AACBNC
THE AAMC COUNCIL OF ACADEMIC
SOCIETIES MEETING
TAMPA, FLORIDA -  MARCH 13-16, 2003



The Scientific Basis of Medicine: Preserving
Curiosity and Rigor
Meeting Summary

Pre-Meeting Activities

Administrative Board:  The CAS Administrative Board held a luncheon meeting.  The
panel heard various staff reports and reviewed a draft policy statement on NIH stipend
levels proposed by the AAMC Group on Graduate Research, Education, and Training.  

Chairs Task Force:  The CAS Chairs Task Force met to discuss future activities of the
panel.  It was proposed to change the name of the Task Force to the CAS Taskforce on
the Development of Institutional Leadership.  Among other activities, the Task Force
discussed developing a core curriculum for use by chair societies in organizing their
own leadership development programs, by individual chairs or center directors for
their personal development, and for developing talented members of the faculty; and
developing a series of cases in leadership and management, which could be used as
part of programs organized by CAS members and medical school departments.

Program Committee: The CAS Program Committee meet to discuss CAS-sponsored
programming at the AAMC Annual Meeting, November 7-12, 2003, in Washington, DC.  
The CAS will sponsor two plenary sessions on Sunday morning, November 9, hold a
Business Meeting during lunchtime on Monday, November 10, and sponsor another
plenary session that Monday afternoon.

CAS Orientation: Mr. Tony Mazzaschi, AAMC Director of CAS Affairs, gave an orientation
to the AAMC and the Council of Academic Societies for new CAS representatives.  The
session discussed the history of the CAS, its role in AAMC governance, recent CAS
initiatives, and some of the challenges and opportunities offered by the CAS.


Plenary I: Creating a Culture of Curiosity

Faith T. Fitzgerald, M.D.
Assistant Dean, Student Affairs, University of California, Davis, School of Medicine,
made the keynote presentation on how medical schools and faculty consciously and
unconsciously influence whether practicing physicians remain interested in exploring
the scientific basis of medicine throughout their careers.
Dr. Fitzgerald said our goal should be preserving the vitality of science noting that we
want to produce efficient and competent caretakers, but that we give students many
differing tasks that do not contribute to this goal.  Medical students are
technologically advanced; and as a result, the young must teach the old.  Dr. Fitzgerald
stated that today’s students seem more interested in looking forward than into the
past.  She noted that children are naturally curious; but that this natural curiosity is not
being maximized.  Curiosity is as necessary to the clinician at the bedside as it is to the
researcher at the bench.  Among the most powerful of human endeavors is the effort
to control the environment; to observe it; and to draw conclusions from such
observations.  Dr. Fitzgerald questioned:  As teachers do we nurture curiosity?

Dr. Fitzgerald discussed the four parallel and distinct curricula that take place during
the pre-clinical and clinical years:

·         The formal medical school curriculum. She noted that standardized tests are
used which make variations between students (such as a curious individual)
imperceptible since such skills are not or cannot be measured.

·         The hidden curriculum – a collection of myths, attitudes and influential
communications.  The hidden curriculum is destructive to curiosity for it promotes a
sense of “look like me,” “act like me,” and “think like me.”

·         The accidental curriculum – this is the most influential type of curriculum -
chance encounters students have with teachers and patients that determine their
future decisions.  Dr. Fitzgerald urged that we allow more opportunities for this to
occur.

·         The indirect curriculum – overall knowledge from before medical school and
after, which includes politics, social, cultural mores.

Dr. Fitzgerald concluded by stating that there are two pre-requisites to being curious:  
competency and time.  She discussed the challenges of ensuring competency and
providing the time necessary for curiosity to bloom.

Response Panel: Three individuals responded to Dr. Fitzgerald’s address.

Michael Rosenthal, an M.D., Ph.D. student from the University of North Carolina -
Chapel Hill and Past Chair, Organization of Student Representatives, discussed the
role of the admissions processes in finding curious students. He feels that medical
school admissions officers look mostly at MCAT scores and GPA averages and that
curiosity is overlooked. He echoed Dr. Fitzgerald’s lament that time constraints are by
far the most pressing factor restraining curiosity in medical school

H. Jonathan Polan, M.D., Dept. of Psychiatry, New York Presbyterian Hospital, said that
medical school has three components: curiosity, compassion and expertise. He said
that in the clinical years expertise largely crowds out compassion due to lack of time.
Dr. Polan asked attendees to consider, “What does the culture of curiosity we want to
establish look like?” He also asked attendees to consider, “How can curiosity be
rewarded?”

Lisa Staiano-Coico, Ph.D., Senior Associate Dean for Research, Weill Medical College
of Cornell University, felt that we have many curious students. The key to student
curiosity is encouraging them early in the education process, preferably in the K-12
years. She felt that we couldn’t afford to wait until medical school. Dr. Staiano-Coico
said we must work to change faculty attitudes so students are not seen as
commodities but as “precious gems.” Dr. Staiano-Coico said the biggest challenges
are: an exhausted faculty, the need to provide an infrastructure for students and
scientists to be curious; and to maintain in the pipeline talented and enthusiastic
faculty teachers and mentors.


Friday Morning- Breakout Sessions

Two breakfast breakout sessions were held on Friday morning, March 14. One focused
on the Clinical Competency Examination and featured a presentation by
Richard E.
Hawkins, M.D.
, Deputy Vice President, Assessment Programs, National Board of
Medical Examiners. The second was Current Issues in NIH Peer Review and featured a
presentation by
Brent B. Stanfield, Ph.D., Deputy Director, Center for Scientific Review,
National Institutes of Health  followed by a lengthy question and answer period.  I
attended this latter session.

The Center for Scientific Review was formerly the Division of Research Grants.  It is
still directed by Dr. Ellie Ehrenfeld (she is not moving to another part of NIH as
erroneously reported at the Panama meeting).  More than 55,000 applications are
received by CSR each year, which refers them to Institutes, IRGs and Study Sections.  
~75% get reviewed at CSR, mostly RO-1s.  

Reorganization of Study Sections began in 1998, compelled by big organizational
changes at NIH.  The research components of ADAMHA were moved to NIH by
Congress, mostly Neuroscience research, requiring the creation of 28 new Study
Sections for Neurosciences, 18 for Behavioral Sciences, and, of course more for AIDS.  
There are now over 150 Study Sections, grown from 20 over a period of 50 years.  
There never had been a comprehensive review of this setup.

A committee chaired by Bruce Alberts examined this set up in 1998 and came up with
24 clusters (IRGs)  Draft report was sent to scientific societies and posted on Web.  
Phase 2 was to design and establish Study Sections for each IRG.   The new IRGs from
ADAMHA were exempt.  Cross cutting themes must be considered, e.g., aging,
development, vs specific diseases or organ systems.  Professional societies submit
names for boundary teams for Study Sections.  

IRG starts – Hematology, Musculoskeletal, Oral & Skin, Oncology, etc.  15 of 16
boundary teams have met.  Organization will be completed by 2005.  

“New Investigator” review at CSR.  R-29s no longer exist, there is now a check box on
398 forms.  New investigator means someone who “never had PI support from NIH
before”.  Type 2 applications, i.e., competitive renewals, do getter than new RO-1s,
even from seasoned investigators.  

Technological changes:  Internet Assisted Peer Review – secure Web site with posted
reviews.  The curtain is lifted a few days before meetings so Study Section members
can see other reviews.  This reduces the rhetorical advantage in the meetings.  
Applications are distributed on CD-ROMS, no big paper packets.  Discs are menu
driven, searchable, and indexed (pdf files)

NIH Commons:  Commons Home Page, open to institutional registrants.  Currency of
applications, new PI database, update Personal Information Page, can maintain
bibliography in PIP.  Institution MUST register.   

Visit the CSR Homepage
www.csr.nih.gov


Plenary II: The Scientific Approach to Dealing With Uncertainty and
Ambiguity

Moderator: Barbara Schuster, M.D., Chair-Elect, CAS; Department of Medicine, Wright
State University of Medicine

Making Anesthesia Safer:  Unraveling the Malignant Hyperthermia
Puzzle:  
A Case Study Marilyn Green Larach, M.D., F.A.A.P., Associate Professor of
Anesthesiology, Pennsylvania State University College of Medicine, and Senior
Research Associate, The North American Malignant Hyperthermia Registry  See
Handout with Slides!

Malignant hyperthermia is a syndrome that can afflict susceptible humans and animals
that receive general anesthesia. Certain commonly used anesthetics may trigger
deadly high fever and muscle rigidity, as well as blood chemistry.   Dr. Larach
demonstrated how serendipitous results in often seeming unrelated disciplines can
together lead to an improved understanding of the causes and treatment of this often
deadly syndrome.

Evidence Based Medicine (EBM): Lifelong Learning for Curious
Clinicians

W. Scott Richardson, M.D., Associate Professor, Chief, General Internal Medicine,
Wright State University School of Medicine  See Handout with Slides!

EBM = conscientious, explicit, and judicious use of the current best evidence in the
care of clinical patients and as a basis for clinical decisions.  A lot of clinical research
is being published.  Only a tiny fraction is valid, important, and applicable to patient
care, i.e., it is needed frequently, “usual” sources don’t work.  Research to practice
gap can be up to 20 years.  

While clinical judgment  and skills improve with time, knowledge of current best core
decreases with time.  If knowledge could make a difference, we
ought to learn how to
use it.  “I don’t know” is different from “nobody knows”.  EBM is a way  to practice, it is
not research.  Limits of EBM:  incomplete or inconclusive data, contradictory
interpretations, does the knowledge apply to individual cases?, hard to learn new
skills, limited resources, still in infancy.

Using Uncertainty and Ambiguity to Teach Basic Science:  
A Case Study

Aviad Haramati, Ph.D., Professor, Department of Physiology and Biophysics,
Georgetown University School of Medicine

He asked his students and colleagues for their reactions to the topic.. faculty:  How do
we get students to behave like professionals, to understand the incredibly privileged
state of what they  are asked to do, to be inspired to understand the science
underlying what they are supposed to learn.  Student’s opinions, the Faculty is the
problem.  However, part of the problem is the curriculum.  Need to teach in context, go
beyond memorization, increase relevance.  

Faculty:  Lack of lab exercises has eliminated an important opportunity for faculty-
student interaction at the level of questioning and learning.  Student now demand
clear-cut, unambiguous answers, they don’t care about science.  How do we get
students to understand that science is a process, not merely a collection of facts?  

What can the faculty do?  Understand our role.  What are we here to do?  To inspire, to
teach by example, to model thinking.  Be open-minded, encourage questioning, be
flexible, encourage students to explore.   In current curriculum:  Prioritize information
– less is more – principles vs facts.  Enhance relevance.  Make connections across  
disciplines and courses (GK comment:  in that attempt, one is often fighting the Assoc.
Dean for Curriculum), students pigeonhole.

Are there topics and methodologies that could address this goal?  He used CAM
(complementary and alternative medicine) program to do this.  In Gross Anatomy he
introduced acupuncture and massage.  In Physiology, biofeedback, neuromuscular
manipulation, In Human Endocrinology, stress reduction imagery (used biodots),
meditation, breathing.  In Neuroscience, acupuncture, etc., etc.  

Specific Aim 1:  Increase student awareness of self, awareness of self-care.  Mind-
body approaches to self-awareness.  With trained faculty, tried the above techniques.

Luncheon Address - Salvation from a New Physiology: What, Who,
How

Daniel D. Federman, M.D., Senior Dean for Alumni Affairs and Clinical Education,
Harvard Medical School

1.                  To make students curious and rigorous, we must first make the faculty
curious and rigorous.

2.                  We must align the worlds of the faculty and students

(The following summary of Dr. Federman’s talk was prepared by Tony Mazzaschi from
the tape thereof)

He presented an analysis of the relationships between basic science faculty and the
first and second year medical student. The two are by nature on orthogonal courses,
which makes it difficult for them to understand each other in the courses in question.
The student is pursuing an unorganized, horizontal, superficial traverse of a vast body
of unconnected material, en route to a clinical destination not yet chosen or
characterized. The faculty member is pursuing a vertical excavation of a necessarily
narrow shaft in the pursuit of a bit of new knowledge that will withstand peer review.
The two meet in a moment that exposes their differences rather than their
commonalities.

Dr. Federman said we need a new physiology or systems biology comprising a
translational education just as the new science requires translational research. He
suggested that basic science faculty are already interrelating across disciplines for
their research interests, and that we should take advantage of those connections to
generate a new physiology to underlie medicine. He pointed to applications of this
approach to curriculum planning, faculty development, the training of physician
scientists (including the special opportunities of MD/PhD programs), and the long-
range preparation of consumer scientists - doctors in practice.

(The following material on the Optional Workshop and Basic Science Chairs
Leadership Forum was also provided by Tony  Mazzaschi)

Optional Workshop: Resident Duty Hours – Strategies to Achieve
Cultural, Organizational and Operational Change   

Sunny G. Yoder Senior Staff Associate, Division of Health Care Affairs, Executive
Secretary, Group on Resident Affairs, AAMC, and
Peter J. Fabri, M.D., Professor of
Surgery, Associate Dean for Clinical Affairs, University of South Florida College of
Medicine, led a workshop on the duty hours requirements approved for all specialties
by ACGME on February 11, 2003. The session provided insights on these requirements
in today's GME environment from the perspective of an institutional GME leader, and
provided a forum for sharing strategies to comply with the limits and other ACGME
requirements.

Basic Science Chairs Leadership Forum

On Friday afternoon, March 13, the Basic Science Chairs Leadership Forum held a
meeting.  The members reviewed the October 2002 meeting of basic science chairs in
Philadelphia.  Plans were made for a second national meeting in October 2005.  The
Forum discussed efforts to integrate basic science into the clinical years of physician
training.  A survey will be distributed to basic and clinical chairs, as well as to vice-
deans for medical education, seeking information on integration efforts.

Optional Workshop: Resident Duty Hours – Strategies to Achieve
Cultural, Organizational and Operational Change   

Sunny G. Yoder, Senior Staff Associate, Division of Health Care Affairs, Executive
Secretary, Group on Resident Affairs, AAMC, and
Peter J. Fabri, M.D., Professor of
Surgery, Associate Dean for Clinical Affairs, University of South Florida College of
Medicine, led a workshop on the duty hours requirements approved for all specialties
by ACGME on February 11, 2003. The session provided insights on these requirements
in today's GME environment from the perspective of an institutional GME leader, and
provided a forum for sharing strategies to comply with the limits and other ACGME
requirements.

Basic Science Chairs Leadership Forum
On Friday afternoon, March 13, the Basic Science Chairs Leadership Forum held a
meeting.  The members reviewed the October 2002 meeting of basic science chairs in
Philadelphia.  Plans were made for a second national meeting in October 2005.  The
Forum discussed efforts to integrate basic science into the clinical years of physician
training.  A survey will be distributed to basic and clinical chairs, as well as to vice-
deans for medical education, seeking information on integration efforts.

Breakout Sessions

Two breakfast breakout sessions were held on Saturday morning, March 14. One
focused on the Trends in Student and Resident Debt and featured a presentation by
Paula Craw, Director, MEDLOANS. A second session focused on Diversity Issues and
featured a presentation by
Jordan J. Cohen, M.D., President, AAMC. I attended Dr.
Cohen’s session.

Please see handouts from Dr. Cohen included with meeting binder.  Much of Dr. Cohen’
s session was devoted to presentation and discussion of the suggested new
operating definition of underrepresented minority.  Rather than specifying particular
racial or ethnic groups it speaks only in very general terms of disparity in
representation between fraction in the population and fraction in medical education.  It
is also very vague on the question of definition of the geographic area containing a
particular population sample leading to the possibility that significant minorities in
individual cities could claim under representation in a medical school located in that
city.  Many in the audience saw the new definition as a virtual invitation to litigation.  

Plenary III: Teaching to Promote Scientific Rigor and to Encourage
Curiosity

The Psychology of Learning: How do we learn, remember and use knowledge?  
Geoffrey Norman, Ph.D., Professor, Clinical Epidemiology and Biostatistics, McMaster
University School of Medicine  (See handout of slides in Meeting binder).   An
introduction to the subject of cognitive psychology and how we learn.

It is important to impose meaning on new information, to provide a context for any new
information.  Teachers must let students make connections themselves but can
provide examples of how connections can be made.  The use of concepts in new or
different situation from those in which they were learned in not automatic or
effortless, the process is enhanced by active learning and using multiple examples to
reinforce the principles.  Learning for memory alone impedes the transfer of principles
and concepts to new situations or problems.

What We Know About the Way We Teach  
Georges Bordage, M.D., Ph.D., Professor and
Director of Graduate Studies, University of Illinois College of Medicine

Dr. Bordage presented two case studies.  Send an e-mail request for his slides (Power
Point), to the address in the Meeting book.  He introduced the idea of two conceptual
frameworks for organizing analytical knowledge, the prototype theory, i.e., prototype
formation from examples, and the structural semantic theory, i.e., adding semantic
qualifiers to descriptions of clinical information  to enhance their meaning and relation
to other examples of clinical information from identical or related disease patterns or
symptomology.  Semantic qualifiers aid in organizing knowledge, allow better
communication among physicians, and, thereby, enhance diagnostic competence.  He,
too, emphasized that “less is more”, smaller chunks of knowledge are easier to
organize into prototypes, it is necessary to revisit and reinforce prior knowledge, and,
in medicine as in any other education, a spiral curriculum is the most effective
because it always builds on prior knowledge and skills.

Humanism vs. Science: A False Dichotomy  
Joseph Scherger, M.D., Professor, Florida
State University College of Medicine  

Medicine is a science applied to people.   The art of medicine is now very scientific.  
Osler:  “It is just as important to know the person with the disease as it is to know the
disease.”  Application of humanistic skills is essential to success in medicine.  

Relationship science:  Communication  (Moira Stewart, et al., W. Ontario)
                    Relationship Centered Care  (Epstein, U of R)
                    Illness and sick role behavior  (Kleinman, Harvard)

Disease and Illness – which truly exists?

Disease is the objective label.
Illness is the patient’s experience of not being well.
Ill people are real!!

Disease management does not equal healing, do not equate them.

75% of  noncompliance is a willful decision of the patient not to cooperate with the
treatment.

Science of healing:
           Knowledge of the patient
           Compassion and empathy
           Communication skills
           Relationship skills
           Cultural competence
           Treating the disease and the illness
Biases to do away with:
           Hard vs soft science
           Basic vs applied science
           Quantitative vs qualitiative
           Basic science vs social science – both in departments and curriculum
The training environment lacks attention to the needs of the patient, the faculty, and
the students.For humanism to flourish, it must translate into delivery of care.


CAS Business Meeting - See Business Meeting minutes.

Dinner Address   

Science, Medicine and Medical Education in a State of Hostility Daniel Shouval, M.D.,
Professor of Medicine and Dean, Faculty of Medicine, Hebrew University and
Hadassah Hospital

The address focused on the impact of terrorism on medical school curricula and on
the operations of the academic health center.

Special Session: New Medical School Models

J. Ocie Harris, M.D., Dean, Florida State University College of Medicine

Dr. Harris briefly reviewed the legislative history of the new college and then
discussed its organization and philosophy.  There are only 5 departments, 2 basic and
3 clinical.  Basic = Boiomedical Sciences and Medical Humanities and Social Sciences.  

Why start a new school – 14 of 67 counties in FL are medically underserved.  There is a
large and growing elderly population.  There are large underserved minority groups.  
There is limited capacity in the existing medical schools.  There are, therefore, limited
opportunities for FL students.  

Primary focus:  Recruit and train physicians to meet community needs.  Priorities:  
Primary Care, Geriatrics, Rural Health, Cultural Diversity, Underserved populations.

Need  outreach programs, post-baccalaureate programs, beef-up backgrounds of
selected students.  Their student population has proven that they are not good at
taking standardized tests.

Community-based clinical education – NO Hospital.  2 yrs at FSU, then to regional Med
School Campuses.  Faculty scholars = senior, experienced faculty to teach and mentor
younger faculty.  Comprehensive faculty development program.  Affiliate with existing
community medical facilities and practices.  Paying community faculty – they also
participate in faculty development programs.  6 regional centers for clinical education-
now Orlando, Tallahassee, Pensacola, later Ft. Myers, Jacksonville, Sarasota.

There will be a single curriculum developed with the clinical faculty.  Standard
evaluation processes, including OSCEs – student s must pass that at 2 years before
clinical clerkships..  

Information technology:  Wireless environment – all students have laptops with
wireless devices.  Video conferencing.  Clinical learning center – simulated clinic, ½
day/week, alternate weeks.

Cleveland Clinic Lerner College of Medicine of CWRU  
Lindsey C. Henson, M.D., Ph.D.,
Vice Dean for Medical Education and Academic Affairs, Case Western Research
University School of Medicine

This school will start July 2004.  Mission: to train clinical investigators.  Will matriculate
40 students.

Dr. Hensen presented lots of plans and dreams for the future that must be contrasted
with a long history of conflict between the two institutions and their respective
cultures.

International Virtual Medical School (IVIMEDS)  Michael S. Gordon, M.D., Ph.D. Director,
Center for Research and Medical Education, University of Miami School of Medicine   
See handout and summary in Meeting binder.  Summary below provided by Tony
Mazzaschi.

The effort is a “collaboration among leading edge medical schools and institutions
world-wide committed to achieving maximum benefit from new educational
technologies.” IVIMEDS aims to play a part in improving health and tackling human
disease worldwide by providing a blend of e-learning and high quality face-to-face
learning for medical professionals. IVIMEDS will include: A bank of shareable learning
resource materials in the form of reusable learning objects (RLOs); curriculum maps
that assist students and instructors to exchange information about what is being
taught and when it is taught; student study guides in the form of personal learning
plans that will help the student follow their optimal path through the curriculum;
appropriate face-to-face learning experiences blended with the e-learning
opportunities and provided in a partner school, in the community or elsewhere;
Student support provided through face-to-face and/or online faculty mentors, student
study guides and peer-to-peer collaborative learning experiences using software
developed for the purpose; and state of art assessment methods that serve both a
formative and summative role in the evaluation of students.

The Challenge to the LCME of Evolving Medical School Models
David Stevens, M.D., Secretary, Liaison Committee for Medical Education and Vice
President for Standards and Assessment, Association of American Medical Colleges

(GK had to leave session early to catch his plane.  Summary below from Tony
Mazzaschi)

The challenge to the LCME posed by new medical school models in 2003 is, in the
words of Dee Hock, to “preserve substance; modify form; [and] know the difference.”
In retrospect, there were 43 new medical schools established between 1960 and 1990.
Three models of substantial reform emerged that have since been embraced by other
medical schools: organ-based curricula (Western Reserve in the 1950s), problem-
based learning (McMaster in the 1960s) and the WWAMI model of distributed learning
(U. Washington in the 1970s). In view of the rapid changes in medicine and healthcare
in the last decade, it is worth examining additional lessons from the recent past. For
example, rapidly emerging new knowledge—such as that reflected by the new
genomics, information science, or complex health systems and patient safety—calls for
re-thinking the alignment of the traditional roles of the teacher and student. This is of
particular significance because increasingly the student may possess more knowledge
in a particular topic than the teacher. To explore new strategies to facilitate
accreditation in the emerging era of change, the LCME has spent the recent academic
year exploring accreditation and the hidden curriculum. It has identified leadership,
institutional mission and resource deployment as important gauges of the hidden
curriculum in medical schools. In a second ongoing initiative, the AAMC has
collaborated with the Institute for Healthcare Improvement and the ACGME to explore
models for redesign of clinical settings where medical students and residents learn.
The challenge to the LCME going forward will be to identify valid reform that emerges
in new medical school models and to nurture “substance” even when it does not
resemble familiar “form.”

Respectfully submitted,
Gordon I. Kaye, Ph.D.
Member Emeritus, AACBNC

(The summary of pre-meeting activities and Plenary 1 were extracted from a meeting
summary prepared by Tony Mazzaschi because Dr. Kaye could not arrive in Tampa until
late Thursday evening.)
Council of Academic Societies

Business Meeting Summary Minutes (Draft)
Tampa, Florida - Saturday, March 15, 2003
I. Call to Order
William H. Dantzler, M.D., Ph.D., called the Council of Academic Societies Business
Meeting to order at 12:25 p.m. on Saturday, March 15.

II. Chair’s Welcome
Dr. Dantzler presented the minutes from the November 11, 2002 CAS Business
Meeting.  A motion to approve the minutes was seconded and approved.

III. CAS Task Force on Dual Degree Students, Faculty, and Programs
Lynn Eckhert, M.D., Dr.P.H., reported that a small organizing committee would meet
shortly to begin organizing the efforts of the CAS Task Force on Dual Degree
Students, Faculty, and Programs.  The meeting planned for February was postponed
due to a snowstorm.

IV. Recognition of the Past CAS Chair:  Lynn Eckhert, M.D., Dr.P.H.

Dr. Dantzler recognized and thanked Dr. Eckhert for her dedicated service as CAS
Chair.  Dr. Eckhert was presented with an engraved plaque of appreciation.

V. President’s Report
Dr. Jordan Cohen, M.D., thanked the CAS Program Committee for developing an
excellent agenda for the CAS Spring Meeting.  Dr. Cohen also welcomed the evening’
s dinner speaker, Dr. Daniel Shouval from Hebrew University and Hadassah.

Dr. Cohen discussed the current status of the AMCAS program.  The AMCAS program
has been through a very difficult time but the application service is back on track.
Special tribute was paid the invaluable help of SMAC (the Senior Management
Advisory Committee).  Dr. Cohen said version 2.0 of the software is near completion
and should be launched for the 2005 cycle. Time is being allowed to insure adequate
testing and training.

Dr. Cohen reported that AAMC’s financial health has improved. The AMCAS troubles
and poor results in our investment accounts led to significant cost reductions,
including the reduction of 31 staff positions. AMCAS revenues have rebounded as the
medical school applicant pool has increased.  

Dr. Cohen reviewed the Association’s various chair initiatives, many of which
originated in the CAS.  He also discussed the creation of the AAMC Institute for
Improvement in Medical Education.  Over the next year, the board of the Institute will
coordinate a comprehensive review of the current state of medical education in the
country, in order to set a strategic direction for reform across the medical education
continuum. The Advisory Board is expected to release the results of this review by
February 2004. Their findings will serve as a blueprint for the Institute's future
projects and activities.

Regarding research issues, the HIPAA implementation deadline is April 14, 2003 and
Dr. Cohen stated that there exists great confusion and concern regarding how the
new regulations will adversely affect research.  Dr. Cohen thanked Dr. David Korn,
and his staff for their tireless work on this issue.  In addition, Dr. Cohen recognized
Dr. Korn’s leadership in producing two AAMC documents on conflicts of interest (both
available through the AAMC).

Dr. Cohen discussed the Resident Duty Hours issue stating that a major concern is
the financial impact of compliance.  The AAMC maintains a listserve to disseminate
information as well as sponsoring two conferences on the subject: one was held in
October 2002 and the other is scheduled for September 2003.  Dr. Cohen also noted
the CAS Spring Meeting workshop held just the day prior on Resident Duty Hours –
Strategies to Achieve Cultural, Organizational and Operational Change.

Dr. Cohen briefly discussed three legal matters.  The timetable of the Jung v. AAMC et
al litigation was discussed.  The case’s trial date is set for 2006. The litigation
challenges the National Residency Matching Program.  A litigation support fund has
been created and many CAS societies have generously contributed to the fund.

Dr. Cohen also addressed the litigation, Duke v. Madey, which challenges the
research exemption under patent law.  He concluded by discussing the Association’s
amicus curiae brief in the University of Michigan affirmative action case.

VI. Government Relations Report
Dr. Richard Knapp discussed the FY 2003 federal budget agreement.  In the final bill,
physicians received substantial relief compared to the decrease that was initially
expected. In addition, NIH funding did well again although AHRQ funding was a big
disappointment.  Dr. Knapp explained that despite OMB’s continuous desire to wipe
out Title VII funding each year, it received a 4.5 percent increase.  The National Health
Service Corp received a big boost, as did bio-terrorism programs.  

In addition, Dr. Knapp reported that the small amount allotted to public health was a
big surprise.  Geriatrics and nursing did well, though.  The VA still struggles due to
being overwhelmed by individuals that could use their Medicare benefits but are
instead opting for the VA’s drug coverage.

Dr. Knapp is not optimistic regarding malpractice reform.   While malpractice
legislation passed the U.S. House of Representatives, the same outcome does not
seem likely in the U.S. Senate who feels it is more of a state issue.  Dr. Knapp stated
that the AAMC is working closely and diligently with the AMA on this issue.

VII. AAMC-ORI Cooperative Agreement
Mr. Tony Mazzaschi provided information on the AAMC-ORI Cooperative Agreement
reporting that last Spring $250,000 was made available for awards to academic
societies for programs that promote the responsible conduct of research.  Four
societies have already been awarded funding and the deadline for applications for
the second round just passed on March 14, 2003.  Mr. Mazzaschi stated that a third
and fourth round with additional ORI funding are likely and asked all present to alert
their colleagues about the opportunity.

VIII. Basic Science Chairs Leadership Forum Update
Toni Scarpa, M.D., Ph.D., co-chair of the Forum, reported that at the Forum’s recent
meeting the participants discussed initiatives related to basic science’s role in
physician education.  Dr. Scarpa reported that the October 11 – 13, 2002 basic science
chairs conference in Philadelphia, Pennsylvania was very successful with more than
215 basic science chairs participating.  It has been decided to hold another
conference in October 2005.  The focus of the 2005 conference will be on basic
science and teaching at the medical school of the future.

IX. Membership Committee Report
Barbara Schuster, M.D. stated that there are currently 96 society members of CAS.  In
the past year five new societies have become members (American Academy of
Dermatology, American Headache Society, Association of Directors of Medical Student
Education in Psychiatry, International Association of Medical Science Educators, and
The Society of Neurological Surgeons. Dr. Schuster extended a welcome to
representatives from these new member societies.  

X. Program Committee Report
Dr. Dantzler thanked the Program Committee for the current Spring Meeting Program
stating that it has been extremely successful.  He then discussed the AAMC Annual
Meeting, which will be held this year in Washington, DC from November 7 – 12, 2003.  
The CAS will hold sessions on Sunday and Monday during that period.  Dr. Dantzler
also mentioned that the next CAS Spring Meeting will be held on March 11-14, 2004 in
Santa Monica, CA.

XI. Chairs Task Force Report
Lloyd Michener, M.D., announced that the Task Force is currently considering
changing its name to emphasize the Task Force’s focus on leadership development.  
The Task Force has been discussing various initiatives aimed at further developing
AAMC’s leadership development portfolio.

XII. New Business and Discussion
Dr. Dantzler recognized Donald E. Wilson, M.D. of the University of Maryland as the
Chair-Elect of the AAMC.  With no new business Dr. Dantzler adjourned the meeting at
2:00 p.m.