Educational institutions must go through a rigorous, time-intensive accreditation process to assure the public that their programs meet the highest quality standards. The UNLV School of Medicine must meet three different accreditations:
1) The Northwest Commission on Colleges and Universities (
NWCCU) is the
regional body authorized by the Department of Education to accredit universities, such as UNLV. We first received permission from NWCCU to grant a M.D. degree.
2) The Liaison Committee for Medical Education (LCME) is the recognized authority for medical education programs leading to a M.D. degree. This is the most important accreditation needed for a medical school. There are multiple steps to this process. Currently, we have "Candidate School" status. In October, the LCME will meet and notify us if the school has received preliminary accreditation to accept our first class of students.
3) The Accreditation Council for Graduate Medical Education (ACGME) allows medical schools to sponsor residency programs.
ACGME Milestone Achieved
Last week, we were granted accreditation from ACGME as an institutional sponsor of graduate medical education (GME). This means that as of July 1, 2017, UNLV School of Medicine will be able to accept sponsorship of the current residency and fellowship programs at University Medical Center (UMC), Sunrise Hospital, Southern Nevada Veterans Administration Hospital, and the Southern Nevada Adult Mental Health Services. These programs are currently sponsored by University of Nevada, Reno School of Medicine (UNRSOM) and will transfer to UNLV School of Medicine.
Becoming a Physician
When a student graduates from medical school, they have a M.D. degree but may only practice medicine under the supervision of a faculty or community physician in a residency program. Residency programs run three to six years to completion (depending upon the specialty). Many physicians complete a two-to-three-year fellowship after their residency with even more specialized training. These programs are educational but residents and fellows receive a salary during this portion of their training.
Within the ACGME, each individual residency specialty program contains its own Residency Review Committee (RRC) that sets the standards for that particular specialty and determines which programs are accredited. We now need to secure permission from the RRC to move each residency program to our sponsorship next July.
Each institution sponsoring accredited GME programs has one person, called the Designated Institutional Official (DIO), who is responsible for maintaining the residency programs and keeping accurate and current records. The UNLV School of Medicine DIO is Miriam Bar-on, MD, who is the Co-DIO for UNRSOM. Dean Thomas Schwenk, from UNRSOM, and I agreed that having a joint DIO would allow a smooth transition of the residency programs. Dr. Bar-on submitted our application and will remain responsible for our residency and fellowship programs in the future. She carries a national reputation for her innovation in program leadership and was awarded the "Parker J. Palmer Courage to Lead" award from the ACGME last year.
Currently UNRSOM has 249 residents in 11 different residency programs in Las Vegas. These include Emergency Medicine, Family Medicine, Rural Family Medicine, Internal Medicine, Obstetrics and Gynecology, Orthopaedics, Otolaryngology, Pediatrics, Plastic Surgery, Psychiatry, and Surgery. There also are 32 fellows in six programs including Cardiology, Gastroenterology, Pulmonary/Critical Care, Child Psychiatry, Sports Medicine, and Surgical Critical Care. This seems like a lot of residents, but considering each program is at least three years and several are four, five, or six years, there are only 86 first-year positions.
Bridging the Residency Gap
Though Nevada has many residency programs, some of the most popular residency and fellowship programs are not taught here, such as Urology, Neurosurgery, Dermatology, Ophthalmology, Radiology, Anesthesiology, Pathology, and many of the fellowships in Internal Medicine and Pediatrics. Graduating medical students must leave Nevada to receive the training in these needed specialties, and many never return. This means we are exporting many of Nevada's own educated medical students to other states because of the lack of training opportunities here. UNLV School of Medicine plans to create residency programs in these specialties so we will keep more doctors in Nevada.
Residency Review Committees
In the 1990's, I was a trustee of the American Board of Pathology for 12 years. Boards and RRCs work closely together, and during that time I was a member of the RRC for Pathology. This is the group that makes recommendations for all programs in my specialty, pathology and laboratory medicine. All members of the boards and the RRCs are volunteers who spend hours deciding what the future of their specialty will be, how to appropriately train and then examine the finishing residents to ensure patients have the best possible physicians and medical care.
We spent a lot of time evaluating separate specialties within pathology to determine whether they should be individually certified. While I was on the committee we decided to accredit molecular genetic pathology as a new specialty and then designed a new board examination to certify those who take this specialty training.
I'm extremely grateful that my career has allowed me to shape the future of medical education, residencies, and fellowships, and I'm so excited about the programs we are building at UNLV School of Medicine.