Discussion Items

1. Minutes

Dr. Borgia made a motion, seconded by Dr. Barnhart, to approve the minutes as submitted. The motion passed unanimously.

2. Announcements

Dr. Distlehorst announced that she carried Mr. LeBlang’s proxy. Dr. Cooper announced that he carried Dr. Caspary’s proxy.

Dr. Distlehorst announced that the NBME is now allowing for faculty review of the computer-based USMLE Step 1. She will work with Dr. Constance, as the NBME-designated Executive Chief Proctor, to make arrangements for designated faculty to go to the Springfield Sylvan Center. She added that this is a good experience for faculty, but, due to the expense and logistics involved, curriculum committees will have to designate faculty for the review, rather than opening it up to all faculty.

3. Review of Four-Year Curriculum

Dr. Kruse reminded EPC members that the main order of business for the meeting was to review the four-year SIUSOM curriculum, using the distributed chart to review how each year’s proposal interacted with the remainder of the curriculum. He added that the Year 1 proposal to increase the year by three weeks, with its resultant decrease in time for the Mentored Professional Enrichment Experience, was approved at the January 14 EPC meeting. He suggested that the Year 3 proposal be discussed next.

3.1 Year 3 Curriculum

Dr. Kovach reminded the EPC that the Year 3 proposal had been approved by the Y3 Curriculum Committee in November and presented to the EPC in December and January. She summarized that the Surgery Clerkship continues to have 10 weeks, with Internal Medicine and Neurology comprising a 13-week experience. Nine of the 18 students in the Internal Medicine Clerkship will rotate into a two-week Neurology experience at two different times during the IM clerkship. Other than the two-week overlap in Internal medicine Clerkships, there is not a drastic change. Students will be assigned to preceptors during the overlap period as much as possible and then take the Internal Medicine Subject Exam the last day of the clerkship. Students will take the Neurology exam at the conclusion of the two-week Neurology Clerkship. Although there has been some preliminary discussion regarding an integrated exam, there are some logistical issues that may make this difficult, if not impossible. Short clerkships remain at six weeks each, with Doctoring as two two-week segments (each for half of the class) in the Spring semester. Students have a long weekend at the end of their Family and Community Medicine Clerkship; Dr. Kovach will be asking the Psychiatry Clerkship to make the same arrangement. Since OB/GYN and Pediatrics separate their clerkships into two three-week experiences, it is harder for them to insert the long weekend.

It was suggested that, since the proposed schedule is two weeks longer than the current Y3 schedule, requirements for Y4 should be reduced by two weeks. In the discussion that followed, it was noted that the Y4 Committee will be reviewing a proposal to include two additional weeks of Neurology in Y4 so that, beginning with the Class of 2004, Neurology becomes a four-week clerkship, with two weeks in Y3 and two weeks in Y4.

After much discussion regarding the amount of vacation and open time in Y4 and the amount of time students need for residency interviews, Dr. Resch made a motion to strongly encourage the Y4 Curriculum Committee to reduce the number of required elective weeks from 31 to 29. After additional discussion as to whether this motion should be voted on before the Y3 schedule had been approved, the motion passed with six in favor, four opposed and one abstaining.

Dr. Resch then made a motion, seconded by Dr. Borgia, to approve the Y3 schedule as presented, with the caveat that Y4 will reduce the number of required elective weeks to 29. After much discussion as to the advisability of passing a motion contingent on a decision by another curriculum committee, the motion failed with five in favor, five opposed, and two abstaining.

Dr. Borgia then made a motion, seconded by Dr. Cooper, to approve the Year 3 schedule as submitted. The motion passed with seven in favor, one opposed, and four abstaining.

3.2 Year 2 Curriculum

Dr. Borgia explained that the Year 2 Curriculum Committee has had many discussions about the curriculum over the past two years and specifically at an April 2001 retreat. Although there is general agreement regarding content and lengthening of segments, a major source of contention has been whether the segments should rotate. A Y2 Planning Subcommittee deadlocked over the rotation issue, so it did not seem appropriate to try to have the same discussion at a full committee meeting. Dr. Borgia met with Dr. Distlehorst, Dr. Dorsey and Dr. Kruse to discuss the issue, and felt that the consensus was that the plan should be brought directly to the EPC. The Year Directors, Dr. Distlehorst, Dr. Dorsey and Dr. Kruse met on January 21 to review the four-year curriculum, and there was consensus to proceed with the Year 2 schedule as outlined by Dr. Borgia. Dr. Borgia and Dr. Kruse called a special meeting of the voting members of the Y2CC on January 22. A motion was made to vote on the schedule at the regularly-scheduled Y2CC meeting on January 25, but the motion was not seconded. Dr. Borgia concluded that he felt that any further discussion at the Y2CC level would make the committee dysfunctional, and that, in order to meet the EPC January 28 deadline for curriculum plans, he was bringing his proposal directly to the EPC.

There was much discussion as to whether the Y2CC should have an opportunity to vote on the schedule before the EPC approved it, with the main concerns being disenfranchisement of a curriculum committee, and concern as to whether the Y2CC has been given the opportunity to adequately discuss issues such as the effect of non-rotation on clinical experiences, the effect of lengthening of segments on clinical faculty ability to tutor, and the potential effect of the Y3 two-week overlap on the Y2 curriculum with regard to tutors from Internal Medicine specialties (for example, Y3 IM overlaps occur during the Y2 Infection and GI/Endo/Repro segments, when there will be heavy call for IM faculty in those specialties to tutor and offer clinical activities and resource sessions).

Dr. Borgia and Dr. Kruse felt strongly that the proposal brought forth by Dr. Borgia reflected the recommendations from the April 2001 retreat, and that it was necessary to enact those recommendations. They noted that the proposal mirrors the Y1 Curriculum, with the segments in the same order, with the idea that this will increase educational maturation and vertical integration.

Dr. Cooper added that the Basic Science Chairs with a vested interest in the curriculum had met with Dr. Borgia and Dr. Kruse and supported Dr. Borgia’s Y2 Schedule. It was noted that Clinical Chairs had not reviewed the proposal and that, historically, they have opposed non-rotating plans.

Dr. Wade made a motion, seconded by Dr. Cooper, to approve the Y2 Curriculum schedule as submitted, with a clear designation that the curriculum is sequential.

After much additional discussion, in which Ms. Lipcamon reported unanimous support of the proposal by the Year 2 students, other members pointing out the increased support of the curriculum by Basic Science faculty if the proposal were approved, others noting that the proposal could make it impossible for clinicians to tutor in Y2, and others reiterating their concerns regarding curriculum committee process, Dr. Distlehorst suggested that the vote be held for two weeks so that additional input could be obtained from the Y2CC and the Clinical Chairs.

Dr. Wade called the question, and the motion passed with nine in favor, two opposed, and one abstaining.

Dr. Kruse said that he understood concerns regarding committee process but that this was not the first irregular process the EPC has dealt with in the past 14 months.

3.3 Year 4 Curriculum Committee

No report was made in Dr. Lower’s absence.

4. Next Educational Policy Council Meeting: Monday, February 11, 2002, 1:30 to 3 pm.

	Minutes