Accepted Students Day Clinical Education - Overview Jim Powers, DO, FACEP, FAAEM Associate Dean for Clinical Integration Interim Associate Dean for Clinical Affairs

CONGRATULATIONS!!!!! 2

Medical School is Fun! 3

CUSOM Mission To educate and prepare community–based osteopathic physicians in a Christian environment to care for the rural and underserved populations in North Carolina, the Southeastern United States and the nation. 4

Life Long Learning Years Life Long Learning Years Med Ed 4 Years Med Ed 4 Years Years 3 and 4 Pre Clinical Years Pre Clinical Years Years 1 and 2 Residency (GME) Graduate Med Ed 3-10 Years Graduate Med Ed 3-10 Years Practicing PhysicianIntern/Resident/Fellow MS 3 & MS 4 MS 1 & MS2 Medical Education Timeline 5

CUSOM: Meeting the Mission North Carolina - Regional Clinical Campuses Rural and Underserved – Health shortage areas – Medically underserved areas Early Clinical Experiences Service Projects – Student Run Community Care Clinic – Local Community Clinics – Migrant Workers International Opportunities – Africa (Tanzania and Kenya) – Central and South America (Guatemala, Honduras) – Caribbean (Haiti, Jamaica) Student Organizations 6

Goals of Clinical Education Provide exceptional clinical education in the art and science of osteopathic medicine Through hands-on training in rural and medically underserved areas, students will gain an appreciation for the many rewards of rural and community based medicine Be recognized for continued excellence in clinical medical education Maintain high academic standards and consistency Collaborate with our regional partners to support outstanding Osteopathic experiences and meet CUSOM’s Mission

CUSOM Curriculum Year 3 Simulation (4 weeks) Internal Medicine I, II(8 weeks) Medical Selective (4 weeks) Surgery (4 weeks) Obstetrics/Gynecology(4 weeks) Pediatrics (4 weeks) Psychiatry/Behavioral Science(4 weeks) Family Medicine(4 weeks) Rural / Underserved(4 weeks) Elective (4 weeks) 8

Simulation Month s 9

KEY: VAC = Vacation; IM = Internal Medicine; MS = Medical Selective; SUR = Surgery; R/U/I = Rural/Underserved; OBG = Obstetrics/Gynecology; PED = Pediatrics; PSY = Psychiatry; FM = Family Medicine; ELEC = Elective; SIM = Simulation Medicine; CAA = Clinical Academic Assessment; Core rotations are in blue. Third Year Example Schedule 10

CUSOM Curriculum Year 4 Medical Selective(8 weeks) Primary Care Selective(4 weeks) Surgical Selective(4 weeks) Geriatrics(4 weeks) Emergency Medicine(4 weeks) *Electives I, II, III, IV(16 weeks) Residency Development(4 weeks) * For one of the 4 th year electives, selectives or emergency medicine, the student must complete a Sub Internship (Sub I) 11

KEY: VAC = Vacation; MS = Medical Selective; ELEC = Elective – one of the electives must be completed as a Sub-Internship (SUB I), RES DEV = Resident Development; EM = Emergency Medicine;; PCS = Primary Care Selective; GER = Geriatrics; SS = Surgical Selective; Grad = Graduation. Core rotations are in blue. Fourth Year Example Schedule 12

High Quality Standardized Clinical Curriculum The standardized curriculum ensures that all students, regardless of the geographic location of their clinical rotation, will complete the same clinical objectives and didactic lessons. In order to ensure a high quality, standardized curriculum, the Associate Dean works with the Clinical Chairs to develop – an online syllabus – clerkship objectives – required textbooks and reading assignments – clinical cases to enhance student learning – supplemental instructional videos 13

So How Are We Doing? CUSOM students have a 99.9% passage rate on the National NBOME COMAT end of rotation exams CUSOM students have had a mean rotation evaluation by faculty of a 4.1 out of 5 14

Community-Based Clinical Training CUSOM clinical training (years 3 and 4) will be done regionally throughout the state Students complete core rotations at community-based clinical sites Coordination through CUSOM Department of Clinical Affairs, Clinical Chairs, CUSOM Regional Dean and the hospital educational designee Faculty identified, and appointed by CUSOM – 1017 adjunct clinical faculty members – 69 Emergency Medicine – 155 Family Medicine – 300 Internal Medicine – 36 Obstetrics and Gynecology – 88 Pediatrics – 78 Psychiatry – 169 Surgery 15

Clinical Sites 16 Charlotte Raleigh/ Harnett Goldsboro FayettevilleLumberton

Lumberton - Southeastern Health Medical Center bed hospital rd year ; th year students Current Residency Programs – Emergency Medicine – Family Medicine – Internal Medicine – Transitional Rotating Internship Psychiatry residency planned in next 3 years

Fayetteville - Cape Fear Valley Regional Medical Center 514 bed hospital rd year ; th year students Current Residency Programs – Family Medicine Planned residency programs over next 3 years – Emergency Medicine – General Surgery – Pediatrics – Obstetrics and Gynecology – Internal Medicine – Traditional rotating internship

Harnett Health System 2 hospitals with total of 200 beds rd year ; th year students Current Residency Programs – Family Medicine – Internal Medicine – Traditional Rotating Internship

WakeMed Raleigh Campus 566 bed hospital rd year ; th year students No current residency programs

Goldsboro Region Includes: – Sampson Regional Medical Center – Wayne Memorial Hospital – Lenoir Memorial Hospital 22-3 rd year & th year students

Goldsboro - Sampson Regional Medical Ce nter 75 bed hospital Current Residency Programs – Family Medicine – Dermatology – Traditional rotating internship

Goldsboro - Wayne Memorial Hospital 261 bed hospital Plans for several residency programs in the near future

Goldsboro - Lenoir Memorial Hospital 138 beds No residency programs at this time 24

Charlotte Region - Novant Rowan Medical Center 181 bed hospital rd year ; th year students No current residency programs but plans for development of programs in near future

Advantages of Community-Based Clinical Campus Students are part of the community - remain “local”; establish connections and roots Students become integral part of health care team Better tracking of student progress over the course of the year Students often pursue residency spots at their sites of training and increase chances of them practicing in the community Consistency for students in relationship to Regional Dean/DSME, site coordinator, educational activities, computer systems, policies/procedures etc CUSOM appointed faculty delivering a standardized curriculum Financial support for Regional Dean/ DSME and Site Coordinator

General Teaching Service Students with a CUSOM-appointed teaching physician who manage patients by the team. The interdisciplinary team – A faculty-appointed teaching physician – A senior resident (PGY-2 or PGY-3) – 1 or 2 junior resident(s) (PGY-1) – 1 or 2 Medical student(s) – 1 Physician Assistant and/or Pharmacy student Responsibilities – Management of the patients – Morning report – Daily teaching rounds Students & residents gain broad experiences in the management of a diverse population of patients 27

Assuring Clinical Knowledge and Competency 3 rd year – NBOME discipline exam at the end of each core rotation – The preceptor completes a performance evaluation of each student based on the 7 core competencies – Students participate in call-back Fridays - practice and are evaluated in Osteopathic Principles and hands-on techniques – Students participate in weekly educational sessions with board review questions, case presentations, and review of journal articles – Students take the NBOME COMSAE exam in order to ensure preparedness for their COMLEX Level 2-CE exam 28

Assuring Clinical Knowledge and Competency 4 th year – Residency Development Students evaluated in a number of Standardized Patient encounters to ensure proficiency and preparedness for COMLEX-PE exam – Students take the COMLEX Level 2-CE and PE exam – The preceptor completes a performance evaluation of each student based on the 7 core competencies – Students participate in call-back Fridays – Students participate in weekly educational sessions with board review questions, case presentations, and review of journal articles 29

Summary CUSOM’s clinical training program provide exceptional clinical education in the art and science of osteopathic medicine Training in rural and medically underserved areas provides students an understanding of the many rewards of rural and community based medicine Student achievement of knowledge and skills competencies evaluated through multiple methods Students are well prepared to enter any residency training program 30

Onward to Residency… 31

Questions? 32