LCME to Conduct Public Hearing on
Deletion of Accreditation Standard IS-15

The Liaison Committee on Medical Education (LCME) will hold a hearing for public comment on a proposed deletion of accreditation standard IS-15 during the Interim Meting of the American Medical Association. The hearing will be held on Saturday, November 8, at 1:30 p.m. in the Crystal D/E room of the Orlando World Center Marriott, 8701 World Center Drive, Orlando, Florida.

Written comments may be forwarded until December 31, 2008, to Dan Hunt, MD, MBA, LCME Secretary, at the Association of American Medical Colleges, 2450 N Street, NW, Washington, DC 20037, or via e-mail to: lcme@aamc.org. Anonymous comments will not be considered. For further information, contact Dr. Hunt at 202-828-0596.

Background The LCME carries out ongoing reviews of its accreditation standards, which are organized into five sections: institutional setting, educational program, medical students, faculty, and resources for the educational program. One section of standards is reviewed each year.

During the 2007-2008 academic year, the LCME reviewed the standards related to the institutional setting. The review process included a survey of four stakeholder groups: medical school deans, associate deans, department chairs, and the public. Respondents rated each of the 15 standards in the institutional setting section on (1) the importance of the standard as an indicator of educational quality and (2) the clarity of the standard's meaning and intent. Each standard was rated on a 5-point scale. Average ratings were determined for each group of respondents and for respondents as a whole. Respondents also were invited to comment on each standard's importance and clarity.

The proposed deletion was approved by the LCME at its meeting on June 3-5, 2008. The LCME's sponsoring associations, the Council on Medical Education of the American Medical Association and the Association of American Medical Colleges, have approved the deletion of this standard at their meetings on September 7, 2008, and September 17, 2008, respectively. Following public comment, the LCME will take final action on this proposal at its next meeting on February 3-5, 2009.

Recommendation That LCME Accreditation Standard IS-15 ("All medical school faculty members should work closely together in teaching, research, and health care delivery.") be deleted.

Rationale While the intent of standard IS-15 is laudable, the standard received an average rating of 3.7 for clarity, the lowest score for any of the 15 standards in the section. Survey respondents indicated that the wording is vague and idealistic and that it lacks the specificity required for reliable and valid measurement of compliance. Some respondents identified a problem with the use of the word "all," asking how basic science faculty can work together "in health care delivery." The vague wording also makes it difficult for schools to identify the types of information that would document their compliance. Thus, responding to the standard requires considerable effort that is perceived as "busy work."

This situation is exacerbated by the lack of benchmark data for use by schools and survey teams in reporting and determining compliance with the standard. Between 2002 and 2006, the standard was only cited once by a survey team. In that instance, it was cited because clinical faculty workloads did not allow them time to conduct research. That situation would still be covered with standard FA-5, which states, "Faculty members should have a commitment to continuing scholarly productivity characteristic of an institution of higher learning." In summary, because of the lack of reliable and valid measurability, the significant amount of information that schools must provide in the medical education database for this standard, and its inherent overlap with FA-5, it is the LCME's recommendation that standard IS-15 be deleted.