RELATIONSHIP WITH BROWN UNIVERSITY

Autonomy (1.7/4)

Student Concerns: Students urged more recognition for the medical school by the University as an autonomous body with unique needs, and remarked that the medical school is not physically visible within the University campus.

Response: Questions about autonomy arise from several sources, of which the geographic separation of the various parts of the medical school and the organization of the Division of Biology and Medicine are the most important.

Many medical schools occupy a single campus; some others, like Brown, have the sites for clinical instruction separate from those for the basic sciences. There is little question that the arrangement in which we find ourselves promotes closer associations of faculty on the Brown campus with their colleagues from the college than with those in the hospitals. Efforts to bring the campus-based and hospital-based faculty together more have not been very effective because they cannot meet on a daily basis. While additional steps can and should be taken to bridge this gap, there is no prospect of moving the medical school completely off the Brown campus.

The Division of Biology and Medicine contains the medical school and the Program in Biology. This organization permits the creation of a single faculty, responsible for the medical school basic sciences and graduate and undergraduate education in the biological sciences. Many other universities have biology departments that are separate from the basic sciences in the medical school. Such arrangements are redundant and wasteful. The organization at Brown is much more efficient, and provides a stronger faculty in both the medical school and the college than either could have alone. The perception that the Division reduces the autonomy of the medical school is probably correct to some extent, but the offsetting advantage of the quality and quantity of the faculty that results is more than sufficient compensation.

The Biomedical Center, the Animal Care Facility, and the Grimshaw Gudewicz Building constitute a physical complex that is the single largest at Brown. The new Life Sciences Building, which will adjoin the complex, will be the largest single building on the campus. These are all medical school buildings, and they give us a physical presence that dwarfs anything else at Brown. A concern raised by others in the University in response to these plans is that the medical school is coming to dominate the rest of the campus. We plan to place a sign in front of the Biomedical Center identifying it Brown Medical School. An architect is currently designing the sign and, if all goes according to schedule, the sign should be ready for the opening of the next academic year in September 2001.

The report recommends that the medical school calendar be uncoupled from the undergraduate calendar so that first- and second-year daily schedules are not so compressed, thus allowing medical students more time to learn the huge amount of material. The linkage of the calendars has been a long-debated issue in the medical school. Medical school courses in the first two years generally use the same recitation blocks used by classes in the college and graduate school, and have done so since the inception of the medical school. The purpose is to allow students the flexibility of taking courses in the college, medical school, and graduate school simultaneously. As noted in a previous section of this response, the opportunity to integrate course selection is considered an attractive and important feature of Brown's medical program.

The main thrust of the senate report, however, is on decompressing the density of material by extending the length of the semester. This has, in fact, been done at the students' behest. The second-year spring semester for the medical school starts in the first week of January for pathophysiology. The introduction to clinical medicine course begins in the last week of August. Skeptics of the change in the length of the semester believe that the increased time would be filled with more content rather than resulting in decompression. This appears to have been the case, though the first three weeks of the spring semester are less intense because only the pathophysiology course is running. However, this has also caused some problems with the goal of integration between pathophysiology, pathology, and pharmacology. Anecdotally, the administration is also hearing complaints from second-year students that the winter break is now considered too short.

The changes in the last few years demonstrate that the medical school is willing to modify the calendar in response to student concerns. However, the changes do not seem to have addressed the basic underlying concern that the medical curriculum is too dense. Also, the changes appeared to have had some of the negative consequences that were predicted, namely, addition of content rather than decompression and a feeling that the vacation time is too short. In addition, January Term opportunities are more limited because of the early start.

The administration remains committed to being responsive to student concerns. In this spirit, we suggest that a review of the changes in the calendar be conducted by the MD Curriculum Committee to assess the effect.

The report recommends that actions be taken to make the medical school more prominent in the minds of the university faculty. The administration agrees with this goal. However, this presents a challenge because Brown prides itself on being a "university–college" that is distinguished by its emphasis on undergraduate college education. Brown has no professional school other than the medical school and has resisted any proposals to increase the number. Cultural mindsets change only slowly. Nevertheless, we believe that university faculty is more aware of the medical school’s contributions and importance to the university. In its short history, the medical school has developed an excellent reputation among U.S. medical schools. The medical school has invested heavily in those areas designed to increase its within the university. This includes supporting a staff position in the Brown News Bureau, adding its own communication specialist to its core staff in external affairs, publishing Brown Medicine and integrating its development office staff with the university development staff in the same location. The new president, Ruth Simmons, has given an early indication of her strong support for the medical school. The university recognizes the PLME as a value-added component of the university that attracts the best and the brightest to Brown. The medical school's service to the community, which will now be strengthened even further with the addition of the associate dean for public health and public policy, Dr. Terrie Wetle, enhances the university's connections to the community. The substantial research effort of campus-based medical school faculty is a source of pride for the university, and provides important scholarly collaboration with faculty in other departments that enhance their own research efforts. With continued attention by the administration and with the passage of time, we remain confident that the medical school will become an increasing part of the consciousness and source of pride of the university faculty.

The report recommends that the university provide more parking facilities for medical faculty and students. This reflects a long-standing problem and source of irritation, especially to hospital-based faculty coming to campus to teach, do research, or attend meetings. The reinstitution of the shuttle between Rhode Island Hospital, the Jewelry District, where many faculty research laboratories are now located, and the Brown campus, will provide some relief. The university is working to develop a comprehensive plan for parking, which will benefit students, faculty, and staff.

Sense of Community (2.5/4)

Student Concerns: Students want more of a sense of community within the medical school. The report suggested that ways be found to make faculty feel more connected to the medical school through monetary compensation, teaching recognition, and interaction with the university and with students outside the classroom setting.

Response: The student report accurately points out the challenges that face us in creating a sense of community as a medical school. The administration agrees that this is a problem that the medical school should address more vigorously. The new associate dean of medicine for faculty affairs will be asked to make recommendations to the dean of medicine on ways to create a better sense of community among all our faculty in the Division of Biology & Medicine. The new associate dean will be named by the end of the winter. The recommendations should be ready by the end of the calendar year.

The report recommended monetary compensation for clinical faculty. This has, in fact, been instituted for some hospital-based full-time faculty who teach in the first two years of medical school. We are working to extend the plan to all full time hospital-based faculty who teach in the first two years.

The medical school recently created a new position of associate dean for clinical faculty. This dean, Dr. Faiza Fawaz Estrup, works to develop that very same sense of community and belonging alluded to in the report among the clinical voluntary faculty. New programs have been instituted that provide more recognition for excellence in teaching among the voluntary faculty as well as more faculty development workshops and programs tailored specifically to the needs of the voluntary faculty. The response from the clinical voluntary faculty to this recognition from the medical school has been gratifying.

The issue of space in the Biomedical Center for students, administrative staff, and faculty was commented on previously. Creating a space where medical students from different classes can interact with one another will be a high priority in redesigning the terrace level of the Biomedical Center once the new research building is completed.

The report recommended that vertical integration of students in affinity groups be instituted so that undergraduate PLME students could be in the same group as first- and second-year medical students. The affinity group program is actively studying ways to accomplish this and should have a plan ready by this spring. In the meantime, first-year medical students are being paired with a second-year medical student in the mentoring program. As the program matures, each student should be paired with a student a year behind and a year ahead in the medical school, thus enhancing linkages across classes.

Students asked that clinical conferences and hospital events be advertised to the entire medical school. The Office of External Relations is engaged in discussions with the Medical Student Senate on ways to enhance communication, not just about conferences, but broadly on a wide range of issues.

The report urged that more ways be created to support and achieve the mission of the medical school so that students feel that Brown is “the best” at something. This is addressed below in Section 10–Relationship to the Community, under “Advocacy and Activism.”

Exemptions from Registrar policies (2.8/4)

Student Concerns: Students were moderately concerned that the medical school should be exempt from certain University Registrar policies regarding specific medical school and bio-medical center issues (e.g. room reservations, exam schedules, etc.)

Response: The medical school is required to follow the policies set up by the registrar’s office. However, we do have a degree of autonomy. For example, a separate unofficial medical school transcript (the grade card) exists and is used within the medical school. This can be updated daily and reflects the medical school’s grading system of H/S/NC. Students use this transcript for a variety of reasons including scholarship and residency applications. The official transcript will remain under the university. Strides have been made to improve the official transcript. As of 1999, the grade of honors is included on the university transcript.

The curriculum office, not the registrar, dictates the second-year medical school exam schedule. Even though most first-year courses have their examination dates set by the registrar, the medical school has been permitted to alter those dates when appropriate. This is done in conjunction with the registrar’s office and has not been a problem. As stated earlier, the university currently controls most of the rooms in the BMC and has no plans to relinquish this control.

Information about campus events (3.0/4)

Student Concerns: Students asked that information about campus events should be more formally communicated to medical students.

Response: The Dean’s office is creating a centralized calendar for the medical school. We hope to have at least a static format calendar this spring and will work to enhance its capabilities over time. Arrangements have been made to deliver the Brown Daily Herald to the BMC. As you are all aware, the Brown Daily Herald and the George Street Journal are available on the Brown University web site. Email blitzes will be sent out via the medical school listserv advertising programs of interest to medical students.

A calendar of events was recently created for the second-year class listing all spring semester programs and events. A similar calendar will be created for all four classes and given out at the beginning of each semester.