Principles associated with future rural community-based curriculum

• A purpose of the M.D. Curriculum Transformation process is ensuring that OHSU continues to educate and graduate the types of physicians needed by Oregon – across discipline, geography, patient population, cultural competency, and attributes linked to an ability to provide high quality health care and community leadership in the evolving future health care landscape.
   
• Reflecting our commitment to supplying a diverse physician workforce for Oregon, as part of the curriculum transformation, we expect that the rural and community-based curriculum, as well as instruction focused on other underserved areas/populations, will be expanded.
   
• Among other goals, we want to provide enhanced opportunities to introduce students to community-based practice, community leadership and problem solving, population and public health and systems-based competencies.
   
• Multiple ideas for expansion are being discussed, but under any scenario, a rural clerkship will remain a requirement for our M.D. students. Rural in this context is defined by the Oregon Office of Rural Health as "geographic areas 10 or more miles from the centroid of a population center of 40,000 or more."
   
• The rural curriculum expansion now being discussed focuses on increasing the menu of options for fulfilling the rural requirement – options such as adding new sites, more specialties, exploring the creative use of technology (such as telemedicine), creating rotations for teams of students (M.D., PA, Nursing) to reinforce collaborative team-based practice, and others.
   
• Currently, all third-year medical students participate in a required Rural and Community Health Clerkship primarily in Family Medicine. This clerkship was established as part of our 1994 curriculum redesign. This same clinical experience will remain available to all of our students as one of the options (an elective) in an expanded, required rural and community-based curriculum.
   
• In addition to the specific discipline which may be its clinical focus (e.g., Surgery, Obstetrics and Gynecology, Family Medicine, Pediatrics, Psychiatry, Internal Medicine, etc.), all options to fulfill the required rural rotation will also include attributes that focus on unique aspects of the health care needs of rural Oregon communities.
   
• The first cohort to participate in the expanded third-year rural curriculum will be 2016 (the transformed curriculum will be introduced with the entering class of 2014, and will be phased in each year after that).
   
• The OHSU faculty is the responsible entity for ensuring the excellence of the M.D. curriculum and ensuring its accordance with accreditation standards. A faculty and student work group is currently charged with reconsidering all M.D. clinical educational experiences and will make recommendations to the School of Medicine across all specialties.

Approved and posted March, 2013