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339th MEETING OF THE MEDICAL SCHOOL COUNCIL
3 p.m., Wednesday, February 9, 2005
School of Medicine Administration, Board Room 103
PRESENT: Drs. Belzberg, Bhattacharya, Bhatti, Blok, Cooper, Shirin Hassan (for Dagnelie), DeLeon, Dintzis, Gabrielson, Hansel, Hillis, Holcroft, Honeycutt, Horana, Johnson-Greene, Kolodkin, Liu, Martinez, Niv, Sandone, Sterni, Walker, Zellars, Mr.Watkins, Mss. Foy and McCall.
ABSENT: Drs. Adger, Ain, Awad, Caterina, Chan, Choi, Colecraft, Cormack, Denmeade, Hattar, Iacobuzio-Donahue, Leffler (excused), Lorsch, Martins, Miller, Nicolaou, Pomper, Roper, Ross, Schulick, Segev, Woolf, Ziegelstein, Mr. Bagga.
GUESTS: Drs. Baumgartner, Dang, Pasternak,Wiener, Mr. Gilbert, Ms. Gottlieb
The minutes of the January 12 , 2005 meeting were approved.
II. Update on the proposed Medical School Curriculum
– Dr. Charles Wiener
Dr. Wiener opened his presentation with a history of curriculum changes from 1893 to the present. The current curriculum was implemented in 1992 following a several year planning process. For the past 18 months a committee of faculty, students, and administrators have been meeting to develop a revised curriculum that will encompass the following goals:
- Train MD’s as leaders in research, education, and clinical care
- Give students a conceptual framework to understand health and disease
- Train critical thinkers
- Incorporate new and future knowledge; Translational Medicine
- Integrate professionalism/humanism throughout curriculum
- Reorganize clinical clerkships and incorporate basic science into the clinical years
- Create culture of integrity, safety, and compassion
- Provide an understanding of individual and public health perspective
- Coordinate curriculum to frame experience to learner’s level of sophistication
Dr. Wiener outlined a number of assumptions the committee has identified as important to curriculum revision. These include:
- Beginning medical school with fundamental principles of science (basic and social)
- Provide perspective of variability, investigation, and environment
- Begin meaningful appropriate human contact and patient experience early
- Utilize new imaging and other technology in the preclinical curriculum
- Use an intersession approach throughout the curriculum
- Maintain components of the current integrated systems based curricular structure
- Provide experiences that require multi-system problem solving
- Provide organized opportunities for students to master essential clinical information (e.g., ECGs)
- Provide clinical clerkship directors with structure and predictability of student expertise
- Allow opportunities for students to pursue areas of interest within and outside the curriculum
Areas of concern have been identified by the Curriculum Reform Committee that will require major investments of both faculty effort and dollars.
The proposed curriculum will require a restructuring of oversight from departments to the Dean’s Office. As a first step a new position, Associate Dean for Curriculum, has been created to address curriculum oversight.
Dr. Wiener reported some Basic Science directors are worried that the role of basic science teaching will lessen as clear cut boundaries are lessened. There is a perception that there will be loss of department control of content as the curriculum will be centrally managed.
Dr. Wiener reviewed a preliminary outline of courses and content in the first two years and reported there will be a restructuring and pairing of the clinical clerkships and required selectives will be incorporated into the clinical years.
Several slides were presented outlining the current version of the curriculum starting in year one with the Language of Science followed by 14 months of Genes to Society, then transitioning into the clinical clerkship rotations. Throughout the curriculum there will be both basic science and clinical intersession periods covering relevant topics.
The curriculum will be organ based and there are several sub-committees developing content areas and placement in the four year curriculum.
Teaching efforts need recognition both in funding and promotion. Additional resources will be needed for faculty development and outcomes assessment.
III. Update from the CPA
– Drs. Baumgartner and Pasternak
Dr. Baumgartner described the structure and governance of the Clinical Practice Association. The Association has a Board of Governors with representation from nine clinical departments, Johns Hopkins Medicine, Johns Hopkins Bayview, Johns Hopkins Community Physicians, and the Basic Science departments. In addition, there are five standing committees: Budget, Finance, and Planning; Contracting; Government Affairs; Compliance; and Patient Safety and Risk Management.
Statistics on charges and collections and payor mix for the last several years were presented. The bulk of the changes were related to volume and better contracting. It was noted days in accounts receivable have been reduced from 102 in FY98 to 49 in FY04.
The number of international patients has decreased since 9/11 and marketing efforts have increased to regain these patients. The CPA has put an emphasis on practice management and is consulting internally to assist clinical faculty and administrative staff.
Dr. Pasternak outlined a process to improve patient access. Efforts are underway to consolidate access services to make it easier for patients to schedule appointments at any Johns Hopkins Medicine site. Policies are being developed related to canceling clinic sessions. A goal of the patient access effort is to have a universal front door for patients who seek care from a Johns Hopkins Medicine provider.
Drs. Baumgartner and Pasternack responded to questions from the council.
IV. Conflict of Commitment
– Dr. Dang and Julie Gottlieb
Dr. Dang and Ms. Gottlieb presented the Conflict of Interest and Conflict of Commitment Policies and provided an overview of outside activities that constitute each. They addressed issues in the current challenges of promoting technology transfer and responsible interactions with industry while protecting the safety and welfare of human subjects, data integrity, and the interests of students and trainees. The development of the East Baltimore Life Sciences Park will present new opportunities and challenges for faculty and trainees. Anticipated benefits include proximity to company labs doing product development, research sponsorship, and potential licensing of Hopkins inventions. Hopkins may provide park tenants access to core facilities, libraries, educational opportunities, and proximity to leading researchers and research collaborators. Are new policies needed to address faculty and student interactions with park tenants, and should park tenants be treated differently from other companies are questions being addressed.
Council members were encouraged to visit the Office of Policy Coordination’s web site for information on Conflict of Interest and Conflict of Commitment Policies.
V. Update on Proposed Gold Book Changes
– Drs. Hillis and Sterni
Additional revisions will be made after the Clinician Educator Committee meeting on February 23. The Medical School Council may be asked to vote on the document in March or April. Recent changes to the document include: a reorganization back to the original Gold Book form making it easier to compare the new revision with the old; policies have been added on faculty leave; "extended" removed from contract language; and removal of three to five year contracts for instructors unless under unusual circumstances. Discussions are taking place with the Legal Office regarding the impact on a faculty appointment if one loses their hospital appointment. The other substantive changes to the content have been previously discussed.
VI. Other Business
There being no further business this meeting was adjourned at 5:00 p.m.
Mary E. Foy
Future Medical School Council meetings:
All meetings will be held in the School of Medicine Board Room (SOM 103), 3:00 to 5:00 p.m.