Trover Health System
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M-3 and M-4 Academic Years
The Trover Campus provides a small group of medical students the opportunity to complete their third and fourth years of medical school in Madisonville. After completing their first two years of basic sciences in Louisville, Trover Campus medical students move to Madisonville and complete all their clinical rotations there. Students are based within a rural integrated health system with a large tertiary care hospital (Regional Medical Center) providing open-heart surgery and most other services but can be in a truly rural area with a 10 minute drive in any direction. Students participate in the same classroom lectures as the on-campus students by simultaneous live video connection. Clinical rotations on the Trover Campus provide the unique opportunity for daily interaction with an experienced clinician preceptor. The typical teaching group on rounds in an urban medical center is one faculty, 3-5 residents and fellows, and 4-6 medical students. At the Trover Campus, the faculty to student ratio is much higher. The Trover students also experience the value of small group learning by participating in problem-based learning sessions twice a month, facilitated by the Trover Campus Associate Dean, a family physician.
Students indicate their interest in placement at the Trover Campus, apply, visit the campus, and are interviewed. The selection committee ranks the candidates and offers are made to the selected students. Although the goal is 8-12 students per class (16-24 for both years), it has taken time to build the group of qualified interested students to a large enough pool to have a full class. This process has drawn national attention, with recent publication of the Trover experience in the premier peer-reviewed journal concerning rural medicine (1). Trover-based students are reimbursed one-time moving expenses for their move from Louisville after the M-2 year and receive a scholarship of $12,500 per year for their last 2 years of medical school. These Trover Rural Track Students also participate in special activities during the M-1 and M-2 years (a list of all Trover Campus Programs can be viewed here). Program Outcomes
The goal is for the quality of the Trover Campus M-3/M-4 medical training
to meet or exceed the quality of the training available at the downtown
Louisville campus. The curriculum, learning materials, evaluations, examinations,
and grading system for the Trover Campus are identical to those used
on-campus. In terms of quantity, patient logs kept by Trover Campus students
reveal that they see 2-4 times as many patients on most rotations as
their on-campus colleagues, and record 2-10 times as many procedures.
One measure of quality is the "paper and pencil" measure of
National Board Examinations. On Step Two of the USMLE (United States
Medical Licensing Exam), taken during the M-4 (last clinical year) of
medical school, first time pass rates of Trover Campus students are comparable
to those on campus. Step Three of the USMLE is taken during the first
year of residency training, and 100% of Trover Campus graduates have
passed on the first attempt.
A relatively new measure of quality of training is the standardized patient examination. In this measure, an actor is carefully trained and validated to present a clinical scenario to the student. The student knows the "patient" is acting, but must use all the skills learned to date to "connect" with the patient, understand the issues, make a correct diagnosis, and convince the "patient" to follow the treatment plan. Considered by many to be a better measure of clinical competence than paper and pencil exams, this examination has now become part of National Boards testing for licensure. Dr. Gina Wesley, Director of the U of L Standardized Patient program, says "I have been working with U of L's medical students on both the Louisville and Madisonville campuses for approximately nine years. The students in Madisonville consistently demonstrate clinical and communication skills that are equivalent to those of the students at the top of the class on the main campus. Their most marked strength is a strong comfort with talking with patients in a compassionate and professional manner." Another pertinent measure of Trover Campus quality is the perception of how these graduates perform in subsequent residency training. The residency program directors of the programs having Trover Campus graduates are surveyed each year concerning their evaluation of Trover Campus graduates' performance. The summary reveals that the Trover Campus graduates show better scores when compared with non-Trover Campus graduates. The Directors note that the Trover Campus graduates are especially well-prepared in the categories of interview skills, oral presentations, overall patient management, clinical judgment, self-directed learning, and interactions with patients. Most Trover Campus graduates report that they matched to their first choice residency program.
*Percentages show the proportion of Trover Campus graduates who chose that specialty. References
Trover Campus |
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