actions taken at meetings of the executive council, cos, cas and … · 2019-08-12 · after...

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.A C T I O.N S

TAKEN AT MEETINGS OF:

Executive Council (January l3-l4, 1977). . . . lCOD Administrative Board (January l3, 1977). . 5CAS Administrative Board (January l2-l3, 1977) 6COTH Administrative Board (January l3, 1977) . 7OSR Administrative Board (Januaryll-l2, 1977). 9

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EXECUTIVE COUNCIL ACTIONS

January 13-14, 1977

UNIFORM APPLICATION FORM FOR GRADUATE MEDICAL EDUCATION

After discussing the advantages, disadvantages, and feasibility of developing a uniform application form for GME-1 positions, the ExecutiveCouncil agreed that the Chairman should appoint a task force to reviewthis issue and recommend a feasible method of simplifying the applicationprocess.

APPOINTMENT OF A SECRETARY-TREASURER

ACTION: The Executive Council approved the appointment ofDr. David D. Thompson as AAMC Secretary-Treasurer.

APPOINTMENT OF THE EXECUTIVE COMMITTEE

ACTION: The Executive Council appointed the following individuals to the Executive Committee with thecharge listed below:

Dr. Ivan L. Bennett, Jr., ChairmanDr. Robert G. Petersdorf, Chairman-ElectDr. John A. Gronval1, COD ChairmanDr. A. Jay Bo11et, CAS ChairmanDr. David D. Thompson, COTH ChairmanDr. John A. D. Cooper, President

At such times when the Executive Council is notformally in session, the Executive Committee shallhave and may exercise the full power and authorityotherwise commonly incident to and vested in theExecutive Council, to act on behalf of and tomanage the affairs of the Association, and to makeany and all necessary and appropriate policy interpretations on behalf of the Executive Council.

RATIFICATION OF LCME DECISIONS

ACTION: The Executive Council ratified the accreditationdecisions made by the Liaison Committee on MedicalEducation at its October 20-21, 1976 meeting.

ELECTION OF TEACHING HOSPITAL MEMBERS

ACTION: The Executive Council approved and recommended tothe Assembly the election of the following institutions to Teaching Hospital Membership in the AAMC:

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Hackensack Hospital AssociationHackensack, New Jersey

Mount Sinai HospitalHartford, Connecticut

Kern Medical CenterBakersfield, California

ELECTION OF CORRESPONDING MEMBERS

ACTION: The Executive Council approved and recommended tothe Assembly the election of the following institutions to Corresponding Membership in the AAMC:

Greater Southeast Community HospitalWashington, D. C.

Sidney Farber Cancer InstituteBoston, Massachusetts

APPROVAL OF SUBSCRIBER

ACTION: The Executive Council approved the following Subscriber:

Marshall University School of MedicineHuntington, West Virginia

Robert W. Coon, M.D., Dean

LCGME BYLAWS

ACTION: The Executive Council approved the Bylaws of theLiaison Committee on Graduate Medical Educationas presented and approved by the CoordinatingCouncil on Medical Education.

LCCME BYLAWS

ACTION: The Executive Council approved the Bylaws of theLiaison Committee on Continuing Medical Educationas presented and approved by the CoordinatingCouncil on Medical Education.

RULES AND REGULATIONS OF THE GROUPS

ACTION: The Executive Council, with several suggestedmodifications, approved the revised Rules and Regulations of the Group on Business Affairs, theGroup on Public Relations, and the Group on StudentAffairs.

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GUIDELINES FOR THE GSA MINORITY AFFAIRS SECTION

ACTION: The Executive Council recommended a series ofspecific modifications in the Guidelines of theGroup on Student Affairs-Minority Affairs Section,and authorized the President to approve a versionof the Guidelines modified consistent with theserecommendations.

REGENTS OF THE UNIVERSITY OF CALIFORNIA V. BAKKE

ACTION: The Executive Council agreed that the Associationshould file an amicus curiae brief supporting theUniversity of California position in the SupremeCourt if the court agrees to hear the Bakke case.

AAMC RESPONSE TO THE DHEW REPORT: A PROPOSAL FOR CREDENTIALINGHEALTH MANPOWER

ACTION: The Executive Council asked the staff to redraftthe proposed response to the DHEW credentialingreport emphasizing the impact upon health carecosts and the trend toward over-specialization.

GUIDELINES FOR FUNCTIONS AND STRUCTURE OF A MEDICAL SCHOOL

ACTION: The Executive Council approved the Guidelines forFunctions and Structure of a Medical School aspresented by the Liaison Committee on Medical Education. It was agreed that several commentsoffered by the students would be forwarded to theLiaison Committee for future consideration.

SPECIALITY RECOGNITION OF EMERGENCY MEDICINE

ACTION: The Executive Council reaffirmed its position thatthe Association should not respond substantivelyto the Liaison Committee on Specialty Board'srequest for testimony on the recognition of theAmerican Board of Emergency Medicine. It wasagreed that Dr. Cooper should reiterate the petitioning Board's burden to offer a full financialimpact statement prior to any consideration ofrecognizing a new specialty. It was also agreedto reiterate the Executive Council position thatthese broad policy positions appropriately fallwithin the scope of review of the CoordinatingCouncil on Medical Education.

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STUDENT REPRESENTATION ON THE LCME

The Executive Council discussed the advantages and disadvantages ofhaving student representation on the Liaison Committee on Medical Education. It was agreed that no decision should be reached at this time onchanging the composition of the LCME.

APPOINTMENT OF COMMITTEES

ACTION: The Executive Council concurred with the Chairman'srecommendations for members on AAMC committees.

HOUSESTAFF COLLECTIVE BARGAINING

ACTION: The Executive Council approved a motion asking theAssociation to work to defeat the Thompson Amendment which would specifically include housestaffunder the coverage of the National Labor RelationsAct. It was specified that this action did notcategorically oppose collective bargaining at thelocal level but only opposed collective bargainingunder the framework of the National Labor RelationsAct.

FOREIGN MEDICAL STUDENT PROVISION OF THE HEALTH MANPOWER LAW

ACTION: The Executive Council members concurred with theRetreat recommendation that the Association notseek legislative amendment of the provision requiring transfer of U. S. citizens studying abroad. Itwas agreed that the AAMC should continue to assistin the regulation writing process and the ExecutiveCouncil further resolved:

That the AAMC maintain the highest priority upon,and take every practical step to preserve, the independence of admissions and curricula from government regulation. This effort should be directedtoward current and future legislation.

REPORT OF THE OFFICERS' RETREAT

ACTION: The Executive Council approved the Report of theAAMC Officers' Retreat held December 15-17, 1976.

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COUNCIL OF DEANSADMINISTRATIVE BOARD

January 13, 1977

APPROVAL OF SUBSCRIBER

ACTION: The Board recommended that the Executive Council approveMarshall University School of Medicine for Subscriberstatus.

LCGME BYLAWS

ACTION: The Board recommended that the Executive Council approvethe Bylaws of the LCGME as presented.

LCCME BYLAWS

ACTION: The Board recommended that the Executive Council approvethe Bylaws of the LCCME as presented.


ACTION: The Board recommended that the Executive Council approvethe LCME Guidelines for Functions and Structure of aMedical School as presented. The Board acknowledged theinterest registered by OSR in further modification ofseveral items when the Guidelines may be updated at somefuture time. Further, the Board recognized Dr. JamesSchofield for his dedicated service in completing theGuidelines and bringing this important document intogeneral use.

THOMPSON AMENDMENT

ACTION: The Board recommended to the Executive Council that theAAMC do everything within its power to defeat the Thompsonbill, focusing on the narrow issue addressed in the bill asintroduced previously. In addition, the Board urged theAAMC to seek ways to influence and stimulate improvementin conditions where they exist which are not conducive toexcellent housestaff education and patient care. Supportof the LCGME and identification of these concerns in developing the charge to the Task Force on Graduate MedicalEducation were identified as two important avenues for actionin this regard.

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ACTIONSCOUNCIL OF ACADEMIC SOCIETIES

ADMINISTRATIVE BOARD

January 12-13, 1977

RATIFICATION OF LCME ACCREDITATION DECISIONS

ACTION: The CAS Administrative Board voted unanimously to ratifythe LCME accreditation decisions.


ACTION: The CAS Administrative Board voted unanimously to acceptthe LCME Guidelines for Functions and Structure of a Medical School.

SPECIALTY RECOGNITION OF EMERGENCY MEDICINE

ACTION: The CAS Administrative Board took a strong stand opposingin principle specialty recognition of emergency medicine.The consensus of the Board was that emergency medicine doesnot represent a body of knowledge or a discipline butrather that it is an occupation.

UNIFORM APPLICATION PROCESS FOR GRADUATE MEDICAL EDUCATION

ACTION: Although the CAS Administrative Board took no formal actionon this agenda item, it did support the idea to the extentthat it could simplify this process for the dean's office.The stipulation was made that the date issue would need tobe flexible.

ASSOCIATION OF PROFESSORS OF MEDICINE DESK AT AAMC

ACTION: The CAS Administrative Board considered the proposal fromthe Professors of Medicine that to enhance a close relationship with the Association of Professors of Medicine anAPM desk be established at AAMC. The consensus was thatfurther exploration of the APM proposal is justified butthat the CAS Administrative Board would need additionalinformation before taking any specific action.

HEALTH MANPOWER LEGISLATION

ACTION: By a majority vote the CAS Administrative Board took actionto recommend that the Executive Council reconsider thehealth manpower legislation and that it go back to theCongress for the purpose of seeking to have the legislationamended to eliminate from it the provisions regarding U. S.foreign medical students. The vote was six for and threeagainst.

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COUNCIL OF TEACHING HOSPITALSADMINISTRATIVE BOARD

January 13, 1977

MEMBERSHIP

ACTION: It was moved, seconded and carried that the following applicationsfor Corresponding Members in the Association of American MedicalColleges be recommended for approval to the Executive Council:

Greater Southeast Community HospitalWashington, D.C.Sidney Farber Cancer InstituteBoston, Massachusetts

ACTION: It was moved, seconded and carried that the following applicationfor Regular Member in the Association of American MedicalColleges be recommended for approval to the Executive Council:

Kern Medical Center of Bakersfield, California'

LCGME BYLAWS

ACTION: It was moved, seconded and carried that the LCGME Bylaws beapproved.

LCCME BYLAWS

ACTION: It was moved, seconded and carried that the LCCME Bylaws beapproved.

RULES AND REGULATIONS OF GROUPS

ACTION: It was moved, seconded and carried that the recommendation regardingthe rules and regulations for the Group on Business Affairs, Groupon Public Relations and Group on Student Affairs be approved aspresented on page 44 of the Executive Council Agenda.

GUIDELINES FOR THE MINORITY AFFAIRS SECTION

ACTION: It was moved, seconded and carried that the recommendationpresented in the Executive Council Agenda, which called forapproval of the guidelines proposed by the GSA SteeringCommittee with certain specific exceptions as shown on pages60-62 of the Agenda, be approved.

REGENTS OF THE UNIVERSITY OF CALIFORNIA v. BAKKE

ACTION: It was moved, seconded and carried that the AAMC seek permissionto file an amicus curiae brief if the Supreme Court agrees toreview the Bakke case.

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AAMC RESPONSE TO THE DHEW CREDENTIALING REPORT

ACTION: It was moved, seconded and carried that the Board recommendthat the AAMC call for the deletion of recommendation #3 inthe DHEW Credentialing Report and support emphasis on "qualityof output" or "proficiency" as the determinant for reimbursementand, with this specific modification, approve the AAMC responseas drafted.


ACTION: It was moved, seconded and carried that the Board recommend thatthe Executive Council approve, as presented on page 84 of theExecutive Council Agenda, the LCME Guidelines for Functions andStructure of a Medical School.


ACTION: It was moved, seconded and carried that the Board recommendthat the AAMC Executive Council not take a negative positionregarding the establishment of a Specialty Board inEmergency Medicine and state that the Association recognizesthat there is a very real problem in providing and organizingcare in the emergency medical care setting .

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ORGANIZATION OF STUDENT REPRESENTATIVESADMINISTRATIVE BOARD ACTIONS

MEDICAL SCHOOL ACCREDITATION

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard endorsed the LCME Guidelines for Functions andStructure of a Medical School.


ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard endorsed the LCME Accreditation Decisions.

ENDORSEMENT OF LCGME BYLAWS

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard endorsed the LCGME Bylaws.

ENDORSEMENT OF LCCME BYLAWS

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard endorsed the LCCME Bylaws.

GSA RULES AND REGULATIONS

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard endorsed the proposed changes in the GSA Rules andRegulations.

GUIDELINES FOR THE MINORITY AFFAIRS SECTION

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard endorsed the staff recommendations regarding theGSA Minority Affairs Section with the following exceptions:Recommendation 1: Endorsed only the deletion of the phrase:

lito serve in an advisory capacity to the AAMC Office ofMinority Affairs in setting programmatic goals, objectives, and priorities, as well as"

Recommendations 4-9: Abstained from taking action untilrecommendation of the GSA Minority Affairs Committeeis received.

Recommendations 11-15: Not endorsedRecommendation 17: The OSR Administrative Board endorsed

this recommendation but urged the Executive Council toprovide some level of funding to support the Section.

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REGENTS OF THE UNIVERSITY OF CALIFORNIA V. BAKKE

ACTION: On motion, seconded, and carried, the OSR endorsed therecommendation that AAMC seek permission to file an amicus curiae brief if the Supreme Court agrees to reviewthe Bakke case.


ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard agreed not to adopt a position on whether emergencymedicine should be recognized as a specialty. They agreedto support AAMC's previous position that prospective specialties be required to conduct an impact study assessinghow its establishment would affect the nation's totalhealth expenditures as well as tne overall quality of patient care.

UNIFORM APPLICATION PROCESS FOR GRADUATE MEDICAL EDUCATION

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard reaffirmed its support of a uniform applicationprocess for graduate medical education programs and endorsed the creation of a task force to develop a pilotapplication form.

STUDENT NOMINEES TO AAMC COMMITTEES

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard agreed to forward the following nominations to Dr.Bennett, Chairman of the Association, for appointment toAAMC committees:

Health Services Advisory Committee--Daniel MillerData Development Liaison Committee--David DiamondJournal of Medical Education Editorial Board--Richard HarperResolutions Committee--Richard SeigleFlexner Award Committee--Donald WidderGSA Committee on Financial Problems of Medical

Students--Robert TomchikGSA Committee on Medical Education of Minority

Group Students--Richard GomezGSA Committee on Professional Development and

Advising--William Meade/Joan KishelGSA Medical Student Information Systems--Nancy Hardt/

Barbara Carpenter

APPROVAL OF RECOMMENDATIONS OF WORKING GROUP ON STRESS

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard approved the recommendations of the working groupon stress.

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HOUSESTAFF COLLECTIVE BARGAINING

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard approved the following resolution:

The graduate medical experience is inextricably tied toboth education and service. The experience is educationalin that it is a voluntary means for specialty training andattainment of licensure. It is service because housestaffprovide patient care and participate significantly in thetraining of medical students.

The means which presently exist for the resolation ofproblems and inequities in graduate educational programsare less than perfect. The mechanisms available for resolving issues related to housestaff employment are generally unsatisfactory. Past experience has shown thatthere is no clear motivation for the voluntary development of a satisfactory mechanism. Inclusion of housestaff under the NLRA would accomplish this end.

The OSR Administrative Board resolves that:

1. The AAMC should continue its laudable effortsto improve the educational component of thehousestaff experience, particularly throughits participation in LCGME, and further resolves that

2. The AAMC should actively support the passageof the Thompson Amendment to ensure protectionof housestaff under NLRA.

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ACT ION S

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TAKEN AT MEETINGS OF:

Exeautive CounaiZ (Ma~ah 3Z-Ap~iZ Z~ Z9??) . ..COD Administ~ative Boa~d (Ma~ah 3Z~ Z9??) ..CAS Administ~ative Boa~d (Ma~ah 30-3Z~ Z9??) ..COTH Administ~ative Boa~d. (Ma~ah 3Z~ Z9??). .OSR Administ~ative Boa~d (Ma~ah 29-30~ Z9??).

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March 31-April 1, 1977

ENDORSEMENT OF LCME ACCREDITATION DECISIONS

ACTION: The Executive Council endorsed the accreditation decisions acted upon by the Liaison Committee on MedicalEducation at its February 9-10, 1977, meeting.

ELECTION OF COTH MEMBERS

ACTION: The Executive Council recommended to the Assembly theelection of the following institutions" to TeachingHospital membership:

The Children's HospitalBirmingham, Alabama

Veterans Administration HospitalNorthport, New York

Veterans Administration HospitalHampton, Virginia

APPROVAL OF SUBSCRIBERS

ACTION: The Executive Council approved the following schoolsas Subscribers:

University of AlaskaFairbanks, AlaskaDr. Wayne r~yers, WAMI Coord inator

University of WyomingCollege of Human MedicineLaramie, WyomingRobert M. Daugherty, Jr., M.D., Dean

1977 LCCME INTERIM BUDGET

ACTION: The Executive Council approved the proposed interimbudget of the Liaison Committee on Continuing MedicalEducation in the amount of $13,5000, with the requestthat a final budget be submitted as soon as possible.

PLANNING COORDINATORS' GROUP RULES AND REGULATIONS

ACTION: The Executive Council approved a revised version ofthe Rules and Regulations of the Planning Coordinators'Group.

• KOUNTZ V. STATE UNIVERSITY OF NEW YORK

ACTION: The Executive Council agreed to join with the StateUniversity of New York in the case of Kountz v.State University of New York by filing an amicuscuriae brief or otherwise participating as recommended by counsel.

REDUCED-SCHEDULE RESIDENCIES

ACTION: The Executive Council tabled the motion to endorsethe development of reduced-residency positions.

COORDINATION OF APPLICATION CYCLES FOR PROGRAMS RECRUITINGMEDICAL STUDENTS FOR GME-II POSITIONS

ACTION: The Executive Council approved the following statement to be forwarded to the Liaison Committee onGraduate Medical Education, the American Board ofMedical Specialties, the Council on Medical Specialty Societies, and organizations of program directors:

The AAMC is concerned that uncoordinated efforts tofill positions in graduate programs which normallybegin after one year of graduate medical educationare resulting in inappropriate and premature requestsfor student evaluations, often before medical students have completed their basic clinical clerkships.The Association requests that program directors forspecialties which predominantly admit students aftercompletion of a first graduate year of educationcoordinate their application cycle so that studentsand medical schools are not imposed upon to provideletters of evaluation prematurely. A cycle whichdoes not permit acceptance of applications prior tothe late fall of the students' senior year is recommended.

Deans' offices and faculty are urged to respond torequests for premature evaluation by pointing outthat the information being supplied is not basedupon adequate observation of the student and thatstudents are being denied an opportunity to explorethe full range of options for their professionalcareer development.

In the case of programs admitting students directlyafter graduation from medical school, the applicationrules and guidelines of the NIRMP should be followed.

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REPORT OF THE CCME COMMITTEE ON PHYSICIAN DISTRIBUTION: THESPECIALTY AND GEOGRAPHIC DISTRIBUTION OF PHYSICIANS

ACTION: The Executive Council recommended to the CCME that:

1. the report on The Specialty and GeographicDistribution of Physicians not be approved;

2. The CCME implement the recommendation of theCommittee on Physician Distribution that a shortpreamble be prepared along with a planning statement identifying what data need to be collectedbefore policy statements can be made. Phase IIof this effort would then be to prepare a concisereport containing policy recommendations onlyafter the required information became available .

LETTER FROM THE AMERICAN COLLEGE OF SURGEONS

ACTION: The Executive Council reendorsed the following principles to form the basis of the Association's responseto the American College of Surgeons:

1. The Association supports the ACS recommendationthat there be a free-standing, independent stafffor the LCGME and the Residency Review Committees,not related in any particular way to a singleparent organization.

2. The LCGME serves and should continue to serve asthe private sector accrediting agency for programs of graduate medical education. The RRC'sshould continue to review the on-site evaluationsof each particular program and to initiate modifications in the recognized "essentials" for eachparticular specialty. However, it is the utlimateresponsibility of the LCGME to approve theseessentials and to review the accreditation recommendations of the RRC's.

3. The LCGME should have the authority to appointone member to each RRC in place of the membercurrently appointed by the AMA Council on MedicalEducation. This member would be appointed from aroster of specialist educators developed by the AMA,the AAMC, and the AHA. The other two members ofthe LCGME (American Board of Medical Specialtiesand the Council on Medical Specialty Societies) areresponsible for appointing the remaining membersof the Residency Review Committee.

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UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES

ACTION: The Executive Council reaffimred the position takenin 1975 that the Association only speak to thequality of the educational program at the USUHS. Itwas also agreed that the Association members andstaff should work to help place currently enrolledUSUHS students in other U.S. medical schools andshould assist displaced faculty in finding new positions if the Congress should decide to close theschool.

RECOGNITION OF EMERGENCY MEDICINE AS A NEW SPECIALTY

ACTION: The Executive Council agreed that a small groupshould assess the substantive arguments for andagainst establishing a specialty board in emergencymedicine and should report their recommendations tothe Executive Council in June.

REPORT OF THE AD HOC COMMITTEE TO REVIEW THE TALMADGE BILL

ACTION: The Executive Council approved as modified theReport of the Ad Hoc Committee to Review the TalmadgeBill.

ELIGIBILITY REQUIREMENTS FOR ENTERING GRADUATE MEDICALEDUCATION

ACTION: The Executive Council requested that the LiaisonCommittee on Graduate Medical Education withdrawrecognition of ECFMG certification based upon passing the ECFMG examination, and require that afterJuly 1, 1978, all physicians educated in medicalschools not accredited by the LCME be required tohave ECFMG certification based either on passingParts I &II of the NBME exam or an equivalentexam prepared by the NBME.

IMPLEMENTATION OF TITLE VI OF THE HEALTH r~ANPOWER LAW

ACTION: The Executive Council authorized the staff to pressfor speedy implementation of the provisions containedin Title VI of the health manpower law regarding theissuance of J-visas and waivers.

ADMISSION OF FMGs AS EXCHANGE VISITORS

ACTION: With one dissenting vote, the Executive Councilapproved the following statement on the role ofthe AAMC:

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The AAMC, on behalf of the medical schools andtheir affiliated hospitals, should seek sponsorship of the P-II Programs of the Exchange VisitorProgram. In this capacity, the AAMC would facilitate the initiation of contacts and the negotiationof agreements between foreign governments or institutions and U.S. institutions for specified clinical training programs for exchange visitor phsycians.The AAMC would issue the DSP-66 to alien physiciansfor whom programs have been arranged. Support forthis program would be obtained through charges toforeign institutions and/or governmental agencies.Such charges would serve to emphasize their commitment to the individual for whom these agencies seektraining.

The Executive Council approved the following statement on the role of the ECFMG:

The ECFMG should retain the certifying function forall graduates of foreign medical schools not accredited by the LCME. Certification should take placeonly after the conditions required by law have beenfulfilled. It should further maintain records on allcandidates for the examination, on those who passedand failed and on recipients of the ECFMG certificate, as well as those who subsequently enter U.S.graduate programs.

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• COUNCIL OF DEANSADMINISTRATIVE BOARD

March 31, 1977

APPROVAL OF SUBSCRIBERS~

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ACTION: The Board endorsed Executive Council approval of thefollowing as subscribers:

University of AlaskaFairbanks, AlaskaDr. Wayne MyersWAMI Coordinator

University of WyomingCollege of Human MedicineLaramie, WyomingRobert M. Daugherty, Jr., M.D., Dean

COORDINATION OF THE APPLICATION CYCLES FOR GME PROGRAMS RECRUITINGMEDICAL STUDENTS FOR GME II POSITIONS

ACTION: The Board endorsed Executive Council adoption of thefollowing statement to be forwarded to the LCGME,the American Board of Medical Specialties, the Councilof Medical Specialty Societies and organizations ofprogram directors:

liThe AAMC is concerned that uncoordinated effortsto fill positions in graduate programs whichnormally begin after one year of graduate medicaleducation are resulting in inappropriate and prematurerequests for student evaluations, often beforemedical students have completed their basic clinicalclerkships. The Association requests that programdirectors for specialties which predominantly admitstudents after completion of a first graduate yearof education coordinate their application cycle sothat students and medical schools are not imposedupon to provide letters of evaluation prematurely.A cycle which does not permit acceptance ofapplications prior to the late fall of the students'senior year is recommended.

6

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• Deans' offices and faculty are urged to respondto requests for premature evaluation by pointingout that the information being supplied is notbased upon adequate observation of the studentand that students are being denied an opportunityto explore the full range of options for theirprofessional career development.

In the case of programs admitting students directlyafter graduation from medical school, the application rules and guidelines of the NIRMP should befoll owed. II

KOUNTZ VS. STATE UNIVERSITY OF NEW YORK

ACTION: The Board favored the submission of an AAMC briefamicus curiae in the above captioned case butwished to have any decision to do so take intoaccount the judgments of the CAS Board.

CCME COMMITTEE ON PHYSICIAN DISTRIBUTION REPORT: THE SPECIALTY ANDGEOGRApHIC DISTRIBUTION OF PHYSICIANS

ACTION: The Board recommended:

1) That the AAMC not approve the committee report;2) That the AAMC endorse, instead, the committee

recommendation that a new report be draftedwhich a) was short, b) layout the existingdata and its limitations very briefly,c) emphasized the rapidly changing situation,d) identified new information which is likelyto become available in the near future, ande) deferred major policy recommendations untilthe data is available and the situation issomewhat clarified.

3) That the AAMC correspondence relating thisdecision be more moderate in tone than theanalysis in the agenda book.

PROBLEMS REGARDING FOREIGN MEDICAL GRADUATES

Re Distinguished Visitors: the current regulations limit thefunctions which can be undertaken by physician visitors solelyto teaching and research if admitted under the H-l visa.

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ACTION: The Board endorsed Executive Council direction to staffto pursue the following alternative approaches asappropriate:

1) Request the Department of Justice to amend theregulation, striking the word solely.

2) Request the chairpersons of the appropriateCongressional Committees to inform the Departmentof Justice that the present regulations fail toreflect Congressional intent.

3) Seek an appropriate technical amendment to thestatute to clarify this issue.

4) Seek new legislation to authorize the SecretaryDHEW to waive upon application and on the adviceof an appropriately constituted advisory body,the examination requirement and thus enable thecontinuation of a highly desirable distinguishedphysician visitor program.

Re Immigrants:

ACTION: The Board endorsed a proposal that the Secretary DHEWbe empowered by statute to waive the examinationrequirement upon a determination that a candidate (forimmigration to accept a position on a U.S. medicalschool faculty) has competence equivalent to thoseembodied in U.S. faculty members.

Re Foreign Graduate Exchange Visitors:

ACTION: The Board endorsed Executive Council authorization ofstaff to press for speedy implementation of theprovisions contained in Title VI of P.L. 94-484regarding J-visa waivers.

ADMISSION OF FOREIGN MEDICAL GRADUATES AS EXCHANGE VISITOK~

ACTION: The Board recommended that the Executive Council approvethe following policy setting forth the roles of the AAMCand the ECFMG to take effect at the termination of theblanket waiver issued by the HEW Secretary and upon theavailability of the Visa Qualifying Examination abroad.

1. The AAMC, on behalf of the medical schools andtheir affiliated hospitals, should seek sponsor-ship of the P-II Proqrams of the Exchange VisitorProgram. In this capacity, the AAMC would facilitatethe initiation of contacts and the negotiation of

8

AAMC INVOLVEMENT IN THE USFMS TRANSFER PROGRAM

ACTION: The Board urged that the AAMC not accept any responsibilityfor administering the USFMS transfer provisions, but ratheroffer whatever advice to the BHM as might be helpful. Weshould refer the Bureau to other agencies such as the ECFMG,with the skills for validating foreign credentials, orpreferably, an agency linked with academic enterprises butunlinked from medicine.

ELIGIBILITY REQUIREMENTS FOR ENTRY INTO GRADUATE MEDICAL EDUCATION

ACTION: The Board recommended that the Executive Council requestthat the LCGME withdraw recognition of ECFMG certificationbased upon passing the ECFMG examination, and require thatafter July 1, 1978 all physicians educated in medicalschools not accredited by the LCME be required to haveECFMG certification based either on passing Parts I and IIof the NBME exam or the exam determined as equivalent bythe Secretary of HEW.

agreements between foreign governments or institutionsand U.S. institutions for specified clinical trainingprograms for exchange visitor physicians. The AAMCwould issue the DSP-66 to alien physicians for whomprograms have been arranged. Support for this programwould be obtained through charges to foreign institutions and/or governmental agencies. Such chargeswould serve to emphasize their commitment to theindividual for whom these agencies seek training.

The ECFMG should retain t~e certifying function forall graduates of foreign medical schools notaccredited by the LCME after the requirements listedunder B/l above have been fulfilled. It should furthermaintain records on all candidates for the examination,on those who passed and failed and on recipients of theECFMG certificate as well as those who subsequentlyenter U.S. graduate programs.

2.

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ACTION: The Board recommended that the Executive Council endorseresponding to the American College of Surgeons bysupporting the following principles (each of which representspreviously expressed Executive Council recommendationsconcerning the accreditation of graduate medical education):

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• 1. The Association supports the ACS recommendation thatthere be a free-standing, independent staff for theLCGME and the Residency Review Committees, not relatedin any particular way to a single parent organization.

2. The LCGME serves and should continue to serve as theprivate sector accrediting agency for programs ofgraduate medical education. The RRC's should continueto review the on-site evaluations of each particularprogram and to initiate modifications in the recognized"essentials" for each particular specialty. However,it is the ultimate responsibility of the LCGME toapprove these essentials and to review the accreditationrecommendations of the RRC's.'

3. The LCGME should have the authority to appoint onemember to each RRC in place of the member currentlyappointed by the AMA Council on Medical Education.This member would be appointed from a roster ofspecialist educators developed by the AMA, the AAMC,and the AHA. The other two members of the LCGME(American Board of Medical Specialties and theCouncil on Medical Specialty Societies) are responsi-ble for appointing the remaining members of the ResidencyReview Committees.


ACTION: The Board recommended that the Executive Council reaffirmits position as represented in Dr. Cooper's letter ofJune 25, 1975. It also recommended that the ExecutiveCouncil agree that the Association members and staff workto help place the currently enrolled USUHS students in otherU.S. medical schools and assist displaced faculty in findingnew positions in the event that the Congress decides toclose the school.

AAMC MEDICAL LIBRARIANS GROUP

ACTION: The Board declined to forward to the ExecutiveCouncil a proposal that a Medical LibrariansGroup be formed. Instead, it recommended thatthe appropriate response be to suggest tbat thegroup consider organizing to become a constituentmember of the CAS and to meet in conjunction withthe AAMC Annual Meeting.

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AAMC/GPR LEGISLATIVE ALERT TELEPHONE NETWORK

ACTION: The Board suggested that this matter be addressed atthe COD Spring Meeting with the following pointsemphasized:

1) It is important for the deans to contactcongressmen in response to AAMC alerts.

2) The AAMC should be notified of contactsmade and receive feedback on them.

3) The AAMC needs to develop an appropriatemechanism for rapid alerting of deans onshort notice issues.

PROPOSED OSR NEWSLETTER

ACTION: The Board endorsed the expenditure of a modestamount of funds to develop and test a pilotnewsletter for the OSR.

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March 30-31, 1977


ACTION: The CAS Administrative Board accepted the accreditationrecommendations (as set forth in the Executive CouncilAgenda on pages 20-21).


ACTION: The CAS Administrative Board accepted the recommendationsfor COTH members pending review by the COTH Administrative Board (as set forth in the Executive Council Agendaon page 22).


ACTION: The CAS Administrative Board accepted the recommendationsfor subscribers (as set forth in the Executive CouncilAgenda on page 23) .

LCCME 1977 BUDGET

ACTION: The CAS Administrative Board approved the 1977 LCCMEBudget (as recommended in the Executive Council Agendaon page 24).

RULES AND REGULATIONS OF THE PLANNING COORDINATORS' GROUP

ACTION: The CAS Administrative Board approved the modificationsto the Rules and Regulations of the Planning Coordinators'Group (as recommended in the Executive Council Agenda onpages 25-34).

KOUNTZ v. STATE UNIVERSITY OF NEW YORK

ACTION: The CAS Administrative Board approved the recommendationthat the AAMC file an amicus curiae brief in this case(as set forth in the Executive Council Agenda on page 35).


ACTION: The CAS Administrative Board approved the recommendations(as set forth in the Executive Council Agenda on page 36)with one correction in the wording of the second paragraph,last sentence, where II reduced ll should be lIincreased. 1I

12

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March 30-31, 1977


ACTION: The CAS Administrative Board accepted the accreditationrecommendations (as set forth in the Executive CouncilAgenda on pages 20-21).


ACTION: The CAS Administrative Board accepted the recommendationsfor COTH members pending review by the COTH Administrative Board (as set forth in the Executive Council Agendaon page 22).


ACTION: The CAS Administrative Board accepted the recommendationsfor subscribers (as set forth in the Executive CouncilAgenda on page 23) •

LCCME 1977 BUDGET

ACTION: The CAS Administrative Board approved the 1977 LCCMEBudget (as recommended in the Executive Council Agendaon page 24).


ACTION: The CAS Administrative Board approved the modificationsto the Rules and Regulations of the Planning Coordinators'Group (as recommended in the Executive Council Agenda onpages 25-34).

KOUNTZ v. STATE UNIVERSITY OF NEW YORK

ACTION: The CAS Administrative Board approved the recommendationthat the AAMC file an amicus curiae brief in this case(as set forth in the Executive Council Agenda on page 35).


ACTION: The CAS Administrative Board approved the recommendations(as set forth in the Executive Council Agenda on page 36)with one correction in the wording of the second paragraph,last sentence, where "reduced" should be "increased. 1I

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RECOMMENDATIONS FOR COORDINATION OF THE APPLICATION CYCLES FOR GMEPROGRAMS RECRUITING MEDICAL STUDENTS FOR GME-II POSITIONS

ACTION: The CAS Administrative Board agreed with the objectives of this recommendation; however, the need fora stronger statement was felt, and it was agreedthat further exploration of ways to enforce thiswould be pursued.

CCME COMMITTEE ON PHYSICIAN DISTRIBUTION REPORT: THE SPECIALTY ANDGEOGRAPHIC DISTRIBUTION OF PHYSICIANS

ACTION: The CAS Administrative Board agreed with the recommendation to transmit the summary of responses asset forth in the Executive Council Agenda on pages42-47.


ACTION: The CAS Administrative Board approved the policystatement as set forth in the recommendation onpage 50 of the Executive Council Agenda.


ACTION: The CAS Administrative Board approved the recommendation on ECFMG certification as set forth in the Executive Council Agenda on page 52.


ACTION: The CAS Administrative Board agreed with respondingto the American College of Surgeons by supporting theprinciples as set forth in the recommendation on page53 of the Executive Council Agenda.

TALMADGE COMMITTEE REPORT

ACTION: The CAS Administrative Board endorsed the TalmadgeCommittee Report as a very lucid and helpful document.

LIAISON COMMITTEE ON SPECIALTY BOARDS RECOMMENDATIONS ON EMERGENCYMEDICINE

ACTION: The CAS Administrative Board reaffirmed its positionthat emergency medicine does not represent a body ofknowledge or a discipline, but rather that it is anoccupation, and requested an opportunity to reviewthe materials supporting the application.

13

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ACTION: The consensus of the CAS Administrative Board was thatthe AAMC should not take on the additional responsibilityof administering this program, but that AAMC staff shouldcontinue to assist the Division of Medicine in developingregulations for implementation of P.L. 94-484 withouttaking on any contractual obligations.

COUNCIL OF MEDICAL SPECIALTY SOCIETIES LIAISON

ACTION: The CAS Administrative Board agreed that Richard Wilbur,Executive Vice President of the CMSS, be invited to attend one of the sessions (dependent upon the agenda) ofthe next CAS Board meeting; and subsequent meetings onan individual basis.

MEMBERSHIP APPLICATION

ACTION: The CAS Administrative Board voted unanimously torecommend to the Executive Council that the AmericanSociety for Clinical Pharmacology be elected to membership in the Council of Academic Societies •

CLINICAL FELLOWS TRAINING STUDY

ACTION: It was agreed that a small committee would be formed(with individuals outside the CAS Administrative Boardas well) to review the findings of this study and develop a position paper. It was the consensus of theBoard that this would good opportunity to assess policymatters in this area.

Although no specific actions were taken, the following items were discussed and gUidance and direction were provided to the staff for development of these issues: Biomedical Research, Health ManpowerLegislation, Health Planning Act, and Communication with Administration Officials.

14

TALMADGE COMMITTEE REPORT

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MEMBERSHIP

ACTION:

ACTION:

ACTION:


March 31, 1977

It was moved, seconded and carried that the following applicationsfor Regular Members in the Association of American MedicalColleges be recommended for approval to the Executive Council:

The Children's HospitalBirmingham, Alabama

Veterans Administration HospitalNorthport, New York

Veterans Administration HospitalHampton, Virginia

It was moved, seconded and carried that the present AAMCrecommendation be revised to read:

"It is recommended that the AAMC stronglysupport federal payment standards for theMedicare and Medicaid programs based uponthe full financial requirements of hospitals •This recommendation should not be interpretedto preclude support of state level administration of rate review systems, establishedeither voluntarily or by statute, providingsuch systems meet federal standards."

It was moved, seconded and carried that the present AAMCrecommendation be amended to read:

lilt is recommended that the AAMC's positionon payment categories for the tertiarycare/teaching hospital be retained andstrengthened by advocating the developmentof a flexible classification system providingdue consideration for case mix, intensity ofcare, and health science education."

15

GUIDELINES FOR THE APPLICATIONS OF HOSPITAL ACCREDITATION STANDARDS IN SURVEYINGUNIVERSITY HOSPITALS

It was moved, seconded, and carried that the Ad HocCommittee recommendation be approved as reported(as presented on page 63 of the Executive Councilagenda), changing only the word "reimbursement" to"payment."

It was moved, seconded, and carried that the Ad HocCommittee recommendation be approved as reported(as presented on page 64 of the Executive Councilagenda), changing only the phrase lithe segment II

to "those segments. II

It was moved, seconded, and carried that the AAMCretain its present opposition to the provisions ofSection 40.

16

It was moved, seconded, and carried that the six Ad HocCommittee recommendations pertaining to Section 22 beapproved as reported (as presented on pages 64-68of the Executive Council agenda), substituting theword "payment" wherever the word "reimbursement"appears.

It was moved, seconded, and carried that the Ad HocCommittee recommendation be approved as reported(as presented on page 68 of the Executive Councilagenda).

It was moved, seconded, and carried that the letter toSecretary HEW Joseph A. Califano, Jr., concerningthe treatment of federal and state grants (i.e.,"seed money" grants) for medical education in computingallowable costs for providers under the Medicare program,be approved and sent to him as drafted.

It was moved, seconded, and carried that the Ad HocCommittee recommendation be approved as reported(as presented on page 69 of the Executive Councilagenda) .

ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

It was moved, seconded, and carried that the "Guidelinesfor the Application of Hospital Accreditation ProgramStandards in Surveying University Hospitals" be approvedand forwarded to the JCAH with a cover letter that summarizesthe most salient of the unique characteristics of universityhospitals upon which the gUidelines focus.

LETTER TO HEW SECRETARY CALIFANO

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ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

It was moved, seconded, and carried that the ExecutiveCouncil be recommended to approve the policy statementspresented on page 50 of the Executive Council Agenda,which set forth the roles of the AAMC and the ECFMGto take effect at the termination of the blanket waiverissued by the HEW Secretary and upon the availabilityof the Visa Qualifying Examination abroad.

It was moved, seconded, and carried that the ExecutiveCouncil be recommended to request that the LCGME withdrawrecognition of ECFMG certification based upon passing theECFMG examination, and require that after July 1, 1978all physicians educated in medical schools not accreditedby the LCME be required to have ECFMG certification basedeither on passing Parts I and II of the NBME exam or theexam determined as equivalent by the Secretary of HEW.

It was moved, seconded, and carried that the ExecutiveCouncil be recommended to authorize staff to press forspeedy implementation of the provisions contained inTitle VI of P.L. 94-484 regarding J-visas and waivers.

It was moved, seconded, and carried that the AAMC shouldnegotiate with the Department of State on arrangementsunder which FMGs with characteristics qualifying themfor graduate medical education can be admitted understudent (Fl) visas, with the option to change to J-visastatus as soon as the individual has met the J-visarequirements and is acceptable as a participant in anA~erican graduate medical education program.

It was moved, seconded, and carried that no specialprovisions need to be made at this time for advancedgraduate medical education students being trained in theU.S. for faculty positions in foreign medical schools,or for other comparable responsibilities, but thatremedial steps could be taken at a later date if necessary.

It was moved, seconded, and carried that the AAMC requestthat the Department of Justice amend the regulation fordistinguished physician visitors, striking the word solelyand that the AAMC request that the chairpersons of theappropriate Congressional Committees inform the Department ofJustice that the present regulations fail to reflect Congressionalintent.

17

LCCME 1977 BUDGET



It was moved, seconded, and carried that the AAMC recommendthat a technical amendment to P.L. 94-484 or new legislationbe formulated and enacted, under which the Secretary of HEW,upon application, could, on the advice of an appropriatelyconstituted body determine whether the alien FMG candidatesought by U.S. medical institutions for a faculty positionhas competences equivalent to those embodied in U.S. facultymembers. If the Secretary makes such a determination, heshould be empowered to waive the examination requirement forissuance of a visa.

It was moved, seconded, and carried that the ExecutiveCouncil be strongly recommended to transmit to theCoordinating Council on Medical Education the summaryof responses to the report which are set forth onpages 43-47 of the Executive Council Agenda.

It was moved, seconded, and carried that the ExecutiveCouncil be recommended to endorse responding to theAmerican College of Surgeons by supporting the threeprinciples presented on page 53 of the ExecutiveCouncil Agenda.

18

It was moved, seconded, and carried that the AAMC shouldnot undertake the task of verifying the documentssubmitted by USFMS transfer applicants.

It was moved, seconded, and carried that the ExecutiveCouncil be recommended to reaffirm its position as presentedin Dr. Cooper1s letter of June 25, 1975 to Dr. AnthonyCurreri, President of the Uniformed Services University ofthe Health Sciences. It was also recommended that theExecutive Council agree that the Association members andstaff work to help place the currently enrolled USUHSstudents in other U.S. medical schools and assist displacedfaculty in finding new positions in the event that the Congressdecides to close the school.

It was moved, seconded, and carried that the proposed interimLCCME budget for 1977 be approved with the request that afinal budget be submitted as soon as possible.

ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

ACTION:

CCME COMMITTEE ON PHYSICIAN DISTRIBUTION REPORT: THE SPECIALTY AND GEOGRAPHICDISTRIBUTION OF PHYSICIANS




KOUNTZ v. STATE UNIVERSITY OF NEW YORK (SUNY)

It was moved, seconded, and carried that the Rules andRegulations of the Planning Coordinators' Group beapproved as modified.

It was moved, seconded, and carried that the Associationbe recommended to join with the State University of NewYork in filing an amicus curiae brief in the case ofKountz v. State University of New York.

It was moved, seconded, and carried that the ExecutiveCouncil be recommended to approve the statement presentedon page 37 of the Executive Council Agenda, which will beforwarded to the LCGME, the American Board of MedicalSpecialties, the Council of Medical Specialty Societies,and organizations of program director-so

ACTION:

ACTION:

ACTION:

ACTION:

It was moved, seconded, and carried that the ExecutiveCouncil be recommended to "recognize the need for"(instead of "both endorse encouraging," as stated inthe recommendation on page 36 of the Executive CouncilAgenda) the development of reduced - schedule positionsand to ask the LCGME to establish policies and mechanismsto permit their identification so that they may be listedin the NIRMP Directory •

RECOMMENDATION FOR COORDINATION OF THE APPLICATION CYCLES FOR GME PROGRAMSRECRUITING MEDICAL STUDENTS FOR GME-II POSITIONS

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ACTION: On motion! seconded! and carried! the OSR AdministrativeBoard endorsed the LCME Accreditation decisions.

LIAISON COMMITTEE ON CONTINUING MEDICAL EDUCATION! 1977 BUDGET

ACTION: On motion! seconded! and carried! the OSR AdministrativeBoard endorsed the proposed interim budget of the LCME.

KOUNTZ V. STATE UNIVERSITY OF NEW YORK

ACTION: On motion! seconded! and carried! the OSR AdministrativeBoard endorsed'the recommedation that AAMC join with theState University of New York in filing an amicus curiaein the case of Kountz v. State University of New York.


ACTION: On motion! seconded! and carried! the OSR AdministrativeBoard strongly supported the recommendation that AAMCendorse the development of reduced-schedule residencyprograms and ask that LCGME establish policies whic~ wouldfacilitate their identification for listing in the NIRHPDirectory.

COORDINATION OF APPLICATION CYCLES FOR GME PROGRAMS RECRUITINGMEDICAL STUDENTS FOR GME-II POSITIONS

ACTION: On motion! seconded! and carried! the OSR AdministrativeBoard approved the recommendation regarding coordinationof the application cycles for PGY-2 positions.

REPORT OF THE CCME COMMITTEE ON PHYSICIAN DISTRIBUTiON: THE SPECIALTY'AND GEOGRAPHIC DISTRIBUTION OF PHYSICIANS

ACTION: On motion! seconded! and carried! the OSR AdministrativeBoard endorsed the recommendation that the CCME Committeebe asked to prepare a new and more concise statement onthe specialty and geographic distribution of phYsicians.

ADMISSION OF FOREIGN MEDICAL GRADUATES AS EXCHANGE VISITORS

ACTION: On motion! seconded! and carried! th~ OSR AdministrativeBoard endorsed the recommendation that the AAMC shouldseek sponsorship of the P-II Programs of the Exchange

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Visitor Program and that the ECFMG should retain thedocumentation responsibilities involved in issuance ofVisa Qualification Certificates.


ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard recommended that LCGME be requested to withdrawrecognition of ECFMG certification based upon passing theECFMG examination, and require that after July 1, 1978 allphysicians educated in foreign medical schools notaccredited by the LCME required to have ECFMG certificationbased either on passing Parts I and II of the NBME exam orthe exam determined as equivalent by the Secretary of HEW.

UNIFORMED SERVICE UNIVERSITY OF THE HEALTH SCIENCES

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard agreed that while it did not support the concept ofa military medical school, it would support efforts byAAMC to assist students in finding places and faculty infinding positions in other U.S. medical schools in theevent that Congress decides to close the Uniformed ServicesUniversity of the Health Sciences.

OSR NEWSLETTER

ACTION: On motion, seconded, and carried, the OSR AdministrativeBoard agreed to request the Executiye Council to allocatefunds to support an OSR newsletter for all medical students.

21

association 01 americanmedical colleges

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ACT ION S

TAKEN AT MEETINGS OF:Exeoutive Counoil (June 23-24" 1977). . . . . . lCOD Administrative Board (June 23" 1977). . . . .. 5CAS Administrative Board (June 22-23" 1977) . . .. 8COTH Administrative Board (June 23" 1977) •. . lOOSR Administrative Board (June 21.-22" 1.977) . . II

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June 23-24, 1977

FY 1978 GENERAL FUNDS BUDGET

ACTION: The Executive Council, meeting in Executive Session,approved a general funds budget for the Associationfor FY 1978 of $5,800,000. The Executive Councilalso authorized the funding from FY 1977 operatingincome of several fund reserves.

OSR REPORT

ACTION: The Executive Council authorized the continuation ofan OSR report for two additional issues at a cost ofapproximately $3,500, and asked the staff to presentan evaluation of the report following publication ofthese two issues.


ACTION: The Executive Council endorsed the accreditation decisions acted upon by the Liaison Committee on MedicalEducation at its April 5, 1977 meeting.

ELECTION OF PROVISIONAL INSTITUTIONAL MEMBERS

ACTION: The Executive Council recommended to the Assembly theelection of the following schools to Provisional Institutional membership:

Texas A &MUniversityCollege of Medicine

East Carolina UniversitySchool of Medicine

ELECTION OF COTH MEMBER

ACTION: The Executive Council recommended to the Assembly theelection of the following institution to TeachingHospital membership:

Rancho Los Amigos HospitalDowney, California

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ACTION: The Executive Council approved the following schoolsas Subscribers:

University of OklahomaTulsa Medical CollegeTulsa, OklahomaJames E. Lewis, Ph.D., Interim Dean

Morehouse CollegeSchool of MedicineAtlanta, GeorgiaLouis W. Sullivan, M.D., Dean

WITHHOLDING OF PROFESSIONAL SERVICES BY PHYSICIANS

ACTION: The Executive Council authorized the Chairman toappoint a small working group to produce a policystatement on the withholding of professional servicesby physicians. This group was asked to report to theExecutive Council at its September meeting.

ESTABLISHMENT OF A SPECIALTY BOARD ON EMERGENCY MEDICINE

ACTION: The Executive Council, by split vote, supported theestablishment of a Conjoint Board in Emergency Medicinewith mandatory representation of the following primaryboards:

Fami 1y PracticeInternal MedicinePediatricsSurgery

and representation from the following areas:

Emergency MedicinePsychiatryObstetrics and Gynecology

RESPONSE TO THE GAO REPORT: IIPROBLEMS IN TRAINING AN APPROPRIATEMIX OF PHYSICIAN SPECIALISTS II

ACTION: The Executive Council approved the following principlesof AAMC policy to form a basis of a response to the GAOReport:

1. Support the proposal in the GAO Report that theCCME accept the responsibility for recommendingthe appropriate distribution of residenciesamong the specialties of medicine, but not for

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carrying out or enforcing these recommendations;

2. Recommend to the Secretary, DHEW, that theGraduate Medical Education National AdvisoryCouncil (GMENAC) be abolished when and if theCCME accepts the proposal;

3. Recommend that the development of regulatoryapparatus be deferred until obviously needed;

4. Recommend that, should regulatory apparatusbe required, the CCME be invited to participatein its design; and

5. Recommend that, should regulatory apparatus berequired, it be effected by mechanisms that arecompletely separate from the LCGME accreditationprocess.

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COUNCIL OF DEANSADMINISTRATIVE BOARD

June 23, 1977

ELECTION OF PROVISIONAL INSTITUTIONAL MEMBERS

ACTION: The Board recommended, subject to ratification by thefull Council of Deans, that the Executive Councilrecommend to the Assembly the election of the followingschools to Provisional Institutional Membership in theAAMC:

Texas A &MUniversityCollege of Medicine

East Carolina UniversitySchool of Medicine


ACTION: The Board recommended that the Executive Council approvethe following schools for Subscriber status:

University of OklahomaTulsa Medical CollegeTulsa, OklahomaJames E. Lewis, Ph.D., Interim Dean

Morehouse CollegeSchool of MedicineAtlanta, GeorgiaLouis W. Sullivan, M.D., Dean

AAMC POSITION ON THE WITHHOLDING OF PROFESSIONAL SERVICES BY PHYSICIANS

ACTION: The Board recommended that the Executive Councilconsider the appointment of a small working group toproduce a policy statement on the withholding ofprofessional services by physicians.

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ACTION: The Board endorsed the recommendation of the ad hoccommittee that the AAMC support the establishment of aConjoint Board in Emergency Medicine with mandatoryrepresentation of the following primary boards: FamilyPractice, Internal Medicine, Pediatrics and Surgery, andwith representation from Emergency Medicine, Psychiatry,Obstetrics and Gynecology.

DRAFT RESPONSE TO THE GAO REPORT

ACTION: The Board recommended that the Executive Council reviewthe position of the AAMC on the question of privatesector regulation of the number of specialists trainedby graduate medical education programs, and

--Support the proposal in the GAO Report that the CCMEaccept the responsibility for recommending theappropriate distribution of residencies among thespecialties of medicine, but not for carrying outor enforcing these recommendations;

--Recommend to the Secretary, DHEW that the Graduate, Medical Education National Advisory Council (GMENAC)

be abolished when and if the CCME accepts the proposal;

--Recommend that the development of regulatory apparatusbe deferred until obviously needed;

--Recommend that, should regulatory apparatus be required,the CCME be invited to participate in its design;

--Recommend that, should regulatory apparatus be required,it be effected by mechanisms that are completely separatefrom the lCGME accreditation process.

AAMC POSITION ON THE MODIFICATION OF THE CAPITATION CONDITIONS IN P.l. 94-484

ACTION: The Board urged that the AAMC endorse the proposal underconsideration in the Senate that the USFMS transferprovision in 94-484 be eliminated and that in its place anew program of special project grants to support suchtransfers be enacted.

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NOMINATING COMMITTEE FOR DISTINGUISHED SERVICE MEMBERS

ACTION: The Board authorized its chairman to establish a committeeto solicit nominations from the Council of Deans for electionto Distinguished Service Membership in the AAMC. Thecommittee, as appointed, will include Drs. Van Citters andLuginbuhl.

DEDICATION OF THE 1977 COD SPRING MEETING PROCEEDINGS

ACTION: In gratitude for his service to the Council of Deans and inrecognition of his many contributions to the profession ofmedicine as physician, scholar, teacher and administrator,the Proceedings of the 1977 Spring Meeting are dedicated toChandler A. Stetson, M.D.

His warmth and sensitivity profoundly affected both thepersonal and professional lives of all with whom he worked.The Association of American Medical Colleges will be poorerfor the loss of his keen insight, wise judgment and selflessdedication to the Council of Deans, its Administrative Boardand the Executive Council.

1978 COUNCIL OF DEANS SPRING MEETING

ACTION: The Board selected Snowbird, Utah as the site for the nextCOD Spring Meeting to be held April 23-26, 1978.

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June 22-23, 1977


ACTION: The CAS Administrative Board voted unanimously to endorse the LCME accreditation decisions.

AAMC POSITION ON WITHHOLDING PROFESSIONAL SERVICES BY PHYSICIANS

ACTION: The CAS Administrative Board approved the recommendation to appoint a small working group to produce apolicy statement on the withholding of professionalservices by physicians.


ACTION: On motion, seconded, and carried, the CAS AdministrativeBoard recommended that the AAMC oppose establishment ofany type of Emergency Medicine Board; however, the Executive Council should instruct the representatives to theABMS that should this position fail, the next alternativeis to support the establishment of a Conjoint Board; andthe third alternative would be establishment of a Representative Board. This motion was approved by five Boardmembers, opposed by one, and one abstained.


ACTION: The CAS Administrative Board concurred with the recommendation that the Executive Council review the positionof the AAMC and make the recommendations as outlined onpage 34 of the Executive Council Agenda.

IMPLEMENTATION STEPS FOR CAS SERVICES PROGRAM

ACTION: After a thorough discussion of many concerns raised bythe Board members, it was the consensus of the CAS Administrative Board that if this experiment is to besuccessful, and in order to dispel the perception thatthe AAMC is an internal medicine group, the servicesprogram should be extended to other societies (particularly a basic science society) as rapidly as possible.

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AMENDMENT TO THE RULES AND REGULATIONS OF THE COUNCIL OF ACADEMICSOCIETIES

ACTION: On motion, seconded, and carried, the CAS Administrative Board revised Paragraph 1, Section V. Committees,of the CAS Rules and Regulations to amend the selectionof the Nominating Committee, which will now be appointedby the CAS Administrative Board.

RESOLUTION CONCERNING THE DEATH OF THOMAS KINNEY

ACTION: On motion, seconded, and carried, the CAS Administrative Board concurred that a resolution be forwardedexpressing the AAMC's regret on the death of ThomasKinney, who played a major role in the formation ofthe CAS and the activities of the AAMC.

CAS INTERIM MEETING

ACTION: A discussion of the CAS Interim Meeting, which was heldon Wednesday, June 22nd at AAMC Headquarters, indicatedthat the meeting was a success (43 societies were represented); and it is planned to continue to hold thistype of meeting.

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June 23, 1977


It was moved, seconded and carried that the followingapplication for Regular Membership in the Associationof American Medical Colleges be recommended forapproval to the Executive Council:

Rancho Los Amigos HospitalDowney, California

It was moved, seconded and carried that the ExecutiveCouncil be recommended to review the position of theAAMC on the question of private sector regulation ofthe numbers of specialists trained by graduatemedical education programs and carry out the fiverecommendations listed on page 34 of the ExecutiveCouncil agenda.

It was moved, seconded and carried that the report andrecommendations of the Ad Hoc Group on Emergency Medicinebe approved by the Executive Council.

It was moved, seconded and carried that the recommendationthat the Administrative Boards and the Executive Councilconsider the appointment of a small working group toproduce a policy statement on the withholding ofprofessional services by physicians be passively approved.

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June 21-22, 1977

LCME ACCREDITATION DECISIONS

ACTION: The OSR board recommended that the Executive Council ratifythe LCME Accreditation Decisions.

AAMC POSITIONS ON THE WITHHOLDING OF PROFESSIONAL SERVICE BY PHYSICIANS

ACTION: The OSR board supported the appointment of a working groupon the withholding of professional services by physicians andrecommended that a student be included as a member of thegroup •


ACTION: The OSR board endorsed the staff recommendations with regardto the GAO Report, "Problems in Training an Appropriate Mixof Physician Specialists."

INTERIM REPORT OF THE TASK FORCE ON STUDENT FINANCING

ACTION: The OSR board supported the recommendations included in theTask Force's Interim Report with the suggestion that themaximum debt levels of the proposed loan program be increased.

TASK FORCE ON GRADUATE MEDICAL EDUCATION MEMBERSHIP

ACTION: The OSR board approved a resolution expressing dissatisfactionwith the housestaff appointments to the Task Force on GraduateMedical Education. Since the OSR had recommended severalindividuals for the two housestaff positions, the resolutionrequested the Chairman of AAMC to appoint an additional housestaff member from the list of nominations offered by OSR.

CONSORTIUM OF MEDICAL STUDENT GROUPS DOCUMENT OF UNDERSTANDING

ACTION: The OSR board reviewed several proposed changes to theConsortium's Document of Understanding and concurred withall of the revisions with the exception of a new section regardingformulation of Consortium policy. The OSR recommended a substitute section specifying that the Consortium will not developits own policy but will facilitate the input of participatinggroups to the development of positions and testimony of thosegroups within the Consortium that choose to develop policy ortestify independently.

EDUCATION RELATED TO HOSPITAL COST CONTAINMENT

ACTION: The OSR board approved two resolutions regarding the teaching ofcost containment techniques to medical students.

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