Still Gathering Information.
Last month, the University of Louisville School of Medicine was placed on probation by the Liaison Committee on Medical Education (LCME), its accrediting organization. This was an embarrassing piece of bad news for the University, but one which in my opinion flowed inevitably from an overemphasis on the commercial research, real-estate development, and entertainment sports enterprises of the larger University at the expense of its traditional educational and training missions.
One of the several principal factors leading to the adverse decision by the LCME was that the educational facilities of the Medical School are inadequate. This is hard to deny. One look at the Health Sciences Campus (or the Belknap Campus for that matter) shows where the University’s priorities actually lie. Renovations of the existing medical educational space are now underway. The recent Kentucky legislative session awarded state funding for a new instructional building on the Belknap campus which was the University’s highest priority. State funding for a new instructional building for the Health Science Campus was denied. State funding for a medical instructional building was not included in President Ramsey’s short list of UfoL’s general legislative priorities, even though the University already knew the LCME axe was falling. What was requested included a Belknap instruction building, more “Bucks-for-Brains” research funding, and restoration of funding for the QCCT indigent medical care program. Paradoxically, the University was permitted to allocate its own funds for a new private practice clinical building along with other construction and renovation projects. It submitted plans to build 4 additional research buildings over the subsequent 4 years. To me that says it all!
I am optimistic that the Medical School will succeed.
I do not believe the LCME will close the medical school. I believe the leadership of the School of Medicine is addressing the issues in an honest and forthright way. I remain concerned however, that Medical School will be not be given access to the financial resources necessary to do the job, nor sufficient influence over of the new clinical organization of University Medical Center to give our educational and training programs the priority they deserve. One would like to think that the Dean of the School of Medicine would have sufficient influence over the school’s faculty, but historically, at least the clinical faculty has enjoyed unique independence from the Dean’s office. Much of the Medical School’s current research activities operate in seperate institutes or spin-offs outside of a traditional medical school academic organization. From my perspective, all the major calls about clinical and research operations, and many about education and training are being made from the Office of the University President.
Without accreditation, there is no academic medical center.
Many of the clauses in the Affiliation and Operating Agreements between the Universiy and KentuckyOne Health hinge on UofL retaining accreditation of its Medical School and training programs. Clearly some of these are in jeopardy. (Some residency training programs have had their own accreditation warnings or withdrawal in recent years.) I have not been able to identify a single person who can confirm that any of the untold millions of financial and academic support promised to UofL by CHI and KentuckyOne Health have ever been transferred, nor have I seen any planned allocation of how that money was going to be used. Perhaps if there is even a single thread of golden lining in this kick-in-the-pants by the LCME, it is that the leadership of the University and Academic Medical Center have been put on notice that its current organization, style, and priorities have failed the University’s primary mission– to educate Kentucky’s citizens. No amount of public-relations spin, stonewalling, or golden parachutes are going to make this one go away. I and all of you should be watching to see just what is going to be done differently. The status quo has proven a failure.
Information is forthcoming.
I had to file a Freedom of Information Act request to obtain copies of the LCME survey report and attendant correspondence, along with any other materials the School of Medicine thought would enable me to report accurately and fairly on the matter of its probation. I received the four documents available below consisting of a portion of the site visit report ( but without the appendices that include student and faculty survey results), a letter indicating an intention to appeal an earlier notice of probation, the full appeal by the medical school, and a final letter to President Ramsey indicating that the decision to place the school on probation was upheld and final.
It’s not all bad.
I have not completed my own review of the materials and it is my intention to review in person the additional voluminous materials not yet provided. It is obvious that there are many good things going on at the Medical School that it can be proud of. It wants to, and undoubtedly can do even better. Its students think they are getting a reasonable education, but outside educational experts think they deserve more. In the meantime, the documents below are in the public domain. Readers can now begin to draw their own conclusions and become better prepared to both advocate for the Medical School and to monitor the changes that must come.
Peter Hasselbacher, MD
President, KHPI
Emeritus Professor of Medicine, UofL
April 26, 2014
LCME Documents
Report of Team on Site-visit of April 14-17, 2013. (32 MB PDF)
Letter of Intent to Appeal Decision, Nov 7, 2003. (1.1 MB PDF)
Formal Letter of Appeal, Jan 28, 2014. (3.4 MB PDF)
Notification of Probation, Mar 13, 2014. (1.7 MB PDF)