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389th MEETING OF THE MEDICAL SCHOOL COUNCIL
3 p.m., Wednesday, April 21, 2010
School of Medicine Administration, Board Room 103
PRESENT: Drs. Armstrong, Barker, Brayton, Carroll, Chou, Comfort, Cooke, Cromwell, Fine, Gottesman, Herman, Ishii, Matunis, Molinaro, Nyhan, Pavlovich, Regan, Resar, Schramm, Williams, Wolfgang, Wong, Mr. Mandell, Mss. Fairman,and Foy
ABSENT: Drs. Ahn, Bastian, Chuck, Goldstein (excused), Green, Leahy, McCarthy, Meffert, Reading, Shapiro, Stivers, Tis, Tufaro, Messrs. Bicket and Ruzevick, Mss. Matthys and Nguyen
GUESTS: Drs. Nichols and Miller
The minutes of the March 24, 2010 meeting were approved.
Dr. Armstrong reported elections in a number of departments are underway for membership on next year’s council. She asked members to consider nominees for 2010-2011 MSC officers. Even though Dr. Armstrong has one more year to serve before her term expires in 2011, she indicated that she would not be able to serve another term as chair in 2010-2011.
III. New School of Medicine Curriculum- Genes to Society- Dr. David Nichols, Vice Dean for Education
Dr. Nichols updated the council on the recently instituted Genes to Society (GTS) curriculum. He outlined the reason for creating a new curriculum, the principles and design of the GTS, and the evaluation process.
Dr. Nichols listed some of the problems of the old curriculum, which was based on a mechanistic system of thought. They are as follows: a lack of sensitivity in defining latent disease; a lack of specificity in defining disease unequivocally; does not take into account the interactions of the various elements of the biological system and; a single unitary cause rarely explains phenotype, clinical course, and outcome.
The GTS curriculum provides a new system of thought based on the following: understanding of molecular mechanisms will soon be needed for bedside care; individual patients and society expect understanding of the individual and personalized care; doctor-patient communication enhanced by a focus on the individual; and payment system will eventually reward prevention - not treatment of critical illness
Dr. Nichols defined the principles of GTS as follows: Principle I: Phenotype is determined by internal and external factors; Principle II: The dichotomy between normal and abnormal is artificial; disease expression segregates along a continuum depending on risk.
The three major philosophical elements were presented as: Individuality (vs. homogeneity) – why does this particular patient present with illness right now? Integration (vs. isolation) – how do events at various levels of biological hierarchy summate to explain the phenotype? And Nominalism (vs. essentialism) – what limitations in adaptive responses lead to disease?
The curriculum content was presented. The GTS curriculum integrates normal and abnormal human biology. Students begin with a Scientific Foundations course which includes anatomy and imaging, macromolecules, cell biology, metabolism, genetics, pharmacology, and epidemiology. The second phase is Systems Biology which includes immunology/microbiology/infectious diseases, hematology/oncology, mind/brain/ behavior, cardiac, pulmonary, renal, endocrine, reproduction, and musculoskeletal. There is a longitudinal clerkship which provides an opportunity over a year’s time to see the evolution of disease in an outpatient setting. A research experience, “Scholarly Concentrations” is required. There are several one-week Intersessions that address topics such as health care disparities, health promotion and disease prevention, global health, pain, and disaster medicine. In the second year intersession topics have a clinical focus. In the third and fourth years the topics focus on translational sciences (infection, metabolism, inflammation, cancer.) During the third and fourth years, students will take core clerkships in medicine, pediatrics, surgery, obstetrics/gynecology, neurology, psychiatry, and emergency medicine. There is a new pre-clerkship one-week educational exercise focusing on clinical skills related to the clerkship’s discipline. Three advanced clerkships: intensive care, chronic care, and a subinternship (medicine, surgery, or pediatrics) have been added as a requirement in the clinical years. A capstone course, TRIPLE (transition to internship, residency, and life) is a required fourth quarter, fourth year course.
In order to fully implement the GTS curriculum, a new education building designed around the curriculum was required. The Armstrong Medical Education Building opened in August 2009 concurrent with the implementation of the GTS curriculum.
A student outcomes database has been created to assist in the evaluation of the curriculum.
Dr. Nichols responded to several questions related to educating faculty in new teaching methods, outcome measurements, and the need for more primary care providers in this era of health care reform.
Dr. Armstrong thanked Dr. Nichols for his presentation.
IV. The Role of the Vice President for Medical Affairs- Dr. Redonda Miller, Vice President for Medical Affairs
Dr. Miller presented an overview of the Johns Hopkins Hospital Medical Affairs Office which she directs. As an introduction, she noted the Johns Hopkins Hospital has approximately 1,000 beds, over 48,000 discharges each year, and an operating budget of over $1.5 billion. There are several major functions reporting to the Vice President for Medical Affairs: Medical Staff Administration, Patient Safety, Hospital Epidemiology and Infection Control, Pharmacy, Pastoral Care, Medical Records, and the Ethics Committee and Consultation Service.
Dr. Miller reviewed each of the units reporting to her and outlined goals and objectives of each. She also reviewed the medical staff governance structure.
Dr. Armstrong thanked Dr. Miller for her presentation.
V. Other Business
There being no further business this meeting was adjourned at 5:05 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.
May 26, 2010
June 23, 2010