Spring is Coming!

MS1s will have an end of year gateway exam this year for the first time. This will come from the National Board of Medical Examiners (NBME) Custom Assessment Service. It will be Step 1-style questions chosen from an item bank designed to give students a chance to practice integrated clinical vignettes of the sort that they will see on Step 1 at the end of their second year. The exam will be Z scored to the mean and standard deviation of the prior unit exams with a pass line of 70. A committee of all course directors from the first year will check that the question content fits our curriculum.

New courses for the 2015-16 year will include the Molecules, Cells and Microbes course in the first two units of the MS1 year that will cover foundational aspects of cell biology, genetics, biochemistry, microbiology and immunology in the first 8 weeks; and a new course called Excellence in Care that will incorporate the ELSIM and PM portions of the Practice of Medicine course over the entire first year. Plans are under way to combine the Physiology and Microscopic Anatomy courses into a single course called Physiology and Histology.

We have been interviewing candidates for a new Case-Based Learning Course Director position that will begin to design a new course incorporating active learning in small groups studying clinical cases and clinical reasoning that will begin in 2016-17 for both the MS1 and MS2 years. This person will work with the Co-Directors of the Integrated Organ-Based Units that will start in the fall of 2016 to design a modern curriculum featuring active learning in small groups and early clinically relevant topics and cases.

Elective Lottery Meeting for 3rd year students

This past week, we had an elective lottery meeting for the current 3rd year medical students as they begin to think about their 4th year medical school curriculum and schedules. It reminded me a little bit of a 'Fantasy Football' Draft in the sense that students get a # and are able to pick their 4th year electives based on that (only the ones that fill up quickly and are in high demand). I sensed there were some nervous students in the room about this process. Rest assured that regardless of how high or low your lottery number may be, you will be able to get the schedule that will prepare you for your residency application come the Fall. A few tips I mentioned at the meeting:

1. Start thinking about what specialty you may be interested in. Hopefully this is something you've been thinking about the last 3 years of medical school, but it's OK if you aren't sure yet what specialty is the 'right one.' It's probably a good idea by this time (second half of 3rd year) to try to narrow it down to 2 or 3 specialties. Talk to your advisers, clinical faculty, and others to try and get the information you need to make a decision. The AAMC website (https://www.aamc.org/cim/) which all Upstate students should have an account it will give a lot more information and data on the various specialty choices out there.

2. Start talking to the Specialty advisers in the fields you are interested in (http://www.upstate.edu/currentstudents/document/specialty_advisors_com.pdf). There are designated folks in each specialty, who are familiar with the residency process, that can help you and guide you through this. How many AIs to take, whether it is important to do away rotations,etc. Here's a FAQ that may answer some of these questions: (http://www.upstate.edu/currentstudents/document/advisors_qa.pdf)

3. If you are thinking about doing 'Away' rotations (electives at other institutions) start researching them online for deadline for application, dates of their rotations, etc. VSAS is the AAMC tool that many away schools use, so get familiar with that as well. The dates of away rotations may or may not match our school's so pick your aways according.

4. I mentioned this at the meeting, but if you are curious about your competitiveness for a specialty, what each specialty is looking for in a student (eg. how important is Step 1, Research, Extracurricular, etc), there is a survey of program directors in every specialty that gets at this. This document is another one I would look at (http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf) for more info.

5. Lastly, Relax! As I mentioned, Upstate students have been matching at excellent programs in various specialties each year, and you will get there as well! Do your homework, talk to the right people (4th year students who have gone through the process are great resources!) and you will be fine.

I know it's a scary process, but rest assured you will all get there. Match Day is coming up for the current MS3 class and Match Day 2016 will be here before you know it!

Dr Ko

Standardized Patients & the Clinical Skills Exam (CSE)

This morning we had our monthly Clinical Skills Exam Committee meeting. For students & faculty who are not familiar, this group is tasked with reviewing all the Standardized Patient and Clinical Skills that are assessed throughout the 4 years of medical school. In the first 2 years in POM (Practice of Medicine), students are involved in multiple formative SP encounters where they practice the art of History taking and Physical Exam skills. There are also summative SP encounters called CCEs where students do the entire H&P encounter, and write a Post Encounter note in the NBME format similar to what students will do during the USMLE Step 2 CS exam they take in the 4th year of medical school.

Students take formative and summative Standardized Patient Encounters (SPE) in each of the required 3rd year clerkships in a similar format, but with more time constraints than in the first 2 years. Lastly, at the end of 3rd year, all Upstate students are expected to take a high stake Summative Clinical Skills exam we refer to as the CSE (Clinical Skills Exam). Utilizing all the clinical skills they've obtained in the first 3 years, they go through each case, get scored on their History & Physical, Communication Skills, and Post-Encounter Note (again in the NBME Format). Again, this is similar to the USMLE Step 2 CS Format, and students are required to pass this in order to graduate.

To make a long story short, the CSE Committee this morning is in the process of reviewing each of the cases used in the summative CSE exam, as well as each SPE encounter that students do in the Clerkship. Each case scenario, checklist, and evaluation from the previous year is scrutinized by the committee and changes are made to the next year exam. So we take this task and exam quite seriously, and invest quite a bit of time into this process!

There is a saying that 'assessment drives teaching' and in this case, we hope to have CSE assessment as a culmination of what our students have learned and should be able to do before graduation from our medical school. Emphasis and gaps in our teaching can often be seen when we analyze the results of these exams annually. As we move towards Core Entrustable Professional Activities for Entering Residency (CEPAER), a list of expectations for graduating medical students, we hope to incorporate more of these skills and assessment into our CSE exam.

-Paul

My role as Assistant Dean for the Foundational Sciences is to help implement and aid in design of the MS1 and MS2 curriculum (Phase 1), serve as Director of Phase 1 by chairing the Phase 1 Committee, and help with returns to foundational science content in the third and fourth years. Dr. Ko and I share an office on the 4th floor of Setnor Hall so come by and visit us some time! We are in different Learning Communities so you might hear "Go Cayuga!!" coming only from the northwest corner.

Welcome

This is the blog & reflections of the Assistant Deans Dr. Ko & Dr Poole.

By way of introductions, Dr Ko is current Assistant Dean for Clinical Curriculum & Clerkship Director in Emergency Medicine. He oversees the Phase 2 Subcommittee, which consists of the Clerkship Directors of the Required 3rd year rotations (including EM, IM, Surgery, OB/GYN, Peds, Family, Neurosciences, Psychiatry, and threads of Population Health & Bioethics) as well as the 4th year AIs and electives. He also assists with the clinical correlations that crosses over in Phase 1 (1st two years of medical school).

I'll let Dr Poole introduce himself...

We hope to use this blogsite to write about some of our ideas, curricular renewal thoughts, and observations about medical education and articles of interest that we come across.

(As a disclaimer, the opinions expressed on this blog are our own, and does not necessary reflect the opinions of the institution or adminstration as a whole)