Student Designed Curricula: A model for Pre-Clinical and Clinical Electives.

Purpose/Problem Statement: Medical school education has traditionally been describes as a 4-year training focusing on basic science and clinical education, medical schools have continually explored opportunities to innovate medical education. The Liaison Committee on Medical Education currently requires opportunities for students to participate in electives, but does not mandate any specific format.1 Electives play an important role in allowing students to explore educational opportunities that enhance the traditional curricula; teaching students clinical skills, wellness and coping techniques, as well as helping students make more informed career decisions.2 Nevertheless, as not all interests are met by pre-designed electives, students have increasingly been turning to self-designed educational opportunities. While departmental sponsors design many electives, students often have specific interests that are not met by existing electives designed by faculty. The University of Massachusetts Medical School (UMMS) has developed two options for students to design their own educational opportunities: Optional Enrichment Electives (OEEs) aimed at first and second year students and Flexible Clinical Electives (FCEs) aimed at students on clinical rotations. The goal of this innovation is to allow students to explore topic areas outside the preset curriculum in order to both increase student satisfaction and allow them to make more informed choices about their future careers in medicine. Methods/Approach: UMMS offers opportunities for students to design electives at all phases of their medical education. As first and second year students, OEEs are available for students to explore their interests. When a need is not met, students may design their own elective with faculty sponsorship and approval from the Educational Policy Committee. During clinical years, students may design their own FCEs in one of three areas: Administrative, Clinical, or Research. These courses are sponsored by a faculty member and allow students to spend a week immersed in a topic area of their choice. Evaluations are sent to all students receiving credit for either an FCE or OEE. Results/Lessons learned: During 2012-2014 212 students participated in 760 FCEs. Students had the opportunity to design their own FCEs and 121 total (15.9%) self-designed FCEs were created. 84 Students (39.6%) participated in at least 1 self-designed FCE. 28 Students (33% of FCE participants) participated in multiple self-designed FCEs. 33 students had submitted qualitative feedback that reported an overwhelmingly positive experience. Preliminary data from the class of 2016 demonstrates that 242 OEE classes were taken for credit over their 4 years of medical school. These students have reported qualitative feedback suggesting that their experiences were positive and had a role in guiding their clinical experiences and FCE selections. Discussions and conclusions/Significance: The autonomy of self-design curricula has granted medical students the freedom to explore areas outside the traditional curricula such as leadership in a healthcare setting, research, ethics, and sub-specialty medicine. The positive feedback suggests that the ability for a student to design their own electives tailored to their educational interests is not only well received, but allows students more flexibility in exploring their career path than predesigned electives. Reflection: The results are limited to enrollment numbers and participation in self designed electives. Future initiatives will look to implement and analyze the efficacy of teaching a new leadership OEE focused on leadership within the healthcare team as well as look at the impact of both OEEs and FCEs on future career choices. References: 1. Agarwal, Ankit, et al. "Elective courses for medical students during the preclinical curriculum: a systematic review and evaluation." Medical Education Online (2015): v20. 2. Liason Committee on Medical Education. "The Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the M.D. Degree." 2013.