1. Ensuring Educational Quality in a Universe of Expanding COMs Bruce Dubin, DO Associate Dean for Medical Education UNTHSC - TCOM

2. Goal of Medical Education The overall goal of basic medical education is to produce broadly educated medical graduates with an appropriate foundation for further training in any branch of medicine including family medicine medical, surgical, investigational or other specialties, as well as for careers in medical research, public health medicine or health service administration.

3. Has our quest for growth begun to obscure our quest for quality? 1. What are we now and what do we want to be in the future? 2. What are we known for? 3. What do we want to be know for? 4. How will we know when we have arrived? 5. How will the public and the people who judge us know we have arrived?

4. Concern Some may say that: “ We’ve followed the money...and the money has certainly been there” Jordan Cohen, MD AAMC Annual Meeting Washington, D.C., November, 2003.

5. Concerns about Opening New Schools 1. Do we really need them? 2. Are we really looking at the quality of the new programs? 3. Are they just there as diploma mills? 4. Will they steal important resources from existing schools? 5. How will we judge new schools? 6. How will the public and others judge our new schools? 7. What value do new schools bring to the profession? 8. Who is opening them up and why?

6. Mission and Objective Measures of Quality 1. What is the educational program designed to produce? 2. How are students selected? What type of students are they? 3. How are the faculty and administrators selected? 4. What are the educational resources? Is education their primary “business” or does the school merely exist to support a practice plan? 5. How is the program evaluated and by whom? 6. What is the governance and the administration? 7. How is the assessment of students carried out? What standards are used to carry out the assessment? 8. Is there a process for continuous quality improvement?

7. What are the Educational Resources? 1. Do we really put our money where our priorities are? 2. Clinical training spots in years III and IV? 3. Post graduate training spots?

8. How are the faculty and administrators selected? 1. Are we relying on the “old boy network” or are we really selecting the best faculty and administrators to meet the educational mission? 2. Do we really train our future faculty and administrators for both our old and new schools? If so, How?

9. What is the educational program designed to produce? 1. Different schools have different missions and are designed to produce different things. Do we really understand that?

10. How are students selected? What type of students are they? 1. The mission may reflect the type of student accepted. How does this translate to academic rigor? How does this translate to academic rigor? 2. Minority and underserved populations?

11. What is the governance and the administration? 1. Is the governance and administration designed to meet the current and future needs of the schools educational mission?

12. What standards are used to carry out student assessment? 1. COMLEX 2. USMLE 3. Residency programs 4. Success of graduates 5. Location of graduates 6. How do we really measure success?

13. Is there a process for continuous quality improvement?

14. How is the program evaluated, and by whom? 1. Should we have an evaluation body independent of the AOA? 2. Is the evaluation process all that it should be? 3. Is the evaluation process as transparent and as public as it should be?

15. Who Will Define Quality? 1. Our students 2. Our patients 3. Our communities 4. Local, State, and National accrediting associations 5. Hospitals 6. The military 7. Malpractice carriers 8. The Joint Commission 9. The AOA 10. AACOM 11. State legislators 12. Newspapers and the Media 13. And the list goes on and on and on and on.