An Exemplar Milestone Framework for Scaffolding a Competency-Based Medical School Curriculum.

A strong competency and milestone framework is imperative for medical schools adopting competency-based education and assessment. Milestones can be used to align what is taught and what students are asked to demonstrate from matriculation to graduation. We describe the creation and implementation of our milestone framework as an exemplar. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01558-1.

Redesigning the Learning Environment to Promote Learner Well-Being and Professional Development.

There is a high prevalence of burnout and depression among medical students and residents (or learners), which can negatively impact them personally, their professional development, and the patients to whom they provide care. Educators have a responsibility for the system-level factors that influence learners' well-being. In this Invited Commentary, the authors outline strategies institutions and affiliated training sites responsible for educating learners can take to pursue the recommended goal related to learners, their well-being, and the learning environment in the National Academies of Sciences, Engineering, and Medicine consensus study report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being.

Investing in success: student experiences in a structured, decelerated preclinical medical school curriculum.

PURPOSE: Many students in the Michigan State University College of Human Medicine (CHM) are non-traditional with unique needs and experiences. To meet these needs, in 1988 CHM developed a structured Extended Curriculum Program (ECP), which allows students to take longer than 2 years to complete the preclinical curriculum. This work examined the reasons why students extended their programs, their perceptions of that experience, and the outcome with respect to satisfaction and success in their careers after graduation. METHODS: The analysis used data from the college database, follow-up surveys of residency directors and graduates, surveys of graduates who extended, and the AMA Physician Masterfile. RESULTS: Graduates who responded to the survey were evenly split between those who extended for academic reasons and those who extended for other reasons. Although feelings about extending were mixed at the time of extension, nearly all respondents agreed that extending was the right decision in the long run. Extended students continued to face academic challenges having lower basic science averages, lower USMLE Step 1 and 2 first attempt pass rates, and more instances of repeated clerkships compared to those who did not extend, however, most were able to secure a residency in the specialty they desired and had comparable career satisfaction ratings. CONCLUSIONS: The ECP allows some students to complete medical school who otherwise may not have been able to do so. This analysis has provided valuable information that was used to improve the program, allowing CHM to continue its mission of training a diverse set of students to be exemplary physicians.

Postbaccalaureate premedical programs to promote physician-workforce diversity.

There is a critical need for enhanced health-professions workforce diversity to drive excellence and to improve access to quality care for vulnerable and underserved populations. In the current higher education environment, post-baccalaureate premedical programs with a special focus on diversity, sustained through consistent institutional funding, may be an effective institutional strategy to promote greater health professions workforce diversity, particularly physician-workforce diversity. In 2014, 71 of the 200 programs (36%) in a national post-baccalaureate premedical programs data base identified themselves as having a special focus on groups underrepresented in medicine and/or on economically or educationally disadvantaged students. Three post-baccalaureate premedical programs with this focus are described in detail and current and future challenges and opportunities for post-baccalaureate premedical programs are discussed.

Learning about medical student mistreatment from responses to the medical school graduation questionnaire.

Although evidence of medical student mistreatment has accumulated for more than 20 years, only recently have professional organizations like the Association of American Medical Colleges (AAMC) and the American Medical Association truly acknowledged it as an issue. Since 1991, the AAMC's annual Medical School Graduation Questionnaire (GQ) has included questions about mistreatment. Responses to the GQ have become the major source of evidence of the prevalence and types of mistreatment. This article reviews national mistreatment data, using responses to the GQ from 2000 through 2012; examines how students' experiences have changed over time; and highlights the implications of this information for the broader medical education system. The authors discuss what mistreatment is, including the changing definitions from the GQ; the prevalence, types, and sources of mistreatment; and evidence of students reporting incidents. In addition, they discuss next steps, including better defining mistreatment, specifically public humiliation and belittling, taking into account students' subjective evaluations; understanding and addressing the influence of institutional culture and what institutions can learn from current approaches at other institutions; and developing better systems to report and respond to reports of mistreatment. They conclude with a discussion of how mistreatment currently is conceptualized within the medical education system and the implications of that conceptualization for eradicating mistreatment in the future.

The College of Human Medicine at Michigan State University: expansion and reinvention.

The College of Human Medicine (CHM) at Michigan State University, which graduated its first class in 1972, was one of the first community-based medical schools in the country. It was established as a state-funded medical school with specific legislative directives to educate primary care physicians who would serve the needs of the state, particularly those of underserved areas. However, the model has proved challenging to sustain with the many changes to the health care system and the economic climate of Michigan. In 2006, a two-phase expansion plan was implemented, and in 2010, CHM permanently expanded the matriculating class from 106 to 200 students with the establishment of a second four-year site for medical education in Grand Rapids. This article describes what school leaders and faculty have learned as they look back at the opportunity provided by expansion as well as the growing pains and lessons learned. The community-based model met many of the mission-related goals for CHM's graduates, who represent a diverse group of practitioners whose values resonate with the school's mission. Expansion has offered an opportunity to explore new research and clinical opportunities as well as to more fully realize the potential of community partners to meet local health care needs and reinvent a robust future for community-integrated medical education.

The effectiveness of a postbaccalaureate program for students from disadvantaged backgrounds.

BACKGROUND: This study examines the long-term effectiveness of an institutional postbaccalaureate program designed to provide an opportunity for students from disadvantaged backgrounds to enter medicine in response to diversity needs. METHOD: An 18-year retrospective analysis of the academic outcomes, performance, progress, and specialty choices of postbaccalaureate participants. Comparisons across cohorts were conducted using chi-square tests, t tests, and ANOVA. RESULTS: Ninety-four percent (94%) of the postbaccalaureate students successfully completed the program and matriculated into medical school. Sixty-four percent (64%) of the matriculants have graduated from medical school, and 26% are still enrolled. More than 50% of the graduates selected primary care specialty fields. CONCLUSIONS: The implementation of the postbaccalaureate program provided a successful strategy to diversify the medical school student body and increase the number of physicians from disadvantaged backgrounds in the medical profession following the mission-driven commitment of the medical school.

Diversity in academic medicine no. 6 successful programs in minority faculty development: ingredients of success.

This article describes the ingredients of successful programs for the development of minority faculty in academic medicine. Although stung by recent cuts in federal funding, minority faculty development programs now stand as models for medical schools that are eager to join the 140-year-old quest for diversity in academic medicine. In this article, the ingredients of these successful faculty development programs are discussed by experts in minority faculty development and illustrated by institutional examples. Included are descriptions of program goals and content, mentoring and coaching, selecting participants, providing a conducive environment, managing the program, and sustaining support. This article is a companion to another article, "Successful Programs in Minority Faculty Development: Overview," in this issue of the Mount Sinai Journal of Medicine.