Minutes for the June 16, 2015 EC meeting were approved with no corrections or additions.
Dr. Brad Benson introduced new Council members who were in attendance, Dr. Kelly Deitz, Radiology, Dr. Nersi Nakakhatar – Faculty Advisor and Matt Wagar, MS2.
Going forward attendance will be important and will be reviewed; for the Counil to function well members should attend and if unable, send a representative. An annual summary of the Council’s work will be sent to all involved. The time is important and a letter will be sent to department chairs with information about the work of the Council and thanking each member for their participation. The goal will be to give credit for the effort and to have the time recognized and valued for addition to educator portfolios for promotion.
RPAP & MetroPAP
Objective: Periodic review of inputs, outcomes and impact of the RPAP and MetroPAP programs, discussion on how RPAP is/should be positioned in the medical school's clinical curriculum, ideas for appropriate use of new resources allocated from the legislature meant to enhance RPAP and MetroPAP over the next 2 years.
Dr. Kathleen Brooks provided an overview of RPAP, reporting that it is a 44 year old program within the Medical School, which medical students apply for and are selected for. These third year medical are specifically interested in the role of rural physicians. RPAP was established by legislative action in the late 1960s to respond to a lack of rural physician partners in small community practices. The program is known internationally as the oldest integrated longitudinal clerkship in the world dedicated to the rural workforce. It has had real staying and a number of places in Canada, Australia and the United States have replicated this program.
The mission of the program is to nurture third year students, who are interested in primary care in a rural setting, by providing a strong education based curriculum in rural setting. They are placed at RPAP sites around the State for nine months to learn in this longitudinal integrated clerkship. They complete the requirements for some of the School’s core clinical clerkships; family medicine, primary care selective, surgery and for some primary care elective time. Depending on the site and the student’s interests and availability experiences may include OB/GYN, urology, pediatrics, emergency medicine and orthopedics.
This is a collaborative educational experience with both academic faculty who make visits to sites and with site specific preceptors who make a very large commitment for the 9-month period. The placements are meant to enhance development of professional identity by providing them with authentic roles of care giving. They are imbedded in these systems and gain a broadened perspective of patience with illness and comprehensive care.
Time frame for this report is 2014-15 with 34 students enrolled in RPAP, generally enrollment numbers run from 33 to 40 each year. The report format provides a number of measures for both goals and outcomes of the program. Student feedback ranks the following as important aspects of their RPAP experience:
continuity of care with patiencs, families, preceptors, staff
A high percentage of students would recommend RPAP/MetroPAP for other medical students and also a majority agree the 9-month experience will impact their health care career. Students are required to complete a 1500-word essay about the program experiences and in 2015 all students passed all assessments that are required for medical students who complete more traditional clinical rotations. Match data for graduates of 2014 and 2015 indicates that 70% received placement in their 1st choice residency program and 87% were very satisfied with their Match result. More clinical facilitaties are requesting they be added to RPAP as an available site. To date there are 1164 alums in active medical practice and 167residents/fellows in training.
Planned changes for 2015-16 include addition of an assistant director to work with rural health systems, planning process to consider growth of the program, planning for curriculum changes to RPAP for implementation in 2016-17 (possibly a more specific track) and clarifying implications of students and sites with curricular changes. These steps will allow for a more in depth look at how health care is structured now in the State and where and how might curricular changes fit with the current health care systems.
This program began in 2010 and was developed with the plan that it would run parallel to RPAP but for students who have a strong interest in urban under-served medicine. There are four students per year who are placed at urban sites. The curriculum was designed to be the same as the RPAP courses/clerkships. The data is much newer and for a smaller group; they describe the strengths of the program as continuity, camaraderie with faculty and residents and community health experience. There is a trend for students of the MetroPAP program, many choose to take a flex year for travel and healthcare work abroad or for added academic achievement.
Changes for the next year are also being considered for areas of development that would be supported by the new monies from the legislature. Some possibilities are as follows:
consider a stipend for MetroPAP (RPAP student do receive a stipend from School and community site)
Major challenges for the next year include consideration of clinical clerkship curriculum changes and how RPAP is affected. A requirement for students to complete all required clerkships in year-3 will have an affect, it’s possible to resolve some areas by declaring RPAP a track. How should the allocation of monies from the legislature be used to enhance the program? Dr. Rosenberg noted the ultimate goal for the legislative funding is to grow the numbers of physicians working both in the urban and rural settings in the State. How are students affected by the having or not having a stipend for the 9 months while in RPAP or MetroPAP?
Education Council Self-Assessment
Members will review the data from the self-assessment survey and set priorities for the EC for the coming year. By the end of the discussion, all will share a mental model of the role of the EC in the Medical School and the priorities for the group going forward.
Goals for 2015-16
Address cultural aspects of innovation
Adaptation to innovation
Charge: where to make changes (ESC input into curriculum)
Trends (vet them and make decision on which to act on)