UF College of Medicine: LCME Self-Study Opportunities Ahead

Joseph Fantone, M.D.Senior Associate Dean of Educational Affairs

University of Florida College of Medicine

Joseph Fantone, M.D.Senior Associate Dean

Educational Affairs

UF-COM Educational ProgramsMedical Students

Graduate Students

Physician Assistant Students

Undergraduate Students

Distant Education Students

Residents and Fellows

Post-doctoral Fellows

CME & MOC

Patient Care

EducationDiscovery

Scholarship

Service

UFCOM LCME SELF-STUDYSummary of Strengths

Quality of Students and Graduates

Quality of Faculty

Quality of Education Program

Dean’s Offices and Student Services

Diversity of the Medical Student Body

Extracurricular Opportunities

Research and Scholarship

University Campus

Clinical Programs - Education Sites

LCME Preliminary Findings

• New curriculum - Faculty highly responsive to student feedback

• Comprehensive and proactive student counseling services - highly responsive to student needs

• Admissions process widely praised by students for patient-centeredness - strong factor in choosing UF

• Faculty development and mentoring programs

• Accommodations made for space constraints – New ed. bldg. will address

LCME Preliminary Findings: Opportunities

• Diversity – programs in place – too early to assess effectiveness

• New curriculum is incomplete – unable to determine if program objectives have been attained and competencies realized

• Observation of core clinical skills (history & physical exam) has not systematically occurred in each required clerkship – AAMC GQ

• Timeliness of clerkship grades

2014-15 % URM Incoming

% URM Total

Medical students 25.9 22.3PA students 13.3 15.8Graduate Students 9.0 8.4Residents - GNV 17.7 10.6Residents - JAX 20.4 14.9Faculty - GNV 10.9 7.7Faculty- JAX 19.5 19.6

Diversity: A Commitment to Inclusion

UF MATCH DAY 2015

UF Graduates

Incoming UF Residents

MATCH 2015

Match Results (2010-2015)

Outcome 2015 2014 2013 2012 2011 2010

# in Match 121 125 127 131 120 126

Primary care specialty *

UF-GNV

UF-JAX

Florida: total

* Includes Ob-Gyn

Match Results (2010-2015)

Outcome 2015 2014 2013 2012 2011 2010

# in Match 121 125 127 131 120 126

Primary care specialty * 42 % 47 % 41 % 44 % 35% 38%

UF-GNV

UF-JAX

Florida: total

* Includes Ob-Gyn

Match Results (2010-2015)

Outcome 2015 2014 2013 2012 2011 2010

# in Match 121 125 127 131 120 126

Primary care specialty * 42 % 47 % 41 % 44 % 35% 38%

UF-GNV 22 % 23 % 23 % 9% 17% 14%

UF-JAX 2.4 % 3.2 % 2.4 % 5.3 % 3.3 % 2.3 %

Florida: total

* Includes Ob-Gyn

Match Results (2010-2015)

Outcome 2015 2014 2013 2012 2011 2010

# in Match 121 125 127 131 120 126

Primary care specialty * 42 % 47 % 41 % 44 % 35% 38%

UF-GNV 22 % 23 % 23 % 9% 17% 14%

UF-JAX 2.4 % 3.2 % 2.4 % 5.3 % 3.3 % 2.3 %

Florida: total 32 % 36 % 31 % 23 % 27% 26%

* Includes Ob-Gyn

2015 RESIDENCY MATCH UF-COM

SPECIALTY # STUDENTS (%)

# UF-GNV + UF JAX

Anesthesiology 4 (3.3) 1Cardiothoracic Surgery 1 (0.8)

Dermatology 4 (3.3) 2Emergency Medicine 14 (11.5) 1 + 3

Family Medicine 7 (5.7) 1

Medicine 18 (14.8) 8Med - Peds 2 (1.6) Neurology 2 (1.6) 1Neurosurgery 4 (3.3) 1OB-GYN 8 (6.6) 1Ophthalmology 5 (4.1) 3

SPECIALTY # STUDENTS (%)

# UF-GNV + UF JAX

Orthopedics 3 (2.5) 1Otolaryngology 2 (1.6) Pathology 2 (1.6) Pediatrics 16 (13.2) 2Plastic Surgery 1 (0.8) Prelim. Medicine 3 (2.5) 2Prelim. Surgery 1 (0.8) Psychiatry 3 (2.5) Radiation Oncology 4 (3.3) 1

Radiology 8 (6.6) 1Surgery 7 (5.7) 1Urology 2 (1.6) TOTAL 121 30 (25 %)

OUTSTATE PROGRAM MATCHES # STUDENTSBeth Israel – Boston 1Children’s Hospital-Boston 1Children’s Hospital-Philadelphia 1Colorado 1Duke 1Emory 3Mayo - Rochester 2M.D. Anderson 1MGH 1Michigan 2Mt. Sinai – New York 2NYU 1Oregon 1Stanford 2UAB 1UCSF 1UTSW – Dallas 6Washington University 1TOTAL 29 (24%)

• 60 students per year: 24 month program

• Surgery, CCU, and EM: most popular

• Approx. 30% enter primary care

• 2014: all graduates had jobs within 3 months of graduation

• Distinguished Young Alumnus Award: David Indarawis ,

Director of Clinical Education

School of Physician Assistant Studies

School of Physician Assistant Studies:

Opportunities & Challenges

• New clinical affiliations: Competition for clinical sites

o FSU med school o 5 PA programs in the state - expansiono Payment up to: $2000/mo./student

• Funding and costs of tuition

• Independent practice: Florida Academy of PAs – PAs are part of a healthcare team headed by a physician

School of Physician Assistant Studies

Accreditation Review Commission on Education for Physician Assistant (ARC-PA)

Self-study underway – submitted May 2015

Site visit: June 12-13, 2017

Graduate Programs

New ProgramsIDP-BMS: Cancer Biology Concentration

Medical Physics Certificate Programs and Distant Education Courses

OpportunitiesRecruitment

Stabilize Funding Model for Ph.D. (~ $42,000/yr.)

Curriculum: Flexible and design for future workforce needs

IDP-2

Department or Program # of Master’s Students

# of Doctoral Students

Biochemistry and Molecular Biology 0 23

Genetics 0 35Immunology and Microbiology 0 41Molecular Cell Biology 0 20Neuroscience 0 39Physiology and Pharmacology 0 19Cancer Biology new newInterdisciplinary Program in Biomedical Sciences 0 20

Epidemiology 33 26Biostatistics 14 16Genetics & Genomics 0 26Clinical and Translational Science 5 0Health Outcomes and Policy 3 0Translational Biotechnology 2 0Medical Science 7 0

2013-14

Total Apps Offers Enrolled %

Offers%

Enrolled2008-2009 359 92 49 26 532009-2010 308 70 37 23 532010-2011 289 84 43 29 512011-2012 333 64 30 19 472012-2013 290 69 41 24 592013-2014 274 60 25 22 422014-2015 239 66 44 26 672015-2016 294 58 28+ 20

IDP-BMS Admissions

Graduate Student Medical Guild

Awards

UF College of Medicine

Celebration of Research

Year # Medical Students Percent of Class

2012 82 60.7

2013 92 69.7

2014 95 70.9

Medical Student Research: MSRP

Undergraduate Student Teaching

• BMS 4905: Senior Research (>320)• BMS 3521: Human Physiology• MDU 4000+: 5 Junior Honors Courses• MDU4000+: 5 Psychiatry Courses• BMS 400?: New Histology

UFCOM Strategic Planhttps://oea.sites.medinfo.ufl.edu/files/2014/10/UFCOM-Strategic-Plan-20141.pdf

Strategic Plan

UFCOM Strategic PlanI. Excellence in Education: 9 objectives and 34 Strategies

OBJECTIVE 1: Recruit the brightest, most empathetic and service-oriented students who possess leadership potential and reflect the diversity of the state of Florida and nation. Engage in ongoing, systematic and focused efforts to attract and retain students from diverse backgrounds.

OBJECTIVE 2: Enhance the curricula of our educational programs to improve students’ ability to master educational program learning outcomes and stated competencies.

OBJECTIVE 3: Promote individual academic pursuits.

OBJECTIVE 4: Promote the career development of teaching faculty.

OBJECTIVE 5: Promote service learning in the educational programs.

OBJECTIVE 6: Recruit the highest quality applicants of diverse backgrounds for our Graduate Medical Education (GME) programs.

UFCOM Strategic PlanOBJECTIVE 7: Train the next generation of excellent medical and biomedical science educators.

OBJECTIVE 8: Integrate patient safety and quality improvement training into all health care-related educational programs.

OBJECTIVE 9: Develop students, trainees and faculty into lifelong learners.

Strategy: Engage students in interprofessional and collaborative team-based patient care, education and research.

Strategy: Leverage technology to promote individualized self-directed education.

Strategy: Stabilize funding support for graduate education programs.

Strategy: Develop and implement assessments of Entrustable Professional Activities (EPAs) for each developmental transition

Timothy Flynn, M.D., ChairSenior Associate Dean for Clinical affairs

University of Florida

Motivation: Patient Safety

“… aligning the professional development at the UME-GME transition with safe, effective, and compassionate care.”

What do we want the person to do?

EPA 1: Gather a history and perform a physical examination

EPA 2: Prioritize a differential diagnosis following a clinical encounter

EPA 3: Recommend and interpret common diagnostic and screening EPA 4: Enter and discuss orders and prescriptions

EPA 5: Document a clinical encounter in the patient record

EPA 6: Provide an oral presentation of a clinical encounter

EPA 7: Form clinical questions and retrieve evidence to advance patient care

EPA 8: Give or receive a patient handover to transition care responsibility

EPA 9: Collaborate as a member of an interprofessional team

EPA 10: Recognize a patient requiring urgent or emergent care and initiate evaluation and management

EPA 11: Obtain informed consent for tests and/or procedures

EPA 12: Perform general procedures of a physician

EPA 13: Identify system failures and contribute to a culture of safety and improvement

Description of the activity: “Day 1 residents should be able to do …….”

EPA 1: Gather a history and perform a physical examination

Functions: History: examples• Obtain a complete and accurate history in an organized fashion. • Demonstrate patient-centered interview skills ……..

Physical Exam: examples• Perform a complete and accurate physical exam in logical and fluid sequence. • Identify, describe, and document abnormal physical exam findings.

Assessments

Clinical Skills Exams

Curriculum

THE POWER OF TOGETHER UF Health Strategic Plan 2015 – 2020

Patient Care

EducationDiscovery

Scholarship

Service

UF Health: Education

“UF Health professional and academic programs will produce graduates who excel and lead in clinical care, science, teaching,

and community health.”

Goal #1: Train leaders of the future in science, the health professions, education and community service

Goal #2: UF HSC is an inclusive learning community.

Goal #3: UF Health interprofessional and team learning programs are nationally recognized for excellence and innovation.

Goal #4: Professionals and scientists training at UF HSC are prepared for a technology-facilitated career.

Goal #5: UF HSC graduates are prepared for a broad range of science careers

UF Health Research (6 total)Goal #3: Support research and research training programs of existing research faculty at UF Health.

Goal #4: Attract well prepared and highly motivated graduate students and chart new pathways for developing the translational workforce

Goal #5: UF Health will become a leading Learning Health System.

UF Health Clinical (8 total)Goal 5: UF Health will provide integrated team care throughout the patient experience

George T. Harrell, M.D. Medical Education

Building

Thank You

Patient Care

EducationDiscovery

Scholarship

Service