The Liaison Committee on Medical Education is currently meeting through October 15th. On their agenda is what to do about the report of the ad hoc survey team that visited the medical school last May to follow up on the deficiencies of the full review in 2013 that lead to the school being placed on probation. Through an open-records request, I obtained a copy of the survey team’s report. To me, It looks quite favorable. Obviously, being placed on probation lit a fire under the powers that be. Although the report makes it clear that the LCME “may come to different conclusions when it reviews the team’s report and any related information,” I will be frankly surprised if probation is not lifted. As a result of the full site visit in April 2013, a total of 19 standards were found to be deficient in some way. Nine standards were unequivocally noncompliant, and an additional 10 were judged to require monitoring. A few of the deficiencies were embarrassingly bad by any standard. The current follow-up survey team did not declare any standard to be in a state of noncompliance, but did recommend that four required further monitoring.
Remaining concerns of the review panel.
The four standards not fully in compliance and requiring monitoring were in the area of diversity of minority and gender for faculty and students; provision for active and independent study for students, comparability of instruction and evaluation across instructional sites, and inclusion of behavioral and socioeconomic subjects in the curriculum. To me these things should be quite fixable. I have no notion whatsoever on what the impact of the remaining four standards for which further monitoring is recommended will be on the decision of the full LCME accreditation panel. I asked for the site-visit report because I was hearing credibly from a handful of faculty and others that there was an expectation that our probationary status was not going to be lifted. Perhaps that was just due to old-fashioned nervousness because of the high stakes on the outcome.
The hard knocks taken earlier because of inadequacy of facilities to fulfill the mission of the school, including inadequate instructional facilities and the lack of a complete panel of required affiliation agreements with partner clinical instructional institutions, were now judged to be fully in compliance. Favorable student evaluations lent great support to the changes that have been made in this relatively short time. I congratulate the Medical School Faculty and their Dean, Dr. Toni Ganzel, for their achievement as judged by the report. I am fully aware of the effort that went into this improvement.
Nothing at the Medical Center occurs in a vacuum and several things occurred to me as I read through the site-visit report. One of the stated reasons that the non-compliance rating for adequacy of teaching facilities was recommended to be lifted was the promise that a new instructional building was going to have the highest priority of the University in the coming legislative budgetary session. Having heard President Ramsey’s comments last month, I will believe that when I see it. Even if it remains the University’s highest priority for state funding, it remains to be seen if the legislature will have any money to give. The LCME report mentions that yet another research building is planned and in my opinion it was the shift of priority from teaching to research that bought us to probationary status in the first place.
The only affiliation agreement that was deemed to be insufficient was the one between UofL and KentuckyOne Health. That has apparently been fixed. There was no mention of any problem with the affiliation agreement between Norton Healthcare and the University. UofL has been making a big deal in its lawsuits about a lack of a current affiliation agreement with Norton. Are we to now assume that UofL admits that their longstanding affiliation agreement is valid? [The two parties are in mandated arbitration as we speak in an attempt to resolve their dispute over Children’s Hospital. I am anticipating some news in the lawsuit departments soon as well.]
Here is for a crossing of fingers and a rising of the clouds.
Peter Hasselbacher, MD
Emeritus Professor of Medicine, UofL
October 14, 2015