Minutes from the Curriculum Committee Meeting
12/7/10
Topic
Attending:
Information Items
Consent Agenda
Clerkship Capacity
Discussion
Bacon, Bainkaitis, Byerley, Bynum, Cairns, Chuang, Cross,
Dent, Dreesen, Enarson, Farrell, Felix, Fields (phone)
Gilliland, Heck (video), Johnson, Newton, Perry, Rao,
Serra, Shaheen, Slatt, Steiner, Stone, Trice-McNeal, Viera,
Wood, White (video); Absent: Perry, Darrow, ClarkePearson
 See Agenda. Note that the milestone documents were
approved electronically before the retreat.
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Action Items
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Inpatient Internal Medicine was taken off for
discussion. A key issue is that LCME has identified
clerkship grades after 4-6 weeks as a major problem –
has become the single most common citation for
medical schools. The report describes an excellent
Internal Medicine hospital clerkship but an effort
needs to be made with this and other clerkships to get
all of the other required courses in by 4-6 weeks
afterwards.
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Please see agenda.
After the meeting, Newton followed up with regard to
capacity for the fourth year. The data suggest and the
curriculum confirms that fourth year capacity is
sufficient. Moreover, the Curriculum Committee
affirmed the current policy of giving UNC students first
preference. A remaining issue is to discuss those
experiences such as AIs in which there is a desire on
programs to bring in people from outside. This does
come up from time to time but is not a major issue. It
needs to be kept in mind as we move forward.
The committee also reviewed capacity for the fourth
year curriculum. The consensus was that the capacity
for fourth year courses was sufficient.
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Newton will follow-up
with an invitation for
the architectural
consultants on 12/20.
Newton will follow-up
with CC3/4 and Dr.
Klipstein regarding the
importance of grades
within 4-6 weeks.
Newton will follow-up
with Stone about
getting the right
metric/regular
information on time
to 100% completion of
grades. The
incompletes can be
legitimate and does
represent completion
of grade for purposes
of this but the one45
measure is not
perfect.
The Clerkship
Committee endorsed
a capacity of 180 slots
distributed as evenly
as possible
throughout the year
with an understanding
that new slots coming
from the expansion
will need to be added
in addition to this
number.
No changes necessary
in the current policy.
Document1
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Clinical Skills Test
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Revisiting Electives in
the Third Year –
Review of Policy
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The policy of giving UNC’s students first choice worked
well, along with the operational policy if students
change their minds, we work them in and find a place
for UNC students.
We need to keep in mind the dual goals for bringing
AI’s in for recruitment and having UNC students early
in the year. We can organize this by keeping some
slots open for outside students. That seems to be
working pretty well.
Discussion about national capacity and timing of
clinical skills. Current written policy is to mandate
taking but not passing the clinical skills test. In the last
couple of years, we’ve tried to get people to take CSII
early so they could pass it in advance of graduation.
The CSII exam was intended for internship rather than
the end of the third year. So, this is consistent with its
original. Another question is what do other schools do
with this and what are the requirements for a training
license here?
There was a spirited discussion about this issue. Key
points included:
o The context is that this committee decided
that we needed to move towards flexibility in
that third year. The data show that in fact
we’ve not made progress with flexibility in the
third year. This is an urgent issue because the
students are now putting in selections.
o Increasing clerkship capacity will help.
o The electives we want them to have are career
development electives – that is where they try
to see whether they want to do that.
o Some prerequisites will need to be changed in
order to allow flexibility.
o Before Dr. Newton came on board, there was
a very extensive and explosive discussion
around core clinical clerkships.
o It was consensus that we will need to look at
the competencies to decide what we’re going
to do.
o The students are voting with their feet and
choosing to defer outpatient Internal
medicine. Previously, Outpatient Internal

The committee
endorsed the written
policy – UNC students
should take (clinical
skills II in advance of
graduation).
 Dr. Dent will query the
Student Affairs about
this issue of passage
and Dr. Newton will
follow-up with
clerkship directors
here at UNC to see
what they do about
the issue.
Further discussion is
necessary but there is
agreement that:
 Increasing clerkship
capacity will be
helpful.
 We need to add
flexibility into the
third year and we
need to have data
drive the process.
 The due date for
completing the clinical
core will be the end of
fall semester.
 The electives that we
want to encourage in
the third years are
exploratory career
development
electives.
 Newton will follow-up
with Clerkship
Document1
Curriculum Change
Plans
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Schedule
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medicine was a fourth year elective. The
Clerkship Directors would prefer it to be in the
third year. Their interpretation of the decision
in fall 2008 was that it became a third year
elective.
o It’s important to understand that the
Outpatient Medicine rotation is part of our
clinical core and that we should begin using
language that reflects core vs. advanced as
opposed to third vs. fourth.
o Extension of the deadline from early fall to the
end of the fall semester seems reasonable.
First was a review of the clinical log. The total number
of items on the clinical log was at the high end of what
we want. In combination with the issues we track, we
have a formidable number (>140) to track and do
longitudinally over the curriculum. We’ll need to think
about how this number can be brought down. Some
lumping may be possible but the committee affirmed
that the list was a good list with a lot of faculty input
and we wanted to have that going forward.
With respect to procedures, the Clinical Task Force will
reconvene with that list of procedures.
With respect to process of mapping, we will begin to
try to map at the course level first to see what is
missing in the aggregate and what new assessments
are necessary. We will later drill down to finer units
including sets of lectures. We hope to hire a student
to help with this process and will be piloting it over the
next week.
After the meeting, Newton queried the Curriculum
Committee for a possible schedule change. There was
good consensus that we needed to have more regular
meetings, initially 1.5 hours but there was a lot to do.
We might have better communication that way. A
retreat might be useful for the end of the school year.
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Directors as well as
review the data on
third years and will
coordinate meetings
with students.
OME will also look
into prerequisites and
loosen as appropriate.
Competency process
will need to drive/log
team process.
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We affirmed the list of
conditions. We’ll add
the procedure list
when the Clinical Task
Force meets and
operationalize
milestones. We may
come back and
change the list when
we learn how we’re
going to map.
 The administration
will begin to work
together the clinical
log pieces. The
curriculum
management
document was noted
and will continue to
be discussed in the
future.
Newton will set regular
Curriculum Committee
meetings and a spring
curriculum retreat.
Document1