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Undergraduate Medical Education UNDERGRADUATE MEDICAL EDUCATION: A Survey of Texas Medical Schools Clinical Clerkships and Rotations DRAFT DRAF December 2012 Texas Higher Education Coordinating Board Fred W. Heldenfels IV, CHAIR Austin Harold W. Hahn, VICE CHAIR El Paso Dennis D. Golden, O.D., SECRETARY OF THE BOARD Carthage Ryan T. Bridges, STUDENT REPRESENTATIVE Huntsville Durga D. Agrawal Houston Robert W. Jenkins Jr. Austin Munir Abdul Lalani Wichita Falls James H. Lee Houston Janelle Shepard Weatherford David D. Teuscher, M.D. Beaumont Raymund A. Paredes, Ph.D. COMMISSIONER OF HIGHER EDUCATION Mission of the Coordinating Board The Texas Higher Education Coordinating Board’s mission is to work with the Legislature, Governor, governing boards, higher education institutions, and other entities to help Texas meet the goals of the state’s higher education plan, Closing the Gaps by 2015, and thereby provide the people of Texas the widest access to higher education of the highest quality in the most efficient manner. Philosophy of the Coordinating Board The Texas Higher Education Coordinating Board will promote access to quality higher education across the state with the conviction that access without quality is mediocrity and that quality without access is unacceptable. The Board will be open, ethical, responsive, and committed to public service. The Board will approach its work with a sense of purpose and responsibility to the people of Texas and is committed to the best use of public monies. The Coordinating Board will engage in actions that add value to Texas and to higher education. The agency will avoid efforts that do not add value or that are duplicated by other entities. The Texas Higher Education Coordinating Board does not discriminate on the basis of race, color, national origin, gender, religion, age, or disability in employment or the provision of services. Table of Contents Executive Summary ......................................................................................... 1 Board Directive .............................................................................................. 4 Methodology ................................................................................................... 4 Medical Education Overview ............................................................................ 4 First Year Entering Enrollment ......................................................................... 7 Required Third and Fourth Year Core Clerkships ............................................... 8 Core Clerkships – Location and Number of Sites................................................ 8 Psychiatry ........................................................................................... 10 Family Medicine .................................................................................. 11 Internal Medicine ................................................................................ 12 Surgery .............................................................................................. 13 Pediatrics ........................................................................................... 13 Obstetrics and Gynecology .................................................................. 14 Neurology ........................................................................................... 15 Scheduling and Supervision of Medical Students in Core Clerkships ................. 16 Medical Students Completing a Core Clerkship at Each Site .............................. 17 Psychiatry ........................................................................................... 19 Family Medicine .................................................................................. 20 Internal Medicine ................................................................................ 21 Surgery .............................................................................................. 22 Pediatrics ........................................................................................... 23 Obstetrics and Gynecology .................................................................. 24 Neurology ........................................................................................... 25 Evaluation of Medical Students on Core Clerkships .......................................... 25 Financial Commitment to Core Clerkships ....................................................... 26 Selective/Elective Rotations ........................................................................... 27 Selective Rotations .............................................................................. 27 Elective Rotations ............................................................................... 28 Texas Medical Students Who Complete an Elective Rotation Away from their School ....................................................................... 29 Medical Students Visiting Texas Medical Schools ............................................. 30 Adding Core Clerkship and Rotations Sites ...................................................... 32 Medical School Expansions and Other Information .......................................... 33 Findings ....................................................................................................... 34 Recommendations......................................................................................... 35 Appendices References Figure Figure 1. Texas First-Year Entering Enrollment .................................................. 7 Tables Table 1. Texas Health-Related Institutions and Medical Schools ..................... 6 Table 2. Texas Medical Schools – Core Clerkships and Required Weeks .......... 9 Table 3. Core Clerkship – Psychiatry............................................................ 10 Table 4. Core Clerkship – Family Medicine ................................................... 11 Table 5. Core Clerkship – Internal Medicine ................................................. 12 Table 6. Core Clerkship – Surgery ............................................................... 13 Table 7. Core Clerkship – Pediatrics ............................................................ 14 Table 8. Core Clerkship – Obstetrics and Gynecology ................................... 15 Table 9. Core Clerkship – Neurology .......................................................... 16 Table 10. Fall 2011 Medical School Enrollment – Total Headcount ................... 18 Table 11. Average Number of Medical Student Per Clerkship Site, Psychiatry ....................................................................... 19 Table 12. Average Number of Medical Student Per Clerkship Site, Family Medicine ............................................................... 20 Table 13. Average Number of Medical Student Per Clerkship Site, Internal Medicine ............................................................. 21 Table 14. Average Number of Medical Student Per Clerkship Site, Surgery ........................................................................... 22 Table 15. Average Number of Medical Student Per Clerkship Site, Pediatrics ........................................................................ 23 Table 16. Average Number of Medical Student Per Clerkship Site, Obstetrics/Gynecology ..................................................... 24 Table 17. Average Number of Medical Student Per Clerkship Site, Neurology ....................................................................... 25 Table 18. Medical Students Visiting Texas Medical Schools ........................... 31 Table 19. Adding Core Clerkship and Rotations Sites .................................... 32 Executive Summary Board Directive In April 2012, the Texas Higher Education Coordinating Board (Coordinating Board) directed staff to conduct a survey of Texas medical schools’ undergraduate medical education, with a focus on the availability of required clerkships and selective and elective rotations, and the capacity of existing clinical education sites. This report presents information and data to document the current availability of required clerkships and selective and elective clinical rotations. Staff compiled and analyzed data submitted from the state’s nine medical schools to better understand whether clinical availability was adequate to accommodate the recent and anticipated medical school enrollment increases. The staff analysis also explored whether there is enough clinical capacity at the existing sites to accommodate additional medical students, including those who may be from an international medical school. Methodology Information and data detailing the requirements and locations of the third and fourth years of medical education have not been previously collected by the Coordinating Board and are not available elsewhere. Most medical schools provide general descriptive information about their curriculum on their websites; however, the information is not presented uniformly, and the specific requirements for clinical experiences are often not presented and clinical sites are not listed. Consistent information and data across medical schools related to undergraduate medical education clinical experiences and sites were essential to this report. To facilitate the preparation of the report and ensure consistency in responses, the Coordinating Board staff convened a workgroup, which included representatives from the Texas health-related institutions that offer degrees in medicine or osteopathic medicine, system office officials,
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