College of Medicine

   I hope everyone has had a good summer and enjoyed or about to enjoy your vacations. I thought that I would give an update on our LCME experience and where we are in the process of accreditation.  First, I want to thank all the faculty, staff, and students who worked so hard for 15 months preparing for the visit, completing the documents and analysis for submission, and meeting with the site visit team when they were here from 14-17 April.  We have recently received the Draft Site Visit Survey Report from the Team Secretary and had 10 days to respond with comments on the identified findings.  We have done that and now await the Survey Team’s Final Report. This will go to the LCME and be reviewed at their next meeting in Chicago in October. So, we still await their determinations.

   In the meantime, we’ve had an opportunity to review the 203 page Draft Survey Report that we received and I wanted to share some of the many things that they found in their very detailed review and site visit.  I continue to be proud of our school, our model and our great students, faculty and staff. This is a long list and I thank Dr. Littles for extracting all the areas noted by the survey team.  Thanks to all of you for showing the team what a great school we are. 

   Areas the team found where we met or exceeded the requirements.

• All our Affiliation Agreements are up to date (great news since we have so many and this was a prior citation).
• The survey team concluded that I am qualified to provide effective leadership in medical education (you can fool some people some of the time!).
• They had multiple comments about our regional campuses and these speak strongly about our model. It is a long list and cuts across many standards. Some were great to see since we believe that our model focusing on ambulatory experience is best.  Not all schools feel that way.
  • The dean regularly attends all-faculty meetings, which are held at each regional campus site and routinely interacts with the leadership of affiliated hospitals across the six clinical campus sites.
  • Hospital leaders with whom the survey team met noted that their relationship with the school was positive and productive and that they valued their relationships with us.
  • The survey team noted that the organizational structure for oversight of the regional campuses is appropriate and effective.
  • Faculty and students with whom the survey team met confirmed the adequacy of faculty at all campus sites.
  • Administration of the regional campuses, reporting structures, and management of the medical education program was effective and oversight was clear.
  • There are sufficient mechanisms in place at FSU COM to support functional integration and communication among the campuses at all levels.
  • Regional campus faculty with whom the survey team met were satisfied with the initiatives undertaken by the college to promote functional integration at the departmental and medical school levels.
  • The survey team concluded that the faculty at each of the college’s regional campuses are functionally integrated at the departmental and medical school levels by appropriate administrative mechanisms.
  • The survey team concluded that the overall balance between inpatient and outpatient clinical experiences was appropriate to meet the needs of the college’s medical education program.
  • Comparability - The survey team confirmed that, at FSU COM, clinical clerkships at all instructional sites employ the same learning objectives, equivalent assessment methods, and the same policies for determination of clerkship grades. Given the distributed model of the FSU COM clinical curriculum, the survey team explored the various processes and procedures used to manage clerkship comparability across sites. The team concluded that the aforementioned structural (i.e., single syllabus and evaluation form for all sites), communication, and management mechanisms have resulted in comparable clerkship experiences across all college of medicine educational sites.
  • The survey team determined that processes are in place at FSU COM to ensure that medical students are adequately supervised during required clinical clerkships and other required clinical experiences.
  • The survey team concluded that, at FSU COM, supervision of medical student’s learning activities is provided during required clerkships by members of the college of medicine faculty.
• Staffing in the Dean’s Office is sufficient and time allotted to each assistant and associate dean is adequate. 
• We were concerned that they would not understand that our students work with practicing physicians, but they recognized our requirement for each medical student to spend a minimum of four weeks at an educational site with residents and acknowledged we meet this requirement through experiences in required clerkships, externships, or M4 electives.
• On Diversity
  • They recognized our diversity pipeline programs as a strength.  “The efforts to identify and recruit medical students involve multiple pipeline programs that cultivate qualified applicants from underserved backgrounds as early as the seventh grade and continuing through their college years.”
  • The 2018 AAMC GQ data show that student respondents have been positively influenced by the school’s diversity efforts, with 72.7% of FSU COM respondents agreeing with the statement “ The diversity within my medical school class enhanced my training and skills to work with individuals from different backgrounds” (vs. 66.3% nationally). ISA data indicated that 92.8% of respondents reported that they were satisfied with the diversity of the student body.
• Retention efforts for students and faculty include student counselling services, an active Council on Diversity and Inclusion, and the efforts of the assistant dean for student affairs and diversity. The college also emphasizes wellness in its retention efforts.
• For Faculty
  • We have effective communication mechanisms for our faculty to be aware of policies and changes and they have clear opportunities to provide input.
  • The college’s size and the distribution of its faculty appropriately reflect the purpose and reach of its mission. 
  • The college of medicine maintains clear policies for the appointment, renewal of appointment, promotion, granting of tenure, and dismissal of faculty.
• Resources
  • Concluded that the space available for teaching is adequate for the current number of students, the current curriculum structure, and the number of existing and anticipated faculty.
  • The adequacy of patient numbers is further supported in the ISA, with 99% of M3 and M4 respondents reporting satisfaction with their access to patients during required clerkships.
  • There are adequate resources to support medical student education at inpatient sites during required clinical clerkships, including space for clinical teaching (e.g., conferences, rounds) and access to library resources and information technology (e.g., computers, internet access).
  • Concluded that there are sufficient IT resources and facilities for medical student education at hospitals and clinical facilities used by the COM for required clinical learning experiences.
  • They were complementary of our Security, Student Safety, and Disaster Preparedness at the campuses.
  • Study/Lounge/Storage Space/Call Rooms were available at all sites.
• Two areas where we were unsure if we met the requirements during our self-study – we did:
  • Self-Directed and Life-Long Learning – The college’s policy ensured that students have adequate time to engage in self-directed learning and independent study in the pre-clerkship phase of the curriculum.
  • Service-Learning - FSU COM provides an extensive array of structured service-learning and community service opportunities for its students.
• Curriculum management and review
  • The Curriculum Committee and its subcommittees have the necessary information and authority to manage the curriculum. The team reviewed evidence that the Curriculum Committee and its subcommittees are effectively engaged.
  • In its review of school documents, the survey team confirmed that curriculum content was regularly reviewed and discussed.
  • The outcomes evidence available to the survey team (e.g., USMLE scores, NBME examination scores, OSCE performance, and comparability of performance across a variety of measures) indicated that FSU COM students are achieving the college’s medical educational program objectives. The team concluded that the college of medicine has processes in place to identify and address suboptimal performance on outcome measures.
  • The survey team concluded that the college of medicine has in place a system with central oversight that monitors and ensures completion by all medical students of required clinical experiences.
  • The survey team confirmed that the college of medicine ensures that faculty members with appropriate knowledge and expertise set the standards of achievement in each required learning experience.
• Student experiences
  • Each medical student is provided with formal formative feedback sufficiently early in each required course or clerkship to permit sufficient time for remediation. 
  • The COM has in place a system of fair and timely summative assessment of student achievement in each course / clerkship and  final grades are available within six weeks. 
  • The COM offers on-site academic and mental health counseling on the central campus through the Office of Student Counseling Services. Personnel in this office have no involvement in the academic assessment or promotion of students and the psychologists there maintain strict confidentiality of students’ health information.

   This is a long list so you might be asking what they didn’t like. That is a much shorter list and we are working to challenge some of the findings.  I know everyone is anxious to know “how we did.” We are in the midst of that process and I look forward to sharing good news with you in October.  Given all the work we did to prepare for this accreditation site visit, we will start immediately to enhance our continuous quality process for ensuring that we continue to meet all of the standards.

   Looking forward to the fall and hopefully cooler weather. 

   Thank you for all you do every day to make this such a great place to work and thrive. Go Noles!  

   Sincerely, J.

   John P. Fogarty, M.D.

   Dean 

   Florida State University College of Medicine