SLU medical school on life support

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Accreditation despite probation

On March 14, Saint Louis University Medical School accepted a status ruled by the Liaison Committee on Medical Education — LCME for short — which established the medical educational program noncompliant with six of the twelve standards, thereby placing it under a probationary period.

The LCME survey team conducted a visit for full accreditation in early October of 2016, concluding deficiencies strictly involving that of documentation, missed opportunities for a self-directed learning environment, curricular management discrepancies, and an abridgement of central oversight; because the educational shortcomings related solely to curricular content and not to that of patient care or physician medical practice, the medical school remains fully accredited.

“We are fully accredited from the standpoint that all students have the same right as any other student in a different medical school to sit on a national board and enter the National Resident Matching Program,” Vice President for Medical Affairs and Dean of SLU School of Medicine Kevin Behrns, M.D., said. “All our students and any future students we enroll will continue to exhibit the same rights during this probational period, but there are areas we need to fix to strengthen our educational program —there are certainly things we could improve upon.”

Of the required remediation that is necessary for the medical school to retain its accreditation status, it must comply with the missed standards following a 24-month span before it is reevaluated. These missed guidelines specifically include, but are not limited to, the mentioned: mission, planning, organization and integrity; academic and learning environments; competencies, curricular objectives and curricular design; curricular management, evaluation and enhancement; teaching, supervision, assessment and student and patient safety; and finally, student selection, assignment and progress.

Behrns elaborated on his strategy to remediate the work plan, which will consist of a two-part system. “Phase one will work to address the citations while phase two will look at a continuous quality improvement program for medical education,” he explained. Behrns further elaborated on phase one exhibiting an overall steering committee to oversee the process. Underneath this steering committee, there will be work groups designed to address the citations. These citations are centered around three groups, that which consist of documentation, curriculum management and central oversight.

“There will be a work group for each of the citations, with curriculum management having a larger group because we have a fair amount of citations centered around it,” Behrns said.

Currently, SLU School of Medicine is the sole accredited medical institution placed under probation. However, Baylor and George Washington exhibited the same determination prior, with both of their rulings lifted when assessed by the LCME following the remediation period. The question might be raised, however, as to why just this year is the medical school not meeting its standards previously accommodated before — what has changed? While Behrns cannot fully answer these inquiries as he started his position as VP of Medical Affairs and dean in January of 2017, he elaborated that “when you look at the curriculum, you have opportunities for each classroom course or each clinical rotation that a medical student has. There needs to be a well-documented set of objectives for that course, and the evaluation must follow the objectives of the course […] Then, we need to do an assessment of how we’re teaching the topic material and use that information to inform us about whether the students are really getting what we’re trying to teach or whether we have gaps.”

While addressing these “gaps” in learning, he mentioned that there are areas which need to be assessed for improvement to create a more robust learning environment regardless of the LCME’s order. “These accreditation findings are unacceptable,” said Behrns, but he is utilizing them as a push to achieve a stronger medical education program in general.

In taking the next steps, SLU is constructing a new hospital which, according to Behrns, will not be affected by the medical school’s probation.