Say Goodbye to GREs

The Graduate Record Examination (GRE) is a standardized test that most graduate schools across the nation require to accompany student applications. It certainly was required here at UVA’s School of Medicine.

But not anymore.

As of this fall, the School of Medicine’s Biomedical Sciences (BIMS) graduate program has eliminated the GRE requirement as a component of the application.

Why the change?
The GRE has been used as an indicator of a student’s likelihood of success in graduate school. However, over the past few years, reports from Vanderbilt and the University of Carolina Chapel Hill have illustrated that the GRE is actually a poor predictor of success in biomedical sciences graduate programs. Additionally, there are other studies that show the GRE has strong biases against racial and ethnic minorities, females, and those from socioeconomically challenged groups.

Dropping the GRE is a growing trend. In fact, several institutions have already removed it as a requirement, including Massachusetts Institute of Technology; the University of Alabama at Birmingham; the University of California, San Francisco; the Rockefeller University; the University of Colorado, Denver (Anschutz), and the University of Michigan. Members of the Association of American Medical Colleges’ (AAMC) Group on Graduate Research, Education, and Training (GREAT) recently performed a survey and found many more schools are in discussions to follow suit, including those to whom we perennially lose strong BIMS applicants, such as University of Pennsylvania; Washington University in St. Louis; University of North Carolina, Chapel Hill; Emory University; University of Chicago; Vanderbilt University; and others. Of the 90 schools/programs that responded to the survey, 50 percent have either already discarded the requirement (10) or are in discussions about doing so in the near future (35).

It was only three years ago when the National Institutes of Health (NIH) expressed little faith in the exam, too. They ceased requiring the reporting of GRE scores for appointees to T32 training grants and for applicants for individual fellowship awards.

At UVA, we are not the only ones evaluating the GRE as an application requirement. There has been discussion across Grounds, among the Graduate Affairs Network (GAN), and with Executive Vice President and Provost Thomas Katsouleas and the graduate deans about eliminating this test.

In short: The GRE is an obstacle that provides little to no value for us or our students. As such, we are eliminating it.

How will we evaluate potential students?
Going forward, we will be taking a holistic approach to the application review process and look at students’ transcripts, grade point average, research experience, letters of recommendation, and personal statements. We will search for students who are passionate about research. We want them to be creative. We want them to have grit. We want them to have a deep appreciation for why they want to pursue graduate school in the biomedical sciences. We want to evaluate applicants on their abilities and their promise, not on a test score that has inherent biases. As always, we want the best and the brightest students.

It is my hope that strong applicants who were previously concerned about a low GRE score will now consider applying. I am very proud of our decision and look forward to seeing how this positively affects our BIMS graduate program.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

A Special Message from Dean Wilkes

The July 4 holiday begins the most popular time for summer vacations for many of us. I wish for each of you a well-deserved rest. Prior to vacation season, I’d like to share some good news about our School.

Even though we’ve not reached the June 30 end of the current fiscal year, it’s clear that you have knocked it out of park in all areas of our School’s mission.

In education

  • The incoming class of 156 medical students has a mean GPA of 3.86 and a mean MCAT of 518.27 (the 97th percentile!). This year the class is 57% out-of-state and continues to have good diversity. The BIMS PhD programs have recruited a strong new class of graduate students.
  • 99% of our class matched in outstanding post-graduate programs.
  • Richard Baylis, MD/PhD student in the lab of Gary Owens, attended the 68th Lindau Nobel Laureate Meeting in June, where he and other young investigators from around the world had the opportunity to mingle with and get feedback from 43 Nobel Laureates.
  • All of the accrediting bodies that were required to approve the establishment of the School of Medicine-Inova Campus did so without stipulation. Our admissions team is getting ready to start recruiting the class of 2023, which will be the first class to have the option to do their clerkships at the Inova Campus.

In the clinical realm

  • Over 25% of our physicians are included on the 2017-18 Best Doctors in America list. This is phenomenal!
  • Becker’s Hospital Review recognized our hospital as one of the 100 Great Hospitals in America in 2018.
  • Our hospital continues to be #1 in Virginia.

And in research

  • SOM funding is poised to exceed last year’s totals, thanks to the continued outstanding efforts of all of our faculty and new strategic hires.
  • We scored a 21 on our CTSA application! Although we’ll know more in August, a number of people outside of UVA have confirmed that this is an extraordinary score.
  • The Hartwell Foundation again named UVA as one of its Top Ten Centers of Biomedical Research.
  • The UVA IRBs received accreditation from the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP).
  • The U.S. News & World Report rankings were further evidence of the extraordinary work you do. Primary Care rose to 21 (from 24) and Research went to 26 (from 27).

Finally, the School is in a strong financial position with operating revenues exceeding expenditures. Year-to-date through May 2018, the School of Medicine had an operating net income of $8 million. The Dean’s Reserve funded $31 million in strategic investments in all mission areas in clinical and basic science departments, as well as in centers. In addition, with strong financial management at all levels, we are entering our fourth consecutive year of no tuition increase for medical students.

You, our faculty, are the reason we have had such a remarkable year and are in a strong position both academically and fiscally. I am deeply grateful to you for your commitment to our shared vision and for your hard work that has resulted in this banner year for our School.

With warm regards,

David S. Wilkes, MD
Dean, UVA School of Medicine
James Carroll Flippin Professor of Medical Science

Four Faculty Receive Development Certificate

(l-r) Angela C. Piñeros-Fernández, MD; Andrew S. Parsons, MD, MPH; Thomas R. Hartka, MD; Joesph R. Wiencek, PhD; Maryellen Gusic, MD

Last December, we shared information about an ongoing professional development opportunity offered to faculty, fellows, and residents, as well as students and staff who want to advance their skills as teachers and/or pursue scholarly work in education. On June 4, four more of our faculty completed the program and received the Certificate of Commitment to Faculty Development in Medical Education. They are:

  • Angela C. Piñeros-Fernández, MD, Assistant Professor of Plastic Surgery
  • Andrew S. Parsons, MD, MPH, Assistant Professor of Medicine
  • Thomas R. Hartka, MD, Assistant Professor of Emergency Medicine
  • Joesph R. Wiencek, PhD, Assistant Professor of Pathology

Faculty who attend 10 workshops over a two-year period will receive this certificate. It can be included as part of the teaching portfolio which, in turn, can be included in the application for membership to the Academy of Distinguished Educators and/or as part of the portfolio for promotion and tenure.

Since 2013, 60 faculty have earned the certificate. This commitment is outstanding. For more information on the program, click here. To see topics presented in the series, click here. A full schedule of additional opportunities to qualify for earning a certificate will be available later in the summer.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

 

Coming This Fall: Patient Student Partnership

The Patient Student Partnership will pair our students with a chronically ill adult or pediatric patient to follow for all four years of medical school.

With the success of the Phronesis Project (which we wrote about here), the School of Medicine has expanded this longitudinal patient experience and made it part of the curriculum for this year’s incoming class. This program, known as Patient Student Partnership (PSP), will pair each of the 160 students in SMD22 with a chronically ill adult or pediatric patient to follow for all four years of medical school.

Students will attend clinic visits, be present as the patient’s advocate, and help the patient navigate the Health System. This partnership will give students the opportunity to learn about healthcare through the eyes of a patient and to witness the trajectory of chronic illness.

This first patient relationship will give students context to their medical education and will provide them with a real-world touchpoint, something in which to ground their newly acquired knowledge.

A few things to note:

  • Clinicians: Please be aware that, starting in October 2018, first-year students will accompany patients to clinic visits in the role of patient advocate.
  • Pre-clerkship faculty who teach students: Students now will have real patients and thus real exposure to health problems to complement classroom learning.

This is a notable moment in the continuous improvement of our curriculum. Students will receive unique patient exposure during their first semester of medical school. This relationship promises to be an enriching and rewarding (and educational!) experience. It is my hope that the early formation of a special doctor-patient relationship will remind our students exactly why they chose to study medicine at the University of Virginia in the first place.

As students enter their fourth year of study, they will begin the process of handing off their patients to the newly arriving first years — and the cycle will begin anew for many of our patients.

Everything we do at the School is in service to our patients, and the feedback from previous years’ participants has been very enthusiastic. Patients loved the same thing I love, namely, watching our students grow and evolve into young physicians.  And the students have recognized that our patients are our best teachers — something most doctors always have known.

Thank you to all of the faculty who worked on the Phronesis Project. That pilot set the groundwork for this amazing next step. Also, thank you to all the primary care clinics and specialty practices across Grounds who aided in recruiting patients and provided this opportunity for our students. And most importantly, I thank our patients. Without their generosity this initiative would be impossible.

For more information on PSP, visit the website. If you have questions, contact Colleen Kiernan.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Video & Photos: School of Medicine 2018 Graduation

Over Final Exercises weekend, approximately 7,000 University of Virginia students earned degrees during UVA’s proudest tradition. Below are some images from the day.

Congratulations to the Class of 2018!

(Graduate photos courtesy Mary Hall.)

Regional Campus: New Informational Video and Accreditation Updates

Last year we announced that we were entering into an academic affiliation with Inova Health System Foundation to establish a UVA School of Medicine – Inova Campus in Northern Virginia. This regional campus will provide opportunities for 72 students (36 per class) to complete their 3rd and 4th years in Northern Virginia. Beginning in February 2021, our students will be exposed to the practice of medicine in a high-volume, urban environment.

I am pleased to announce that we have now been approved by all of our accreditors:

  • State Council of Higher Education for Virginia (SCHEV):The Commonwealth’s coordinating body for higher education. Its job is to “advocate for and promote the development and operation of an educationally and economically sound, vigorous, progressive, and coordinated system of higher education in the Commonwealth of Virginia and to lead state-level strategic planning and policy development and implementation based on research and analysis …. The Council shall also seek to facilitate collaboration among institutions of higher education that will enhance quality and create operational efficiencies ….”
  • Southern Association of Colleges and Schools Commission on Colleges (SACSCOC):This is the regional body for the accreditation of degree-granting higher education institutions in the Southern states. It serves as the common denominator of shared values and practices among the diverse institutions of the region.
  • Liaison Committee on Medical Education (LCME):This is a U.S. Department of Education-recognized accrediting body for programs leading to the MD degree in the United States.

Take a look at our new informational video for prospective applicants to see the outstanding offerings on this campus.

Highlights include the 12,000 square-foot Claude Moore Education and Research Center, a 12,000 square-foot medical simulation center, surgical simulation and advanced practice training space, newly renovated areas to provide inter-professional collaborative training and educational experiences, 24/7 access to a health sciences library supported by an outstanding team of librarians, and more. Campus details can be found on our admissions website.

This is an exciting time for the School of Medicine, our faculty and staff, and our students. I look forward to the opportunities this affiliation will present.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Highlights: April MAC Meeting

Opening Comments from the Dean
David S. Wilkes, MD

  • UVA School of Medicine Inova Campus: We have received formal approval from the State Council on Higher Education for Virginia to establish this campus. Thanks to Dr. Randy Canterbury for his work in shepherding the work required to earn this approval.
  • U.S. News & World Report Rankings: Congratulations and thank you to our faculty and staff whose sustained work has resulted in an improvement in our rankings. Primary Care moved from 24 to 21, a significant increase. Research also rose from 27 to 26. The credit goes to those who are “in the trenches” carrying out the hands-on work.
  • General Faculty Meeting and State of the School Address: This event will be Thursday, April 19, at 5 PM in the third-floor auditorium of the Medical Education Building. Faculty will vote on the graduating students. This will be the first time the faculty vote on the PhD and Masters candidates.
  • Climate Survey: The Deans Working Group, headed by Risa Goluboff, Dean of the Law School, has developed an extensive survey of 92 questions in the wake of the August 2017 events. This survey may be distributed within the next few weeks. Our clinical staff will be participating in the 2018 HS Engagement Survey that also is going out soon, and which is a priority for us.
  • Personal Safety and Office/Lab Security: Within recent weeks, we have had several break-ins and attempted break-ins, including one in which it appeared that the person was attempting to sabotage a PI’s research. Please adhere to basic safety and security guidelines. The safety and health of our faculty and staff are of primary concern.

Update on Health Information Technology Upgrade
Rick Skinner, Chief Information & Technology Officer
Regina Verde, Chief Corporate Compliance & Privacy Officer

  • As background, Ms. Verde reminded us that in November 2017, the FBI informed us that a form of spyware malware had attacked one provider’s personal devices, compromising Health System information as that individual connected via VPN. She described the steps taken to control and investigate the breach and to inform any individuals whose information was potentially at risk. The perpetrator has been arrested.
  • Mr. Skinner noted that approximately 8,000 personally owned devices are permitted to access HS IT systems. These devices must have protection before accessing the networks. An additional precaution is restricting the ability to download information in attachments, especially from web mail or Outlook email.
  • These network access controls will be retained as HSIT determines the next steps for users to manage email and attachments while maintaining security.

Budget Update
Kathy Peck, Chief Operating Officer

  • The FY19 budget was completed on April 3 and submitted for review. The Board of Visitors must give final approval. The next BOV meeting is in June.
  • Many people contributed to putting the budget together, and Ms. Peck stated her great appreciation for this effort.

Match Update
Susan Kirk, MDDesignated Institutional Official and Associate Dean for Graduate Medical Education

  • The most popular programs that the medical students matched were internal medicine (35); emergency medicine, obstetrics and gynecology, and pediatrics (each 15); and anesthesiology (13). The students are going to well-respected institutions, including Yale, Emory, Penn, Vanderbilt, UPMC, Johns Hopkins, Mass General, Wake Forest, and Chicago.
  • At the national level, 1,410 additional positions were offered in 2018, and 1,078 US seniors were not matched. Dr. Kirk notes that more DOs are competing for slots because of the single accreditation system and because osteopathic residencies are being eliminated.
  • At UVA, all 161 positions were filled through the main Match. Sixteen UVA medical students will complete all or part of their residency at UVA.
  • Our preliminary data indicates that we recruited fewer URM residents in 2018 (9.9%) than we did in 2017 (16.25%). The application opened two weeks after last August’s demonstrations and may have been impacted by those events.
  • Programs that participated in a separate recruitment activity (e.g., institutional Diversity Days or institutional Second Looks) were more successful in recruiting URM residents.
  • Dr. Kirk expects that tracking the percentage of URM physicians, both faculty and GME trainees), will become a common program requirement in July 2018.

The next meeting will be Tuesday, May 8, 2018, in the BIMS Classroom.

How’d Your Bracket do During MATCH MADNESS?

On Friday, March 16, 154 members of the UVA School of Medicine’s Class of 2018 opened envelopes and learned where they would be going for additional training as residents.

I am extraordinary proud of this year’s class. The below list shows how the residency spots filled out, by specialty:

  • Anesthesiology | 13
  • Dermatology | 2
  • Emergency Medicine | 15
  • Family Medicine | 10
  • General Surgery (including premlim) | 11
  • Internal Medicine | 35
  • Interventional Radiology | 1
  • Neurological Surgery | 1
  • Neurology | 5
  • Obstetrics and Gynecology (including prelim) | 15
  • Ophthalmology | 2
  • Orthopaedics | 4
  • Otolaryngology | 4
  • Pathology | 3
  • Pediatrics | 15
  • Physical Med/Rehab | 3
  • Plastic Surgery | 2
  • Psychiatry | 5
  • Radiology/Diagnostic | 6
  • Radiology Oncology | 2

This list represents great matches to top-rated institutions such as Duke, Mass. General, Yale, Stanford, Vanderbilt, UCSF, Cornell, and Johns Hopkins. Thank you to our dedicated faculty and staff for helping these students for the past four years. Your support and encouragement will stay with them throughout their careers.

For me, March is bittersweet. Students I have come to know and care for will be leaving soon; however, watching them grow as learners and physicians over the last few years has been incredibly rewarding. It’s also nice to know that 16 of our graduates chose to stay in Charlottesville, doing all or part of their residency program here at the University of Virginia.

Thank you to our colleagues at the Medical Alumni Association for hosting such a fantastic Match Day event. Congratulations to the 154 matched students — we wish you well in all future endeavors.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Med Students Partner with Architects to Benefit Patients

 

The Medical Design Program’s teaching team: (l-r) Program Manager Alex Gregor; Co-director Matt Trowbridge, MD, MPH; and Co-director David Chen, MBA

Last year, I shared with you the design-thinking program for first-year medical students created by Matthew Trowbridge, MD, MPH, Associate Professor of Emergency Medicine and Public Health Sciences; David Chen, MBA, Coulter Program Director, Department of Biomedical Engineering; Erik Hewlett, MD, recently retired from his role as Professor of Medicine, Infectious Diseases and International Health; and Program Manager Alex Gregor of the Department of Emergency Medicine. This academic year, the third edition of the course has been a resounding success.

Design-thinking is a creative problem-solving tool, a systematic way of looking at complex challenges, a mindset that teaches how to ask the right questions to tackle the real problem. This program is teaching first-year medical students how to use design thinking to be more effective clinicians and help innovate the next era of patient-centered clinical care.

A core tenet of design-thinking is serving the person for whom you’re designing. Design-thinking does this through a relentless emphasis on developing empathy for the intended user of a new product, service, or other type of innovation. The UVA Medical Design programs adapts these approaches for medical education giving the students structured instruction on interviewing and problem-solving to use as future physicians, whether it is part of their clinical care, while on research teams, or in a leadership role.

The Exercise: Empathizing with Visually Impaired People to Design Healthier Communities
For one of their recent workshops with students, Trowbridge, Chen, and Gregor wanted students to think about empathizing with patients who have different lived experiences than their own. But it had to be more than merely talking about it. How does one not only empathize deeply with a patient, but take action based on that empathy to serve the patient?

They created an exercise that instructed students to walk a path from the Battle Building to the UVA Eye Clinic, and asked them to navigate as if they lost their sight. They were to experience what it was like, the pros and cons of the built environment — the sidewalks, the roads, the signage, the sounds — anything that might help or hinder the progress of a person with visual impairment.

First-year medical students Sean Haughey and Sabrina Swoger partnered to do their fieldwork before the workshop. Describing what motivated him to learn about design thinking and participate in the course, Haughey said he thought, “‘I don’t want to be a doctor who’s resistant to innovation,’ and a great way to start is, in the first year of medical school, going out and joining a group that is looking to innovate as doctors.” Describing the empathy exercise for this workshop, Swoger added, “It is so important to actually experience it … because I have that very visceral sense of emotion tied to it, now I feel so much more motivated to actually solve it. I think that’s key, and I think that’s what we want to identify as doctors and as design thinkers.”

Sabrina Swoger, SMD21, and classmates navigated to UVA clinics while simulating blindness to empathize with visually impaired patients and think about how we might make our hospital — and city — more accessible for patients.

Swoger, Haughey, and the other students in the course captured their findings from this fieldwork, shared that data with designers at Charlottesville-based architecture firm VMDO, and worked with the firm at its downtown studio to brainstorm potential solutions to improve the actual streetscape. It was a wonderful opportunity to show how medical professionals and designers can collaborate to help create healthier and more inclusive communities.

The medical students’ proposals were varied and creative, and ultimately they were all empathetic and aimed to helping our patients in an area where medicine alone was not the answer.

One example that came out of this exercise was the recommendation to install dog-bone-shaped beacons around Grounds and train seeing-eye dogs to locate these beacons. The beacon would release a treat for the dog while providing critical navigational information to the visually impaired person. Additionally, the beacon would recognize who is interacting with it and, perhaps, include personalized information about wayfinding. Some of this may be “magical thinking,” but that kind of ideation is encouraged in the early stages of the iterative design-thinking process, so long as solutions are rooted in a deep understanding of the user’s needs. As a blind person, would it be helpful not just to be able to safely cross the street, but to be told that you are, indeed, on the correct path and that your physician has been notified you’re running a few minutes late and that they are waiting for your arrival? Sounds futuristic, but most certainly a future I’d like to see come to fruition.

An important element of design-thinking is for students not to constrain their initial brainstorming with the practical details of implementation — those are sorted out in later stages of the innovation process — but to think broadly about different ways to meet latent needs that are not being addressed by the status quo. One of the most powerful roles a physician has is to help patients articulate their needs and then work with professionals from diverse fields — such as other clinicians, technologists, designers, architects, engineers, scientists, and others — to create multi-talented project teams with the know-how to address patients’ needs holistically.

SMD21 students Dan Lewis, Aamir Javaid, Deson Haynie, and Oom Pattarabanjird collaborate with architects Rob Winstead and Lauren Shirley of VMDO to map the physical and emotional journey of navigating to UVA while visually impaired, and to design radical new ways to improve that experience.

Allowing Scientists to Dream
We know that the grand challenges of healthcare are changing fundamentally and that the big problems tend to be systems problems. No single discipline can hope to tackle them alone. Design thinking helps our medical students address these challenges. The VMDO workshop showed them how a physician can dream big and partner with other disciplines to create better built environments and healthcare systems for patients.

The goal here is not to turn medical students into architects, but to be world-class collaborators with other skilled professionals. And it’s working. Previous classes have reported back that they are using their design-thinking skills in summer projects with the UVA-Guatemala Initiative, in Ghana with support from the Center for Global Health, with the Medical Student Summer Research Program at UVA, and on other projects. Students have also noted that training in design thinking has increased creativity in their process for developing basic-science hypotheses. One student combined design thinking and a maker mentality in collaboration with an orthopedic faculty member to 3D print a new type of teaching model, based on imaging of patient’s joints, for orthopedists to learn a procedure that is not frequently performed.

Trowbridge, Chen, and Gregor are working on scaling up the class to provide access to more students. To that end, I am happy to share that the design-thinking program recently received a second funding award from the School of Medicine Curriculum Committee as part of its Education Fellowship program for a new initiative to develop online workshop modules that will extend access of design thinking learning opportunities, such as the one with VMDO, to a broader range of UVA students.

Congratulations to Matt, David, and Alex for their hard work on bringing this cutting-edge pedagogy to our school, and to our students, who are the real drivers of its success. Thanks as well to Rob Winstead and his team of world-class architects at VMDO for partnering with UVA to offer such a great learning opportunity to our students.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

iCan. Can You?

A few months ago, we discussed the development of VMED, an integrated learning-, curriculum-, and student-management system. The development team is still working on the first iteration of the product, which we hope to have available in the summer to test.

Related to VMED is the Interactive Clinical Assessment Navigator (iCan), a tool through which we can assess entrustable professional activities (EPA). EPAs cover basic skills a physician should have, such as taking a patient history, documenting an encounter, performing basic procedures, collaborating as part of an interprofessional team, and interpreting lab values. In terms of use, we have seen dramatic expansion of iCan’s use in the past few months. It was first implemented in part of the clerkship class, then moved to all of SMD19, and is now also being used by SMD20. By the fall, SMD21 and SMD22 will be using it as well. It’s exciting to see a product we developed being implemented so widely and quickly.

But this is about more than a new tool and who is using it. This is about using the lean methodology and continuous process improvement to make our systems better. Better for faculty and better for students. It’s about asking, “Is this the best way to assess our students’ clinical performance?” If it’s not, we stop the process and collaborate to find a solution. The key word here is “continuous.” There’s no finish line in our improvement journey.

iCan is a part of the larger VMED system and, thus far, has been well received. The team is continuing to meet with system leaders, clerkship directors and coordinators, faculty, and staff to discuss what to expect from iCan and to understand how it will help facilitate preparation for the next academic year.

I offer my thanks to Maryellen Gusic, MD, who has been a champion for EPAs and iCan, and is one of the reasons its expansion across the cohorts of students is going so well. For more information on VMED — a timeline, progress dashboard, and other documentation — visit the website here. If you have questions, please contact Kim Holman. Keep an eye on the Dean’s Office Blog in June for the next VMED update.

R.J. Canterbury, MD
Senior Associate Dean for Education
Wilford W. Spradlin Professor

Making Virginia Medicine Better: (l-r) Dr. Megan Bray, Dr. Mary Kate Worden, Kim Holman, Dr. Maryellen Gusic, Robert Pastor, Dr. Randolph Canterbury, and Mark Moody.