LCME reports its findings, school accredited with areas for improvement

July 11, 2012

lcmeAction plan underway to bring school into full compliance

The School of Medicine Undergraduate Medical Education (UME) program underwent a full-scale accreditation site visit and review by the Liaison Committee on Medical Education (LCME) in January this year. This was the school's first full-scale review since 2004.

Faculty and students were deeply involved in preparation for the review. They directly participated in the process by providing data, helping prepare reports and attending meetings. The entire process was transparent and inclusive, and comprehensively addressed all 129 LCME accreditation standards, driven by a commitment to continuous quality improvement.

"Thanks to the hard work and dedication of all involved, I'm proud to say the LCME process drove much positive change, while also demonstrating the undeniable quality of the OHSU undergraduate medical education program," said Dean Mark Richardson. "I'm pleased to report that our UME program continues to be accredited."

The LCME has adopted new accreditation terminology. "In compliance with a need for monitoring" has replaced the previous designation of "in transition." Regarding accreditation status, determinations include "Accredited"; "Accredited, with Warning"; "Accredited, on Probation"; and "Not Accredited."

The LCME confirmed the findings of the site visitors to OHSU President Joe Robertson. The current accreditation status includes a "warning."

The designation, the LCME concluded, was based on six (out of 129 reviewed) areas of noncompliance. These are 1) diversity among students, faculty, and staff; 2) observation by an attending physician of students obtaining a patient history and performing a physical exam; 3) fair and timely formative and summative assessment of medical students; 4) narrative description of medical student performance in each required course and clerkship rotation; 5) financial aid and debt management counseling; and 6) impact of direct educational expenses on medical student indebtedness.

These six are significantly less than the 14 areas of noncompliance or transition indicated in the school’s last full accreditation review in 2004, after which it was fully accredited. The majority of noncompliance areas the LCME cited in 2004 have been satisfactorily resolved. But because some of the noncompliance areas were concerns cited in 2004 – specifically diversity and medical student indebtedness – the LCME voted to place the school on “warning.” Although the school has made progress on diversity and medical student indebtedness, they were not fully resolved.

These are longstanding challenges that the School of Medicine has been actively trying to rectify for some time. In the self-study portion of the LCME review, the school recognized that "lowering the level of medical school indebtedness" and "increasing diversity within the school" continue to be areas for improvement.

Regarding student debt, OHSU ranks second to last among public medical schools nationwide for financial support it receives from the state. The school is deeply concerned about student debt and is in full-court press to find ways to alleviate it. Student scholarships are among the school's highest priorities, as well as identifying any and all funding sources.

Recently, the state approved OHSU's use of $13 million (OHSU login required) in previously restricted funding to help support scholarships for medical students. This was the direct result of School of Medicine recommendations identified during the LCME review process.

"While this warning designation is not the outcome we all worked so hard for, we have the opportunity to clear it quickly from our status and we will clear it," said Dean Richardson. "As we craft our action plan to address areas of concern—which will include bringing renewed urgency and vigor to plans already underway­—your energetic and committed involvement will be crucial to our success."

The school must submit its action plan by December 15, 2012 for consideration at the LCME's February 2013 meeting. Following its consideration of the action plan, the LCME will review the accreditation status of the UME program and set a date for a limited survey to assess the areas of noncompliance as well as additional areas LCME identified are in compliance but require monitoring. The school must demonstrate sufficient progress toward compliance within 12 months.

Please contact Jennifer Boyd, Director of LCME Accreditation, with any questions.