VOL 2, No 3, March 2000
Core Curriculum is national first
new feature of 1st-year curriculum
As the expression goes, “when you are out in the lead, the scenery is constantly changing...so you never know what to expect next.” This describes the experiences of MUSC Graduate Medical Education as it leads the way, nationally, in developing an innovative educational program called the Core Curriculum.While many of them may not know it, MUSC’s 500 residents and fellows are pioneers in a nationwide effort to teach residents the realities of medical practice alongside their traditional clinical training experiences.
MUSC is the first medical school in the nation to report the successful implementation of an institutionwide program to address the Accreditation Council for Graduate Medical Education (ACGME) requirement to provide residents with the knowledge and skills they need to meet the challenges of today’s health care marketplace. A major reason for this success has been the cooperative spirit among the 45 residency program directors, the departmental chairs and the Graduate Medical Education Office.
“The ACGME now requires residency programs to provide residents with information on general topics related to the practice of medicine regardless of clinical specialty,” said Franklin Medio, Ph.D., director of the Office of Graduate Medical Education.
Beyond the accreditation requirements, Medio continued, teaching hospitals were once exempt from many federal rules and regulations imposed on private non-teaching hospitals, but changes in compliance regulations mean teaching hospitals are expected to function just as their private counterparts. Residency education must adapt to these changes.
Through a series of lectures and seminars offered at multiple times each year, residents receive instruction in bioethics, professionalism, evidenced-based medicine, Medicare, socioeconomic factors in patient care, medical-legal issues, quality improvement processes, teaching skills and hospital practice.
The toughest challenge facing program directors, faculty and residents is fitting Core Curriculum sessions into an already packed clinical training schedule.
“Residents have questioned the necessity of these programs and felt frustrated when time is taken away from their clinical training and burdened by the additional workload,” said George Arana, M.D., associate dean for Graduate Medical Education. “But it’s a critical part of their clinical education and a requirement by most specialty boards that certify the competence of physicians.”
For example, Arana said, as licensed practitioners, residents are responsible for following the same rules and regulations as faculty. “We’re preparing our residents for the world of medicine they’ll encounter when their training ends.”
Initially Core Curriculum programs were held on weekends and evenings; now sessions are scheduled primarily on Thursday and Friday mid-to-late afternoons.
“The development of the Core Curriculum has been an evolving process,” Medio said. “We’re continually working to ensure that the topics and content have relevance to residents’ needs and situations. We’ve also made changes in the format and schedules to be as flexible as possible to meet the demands of 45 different training programs.”
Recognizing the changing face of health care, initial development of the Core Curriculum began in 1995 as part of the strategic planning process of the College of Medicine. In 1997, Arana recruited Medio, a nationally recognized professional in medical education, to head the Office of Graduate Medical Education and take the lead in the Core Curriculum’s development.
By having a collegewide program instead of requiring individual departments to provide residents with relevant information, the Core Curriculum achieves standardization of information and eases the burden on individual departments to develop programs themselves. Curricular content is determined by MUSC’s Graduate Medical Education Committee (GMEC)—a group whose members include all residency program directors and two residents selected by their classmates through an annual election. The GMEC is also responsible for determining the attendance policy and requirements for graduation.
The first program, The Resident as Teacher, was initiated in 1998. Its goal is to provide residents with a better understanding of their role as a clinical teacher and increase their awareness of the many teaching opportunities that exist through the course of daily patient care activities. Introduction to Medicare and Principles of Hospital Practice where the second and third elements, respectively to join the Core Curriculum in 1999. In addition, a one-day symposium on managed care, featuring national speakers, was held in March 1999.
“Given the proliferation of managed care across the country, it is incumbent on us to prepare our residents to practice in the ever-changing health care environment, even if they are not exposed to it through daily patient care experiences at MUSC ,” Medio said.
Last summer a series of optional programs were added to the Core Curriculum covering personal and professional development issues like debt management, job hunting, taxes and alternative and complementary medicine. (See story on page 8)
Residents
discuss evidence-based medicine at a recent Core Curriculum session.
MUSC’s Core Curriculum has been recognized as a model for other schools
who are beginning to develop similar programs. Arana and Medio have presented
the MUSC Core Curriculum at national medical education meetings and have
been asked to describe the Core Curriculum in detail at the 2000 American
Medical Association meeting.
Programs promote personal, professional development
Through a series of optional Core Curriculum sessions, residents can learn how to manage student loan debt, deal with job recruiters, develop financial plans or determine their insurance needs.Implemented into the Core Curriculum last summer, the sessions are designed to promote residents’ personal and professional development.
“There’s a whole body of information dealing with personal and professional development issues that residents have not been exposed to because they have concentrated on their medical education,” said Franklin Medio, Ph.D, director, Office of Graduate Medical Education (GME).
Other topics include alternative and complementary medicine, preparing income taxes and assessing career opportunities. Optional sessions are open to residents' spouses and partners.
“We want to provide residents with valuable advice and guidance as they make some important decisions in their lives,” Medio said.
The concept of the Core Curriculum has extended beyond the classroom to include a series of social activities and an auxiliary organization for residents’ spouses and partners. Traditionally residents tend to socialize only with other residents and spouses in their program. The auxiliary, Medio said, provides an opportunity for interaction with others outside their programs and allows residents and their families to develop a greater sense of belonging to the MUSC community.
Medio and the GME office staff have worked with the auxiliary group to conduct a variety of events including a night at the Riverdogs, a halloween party, hayride, golf tournaments and family picnics. A bimonthly newsletter serves as the main link between the GME office and auxiliary members.
“The response from residents has been very positive,” Medio said.
Third-year Internal Medicine resident Collin Curran, M.D., said, “The social activities and optional programs are a good addition to GME. The financial and insurance information was especially helpful.”
Optional Core Curriculum sessions are offered throughout the year.
Apple Tree to expand offerings
by Kristen KarigPublic Relations
Until now, a centralized resource for faculty development in teaching didn’t exist on the MUSC campus. That void has been filled with the expansion of the Apple Tree Society—a group well-known for its yearly workshop promoting excellence in education.
“The annual retreat has always been popular, but there was a clear need for more faculty development opportunities on campus,” said Bill Stillway, Ph.D. professor of biochemistry and molecular biology. “The mission of Apple Tree—to foster dialogue and activity related to the scholarship of health professions teaching—will be greatly enhanced through the year-round work of a steering committee and four working groups.”
Dr.
Coleman Bender, center, discusses teaching techniques with two participants
at an annual Apple Tree retreat.
Stillway established the Apple Tree Society in 1985. The annual retreat has been held every year since 1986. Stillway, along with Amy Blue, Ph.D., assistant dean for curriculum development and evaluation, and Franklin Medio, Ph.D., director of the Office of Graduate Medical Education, are spearheading the extension of the society and broadening its activity for all colleges.
The steering committee and working groups, each with faculty representation from all six colleges, began meeting late last year.
One goal of the newly expanded society is to establish a series of regular activities that enable faculty members to improve their teaching techniques and testing/evaluation methods. To assess which topics are of greatest importance to faculty, the Teaching Skills Seminar Series working group will survey the MUSC faculty this spring.
The Mentoring and Networking working group aims to promote professional development of current and future educators. Currently, the group is gathering information on the different mentoring programs that exist on campus for both junior and senior faculty. Future plans include the development of mentoring programs to cultivate future academicians.
Another Apple Tree working group is representing MUSC in the Campus Program of the Carnegie Teaching Academy conducted by the American Association for Higher Education. The Carnegie’s Campus Program asks that institutions make a public commitment to reconsider the scholarly work of teaching.
The working group asks that all MUSC faculty consider the following definition of the scholarship of teaching on our campus: “The scholarship of teaching encompasses both the scientific study of teaching and learning and the application of that knowledge to institutional and individual pedagogy.”
Plans for the annual Apple Tree retreat, scheduled for this fall, are underway through the Annual Retreat/Symposium working group.
For more information about the Apple Tree Society and its activities, e-mail one of the Steering Committee members listed below.
Apple Tree Steering Committee Members
Amy Blue, Ph.D...................................blueav@musc.edu
John Cormier, Pharm.D.................cormierj@musc.edu
Suzanne Doscher, M.S.................. doschers@musc.edu
Donna Johnson, M.D.....................johnsodo@musc.edu
Mary Mauldin, M.Ed...................mauldinm@musc.edu
Franklin Medio, Ph.D........................mediof@musc.edu
Jimmy Rivers, DMD.......................... riversj@musc.edu
Lisa Saldin, M.Sc.............................. saladinl@musc.edu
Terry Schmidt, MBA......................schmidtt@musc.edu
Bill Stillway, Ph.D.............................stillway@musc.edu
Valerie West, Ed.D.............................westvt@musc.edu
Roger White, Pharm.D......................whiterl@musc.edu
AMA changes PRA category 1 credit system
Thanks to the effort of the MUSC Office of Continuing Medical Education (CME), physicians nationwide have another alterative for obtaining credit for the American Medical Association (AMA) Physician’s Recognition Award (PRA).A physician who provides a new and unique lecture as part of a continuing medical education activity designated for category 1 credit by an accredited sponsor can now obtain two AMA PRA category 1 credits for each hour of his or her lecture, with a maximum of 10 credits available per year.
Acting upon a suggestion by the College of Medicine Educational Policy Council, MUSC CME requested that the AMA Council on Medical Education make this change to recognize the time, effort and expertise physicians devote to CME when they serve as lecturers.
The change was approved by the AMA Council on Medical Education in December 1999.
The following were also authorized for the purpose of obtaining category one credit:
- Articles published in peer-reviewed journals (i.e. journals listed in the Index Medicus): 10 credits for each article, 1 article per year.
- Poster presentations designated for AMA PRA category 1 credit: five credits per presentation, one presentation per year.
- Specialty board certification and maintenance of board certification (specialty board recertification): 25 credits.
- Medically-related degrees, such as the master’s in public health: 25 credits.
All changes to the PRA credit system are effective immediately.
Accredited sponsors will not designate PRA credit for these self-directed
learning activities.
MUSC requires physicians to obtain 50 hours of PRA credit every two years.
For more information, call CME at 876-1925.
Don't miss this
Don’t miss the following opportunities to share your medical education innovations:May 1
Submission deadline for proposals for Generalists in Medical Education Conference
The conference will be held in Chicago concurrently with the Association of American Medical Colleges (AAMC) 111th Annual Meeting from Oct. 28 to 29.
For more information, visit <http://www.thegeneralists.org/>. Or contact Amy Blue, Ph.D., 792-3409 or blueav@musc.edu.
May 5
Submission deadline for small group discussion and mini-workshop proposals
for the AAMC 111th Annual Meeting.
Information and forms are available online <http://www.aamc.org/about/gea/smallgrp.htm> and <http://www.aamc.org/about/gea/miniwrks.htm>.
June 2
Submission deadline for Innovations in Medical Education (IME) Exhibits
for AAMC Annual Meeting.
Information and forms are available online <http://www.aamc.org/meetings/annual/2000/exhibits/start.htm>.
Gradute Medical Eduction
Core Curriculum Lecture SeriesDinner is provided at Thursday sessions; lunch is provided at Friday sessions.
April
6
4 - 7 p.m.
Occupational Health
Lawrence Mohr, M.D., and William Simpson, M.D.
2 West Amphitheater
7
Noon - 3 p.m.
Occupational Health
See April 6 program for speakers
107 Admin. Bldg.
13
4 - 6:30 p.m.
Acupuncture and Chiropractic
Gary Nestler, Director, MUSC Alternative Medicine Group and Zachary
Harrison, DC
Room 419 CSB (Surgery)
14
Noon - 2:30 p.m.
Acupuncture and Chiropractic
See April 13 program for speakers
Baruch Auditorium
20
4 - 7 p.m.
Evidence-Based Medicine
John Heffner, M.D., and Barbara Tilley, Ph.D.
2 West Amphitheater
21
Noon - 3:30 p.m.
Evidence-Based Medicine
See April 20 program for speakers
2 West Amphitheater
27
4 - 6:30 p.m.
Alternative and Complementary Medicine
David Gangemi, Ph.D., Executive Director, National Nutraceutical Center
and Gary Nestler, Director, MUSC Alternative Medicine Group
2 West Amphitheater
28
Noon - 3 p.m.
Alternative and Complementary Medicine
See April 27 program for speakers
Gazes Auditorium
Preregistration is required. Call Angela Ybarra at 792-0761 or Sandra Murrow at 792-2575.
Continuing Medical Education
The following conferences are sponsored by MUSC.April
6 - 8
Symposium on Congenital Heart Disease
Charleston Place Hotel
24 - 25
Issues in Women’s Health
Charleston Place Hotel
27 - 30
Postgraduate Course in Surgery
Mills House Hotel
May
6
Nuclear Medicine: Moving Into the Millennium
Charleston Harbor Hilton
Call the Office of Continuing Medical Education at 876-1925 for more
information.