1. Clinical Education - Overview
Accepted Students Day
Clinical Education - Overview
David L Tolentino, DO, FACOI, FACP
Associate Dean for Clinical Affairs
April 8, 2017

2. CONGRATULATIONS!!!!!

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. Medical Education Timeline
Years 1 and 2
Years 3 and 4
Residency (GME)
Graduate Med Ed
3-10 Years
Life Long Learning
35-45 Years
Pre Clinical
Years
Med Ed
4 Years
Practicing Physician
Intern/Resident/Fellow
MS 3 & MS 4
MS 1 & MS2 4 4

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/Health Screening Bus
Migrant Workers
International Opportunities
Guatemala
Honduras
Ecuador
Haiti
Jamaica
Armenia
Student Organizations
North Carolina is facing a critical shortage of primary care physicians because of the significant growth of residents and an increase in its aging population.
North Carolina’s population has grown from 5.5 million in 1980 to 9.5 million in 2010 with virtually no increase in the number of doctors graduating from the state’s four medical schools each year.
According to a 2010 study published by the Association of American Medical Colleges Center for Workforce Studies, the populations that will be most impacted by a decreasing supply of physicians include rural and underserved populations. 20% of Americans live in rural or inner-city populations.
Campbell University is strategically positioned to serve the medical needs of eastern North Carolina.
Students will gain early clinical experience beginning in the first year and will continue through all four years of their education. Early clinical experiences will emphasize the importance of developing the student’s ability to generate a robust differential diagnosis.
Campbell University has always had a strong commitment to service, and this is no different for the School of Osteopathic Medicine. The support to local service projects will nurture our commitment to the community and serve those people in need in Harnett County.

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
To be recognized for excellence in graduate medical education.
Achieving and maintaining full compliance with AOA standards
Achieving and maintaining high student, resident and graduate retention rates
Maintain high academic standards
Meeting local, state, and regional workforce needs (i.e. Primary Care)
Offer placement services for graduates that want to contribute to the programs
Collaboration with our regional partners to support Osteopathic graduate learning experiences in medical education and medical education research
Student and resident rotations, mentoring, research and rotations for all specialties
To develop a robust research operation:
Emphasis on hypothesis-driven and outcomes research
Research infrastructure supported by the university and our teaching affiliates
Emphasizes collaborative research between clinicians, basic scientists, residents and students – lead by example

7. CUSOM Curriculum Year 3 Simulation (4 weeks)
Internal Medicine I, II (8 weeks)
Medical Selective (4 weeks)
Medical/Surgical Selective (4 weeks)
Surgery (4 weeks)
Obstetrics/Gynecology (4 weeks)
Pediatrics (4 weeks)
Psychiatry (4 weeks)
Family Medicine (4 weeks)
Rural/Underserved (4 weeks)
2:51 Fairly typical 3rd year:
48 weeks of Rotations and 4 weeks of vacation
All start with Simulation month
One elective month

8. Simulation Month s

9. Third Year Example Schedule
MS-3
6/26-7/21
7/24-7/28
7/31-8/25
8/28-9/22
9/25-10/20
10/23-11/17
11/20-12/15
12/18-1/12
1/15-2/9
2/12-3/9
3/12-4/6
4/9-5/4
5/7-6/1
Student
Block 1
Block 2
Block 3
Block 4
Block 5
Block 6
Block 7
Block 8
Block 9
Block 10
Block 11
Block 12
Block 13 A
SIM Month
Hosp Orientation IM MS
Sur
R/U
OBG
Ped
Psy FM
MS/SS
Vac B
M/S
PSY C D E F G
Surg H I J K
KEY: VAC = Vacation; IM = Internal Medicine; MS = Medical Selective; SUR = Surgery; R/U = Rural/Underserved; OBG = Obstetrics/Gynecology; PED = Pediatrics;
PSY = Psychiatry; FM = Family Medicine; MS/SS = Medical/Surgical Selective; SIM = Simulation Medicine; CAA = Clinical Academic Assessment

10. CUSOM Curriculum Year 4 Medical Selective (4 weeks)
Primary Care Selective (4 weeks)
Surgical Selective (4 weeks)
Geriatrics (4 weeks)
Emergency Medicine (4 weeks)
*Electives I, II, III, IV, V (20 weeks)
Residency Development (4 weeks)
* For one of the 4th year electives or selectives, the student must complete a Sub Internship (Sub I)
2:54 4th year structure also fairly typical
44 weeks of Rotations
including required clerkships in Geriatrics and Emergency Medicine
number of selectives, Sub-I
Four months electives
and 4 weeks of vacation

11. Fourth Year Example Schedule
MS-4
Student
Block 1
Block 2
Block 3
Block 4
Block 5
Block 6
Block 7
Block 8
Block 9
Block 10
Block 11
Block 12 A
Residency Development MS
Elec
PCS ER SS
Ger
Vac B C D E F G H I J K
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

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 99.3% first-time passage rate on the NBOME COMAT end of rotation exams
COMLEX-USA Level 1– 92.9% first-time passage rate
National Mean 92.3%
COMLEX-USA Level 2-CE—98.7% first time passage rate
National Mean 93.3%
Comprehensive Osteopathic Medical Achievement Test

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
Over 1300 adjunct clinical faculty members
Emergency Medicine
Family Medicine
Internal Medicine
Obstetrics and Gynecology
Pediatrics
Psychiatry
Surgery

15. Clinical Sites Raleigh/ Harnett Charlotte Goldsboro Morehead City
Region
Locations - Clinical Campus 1
Lumberton (Robeson County) Southeastern Health 2
Fayetteville (Cumberland County) Cape Fear Valley Medical Center Fayetteville VA Medical Center 3a
Raleigh (Wake County) WakeMed Hospitals 3b
Harnett (Harnett County) Harnett Health System CommWell Health 4
Charlotte (Rowan and Mecklenburg Counties) Novant Rowan Regional Medical Center Novant Huntersville Medical Center Salisbury VA Medical Center 5
Goldsboro (Sampson, Wayne, and Lenoir Counties) Wayne Memorial Hospital Sampson Regional Medical Center Lenoir Memorial Hospital Cherry Hospital 6
Morehead City (Carteret, Onslow, and Craven Counties) Carteret General Hospital Onslow Memorial Hospital CarolinaEast Medical Center
Raleigh/
Harnett
Charlotte
Goldsboro
Morehead
City
Fayetteville
Lumberton
2:56

16. Lumberton - Southeastern Health Medical Center
235 bed hospital
44 - 3rd year ; th year students
Current Residency Programs
Emergency Medicine
Family Medicine
Internal Medicine
Transitional Rotating Internship
Psychiatry residency planned in next 3 years

17. Fayetteville - Cape Fear Valley Regional Medical Center
514 bed hospital
rd year ; th year students
Current Residency Programs
Family Medicine
Residency programs starting 2017
Emergency Medicine
General Surgery
Obstetrics and Gynecology
Internal Medicine
Traditional Rotating internship
Psychiatry (starting 2018)

18. WakeMed Raleigh Campus
566 bed hospital
rd year ; th year students
No current residency programs
At CUSOM, we are committed to developing a residency position for every graduate.
You will be able to apply for both osteopathic and allopathic residencies, one of the advantages of a DO program.
WakeMed Raleigh Campus featured in this slide is one of our committed clinical sites.

19. 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

20. 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

21. Goldsboro Region Includes: Wayne Memorial Hospital
Sampson Regional Medical Center
Lenoir Memorial Hospital

22. Goldsboro - Wayne Memorial Hospital
261 bed hospital
22-3rd year & 22- 4th year students

23. Goldsboro - Sampson Regional Medical Center
75 bed hospital
Current Residency Programs
Family Medicine
Dermatology
Traditional rotating internship

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

25. Carteret Medical Center – Morehead City
New for 2018
104 bed hospital
22 – 3rd year; 22 – 4th year students
No current residency programs

26. 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

27. 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

28. Assuring Clinical Knowledge and Competency
3rd year
NBOME discipline exam at the end of each core rotation (COMAT)
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
Comprehensive Osteopathic Medical
Self-Assessment Examination

29. Assuring Clinical Knowledge and Competency
4th 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
CE – cognitive evaluation
PE – performance evaluation

30. 2017 Residency Match Results
At-a-glance
53% Primary Care
4 Anesthesiology
5 PM&R
5 Radiology
9 Surgery
35% Southeastern United States
Duke, UNC, ECU, Emory, Univ of Florida…
Univ of Arizona, UHCMC/Case, Geisinger…
Walter Reed Natl Med Ctr, Tripler….

31. 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

32. Questions?