UB Medical School Wins Reaccreditation for Eight Years; New Initiatives on Curriculum, Fiscal Management Lauded

BUFFALO, N.Y. -- The School of Medicine and Biomedical Sciences at the University at Buffalo has earned reaccreditation for eight more years from the Liaison Committee on Medical Education (LCME).

The action constitutes a ringing endorsement of the school's educational program: Eight years is the longest interval between surveys allowed by the LCME. The program's next accreditation survey will take place in 2010.

"To have LCME say 'We'll see you in 2010' was great news," said Margaret Paroski, M.D., interim vice president for health affairs and interim dean of the medical school. "We have a few areas that need shoring up, but by-and-large, the evaluators really liked our new curriculum.

"Being involved in redesigning the curriculum was one of the most exciting things I've done in my academic career," said Paroski, who directed implementation of this effort. "The feedback from students has been very positive. We now have a living, breathing curriculum. It makes teaching so much more fun."

Redesigning the first two years of the curriculum into organ-based modules instead of department-based modules, plus reorganizing and stabilizing the school's financial underpinnings, were tasks the LCME had directed the medical school to achieve in order to receive its reaccreditation. In its final report, the LCME now labels both those areas specific institutional strengths.

Most of the reaccreditation work was accomplished under the school's former dean, Michael Bernardino, M.D., who resigned his post in February after four years at UB to return to private radiology practice in Atlanta. The LCME notes Bernardino's contributions to the medical school as the first of five institutional strengths.

The report commends him as an effective agent for change and lauds his leadership, communication with faculty and students, and management of the school's financial resources. Other specific strengths highlighted in the report are:

o The new curriculum: "Collaborative efforts of the dean's educational administration and the faculty have led to the creation of a new pre-clinical curriculum that promises a more cohesive educational environment and institutional culture."

o The faculty: "The faculty displays noteworthy commitment to its responsibility for teaching and supporting medical students."

o The students: "Student morale and enthusiasm about the school and its curriculum have shown significant improvement as a result of the faculty and administration's responsiveness to their concerns."

o The Health Sciences Library: "The well-equipped Health Sciences Library is responsive to the needs of a modern, electronically literate academic community, and functions as an important focal point for integrating the academic life of a multifaceted and geographically dispersed institution."

The report also notes five items in which the school was in partial or substantial noncompliance with LCME standards, and three "transition" areas outside of the medical school itself that need attention in order for the school to sustain its ongoing accreditation.

The transition areas named are lack of affiliation agreements with teaching hospitals (Kaleida Health and Erie County Medical Center have since signed agreements, Paroski noted) and residency-program management and oversight. UB also is addressing this concern, Paroski said, by phasing out consortium management of the residency program and transferring responsibility to the medical school.

The final transition item warns that students and residents may not get enough exposure to patients in several specialty areas -- in particular internal medicine, pediatrics, obstetrics and gynecology, and neurology -- because of decreased hospital admissions and shortened hospital stays, a problem faced by teaching hospitals across the country.

UB is addressing this problem, Paroski said, by creating smaller clerkship groups, which give each student maximum exposure to available inpatients, and by using standardized patients when necessary.

Noncompliance issues that the LCME says must be addressed center on the need to set global objectives for the entire curriculum and establish ways to evaluate how the school is meeting those objectives. The report also says UB must offer students more career, residency (specialty) and financial counseling, areas in which the school has made substantial progress, Paroski said.

Nancy Nielsen, M.D., interim senior associate dean for medical education, has set up a program of one-on-one career counseling for third- and fourth-year students, Paroski said, and her entire staff is taking more responsibility for financial-aid and debt-management counseling.

Establishing reliable ways to evaluate the new curriculum as a whole and student performance and improvement under the new curriculum will be a bigger task, Paroski said. "I'm not sure how to measure a better doctor. It's a hard thing to get your arms around."

One approach will be to ask attending physicians who supervise third-year students to compare the performance of students who went through the old preclinical curriculum with those trained under the new curriculum, she said. "We want to see if we have created this 'active learner' as we had hoped."

The LCME has requested a progress report on noncompliance and transition issues by September 2004.