The undergraduate medical educational program at the UT Health Science Center at San Antonio is on probation and must address curriculum issues to remain accredited.

After a regular eight-year review and visit to the School of Medicine in January, the Liaison Committee on Medical Education put the program on probation, according to a letter from the school’s dean to faculty.

The letter from Dean Francisco González-Scarano said the accreditation agency found deficiencies with the undergraduate medical educational program and broke the issues into three major problems. These include complaints that the school relies too much on lectures and lacks “modern active learning that promotes self-learning and problem solving,” an absence of centralized management of the curriculum and lack of alignment between the basic sciences and the clinical sciences.

Third-year medical student at the UT Health Science Center, Ariel Vinas, said the probation surprised him.

“I’ve always felt confident in the quality of the education I was receiving,” Vinas said.

Vinas said most of the classes his first two years were lecture-based, but some involved small group discussions. He said these discussions are supervised by faculty and pose medical problems for students to solve while learning cost-effective medical practices.

“Two students would spearhead the discussions while the rest of the group would propose a differential diagnosis based on the history, physical exam, lab and imaging findings obtained,” Vinas said.

Four schools are currently on probation out of about 135 schools the agency reviews, said LCME secretary Barbara Barzansky. She said for the school to keep its accreditation status, it must provide an action plan in less than a year, and within two years, the agency will visit the UT Health Science Center in San Antonio to review its implementation.

Barzansky said probation status usually does not affect students graduating and getting a residency or the number of applicants to the school.

Barzansky said accreditation standards require schools to give students opportunities to set their own learning objectives and get feedback about how well they did meeting their objectives. This includes activities such as small group discussions.

“When someone is in a lecture, someone else is telling you what you need to learn,” Barzansky said. “So somewhere in the curriculum, there needs to be places for the students to identify their own learning needs and seek information to meet those needs.”

She said to meet the standards, basic curriculum for a school of medicine program should involve the integration of patient issues that students will encounter later in their careers.

“You can’t separate the science from the application of the science,” Barzansky said.

Barzansky said curriculum issues should be regularly confronted and improved by a committee.

González-Scarano said there is a curriculum committee in place, but LCME showed concern that it did not meet frequently enough to review curriculum. He said changes include increasing how frequently the committee meets to review curriculum changes.

“It demands that you look at [the curriculum] in almost real time,” González-Scarano said.

González-Scarano said when he began as dean in August 2010, he knew there were problems, and he said those problems were noted in the review.

“The curriculum for the medical students was already in the planning stages before I got here, and I have accelerated that process,” González-Scarano said.

He said he does not want to hurry into new curriculum, but changes will be made to meet accreditation standards in a timely manner.

“At the end of the day, the school will be better, stronger and something we can be proud of,” González-Scarano said.

Printed on Monday, October 24, 2011 as: Committee puts University medical school on probation