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Summary of November 14, 2002 CME Minutes


1.                  Report from the Student CME

a)      USMLE Step 2½

Student concern over financial impact of USMLE Step 2½ – test costs (about $950) and costs for travel and accommodations.  The students estimate that the total cost to the class will amount to between $140,000 to $215,00.  Students look forward to participating in a forum on the USMLE Step 2½ to be organized by Drs. Henson and Altose.

b)      “Syllabus Standards”

The students are working on an initiative to develop syllabus standards with the idea of offering “A Best Syllabus Award” to faculty.  Dr. Altose suggested that the syllabus standards proposal be developed in conjunction with the CLC and presented to the CME for endorsement.


2.         Report from the Flexible Program Council – Dr. Charles Malemud, Flexible Program Coordinator/Flexible Program Council Chair

a)      Dual degree programs

The Associate Dean for Student Affairs will continue to deal with those students identified as at risk for failing to meet Flexible Program requirements for promotion to Year III.

There remains the issue of joint M.D./graduate degrees not yet approved by both the School of Medicine and the Graduate School.  The M.S. degree in Applied Anatomy has been approved by the Graduate School.  However, the M.D./M.S. in Anatomy has not yet been approved as a joint degree program by the School of Medicine and the Graduate School.  Logistics demand that conflicts in scheduling courses do not arise.  Medical students pursuing the M.S. in Anatomy are able to take their graduate courses in the afternoons.  Medical students enrolled in a graduate program do not have to complete the required menu of Type A electives in the “Diversified Electives” track.  The Flexible Program will “grandfather” all M.D./M.S. in Applied Anatomy students in the Classes of 2005 and 2006.  Approval of the M.D./M.S. in Applied Anatomy joint degree programs should take place before the Class of 2007 enters in August.

b)      Audit of Type A Electives

The Flexible Program Council will decide whether to add new electives and whether to eliminate undersubscribed electives not registered for within the past 3 to 4 years.  Dr. Wendy Johnson, Director of Public Health for the City of Cleveland, is interested in offering an Area of Concentration in Public Health.

c)      Consult 2002-2003 Type A Electives Catalog for

i.         Learning objectives for each elective listed

ii.       Graduate course equivalency for Type A elective credit:  One 3-credit

one-semester graduate course is worth 4 Type A elective credits.

iii.      The 13-credit requirement for promotion.

d)      Focus of subsequent discussion

i.         Necessity for each elective to have explicit written learning objectives

ii.       Requirement that the evaluation of student performance be based on

whether or not the students met the learning objectives

iii.      Need for a formal written evaluation by the students of the elective course

iv.     General agreement that a “Satisfactory” grade based on attendance alone

was not appropriate and lacked the rigor of a high caliber medical school


3.         Report from the CCLCM Curriculum Steering Council – Dr. Andrew Fishleder, Co-Chair of the Cleveland Clinic Lerner College of Medicine of CWRU Curriculum Steering Council

The October 29 faculty development seminar conducted by Harvard faculty on large group case-based teaching was well-attended.  The November 19 faculty development session will be on evaluation methodologies.  November 20, clinical faculty at CCF and the CRDC will meet to discuss clinical education issues for the new curriculum.


4.                  Demonstration of Web-Based Resource for the Primary Care Track

Dr. Linda Lewin, Assistant Director of the Primary Care Track (PCT) and Director of the Community Primary Care Preceptorship (CPCP), and Ms. Betzi Bateman, Web Developer for the CPCP, demonstrated an innovative learning tool for current PCT students that will also be available next year to interested second year non-PCT students as an elective.


Background:  Components of the PCT include a 6-week Rotating Medical Apprenticeship in Year I, a 6-month longitudinal preceptorship in Year II, and an 11-month continuity clinic in Year III.  The Community Primary Care Preceptorship concept derived from the second and third year clinical segments.  Eighteen primary care doctors served as the community preceptor “experts” designing the curriculum.  PCT students choose a Primary Care physician of their choice in the Primary Care discipline of their choice for their actual clinical experience.  The Web site complements the individual’s actual longitudinal community-based experience by providing a common learning tool so that all students meet the “goals, expectations, and learning objectives for clinical learning in CPCP.”


The program is included in the CWRU eCurriculum at with login in the student area as “guest.”


A demonstration of Module 1, which focuses on the primary care doctor’s office, followed.  Students familiarize themselves with the four patient profiles and the duties of the five office staff members in a clever, engaging format.  Actual primary care physicians provide reasons why they chose this aspect of medicine.  There are tutorials on both SOAP (subjective/objective assessment plan) note and prescription writing (where students receive feedback from faculty) as well as on health insurance.  There are discussion board assignments.  Evaluation mechanisms are in place.


Module 2 is in development and should be ready by February 1.  Modules 3 and 4 will be developed during the next academic year.


Dr. Altose was interested in Dr. Lewin’s estimate of how many students the CPCP Web site could accommodate for the 2003-04 year.  Initially, Dr. Lewin felt that all current PCT students, new PCT students that enter the program in Year III, and perhaps an additional 10 to 20 students could be accommodated.  However, she did not foresee the capacity to serve everyone.  This PCT activity is supported by primary care grant funding.  Dr. Lewin did suggest that interested departments could work via the CRDC (Clinical Rotation Development Council) in adapting the Web-based resource by adding an adjunct to the existing online program.  Several discussants were interested in making the Web site accessible to all students.  The “guest account” currently exists.  However, the guest cannot submit forms.  Receiving feedback is reserved for the primary care students going to the preceptor sites.  However, everyone is welcome to access the site.  Dr. Lewin was optimistic that a way could be found to accommodate all who are interested.


Dr. Altose thanked Dr. Lewin and Ms. Bateman for a stimulating and exciting presentation.


5.                  Discussion of Vertical Themes

Dr. Altose proposed that the CME take on an active role in initiating new curricular programs and suggested that this may best be accomplished through vertical themes.  Discussants pointed out the vital importance of adequate financial and human resources.  Dr. Altose encouraged the CME to develop educational priorities and help identify potential “champions” and subsequently work with the Dean’s Office to come up with the resources for program development and implementation.


Vertical themes are generally viewed as multi-disciplinary, involving both basic and clinical sciences and extending over the entire medical school experience.  Online opportunities could be shared in a collaborative effort between the CCLCM and the existing CWRU programs.


In the discussion that followed several themes were raised for consideration:

a)      Nutrition

b)      Diabetes

c)      Cancer

d)      Arthritis

These will be reviewed in more detail and prioritized during subsequent CME meetings.


See Curriculum Revision Update section.

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