A Student Guide to Understanding & Advocating for Curriculum Reform

1. A Student Guide to Understanding & Advocating for Curriculum Reform Developed by Physicians for Reproductive Choice and Health UMED Undergraduate Medical Education Initiative August 2007

2. “They always say time changes things, but you actually have to change them yourself.” — Andy Warhol

3. Objectives • Understand how medical school curriculum is developed & changed • Know how medical students can participate in curriculum development & change • Be familiar with allies & mentors that can aid medical students in their curriculum change advocacy

4. Current StatisticsAbortion Providers • 87% of U.S. counties have no abortion provider. • Only 5% of abortions occur in hospitals where medical students are trained. • Key reproductive health issues are rarely covered in didactic or clinical years. • Finding training on abortion can be very difficult.

5. Medical Education CurriculumMedical School vs. Residency Medical School • Structure is standardized notcurriculum. • Each school develops their own curriculum. • Curriculum change happens institutionally. Residency • Curriculum content is standardized. • Curriculum change is universal across each specialty.

6. Does Your Medical School’s Curriculum Cover: • Contraception • Emergency contraception • Abortion • STIs/STDs • Sexual history taking • Intimate partner violence, domestic violence, sexual assault

7. Current Curriculum Status: A National Survey of Ob-Gyn Clerkship Directors • 17% of the 68 respondents • reported no formal education on abortion in either preclinical or clinical years • 3rd Year Rotation • 23% offered no formal education about abortion. • 32% offered a lecture specifically about abortion. • 45% offered a clinical experience with abortion. • 4th Year Rotation • About half of schools surveyed offered a reproductive health elective.* *Espey Eve, Ogburn Tony. Abortion education in medical schools: A national survey. American Journal of Obstetrics and Gynecology 2005; 192: 640-3

8. Curriculum Change & Development 3 Structures Accreditation Medical Schools Licensing & Testing

9. Medical Education Curriculum Anatomy AAMC AMA Accreditation LCME Medical School Deans Curriculum Committee Medical School Clerkship Directors Department Chairs Clerkship Coordinators Faculty Course Directors Electives Service-learning NBME FSMB Licensing & Testing USMLE Review materials

10. Curriculum Change & Development 3 Structures Accreditation Medical Schools Licensing & Testing

11. AccreditationStructure AAMC American Association of Medical Colleges AMA American Medical Association LCME Liaison Committee on Medical Education

12. LCME • Sponsored by the AAMC & AMA - Each organization • Maintains an LCME office • Coordinates survey visits • Hosts quarterly meetings • Appoints an LCME Secretary • 16 Members - 2 student members appointed by AAMC and AMA

13. LCME Eight-Year Accreditation Cycle

14. LCMEFocus Areas • Medical education program • Student services • Environment for learning • Adequacy of educational resources

15. Curriculum Change & Development3 Structures Accreditation Medical Schools Licensing & Testing

16. Medical SchoolAnatomy AAMC AMA Dean of Medical School LCME Dean/Director of Student Education Medical School Deans Associate/Vise Dean of Education Curriculum Committee Clerkship Directors Department Chairs Clerkship Coordinators Faculty Course Directors Electives Service-Learning/ Extracurricular Activities

17. Curriculum Change & Development3 Structures Accreditation Medical Schools Licensing & Testing

18. Licensing & TestingAnatomy NBME National Board of Medical Examiners FSMB Federation of State Medical Boards USMLE United States Medical License Examiners Review materials: Books, practice exams, etc.

19. Areas Students Can Inject Change

20. AccreditationStudent Injection LCME: • Student representatives • Student participation in accreditation process • Appointment to self-study task force & committees • Independent student analysis • Meets with LCME survey team

21. AccreditationLCME — Student Injection 2 student members a year • Appointed by AAMC & AMA • Participate in all activities • Quarterly meetings • Full voting privileges • Survey visits

22. AccreditationAAMC-LCME Student Member Process • Memo soliciting nominations sent mid-February • Medical school deans nominate one rising 4th year • Deadline typically in mid-March • One nomination per school

23. AccreditationAAMC-LCMEStudent Member Getting Nominated • Contact your medical school dean or student affairs dean to request consideration Questions? Contact: Susan Mortensen, AAMC's Section for LCME and Accreditation Services, at smortensen@aamc.org or 202-828-0596

24. Accreditation AMA-LCME Student Member Process • Conducted through AMA Department of Medical Student Services • Letter soliciting nominations sent in Mid-October • Deadline typically in late January • Final selection made in April by the AMA Board of Trustees

25. Accreditation AMA-LCME Student Member Getting Nominated • Must be a current Medical Student Section (MSS) member • Must submit a package of materials • Application form, essay, & letter of support from candidate's dean Questions? Contact Dr. Barbara Barzansky, Division of Undergraduate Medical Education, barzansky@ama-assn.org Rebecca Gierhahn AMA Medical Student Services, rebecca.gierhahn@ama-assn.org http://www.ama-assn.org/ama/pub/category/109.html

26. AccreditationStudent Injection LCME: • Student representatives • Student participation in accreditation process • Self-study task force & committees • Independent student analysis • Meet with LCME survey team http://www.lcme.org/roleofstudentsguide.pdf

27. Accreditation LCME — Student Injection • Self-study task force & committees • One or more students appointed • Review & analyze accreditation data in the 4 areas • Independent student analysis • Student leadership appointed • Review & analyze accreditation data in the 4 areas • Conduct a student opinion survey • Meet with LCME survey team • Formal meetings with 1-2 & 3-4 years • Informal meetings

28. Areas Students Can Inject Change

29. Resuscitate Your School’s Curriculum! Medical SchoolStudent Injection Medical School Deans Curriculum Committee Clerkship Directors Department Chairs Faculty Clerkship Coordinators Course Directors Electives Service-learning/ Extracurricular Activities

30. LCME states that medical students should sit on curriculum committees Medical SchoolInfluence Curriculum Committee How • Become a student member. Course of action • Express your interest to the committee chair or another faculty member. • Sign up to be a course representative. • Get involved with course feedback.

31. Faculty members are great allies & may know the best avenues to go down or people to contact when pursuing change at your institution. Medical SchoolGet Faculty Involved How • Research which faculty have an interest in sexual & reproductive health. • Contact PRCH to help connect you with supportive faculty members. Course of Action • Approach faculty members. • Build relationships & collaborate.

32. Faculty & StudentCollaboration: Curriculum changed because of ONE comment! Stanford University School of Medicine Injecting Women’s Health into Internal Medicine Clerkship from 1 student’s course-evaluation response Result • Collaboration between student & clerkship director • Substantially revised the curriculum

33. LCME requires that elective courses be included in curriculum so that students gain exposure to & understanding of medical specialties in their career interests & also provides opportunities for students to pursue individual interests Medical SchoolUtilize Electives How • Propose a self designed reproductive & sexual health or women’s health elective Course of Action: • Partner with faculty • Contact curriculum committee student member • Make suggestions on course evaluations

34. LCME states that medical schools should make available sufficient opportunities for students to participate in service-learning activities and should encourage & support student participation. Medical SchoolResuscitate Service-Learning How • Start a student-run family planning clinic • Work with faculty to identify service-learning opportunities Course of Action • Look to fellow AMSA alumni who started student-run clinics • Encourage faculty to provide more service-learning opportunities

35. Student groups are a great venue to supplement curricula & learn how to change them through extracurricular activities. Medical SchoolResuscitate Extracurricular Activities How • Host experts to speak about sexual & reproductive health issues • Host workshops with experts to improve physician skills in reproductive healthcare Course of Action • Contact PRCH to have a member from its UMED Speakers Bureau present at your school • Penny Vick, Medical Education Associate, 646-649-9930 or penny@prch.org

36. Areas Students Can Inject Change

37. Curriculum & coursework usually reflect what will be on the 3 steps of medical licensing exams Licensing & TestingStudent Influence How • Urge for changes in review materials Actions • Write letters & petitions requesting changes in review materials

38. Student SupportIn Sexual & Reproductive Health Curriculum Endeavors • PRCH Physicians for Reproductive Choice and Health • MSFC Medical Students for Choice • ARHP Association of Reproductive Health Professionals • AMSA American Medical Student Association

39. Your SupportPRCH How • Connects students with supportive faculty • Works with clerkship directors • Provides expert speakers Course of Action • Contact PRCH • Penny Vick, Medical Education Associate, 646-649-9930 or penny@prch.org

40. Student SupportMSFC How • Assists students attempting to reform their school’s curriculum • Provides support to help students survey their curriculum • Connects students with authoritative speakers • Organizes opportunities to observe abortion procedures & counseling sessions • Provides support to help develop & implement elective courses & lecture series Course of Action • Contact Christine Hence, the Curriculum and Research Manager at MSFC: • 215-625-0800 x206; Christine@ms4c.org • Visit http://www.ms4c.org/issuereform.htm

41. Student SupportARHP How • Provides individualized support • Cultivate “champions” of reproductive health curricula reform at your institution • Resource: “A Medical Student's Guide to Improving Reproductive Health Curricula” Course of Action • Contact Shana Brown, MPH, program manager, at sbrown@arhp.org or 202-466-3825

42. Student SupportAMSA How • Medical Education Action Committee • Gender & Sexuality Committee • Provides opportunities to get involved • Regional Coordinator Course of Action http://www.amsa.org/women/ http://www.amsa.org/women/regcoordinators.cfm

43. Medical Education Curriculum Anatomy AAMC AMA Accreditation LCME Medical School Deans Curriculum Committee Medical School Department Chairs Residents Clerkship Directors Faculty Clerkship Coordinators Course Directors Electives Service-learning NBME FSMB Licensing & Testing USMLE Review materials

44. Boost Reproductive Health Choices Inject Change Today!

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