LCME UPDATE
Sarah Khayat
T
here has been significant concern over
the last several years’ kerfuffle regarding the University of Louisville School
of Medicine’s probationary status, as cited by
the Liaison Committee on Medical Education
or LCME (though some in the world of Louisville medicine may not have heard). LCME
accreditation is a “voluntary, peer-reviewed
process of quality assurance that determines
whether the program meets established standards,” per its mission
statement. The University of Louisville was granted full accreditation with probationary status during site review by LCME in 2013.
At the time, people who did not know what the implications of
the designation were (which constituted a majority), became very
concerned over what this could mean for our school’s reputation
and whether it would affect our students’ competitiveness nationally. It turned out that neither of those things was at stake and our
school was already in the process of implementing the proposed
changes made by LCME, namely a better infrastructure and a more
integrated curriculum for first and second year students. However,
making sense of the changes to the curriculum in practice is a
challenging feat, in no small part due to the fact that it is a moving
target. The amount of material covered therein is sufficient fodder
for a master’s thesis in graduate educational reform. Nevertheless,
there are some overarching principles common to different facets of
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the curriculum overhaul that can be understood by any layperson
in the medical community. Allow the following brief outline to
guide you through them.
One major development has been in regards to discipline based
courses, which refer to courses that focus primarily on one genre
of basic science such as histology, physiology, and anatomy. This
has given way to an organ based and interdisciplinary system that
tackles one organ system at a time and involves the input of basic
scientists AND clinicians. This has become the preferred instruction
model during preclinical years. This system, which has now more
or less been adopted by U of L, is integrated in every sense of the
word. Instead of learning the histology of various tissues in sequence
followed by their physiology, anatomy, etc., each organ system is
taught in the context of all major disciplines in a comprehensive
manner. When learning about the cardiac system, medical students
now learn about its anatomy, embryology, histology, and physiology,
all during the SAME block of time. This allows for enhanced and
deeper understanding of the science that will form a foundation
for clinical training during the junior and senior years. Students
first get exposure to this system from day one of medical school.
The freshman year begins with blocks of CADE, or Clinical Anatomy, Development, and Physical Examination. The year continues
with “Foundations from Genes to Organs” which is a course series
that integrates biochemistry, medical genetics, neuroscience, and
physiology. The coup de grace comes at the end with NBS (i.e.