California Medical Board Recognition transcript

California Recognition Transcript

Below is the transcript from the California Medical Board meeting in which they voted to recognize AUA.

Moderator:      So at this time I would like to move to item number 21. A consideration and request for recognition of AUA, the American University of Antigua, and ask Mr. Warden and Dr. Nuevo to please come forward and present an item number 21. Mr. Warden.

Mr. Warden:    Okay, please turn to page 97 under packet. Please turn to page 97 in your packet. The American University Antigua College of Medicine, applied to the medical board for recognition for its medical school program. I am going to shorten the name down to AUA.COM. So the evaluation of this school is for requirements of business expression code is 28.9, 28.925 and good compliance of section 13, 14.21a2. AUA.COM was determined to meet the criteria for review by the board pursuant to 13, 14.1a2 by the which is the school that is chartered by jurisdiction which is domiciled primary purpose of the medical school program, to practice medicine in other countries.

Your materials and your staff reported a recommendation to recognize AUA.COM and you make substantial to the compliance with the requirements business suppression should go 20.89, 29.5, California codes regulations, 16 division 13, section 1314.1 and to extend that recognition only to those students who matriculate at AUA.COM, on or after January 1, 2007. Part of the evaluation of AUA.COM presented a lot of materials to the board for review by staff and Dr. Nuello. And also included a side visit to the school and to their teaching hospitals. The site of the team consisted of our Executive Director Linda Whitney, our Board Member Dr. Duruso, or the Staff Council Miss Scurry and Dr. Nuello, our Licensing Medical Consultant.

I would like to take this time to introduce to you the Dr. Nuevo, Dr. Nuevo graduated from the University of Vermont College of Medicine in 1980. Completed his residency in family medicine at Madigan Army Medical Center in 1983 and was board certified. He served in the Army Medical Corp for eleven years. Dr. Nuevo was in faculty at the Uniform Services University of Health and Sciences, the University of Washington and UC Davis. He is been at UC Davis for twenty years. Dr. Nuevo has the end Residency Director and Director of Network Affiliate of Family Practice Program. Dr. Nuevo is currently a Professor and Associate at UC Davis. In addition, Dr. Nuevo has been a Consultant for the Medical Board since 1993 and now I ask Dr. Nuevo to take over the presentation.

Dr. Nuevo:      All right and thank you Curt. Well this slide show is intended to be a supplement to the written report with the goal to give to the Board Members an opportunity to see what it is like to do a site visit and some of the things that we learned on the site visit. And the importance of the site visit. And this is not working.

Okay, next slide. I did want to thank the Board for the team that came for the site visit you gave me. It is the current team, I could not ask for better company, better friends, better colleagues for the site visit, so thank you so much. Many of these slides are Linda’s slides, this one is in  Next slide. I went on this venture as a doubting Thomas and returned with a different point of view. Actually those are not my words, those are the words that Dr. Seymore Schwartz who is on the left here as the Provost of the School and it is endowed and addressed to the meeting of the preclinical sciences and clinical sciences faculty. I think that if you have perceptions about off shore schools, under these circumstances for the site visit we had, I believe your perceptions can be changed by what we have learned. Next slide.

We welcome the strategy for the site visit was to first go to New York City and take a look at two of the training sites. One, this one being Richmond University Medical Center on Staten Island. The train site had a substantial number of the third year core clerkships there, on the flight. We met with faculty from many of the different departments and talked and looked over things such as goals and objectives, how a faculty monitors student performance. Next slide.

This was the surgical faculty on how they and ensure students meet the educational objectives. Next slide. Psychiatry faculty, how the faculty communicate with the School of Medicine and how they complete reports. Next Slide.

OBGYN faculty, on how they – their perceptions of how well the students are prepared in their clerkships. Next slide. And at Richmond University Medical Center we met with 27 of the students. And again we met in sequence, these were half an hour, forty-five minute meetings with students on the different clerkships. I will talk more about our approach that we took with the students. One think I do want to highlight for the Board is the impressive diversity of the student body and frankly the impressive character. We spent a lot of time, well over 100 students either in groups or one on one and we learned a lot about these individuals and I was impressed to be honest. Next slide.

We then went to Wyckoff Heights Medical Center in Brooklyn and it was the same basic approach, we met with faculty from the different departments. Next slide. These are pediatricians, I can tell you stories for hours about the individuals that we met. You would have loved to have met this pediatrician on the right, what a delightful person and the stories that she told. Who went over all theme of all the faculty that we met was how impressed we were with their commitment to education, their commitment to training these students, their commitment to doing a good job. There were areas of improvement but I was very impressed with them. Next slide.

The faculty from surgery, next slide. These are OBGYN faculty, oh just a quick thing. The physician in the middle, I think he serves as a Clinical Director for OBGYN, I was just asking, okay well when the students have to show up. Six-thirty sharp and he meant it. And any student who, God help them if they did not show up at six-thirty sharp. They sent rigorous agenda and we were impressed with that. Next slide.

Family practice faculty again the faculty in the middle gave a suburb description of his goals expectations and what the clerkship was like, and again we were impressed. It met the requirements of any student on a clerkship in Family Medicine. Next slide.

Students also had the opportunity at Wyckoff Heights Medical Center to give us some information about how they look at community resources, research that they do, and again these were all good things to see as part of a student on a clerkship. Next slide.

And themes that we talked about were how they came to be at the school, how performance feedback is given, student logs, next slide. How they evaluated rotation and their awareness of differences of training at that site for that particular clerkship and other sites that the school uses. Next slide. We also toured the facilities, looked at binders, evaluation forms, written exams, all those sort of things that the board would want to take a look at. Next slide. We then flew to the island of Antigua, I learned how to pronounce it, Antigua so I thought you would at least want to see, this was frankly next slide I will talk about this. This is the place that we stayed at, that is the Hugo tree from Hurricane Hugo that we all got a chance to look at, it was horizontal, then goes up. If anybody thinks that going to a site visit oh Caribbean, tough job, must have been a tough thing to do, frankly talk to the eight members of the team, this was exhausting. This was very challenging, they had long hours, there was a lot of information to obtain, we knew what we were trying to do to seek an understanding of the school and the implications of that. Next slide.


This is the school and you know, when you talk about facilities, well first of all, let us take a look at the big picture from the outside. Next slide. Then the same process that we developed and again I will go through as quickly as I can but at least comprehensively as well, was the we started with the leadership and Dr. Naud were here pictured on the left, Shelton on the right there. We started looking at some of the features of the facility, this is the start of tour which began with a simulation suites. Next slide. Give you a sense of the at least a brief visual of the resources that the school has invested in their simulation suites for the introduction to clinical medicine, getting their students prepared for the third clerkship. Next slide.

Many different types of training stations for simulation suites this one incubation, next slide. This was an interesting one, this was actually, you know it was very tough to train students how to look at the retina and this is a model in which those different slides on there could be put in back of the mannikin and you can actually test the student vulnerability to determine different types of funduscopic findings. Next slide.

This was a Vernon Solomon is on the far left there, a teacher for their ACLS, their Advanced Cardiac Life Support, BLS course is another EMT type of training again with a station that allows students to understand complex challenges during codes, physiology changes and in patients and so forth under different conditions. Next Slide.

Dr. Madeline Frazier on the right there is showing another station on the evaluation of an infant. Next slide. Again Dr. Frazier, this is mannikin, though mannikin is probably not the right term, a simulation model called Bertha, that is for delivering babies and they are showing how to examine. It is Bertha, how to examine the size of the uterus. This is Harry and Harry is the student there on the right, Dr. Frazier is there towards the middle and that is to learn how to oscillate the heart and findings and so forth. We tested them on ourselves. Again a very good way, next slide.

This was a ear training device to help students understand the different findings for assessing the tympanic membrane. Next slide. Obviously it is not just all simulation training, there are other issues about a facility that had to be assessed. This is Mahid Pathon, the Dean of Academic Support and Library Services. We did a tour of the library, all the facilities, all the things that went with want in a medical school library. Next slide. The library itself and study cubicles for students. Next slide. A large classroom, we went down and listened briefly to a lecture on diabetic fetal acidosis, a superb lecture, next slide.

Small classroom lecture going on immunology, minemunology, training to pay attention was thirty years ago if they were way beyond my abilities to understand the content. But anyway, we got a chance to watch a lecture on that. Next slide. Pathology lab, I think this was parasitology lecture, next slide. We went to the cadaver lab, just a small view of the cadaver lab and the resources necessary. I am standing behind Shelton there, look at a max screen that was giving a 3D version of how to do dissection. Superb resource for students learning anatomy, next slide.

There is another element to the school that I need to recognize their willingness to dedicate 5FTE, that is the superb dedication in the office of educational enhancement. This is just one of the things that was up on their board in their office. How do you eat a hippopotamus, one bite at a time, one of the challenges of course for students is the overwhelming lull of information and you need educational support people to help direct students how to study efficiently, how to use their time efficiently, how to be effective learners. Next slide.

Linda did a great job in framing this slide. These are three of the five individuals and they are superb people, I wish I had them in my program. Who needs study groups, you do on the back of there, that is their mission and some of the things that they do and we were impressed. Next slide.

The process of the site visit was also to meet with the Deans and the faculty of the school to get a sense of the big picture and then from the faculty that best represents the preclinical sciences, next slide. And some of the resources, on the far left there, is Dr. Marcus Marin with was an extraordinary resource called blackboard learning management system, that would be the envy of any school in medicine. Next slide. Again, some of the resources, Vern Solomon on the far left there, Madeline Frazier more towards the right. Individuals involved in introduction to clinical medicine course. We talked about other things such as how they trained students to be clinically prepared and I will go a little bit more than just a, in a few minutes, how they handle struggling students and then next slide, we met with a lot of students from the school. The strategy that we used was to meet with groups of students in the different semesters. There are four semesters before the August, four semesters before the fifth semester, sorry, did not sound very professorial. But anyway in preparation for the thought clinical correction, it was about 15 students per group. And we talked about the same kind of themes I mentioned before, goals and objectives, how they are set, academic support services, how they came to the school. Next slide.

You can just keep going through the slides and the students here. Give you a sense of who we are meeting with, what we were talking about and so forth. Next slide, next slide, one more, stop right there. Oops, go back to that one. Sometimes you learn things from students that are just terrific. And the student in the middle, I do not remember her name anymore, I just her, well how does the school prepare you for U.S. Emily step one. And her answer should have been recorded and presented to the board because it was very thoughtful, very insightful and toll of the student who was well engaged in the educational process, was not just there, and was understanding the meaning of how to. But one does not just study for it, in medical school to prepare for step one, that the one is getting ready for lifelong learning, but on the other hand you want to do well on step one. But I do want to recognize that student for the understanding that you like to see in a student body. Next slide, next one, again next one. We saw a lot of students, that is the only theme.

Here, let us see, Shelton is there, Dr. Hiney Morcoss is on the left, me and Anita are in the back there, we are heading from the school on our trip to take a look at some of the glimpse of the community. Next slide. We went to Mount St. John Medical Center, a newly built 185 bed facility. Next slide, this is looking down it is built on a hill looking down on the city. Next slide, there were plenty of students there, Linda was kind enough to snap the picture of them. Next slide, the students there, they are not doing their clerkships, it is just hard from their introduction in clinical medicine. We met with a variety of faculty, we toured the wards, the radiographic facilities, I had a chance to speak to a few physicians. Next slide.

And then there were other elements. I could give probably 30 different slides on community engagement. You would love to see those part of the school and what they do for the community. This just happened to be a health fair with the Prime Minister in the center, Dr. Nagara towards the right there, some faculty and students there. And we, I spent a great deal of time talking to students about how they get engaged in schools, in health fairs, and in clinics in the community, and you would be impressed by all the different stories and the excitement of the students. Next slide. Back to the school, next slide. While this is just one of those standard pictures of us, I always want to acknowledge in the background there are staff, next slide. And their staff was superb. This was a very well – well first of all, I forgot to acknowledge Curt’s work, Ron Devalo’s work in preparation from our side and the organization that was necessary to make this site visit work. There our staff also should be acknowledged for their superb organization. It was impressive, we could not have been through this without the good organizational structure so thank you to their staff as well. Next slide.

One of the final things that we did was a cultural event. This is me, Anita and Jim Simon sitting waiting for the cultural event. I wish you could all have seen the cultural event that was put on through recognition of the importance of cultural knowledge and cultural confidence. Next slide. Done in a form we watched dances from all different parts of the world. Next slide.

Moderator:      Put on by students.

Dr. Neuvo:      Put on by students, I am sorry, thank you for, thank you for that qualification. Next slide. Dances, from all different parts of the world, just to give you a sense of the group and the importance of culture. And that was a big deal and the schools should be acknowledged for that.

Next slide, oh that was it. We did spend the end being back with the leadership talking about our findings. And what was interesting, and again testament to the schools capacity, is that towards the end I was reading a number of documents and one being the 2010 report of the preclinical sciences and clinical sciences faculty retreat. And they had their own findings and they were very willing to have us look at all sorts of documents, some of which frankly if I was having a side visit, I would hide, because I would not want to have to disclose the information. But their findings of their 2010 joint faculty meeting were virtually identical to our findings and areas of concern. So we talked about those. We wrote the preliminary report asking for a review, and they responded. Their response I believe was absolutely appropriate and led to the recommendation from myself and the other team members to recommend recognition of the school. That concludes my report except for one final note of thanks to the team again. I could not have done this without you.

Moderator:      Thank you Mr. Warden and Dr. Nuevo. I would like to call upon Dr. Duso now to represent the Board on this site visit to make a few remarks and then he will call on the President of the American University then Peter to come forward and make some remarks as well.

Dr. Duso:         Thank you Madam. I truly enjoyed the team effort that went into it and I appreciate the board having me as their representative. I learned a lot and I was truly inspired and at the same time I want to echo what has already been said. And I want to thank the officials at the University in preparing these students to become the very best physicians with the skills and knowledge to practice medicine globally and more specifically, in the United States. As Jim pointed out and I am sure the team will agree with me, I was more than impressed with the diversity of the student body and how motivated these students are in mastering the work from the time they were admitted to the school until their residencies. And their compassion that was shown by these students in serving undeserved populations. It was truly, truly, impressive. And lastly, I want to congratulate Mr. Neil Simon and his colleagues who are here today for his and their leadership and the vision for overseeing such a fine school. The integrated organizational structure of that university, I found to be a learning environment that has the best opportunities for these students to be successful. So at this time, I would like to make a motion with the requirements of the business and professional code, sections 2089 and 2089.5 in the California Code of Regulations, Title 16, Division 13 to invite the College of Medicine on or about January 1, 2007.

Moderator:      All right, do I hear a comment on the motion from anyone? Thank you. All those in favor of the motion. What I was going to ask for…I apologize.

Unidentified Male:     There is a presentation. Except one of the things that we stressed was the importance of students doing lifelong learning. And we feel like the medical institution is also important for us to be lifelong learning. In doing so, is not always sudden sand rhetoric and the site being those at and help her become a better institution and as an institution believe in lifelong learning. I want to thank the members of the site inspect. The most responsible for out medical education program, Dr. Peter Bell, and the Director of  Dr. Jagbir Nagra, the Dean of the Antigua Campus.

Moderator:      All right, and with that we like.

Unidentified Female:  Do you think you could advise U.S. Medical Schools about having diverse, attracting the diverse student population and having them succeed. That was a very impressive _____[00:25:01]

Unidentified Male:     Thank you, I think that and there is the Macy Report which is in  adopted by the AAMC which indicates that one of the issues to diversity is to recognize that there maybe cultural differences that you should be too happy to score on standardized tests. And I think we have shown that based on income level and other criteria, that students who may score the best on standardized tests, should be given an opportunity to obtain a medical education and they, we have shown that can happen and be successful. So I think that one of the things that I believe is true is that there is too much  but whether or not that is really changing or not I do not know.

Unidentified Female:  I have a question. I was going to ask you as what is the tuition cost for student.

Unidentified Male:     Tuition cost is $11,000.

Unidentified Female:  Per year?

Unidentified Male:     No, per semester.

Unidentified Female:  Per semester?

Unidentified Male:     So it is significantly less than the medical schools in the United States.

Unidentified Female:  And how much, do you have a scholarship programs?

Unidentified Male:     Yes we do.

Unidentified Female:  What percentage of your student body is on scholarship or tuition reduction or…

Unidentified Male:   We have 24 students from the Caribbean region on full scholarship. And then we have about another five to seven students who have taken advantage of different scholarship programs that we have.

Unidentified Female:  Approximately how many students are admitted per year?

Unidentified Male:     Approximately 300, around 300. That’s in, that is not in one, I am sorry, that is in a calendar.

Unidentified Female:  Pardon me?

Unidentified Male:     In a calendar year.

Unidentified Female:  Oh okay, so I was just trying to figure out how you are able to do what you are able to do when we in the states are having such a difficult time as far as finding legally, finding the money to educate our students. So could you give me just a little bit of that where does your support come from, how do you finance.

Unidentified Male:     Well we have our we have people who are owners of the school who have invested a lot of money and who believe in education and believe that providing the quality education product, resulted in becoming successful. And quite frankly to some extent, we piggy back on U.S. system because our students participate in the clinical training in U.S. Teaching hospitals. And those programs were all we bodily do, in fact we pay the facility for that, we get the advantage of how those programs have been developed. The other thing is that we are a university that is primarily interested in educating students to go into primary care. So while that does not change the scope of the educational program, I think it may change the emphasis and allows us to support this kind of program and provide her quality education to our students.

Moderator:      Thank you, any questions?

Unidentified Male:     I think Dr. Navo wants to.

Unidentified Male:     I just wanted to respond to your earlier question with regard to how we prepare our students or community activities. It is a very strong focus right from the moment they enter the campus to be a part of the community. And the works that we have, we are working with almost five non government group agencies. I am with development in various programs. For instance we have HIV Virus, you know our students go to HIV patients and they are working with them or and this whole menu is and that is the focus _____[00:29:30] decide what we have, simulation models, we walk the ground. And actually the slush when we have been providing for the professionals. And that is what we emphasize on the _____[00:29:41]


Unidentified Female:  First I wanted to say, I have been on the foresight business end, I used to _____[00:29:52] into the school but best organized that I had participated in. Second, from my observation, the type of student attending this school is different than in the prior, we counted on the prior side, because it sent out more of these students are fresh out of college as opposed to having, going to medical school as a second career. It is quite a startling change from the prior side of business in that respect. And the third thing that I wanted to mentioned is just though it is not part of the motion, just an understanding that this recognition granted by the board does not extend to students who have completed their preclinical sciences at _____[00:30:34] Medical College International.


Moderator:      Thank you. There is an affiliation between AUA and another institution. You can clear that _____[00:30:54] students we articulate at AUA.


Unidentified Female:  I too wanted to thank the staff of the division of licensing for putting together an excellent packet so that we could go on this site visit. The faculty, the students, the President for ensuring that we had access to all the information that was necessary to perform this site visit and thank you for making sure that we got to where we needed to be on time and allowing us the little late, because we tarried in a few places. We were looking at hospital a little bit longer than we should have, but we really appreciate that. The students tore up in their day for the Spring Fling just so we could participate in that but more importantly, the professionalism shown by the students in dealing with us and being straight forward obviously not scripted. But they wanted to let us know what they were doing and they talked about some of the pros and cons and some of the cons were being so far away from home and how that was dealt with. And I was very impressed with the education faculty that dealt with the individual students that needed assistance. And I was overly impressed with the hippopotamus and the staff there, because they really did have a sincere appreciation with the fact that the students needed guidance all the way through medical school even the top students to get into training each other. Because that made them better students and better physicians. So I want to thank you too for giving the medical board the access that we have.


Moderator:      And in the end things do work out, but this is a long and arduous process. You and I have had that discussion more or less and I just want you to see that in the end, things happen for the right reasons and you obviously your team has shown improvement to those that needed to know what the story was. And it is, take a deep breath and keep smiling, it is nice to see you in that position. So I do have a couple of speakers to comment from Mr. Sheiks so I want to thank you very much and you can have your seats again and we will have a couple of comments and then we will take a vote on the motion. Since there are no more comments, I will call for the question and all those in favor of approval of AUA that is the motion that was stated by Dr. Duso, can you say Aye




Any opposed, or abstentions, so done, thank you very much.