Preclerkship

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ACGME Competencies

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Competency-Based Curriculum Resource for Preclerkship Education (using ACGME Structure):

Budget

Lead Author: Eric Bass, MD

**Workgroup Members**
Christine Matson, MD, Chair	Eastern Virginia Medical School
Scott A. Fields, MD	Oregon Health and Science University
Jeffrey Stearns, MD, Executive Committee Liaison	University of Wisconsin Milwaukee Clinical Campus
Eric Bass, MD	Johns Hopkins University
Thomas Defer, MD	Washington University
Allan Goroll, MD	Harvard University
Larrie Greenberg, MD	George Washington University
Mary Ann Kuzma, MD	Drexel University
Steve Miller, MD	Columbia University
William Raszka, MD	University of Vermont
Rick E. Ricer, MD	University of Cincinnati
John C. Rogers, MD, MPH	Baylor Medical College
William Wilson, MD	University of Virginia

It is unrealistic to undertake a mission of teaching these competencies without the appropriate resources to deliver the content in an effective manner. This includes not only the faculty who actually teach the curriculum, but also those who administer the curriculum. Additionally success will be dependent on a commitment of time and resources to faculty development and assessment of the learners.

Developing an extensive fund of medical knowledge has been the traditional challenge for medical students in their first two years of medical school. Yet these competencies require attention be paid to interpersonal skills and systems issues. Much of this content is most effectively taught in small-group environments, requiring an increased investment of faculty time. Experiential learning in these areas requires moving students from the classroom to clinical sites, including the clinical skills laboratory with simulated patients, and a range of clinical care sites, including in the community. Even when community faculty serve as volunteers, which is not always the case, community-based education requires an appropriate budget to implement and sustain the program.

In addition to recommending the traditional support for basic science and clinical faculty who teach in the classroom, small-group environment, and laboratory, we make the following recommendations for support of the training of medical students before they enter the clinical clerkships:

Salary support is needed for faculty leadership and administrative coordination of programs for training medical students in the fundamental competencies presented in this document.
To determine appropriate levels of salary support for faculty leaders and administrative coordinators, schools should measure the time that faculty spend developing, administering, and running these programs for medical students.
Schools should explore methods for teaching and administering programs more efficiently, taking into consideration the increasing time pressures placed on faculty.
Schools should provide support for national collaborations (e.g., conferences or visiting professorships) for faculty leaders and coordinators, as this may help to foster more efficient and effective use of faculty time by helping faculty to learn from experiences at other institutions and avoid reinventing programs;
Schools should invest in faculty development programs, including workshops, faculty retreats, and mentorship programs, that focus on the training of medical students in fundamental competencies;
In some areas, schools may need to provide funding for stipends to community faculty involved in teaching medical students.
Schools should commit funds for running a standardized patient program, objective structured clinical evaluation program (OSCEs), and/or standardized and structured bedside evaluation of communication skills.
Schools will need to invest resources in developing Web-based programs and other electronic communication technology that may enhance training in the fundamental competencies, such as accessing and assessing published evidence or practice guidelines on relevant clinical questions.
Promotion and tenure committees should affirm that they value success in teaching medical students about fundamental competencies, including practice-based learning and improvement.

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This page last updated November 6, 2004