School Committee Minutes

September 17, 2001

Days Inn

Flatwoods, WV

Attendees: Cindy Moats, Nancy Nedrow, JoAnn Raines, Marilyn Fox, Jacquelynn Copenhaver, Brenda Michael, Richard Meckstroth, Patti Crawford, Kathleen Bors, Norman Ferrari, Ralph Utzman, April Vestal, Carla See, Bill Shires, and Sandra Baker

Dr. Ferrari called the meeting to order.

The Needlestick Policy and Protocol was tabled due to the absence of Dr. Lewis.

Dr. Ferrari stated that the USMLE has a seven-year limit. A student must pass three parts of the USMLE licensing exam within a seven-year period. The three parts of this test does not have to be taken in chronological order. USMLE will only let a student retake the test if new scores are needed/requested by the state board of medicine. Some physicians are forced to go out of state to practice due to this rule. Only four states have this seven-year rule. Florida has no limited timeline, Louisiana has no report of a timeline, California has a ten year limit and Rhode Island’s rule is that you cannot try any one part any more than five times. This is a medical board decision – state by state. Most students are at the edge of the seven-year limit by the time they are in their residency and eligible to take step three of the exam. The West Virginia Board is sticking to the seven-year rule and will not budge. Dr. McKown made a personal appearance, which did not result in any change. An issue brought up is as follows: Do we as the schools, provide a unified front in which we could convince the board to change or make exception for graduates from state schools to the rule? If graduates are from our own schools and we are trying to attract physicians in the rural areas, then why is it that the arbitrary rule keeps them from obtaining a license. The three schools should go together and form a united front. We could propose to go to ten years like California, a no time limit like Florida or we could ask, “Why not make exceptions for graduates of our own schools at least?” or work on a process for extenuating circumstances. Four state students have been lost to this process already.

The MPH curriculum may need to be changed if the state becomes flexible on the matter. MD and PhD students’ clocks are already running, as they don’t take next step until after they graduate. The licensing board sets the cap on the timeline. This is not an issue to most graduates. Patti Crawford suggested the proposal of stating, “Exceptions to the rule will be made on a case by case basis through the state board”. This is more of an informational item. If the three schools are unified in their approach, then their input for the case will be stronger. This will have to be referred to Dr. McKown and Dr. D’Alessandri to decide best way to proceed, along with the Vice Chancellor.

Community-based representative on each school curriculum committee

April reported that the site coordinators have been discussing community-based representation on every school based curriculum committee. She wanted to run this by the school committee and see how this might work; how many committees this will be and the time frame for these committees and how often do they meet, etc. The site coordinators felt it was important for community representation, as questions come up about the curriculum students are learning and why students don’t come out with a certain knowledge base. It is important for us to see first hand, the difficulties around curriculum change that may not ordinarily be seen. Jacquelynn stated that the site coordinators have received curriculum changes from JoAnn Raines at Marshall University and it might have been better for statewide program to have representative in attendance at the meetings to understand the process and know what was going on throughout the process and possibly have some input into these changes. This would be another way to strengthen the partnership. Also to help the community partners understand what goes on, on the campuses and for the campuses to hear community voices. If we want to do this, we have to make a commitment to attending these meetings on campus. This is on the agenda to try to get a consensus of how many meetings there are, how often they meet, in order to get a feel as to the type of commitment they would be making and if it would make sense to the curriculum committees on campus. Patti Crawford conveyed that the curriculum at WVSOM is different from that at WVU and Marshall. Their first two years are basic sciences and would not necessarily be of benefit to a community representative. She reported that a new position is being developed at the osteopathic school for a clinical coordinator to work on the curriculum for the second two years, as the students are rotating, to standardize and have a mechanism for the school to better track the objectives and what the students are coming out of the rotations with. They would be working with faculty on campus and rural preceptors.

JoAnn Raines stated that Marshal University has working sub-committees to basically look at each level of the curriculum. They have a larger curriculum committee that meets once a month. Marshall University has a group for academic affairs that works a lot with RHEP and makes a lot of basic policy making decisions.

Patti reported that RHEP is not really figured into students’ grade.

Kathleen Bors conveyed that the WVU curriculum committee meets monthly. She stated that she does not feel that a community representative would get anything out of being in attendance, as a lot of things are strictly confidential. Work is done by each individual in each section. Carla See informed the committee that the Pharmacy Department also has lot information that is confidential. There are three departments within the School of Pharmacy. Each department has its own curriculum committee. They also have an experientials committee that discusses confidential information on students and their rotation experiences. One that would involve a representative would be the clinical department. And there is a school wide committee. Bill Shires reported that WVSOM’s feedback is obtained from various evaluations of rotations of interns, residents and site coordinators.

Marshall moved the Junior two-month clinical clerkship to the fourth year. The licensing exam is based on the third year of curriculum.

Pharmacy people who are impacted the most is not RHEP, but are impacted the most because of RHEP.

Ralph Utzman stated that PT has four academic faculty and three clinical faculty which make up their curriculum committee. And again, there is confidentiality involved.

Dr. Ferrari stated that there are 25 people on their committee and they oversee the medical curriculum for all four years. The work doesn’t happen at the meetings, but rather prior to and after meetings.

Patti – Who to report to share and to be connected to the school or the process.

Jacquelynn reported that the school and site coordinators feel detached. At times the curriculum has been changed and the site coordinators did not know this until after the impact on RHEP. They are trying to be better prepared before changes take effect. The site coordinators would like suggestions from this committee as to how to feel more connected to the process. (Site coordinator represents the community member)

The school committee suggested inviting school representatives to site coordinator meetings at least annually, to discuss and curriculum changes and receive feedback and interaction.

Dr. Ferrari stated that the medical school received the results back from the graduating students’ survey and there was a 95% response rate to the survey. This survey is done by the AAMC as an online survey. What sticks out in Dr. Ferrari’s mind most is the negative about RHEP: The students stated that they spend too much time in rural health; we force primary care down their throat; don’t like any students that are not going into primary care, etc.

WVSOM exit interview evens out the negative and the positive.

Carla in pharmacy is bringing back their students at the end of their seventh rotations and doing focus groups. One of the topics will be “RHEP and Rural Rotations” in general with feedback going directly to April.

Carla met with the clerkship directors (curriculum committee sub-group) and overwhelmingly, their concern is that students are spending too much time in IDS and community service projects. When you think of 20%, it does not seem like much, but it amounts to one day a week. Why take them out of their clinical hours? Instead, utilize them after their clinical hours or on the weekends. Students expect to work weekends and nights.

Dr. Ferrari does not have a problem with fourth year students spending 20% of their time in IDS/community service, but 20% of the third year students’ time can be a problem.

Patti stated that RHEP does a lot to get health education and information into the school age program and would hate to see this diminish. What if the schools prepared a list of what is acceptable for third year schedule and a separate list for fourth year students? April indicated that there is a section of the Community Outreach Manual (online at www.wvrhep.org) that addresses appropriate community service activities and referred the committee to this document.

A draft copy of the Site Coordinator Evaluation of Student Performance on RHEP Rotations was passed out for discussion. (Please see the attached.)

WVRHEP Information Technology Committee

April stated that as needs have grown, the LRC has now become the IT (Information Technology) Committee. This committee will be made up of five sub-committees:

1. Web site development

2. Training/Support (troubleshooting)

3. Evaluation (of IT resources/projects)

4. TRACKER Committee

5. Standards and Recommendations (textbooks and computer hardware)

The TRACKER list has grown and will go to the TRACKER Committee. April is asking for volunteers of students, school schedulers, support staff, etc. to serve on the committee.

April Vestal and Parr Thacker will be the interim co-chairs of the IT Committee until someone is hired to replace Mark Allen. Mike McCarthy will chair the TRACKER sub-committee. Dr. Ferrari approved of the committee wholeheartedly.

April asked for input to make this system more friendly.

Carla gave a definition of clinical service which follows: Service which involved patient-centered activities that would ordinarily be performed by a licensed health care professional. This would require on-site supervision of the student by a licensed health care professional. This is to be added to the Vision Report Recommendations document as the definition of clinical service.

Meeting was adjourned at 1:00 PM.