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Summary of 1-24-02 CME Minutes 

  1. Flexible Program topics

Procedure for awarding elective credit for graduate courses

Discussion arose specifically over the new graduate course offering Anatomy 523, Histopathology of Organ Systems for Spring 2002, but was relevant for any graduate course being used for elective credit.

Approximately 30 second-year medical students have signed up for this particular graduate course along with graduate students.  All who registered for the course are aware of the stipulations required to get credit.  Passing a graduate course can be used as Type A elective credit.  Passing this particular graduate course qualifies as 3 graduate-school credits.  The amount of Type A elective credits, which appears on the medical school transcript, is determined by the Flexible Program Coordinator.  Every student taking this course (graduate student and medical student alike) has the option of taking either of two modes to earn credit (letter grades or pass/fail with requirements for each clearly stipulated).  Students have been apprised of the oral and written grading stipulations and accepted them.  Discussion focused on tightening up a housekeeping loophole so that no elective credit could be given should the medical student withdraw or fail a graduate course.  This would entail 100% compliance of the elective sponsors in returning the grade sheets that would be signed only at the end of the course.

Areas needing attention:  Establishing procedures so that

  • Students get elective credit only when the form has been signed by the instructor with a grade after student completion of the course.  Currently, the process of signing the forms by the instructor can be done either at the beginning or the end of the course.

  • All of the faculty sponsors turn in their course forms.  Approximately 25% of the elective sponsors do not return these forms, despite numerous rounds of requests from the School of Medicine ’s Office of the Registrar.  The same situation holds true for Type B electives.

  • There is no conflict with the university system (the system used by the CWRU Registrar), particularly regarding limitations imposed by security, confidentiality, and in some cases rigidity.

Dilemma:  reconciling two divergent views of the electives program:

  • As enrichment, expecting that the student will spend extra time enhancing his/her education through some (not all) more challenging courses, where he/she is held more accountable via a rigorous review, exam, or paper rather than satisfying only attendance-based criteria

  • As specifically designed to encourage students to “broaden their horizons” by taking courses on a pass/fail standard with the intent of trying out areas they might never have considered and not be deterred by fear of inability to meet rigorous standards.

Suggestions for restructuring of the Flexible Program:

  • Implementation of a “program of study” for every student that would be looked at by an adviser and could be changed with the adviser’s signature

  • A two-tiered elective system allowing two forms of each elective:  An A' elective would consist of a rigorous review and require an exam or paper.  (Graduate courses would fall under this category.)  An A elective (the regular elective) would be the less rigorous form of the elective.  We could start by requiring that a student take 3 of the 13 Type A electives from the A' category.  This number could be adjusted after a review of the program.  This philosophy could also be applied to the Type B electives.

  • The student would not get credit for any elective without the return of the grade sheet from the elective sponsor.

Survey of CWRU graduates regarding their fourth year experience

Synopsis of published questionnaire sent by the Primary Care Track to all CWRU graduates of the Classes of 1985, 1986, 1987, 1993, and 1998 asking for their opinion of the fourth year.  CME member Dr. Hue-Lee Kaung had prepared a summary of the online article by Dr. Jack Medalie, Dr. Linda Headrick, and Ms. Pam Glover, My Favorite Year, Opinions of CWRU Alumni about Their Final Year of Medical School .  Of the 698 questionnaires sent, 177 were completed and returned.  To read the complete article, see
Two almost unanimous conclusions of the respondents follow:

  • The final year was the best year of Medical School education.

  • They strongly recommended that the student-chosen electives remain the backbone of the final year.

Student recommendations include choosing i) a group of electives in subjects which the student perceived to be his/her weakness and where more experience is needed, and ii) another group of electives in subjects where not much contact is anticipated during the residency years.  Also stated in the survey was the students’ desire for relevant advice and mentoring from the faculty and administration prior to making their elective choices.

  1. Student CME has begun work compiling a standardized format for the syllabus—both hard copy and electronic version—fueled by dissatisfaction with the uneven quality of the current syllabus.  Students are ready to present the new standardized format and are seeking the appropriate forum.  It was suggested that the Student CME contact the Curriculum Leadership Council Chair and try to circulate their materials to CLC members prior to the upcoming March 6 meeting.

Areas requiring attention:

  • Despite an existing standard syllabus format, we have no means of mandating faculty compliance.

  • Since we are lacking the desired “core” of key faculty to coordinate the curriculum and produce an integrated electronic curriculum, the syllabus of the first two years is characterized by diverse individual lectures.

  • Teaching is competing with clinical/research responsibilities.  Even with the inducement of a stipend, the faculty’s need for time may still be greater than their need for money.

  • Suggestion for consideration:  Administrative support—pairing groups of faculty with assistants who have Master’s degrees or with students specializing in education whose job would be to make syllabus improvements

  1. Dr. Clint Snyder has been hired by the Dean’s Office part-time to do faculty development.  Those interested, please contact Dr. Snyder to take advantage of this resource.

  2. So far suggestions pertaining to restructuring the Flexible Program have been included in the “CME Minutes Summary” portion of the Web site.  This material is also in the beginning stages of what will fall under the Curriculum Revision Update section.

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This page was last updated on 12/12/01 by John Graham.

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