At this time of year, most of you are preparing for either a significant transition or a change in activities for the summer. For T2’s, Step 1 season is finishing with the transition to clinical rotations, while T3’s are beginning to focus on how they can prepare for residency in their specialty choice, while T1’s are accepting the reality of facing their last unscheduled summer. Here is an update on curricular activities and enhancements.

In January we underwent our LCME Accreditation Site Visit and had only some citations for non-compliance, fewer than most schools. The Site Visit Team noted areas in which we had made recent changes to ensure compliance and we anticipate that we will have to provide follow-up reports in these areas. We will not receive the final report and recommendations from the site visit until the full LCME Committee meeting in June, though we are anticipating a positive report. As mentioned previously, the School of Medicine used the Site Visit as an opportunity to address self-reported concerns and improve and strengthen our programs, and we plan to build on these programs through a robust continuous quality improvement plan.

The one area of non-compliance specific to the medical education program focused on concerns of students not feeling as well prepared for residency when compared to national means. As a result, the fourth-year curriculum is being re-evaluated and an elective for 4th year students that will address these concerns is being planned for next year. The Curriculum Committee is also likely to do a more in-depth review of year four and whether there should be a unique “course” required of all students to help them prepare for their specific residencies in future years. In addition, the acting internship, required of all students, will have clearer goals and objectives that focus on residency skills such as writing admission and discharge orders, doing handoffs, and obtaining informed consent. Clerkship directors are also working harder to enhance the quality and amount of feedback that students receive over the coming year.

New education floor at Murphy Building

The fifth floor of the Murphy Building is about to undergo a major renovation. For the past four months students, faculty, and educators have been meeting to design another large classroom, more student space, and a new Office of Medical Education. The final plans have been completed and construction should begin shortly, with an anticipated completion date of October. The new large classroom will look similar to the current DeBakey Classroom, but it is also being designed as a location for additional student study space. It will be able to be divided into 3 areas with extensive “whiteboards” on the walls and windows on both sides of the room. On the same floor will be a new student space area with both small rooms and open seating. Adjacent to this will be the new Office of Medical Education. The entire space was designed to enhance opportunities for student learning and to be flexible enough to address future changes in educational pedagogy. All of us are excited about this new renovation.

Curriculum Enhancements for Academic Year 2019-2020

How and why do changes and improvements in the curriculum occur? While we know you wonder about all those evaluations you complete, they really do form the basis for many changes within systems-based modules and overall structure of many activities. In addition to these evaluations, there is an in-person follow-up session, with students, for every module and clerkship. Finally, nationally based surveys, such as the AAMC’s Y2Q (Year 2 Questionnaire) or the GQ (Graduation Questionnaire) are carefully reviewed. Here is a snapshot of changes that are coming.

Overall, we are working with faculty, educational coordinators and others to ensure better organizational support. Dates for the academic year, including module and exam dates in Academic Year 2019-20, are being finalized and will be posted in the immediate future. Module and course directors have been given earlier deadlines to have materials posted and available for students. We are also in the process of transitioning from Mediasite as our lecture capture system to Yuja. This is being done to enhance technology support from the University.

Phase 1: While the module dates and exam dates have been agreed upon, specific suggested changes are still being finalized. Examples including creating more “FiM Days” during the modules and providing more time in the schedule for class preparation. The Pulmonary and Renal Modules have been combined which will create more study time. The on-line biostatistics content has been reduced and time to complete the material has been extended. Moreover, with the addition of more faculty there will be an enhanced ethics curriculum. Finally, Dr. Mary Mulcahey, from the Department of Orthopedics will assume the role of the Musculoskeletal Module Director.

Phase 2: Modules are adjusted every year based on calendar changes, particularly as they relate to holidays. This year, additional time was added to both the cardiovascular and endo-repro modules. This also allowed the endo-repro module exam to be placed on the Friday before Thanksgiving, so T2’s will have the entire Thanksgiving week off. Improvements are also being made to enhance formative feedback and the quality of examination questions.

Clinical Years: One of the biggest changes was the recent move of the inpatient Tulane Pediatrics Service to Children’s Hospital of New Orleans. In the long-run, this will greatly enhance clinical opportunities for students, residents, and faculty. The leadership in Pediatrics is working closely with their LSU colleagues who also practice and teach at Children’s to ensure the best possible clinical experience. Another important change is that all students now have two weeks of ambulatory experience in the wide-range of internal medicine clinics, therefore there is no longer a required month of similar activities in Year 4, providing an opportunity for an additional elective. Finally, significant effort is being made to review, revise, and create fourth year activities that will better prepare students to begin their training as interns. For example, this academic year, the expectations and evaluation process for the Acting Internship have been enhanced. In addition, the clerkship directors are actively working on a new elective for March of 4th year specifically designed to prepare students for their upcoming residency, including skills for all specialties and those that are specialty-specific. It is anticipated that this will be available in March of 2020.

The Learning Environment

Your Learning Environment is extremely important to your educational success and a lot of effort has been placed in creating new systems, programs, and training for the entire Tulane community. An excellent overview of the program is available at:

https://medicine.tulane.edu/education/professionalismenvironment-learning-program

This programed is modeled after the nationally recognized Vanderbilt program, largely designed by Dr. Gerald Jerry Hickson, Tulane alum (M ’78). As you may have seen over the past year, Tulane’s program includes presentations from national leaders in multi-cultural affairs and new programs for training in implicit bias. Our goal is to ensure a stimulating and positive learning environment for everyone regardless of where you are in your medical education training or your educational training site.

Have a great summer, whatever your activities may be!

Dr. Krane

Professor of Medicine, Vice Dean for Academic Affairs

Did You Know?

• All Policies affecting the curriculum are posted at: https://medicine.tulane.edu/home/lcme-accreditation/policies.
• There is a new app called the TUSOM Companion that you can find more information on here: https://medicine.tulane.edu/home/tusom-companion-app
• A full list of study spaces can be found at: https://medicine.tulane.edu/education/academic-affairs/medical-student-study-spaces