Third- and Fourth-Year Curriculum Committee Meeting
Julie Byerley, M.D., and Timothy Farrell, M.D., Co-Chairs
Oct. 27, 2009, 7:30 a.m. – 8:30 a.m., 238 MacNider
In Attendance:
Julie Byerley
Tim Farrell
Lydia Efird
Alice Chuang
Cristin Colford
Ana Felix
Robert Gwyther
Christopher Klipstein
Michael Meyers
Cheryl McNeil
Renae Stafford
Frances Smith
Georgette Dent
Jim Barrick
Ellen Roberts
Joey Woodyard
Mindy Roush
Task Force Reports
o
Content of Curriculum
 Integration Selective Update (Mike Meyers)
 Two primary activities:
o Seminars – 13 different faculty members who have participated by highlighting
basic science aspects of clinical problems.
o Presentation by students – a 10-minute presentation on a topic delivered at the
end of rotation.
 The selective requires students to return one day per week for seminars, which is a halfday on Monday and Friday.
 The electives can be any clinical elective that would allow attendance for seminars and
presentations and can be in- or out-patient.
 Pitfalls/Needs:
o There is a preference to have more continuity of seminars from block to block.
o Increase the number of elective opportunities that would satisfy approximately
120 students.
o It would be extremely helpful to have a co-course director from the basic
sciences.
 Competencies Task Force (Alice Chuang)
 Current deficiencies
o Core competencies for educational programs are not used in planning the
curriculum or evaluating its effectiveness.
o Student performance is not used to document the achievement of the core
competencies.
o The teaching faculty does not know about the core competencies.
 Overview
o An informal query to clerkship directors determined they are aware of the core
competencies. The deficiency of the faculty not knowing the core competencies
was most likely with the first- and second-year faculty.
o Clerkship directors are using national, educational and specialty organizations to
develop their objectives more specifically so it creates a conflict for clerkship
directors.
o Which should come first? Should we be thinking about the core competencies
and matching the ones we have now when there could be a big change? Or,
should we write the core competencies first and adjust the curriculum or vice
versa?
 Recommendation
o The committee cannot offer any recommendations until we have an idea of
what the core competencies are going to look like, if they are going to change.
o We can use the curriculum committee to communicate to all faculty about the
competencies and to make sure the clerkship directors knew and put forth
effort to link objectives to competencies. Will that be destructive if we change
the competencies within the year?
o The clerkship directors need to be an aware when they are communicating and
creating the objectives.
o The committee will reassess after the curriculum retreat in November.
 Total Physician Task Force (Cheryl McNeil)
 Overview
o ED-10: The curriculum must include behavioral and socioeconomic subjects, in
addition to basic science and clinical disciplines.
o ED-13: Clinical instruction must cover all organ systems, and include the
important aspects of preventive, acute, chronic, continuing, rehabilitative, and
end-of-life care.
 Current Deficiencies
o Medical Informatics
 There was a course in prior years, but it was eliminated.
 This material will be covered in the Transitions Course.
o Occupational Health
o Patient Safety
o Rehabilitative and end-of life care
 It is not systematically documented throughout the curriculum. If it is
not documented as one of the competencies then we are not doing it.
It will be a matter of documentation in order to meet the requirements.
 There is some documentation in Social Medicine, ICM and Capstone.
 The committee will meet with PM&R staff to get recommendations.
 Recommendation
o Cheryl McNeil would like assistance from the clerkship directors on where the
deficiencies are covered in the current curriculum.
o We need to determine what competency we want our students to have for endof-life care.
o The committee will meet with PM&R staff and Palliative Care team to get
recommendations.

Administration of Curriculum
 Assessment Task Force (Tim Farrell for Amy Shaheen)
 The Assessment Task Force is scheduled to meet this Thursday, Oct. 29, at 1 p.m.
 Introduction to Acute Care (Frances Smith)
 In the transition of FAC to Introduction to Acute Care there are quite a few students
who have fallen through the cracks.
o Ten students who had delayed FAC until their fourth year.
o The third-year students who are doing clerkships at remote sites. (12 Charlotte,
4 Asheville, and other students at away sites – not including Wake or Cone.)
 The remedy is to provide extra sessions just for them as well as come to sessions that
currently exist.
 Clerkships need to be aware that some students will be asking for late afternoon off to
get in on an existing session.
 Limited amount of time and space in the Clinical Skills Center.

Student Experience of Curriculum
 Comparability Task Force (Julie Byerley for Deb Bynum)
 The student leaders had prioritized concerns about comparability across sites.
 The clerkship directors have been sent an informal survey to gather basic data about
your objectives, assessment methods, etc.
 Work Hours Measurement (Renae Stafford)
 Overview
o Talked with clerkship directors and most have defaulted to the 80-hour work
week based on how the residency programs work.
 Recommendation
o The committee would like to collect data during a 6-month pilot via One45 for
students to estimate the number of duty hours per week averaged throughout
the entire clerkship.
 Duty hours would be defined as all clinical and academic activities
o
o
related to the program, patient care (in-patient and out-patient),
administrative duties, provision for transfer of care, time spent in-house
during call, scheduled activities and conferences.
 Duties do not include reading and prep time spent.
Query clerkship directors formally to find out if they are using the 80-hour work
week schedule and policies on post call, days off, etc.
Julie Byerley mentioned that the data needs to be site-specific in order to help
Deb Bynum with the comparability.
Course Review
o The committee has been charged to develop a new method of course review that indicates to the LCME
that competencies run through our courses and we do have midpoint feedback, etc.
o Recommended review method
 Appointing a “captain” (a senior faculty member).
 Peer review as is done with manuscripts (one to two reviewers who review the course) with a
rotating role of reviewers.
 A conference call or meeting will take place with the course director to allow questions to be
answered after the initial review.
 The review process will come back to this committee as a forum to share best practices and
group-generated ideas for improvement of the course.