’t achieve an initial passing score to retake the exam and still earn a High Satisfactory grade (instead of a maximum Pass) if their clinical evaluations were outstanding. Members encouraged other clerkships to consider making a similar change.
- New Elective Approved: The “Problematic Pancreas” elective from the Department of Pathology will allow students a mixed preoperative/postoperative experience around pancreatic and biliary tract pathology, including operating room, diagnostic conferences, cytopathology lab, and clinic. Dr. Karen Schoedel and colleagues built this elective around a similar thyroid elective.
- Curriculum Reform Phase 3 Final Report Approved: Members approved the full Phase 3 report, allowing UPSOM to move to Phase 4 for final implementation for the fall. Faculty educators are being hired, curriculum materials are being developed, and procedures are being updated.
- Curriculum Committee Mandate Revisions Proposed: To achieve better diversity and “circulation” of voting membership, the committee discussed alterations to its overall mandate, including a leadership “cycle” (Vice Chair to Chair to Chair Emeritus) and enforced term limits of three years with at least five members from each of three departmental clusters (medical, procedural, foundational). The committee will review the proposal and vote in May.
- Social Medicine: FEB Challenge: Dr. Eloho Ufomata reported back on the FEB Challenge, the faculty development project last month that focused on inclusion on belonging in education. Over 200 faculty from virtually every department participated, with Pediatrics winning the prize for most faculty. Good feedback was obtained to make the experience better in future years, and all the resources remain on the OMED website for people to access at any point.
- Curriculum Reform: Phase 3’s final report will be delivered April 3 and voted on by April 20. For Phase 4 (implementation), we are forming new working groups to address needs: Credit System (Bridges electives), Diagnostics course (Clerkships phase), PECs (Foundations phase), and the expanded Preclerkship course (now two weeks). Faculty, students, or staff wishing to serve on those working groups should reach out to Dr. Rosenstock directly.
- Match Results: Dr. Alda Maria Gonzaga reported on last week’s completed match, which was viewed as very successful. 95% of MS4s matched initially, and the majority of unmatched students found spots in the SOAP, for a total match rate of 99%, our highest ever. Advisory Deans, departmental advisors, and a variety of other staff, students, and faculty all helped to make the match a success.
- Library Liaison: The Falk Library (HSLS) has assigned a new librarian liaison, Alyssa Young aly77@pitt.edu, to help students and faculty identify resources for study/teaching. She shared exam review materials, question banks, a video library of content, and more. She hopes to be able to contribute to the new curriculum by working with faculty to create guides to help students learn specific content areas. Everyone should reach out to her with questions/requests.
- Educational Program Objectives (EPOs): We completed our cycle of EPO reviews, finalizing are last four and reviewing the entire list of EPOs. Changes made during the past year were approved and the list is now active on our website. It will be used to update our mapping going forward. The addition of breast conditions will apply to the Class of 2025 as a graduation requirement.