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Accrediting agency places UND medical school into 'warning' category; changes imminent

GRAND FORKS - The University of North Dakota's School of Medicine and Health Sciences' outlying campuses in Fargo, Bismarck and Minot will have less autonomy than in the past as the college works to comply with the findings of an accrediting agency.

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GRAND FORKS - The University of North Dakota’s School of Medicine and Health Sciences’ outlying campuses in Fargo, Bismarck and Minot will have less autonomy than in the past as the college works to comply with the findings of an accrediting agency.

The Liaison Committee on Medical Education sent a report to President Robert Kelley in July detailing about a dozen areas the school needs to improve or face possible accreditation revocation. The school has been placed in a “warning” category and is not on probation.

“This action indicates that there are areas of noncompliance with accreditation standards that will, if not corrected promptly, seriously compromise the ability of the school of medicine to conduct a quality medical education program,” two LCME co-secretaries wrote in the report.

The biggest and most pressing critique is one requiring a more centralized management system of the school’s four campuses, which med school Dean Joshua Wynne said will be addressed in an action plan. The plan must be submitted to the accrediting agency by December.

“We will need to have more central management and control than we have in the past and not everyone is going to be happy with this, but as you see from the letter, bad things will happen if we don’t do this, so we have to do it,” he said.

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Strict standards

Wynne said the accrediting agency schools every eight years and the March visit from the agency was on schedule. The accrediting agency has 132 standards medical schools must meet.

“Good enough isn’t good enough,” Wynne said. “We actually have to be in compliance with every one of the standards.”

The report cites 10 standards UND’s med school doesn’t comply with, including a lack of occupational hazard information available to students, delayed grade posting and several areas of research falling short of expectations.

The agency accredits about 140 schools, and 26 are like UND in that they have scattered campuses and don’t run their own hospitals.

Wynne said he told the accrediting agency that when it comes to research, the UND med school has different needs because there isn’t a full-time instructor in every department.

“As a small school, we cannot do what a big school does and expect every department in every area to have the same level of research productivity,” he said. “What we have chosen to do and what has worked is a focused approach where we select the areas we invest in and set different standards for those departments than our clinical departments.”

Wynne is mostly concentrating on the report’s accusation of a “lack of oversight,” but the slated changes and reduction in autonomy isn’t resonating well with some employees.

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“Some of the feedback I’ve heard has been more ‘Why do we have to do it?’ and quite frankly my reaction is that we don’t have a choice,” he said. “Whether I necessarily agree with each of these findings, and I don’t … it doesn’t matter at this point.”

As a result, Wynne said the three outlying campuses in Fargo, Bismarck and Minot won’t be as autonomous as they have been in the past.

President Kelley also called some of the report’s findings a matter of a “difference of opinion.”

Following the rules

Staff and faculty will have about two months, starting in October, to review and comment on the UND action plan before it is submitted to accrediting agency in December. It will be reviewed at a February meeting.

If accepted, the school has until the end of 2015 to implement the plan.

According to its website, about 9 percent of LCME accredited schools in the United States have the same “pending” accreditation listing as UND. This means that while the schools remain accredited, they are in the process of working to meet some LCME standards.

But Wynne said he isn’t worried about the report’s effect on the school’s external reputation and is confident the med school will receive a positive review after implementing the action plan.

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The report also commended the med school in several areas, including healthy student interaction with medical professionals and educational opportunities, diversity and financial stability.

“Obviously I would have liked if it was just a completely good thing and we could move forward, but this really is not that big a deal because other than some of the issues with this culture change, internally that’s going to be a little more difficult for some people ... externally, I don't think it’s going to have major impact.”

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