Anatomy of a new U.S. medical school: The Commonwealth Medical College.

In response to the Association of American Medical Colleges' call for increases in medical school enrollment, several new MD-granting schools have opened in recent years. This article chronicles the development of one of these new schools, The Commonwealth Medical College (TCMC), a private, not-for-profit, independent medical college with a distributive model of education and regional campuses in Scranton, Wilkes-Barre, and Williamsport, Pennsylvania. TCMC is unique among new medical schools because it is not affiliated with a parent university. The authors outline the process of identifying a need for a new regional medical school in northeastern Pennsylvania, the financial planning process, the recruitment of faculty and staff, the educational and research missions of TCMC, and details of the infrastructure of the new school. TCMC's purpose is to increase the number of physicians in northeastern Pennsylvania, and in the next 20 years it is expected to add 425 practicing physicians to this part of the state. TCMC is characterized by autonomy, private and public support, assured resources in good supply, a relatively secure clinical base, strong cultural ties to the northeast, recruiting practices that reflect the dean's convictions, and strong support from its board of directors. TCMC has invested heavily in social and community medicine in its educational programs while still developing a strong research emphasis. Major challenges have centered on TCMC's lack of a parent university in areas of accreditation, infrastructure development, faculty recruitment, and graduate medical education programs. These challenges, as well as solutions and benefits, are discussed.

Using information contained in the curriculum management information tool (CurrMIT) to capture opportunities for student learning and development.

The purpose of this paper is to examine how West Virginia University Medical School used the AAMC Curriculum Management Information Tool (CurrMIT) to map the undergraduate medical school curriculum. Information gleaned from this analysis identified what students are expected to learn, how they learn and how they are assessed. Information about the curriculum was entered into CurrMIT, creating a comprehensive picture of the curricular landscape. Learning outcomes were parceled out according to a competence-based framework. In addition, learning methods and assessment measures were identified. A total of 639 learning outcomes were identified across several competences. A total of 13 learning methods and 13 assessment measures were also identified in the undergraduate curriculum. The results suggest that students are expected to acquire varied knowledge, skills and attitudes. Further, students are presented with diverse learning methods and assessment measures. The curriculum map ascertains whether the program's components, such as learning outcomes, learning approaches and assessment methods, are designed and linked to further students' learning. This analysis will lead to curricular improvements. The implications of this work can help faculty, students and other academic stakeholders shift tacit expectations of learning and development to a curricular reality and, in turn, help prepare future physicians for the changing field of medicine.

Using PDAs during the internal medicine clerkship.

In 2000, an Institute of Medicine Report stated that there are 99,000 deaths in hospitals each year due to medical errors. Many options have been tried to improve systems and practice patterns, but they have proven to be too cumbersome to be workable and were not accepted by physicians. We conducted a study of 19 third-year medical students (12 males, 7 females) at the West Virginia University School of Medicine, Charleston Division, during their eight-week clerkship in 2002 to determine whether providing them patient information at bedside with Personal Digital Assistants (PDAs) would be valuable. In addition, we also wanted to see if the students would accept the use of these devices and better capture data on patient procedures. The Palm M 500 model was used in the study and every unit was preloaded with Epocrates, Epocrates ID, 5 Minute Clinical Consult, Harrison's and Patient Keeper Version 2.3. The medical students were given 15 minutes of instruction in the use and care of the PDAs, and they were required to input any procedures they performed or observed for patients into Patient Keeper 2.3. A pre-clerkship survey and a post clerkship survey with a five-point rating scale revealed the students had a very wide acceptance of the PDAs for the input and access of medical information. As these devices become cheaper, more powerful, more feature-packed, and as software in the PDA format becomes even more medically oriented, these devices will become much more common in hospitals. PDAs offer a valuable means of reducing medical errors and further modernizing medical record keeping.

Medical students' perspectives on and responses to abuse during the internal medicine clerkship.

BACKGROUND: The abuse of medical students on clinical rotations is a recognized problem, but the effects on students and their responses warrant further study. PURPOSE: To determine the severity of student abuse and the effects of abuse on students during the internal medicine clerkship. METHODS: Internal medicine clerks at 11 medical schools (N = 1,072) completed an exit survey. Students were asked whether they had been abused. If they had, they were asked about the severity of the abuse, whether they reported it, and its effects on them. RESULTS: Of the responding students, 123 (11%) believed they had been abused. Only 31% of the students who felt abused reported the episodes to someone. The most common consequences of the events included poor learning environments, lack of confidence, and feelings of depression, anger, and humiliation. CONCLUSION: Students described a variety of personal and educational effects of abuse. They generally did not report abuse because of fear of retaliation and the belief that reporting is pointless.