M3 and M4 Academic Years
The Trover Campus provides a small group of medical students the opportunity to complete their third and fourth years of medical school in Madisonville. After completing their first two years of basic sciences in Louisville, Trover Campus medical students move to Madisonville and complete all their clinical rotations there. Students are based within a rural integrated health system with a large tertiary care hospital (Baptist Health Deaconess Madisonville) providing open-heart surgery and most other services but can be in a truly rural area with a 10 minute drive in any direction.
Students participate in the same classroom lectures as the on-campus students by simultaneous live video connection. Clinical rotations on the Trover Campus provide the unique opportunity for daily interaction with an experienced clinician preceptor. The typical teaching group on rounds in an urban medical center is one faculty, 3-5 residents and fellows, and 4-6 medical students.
At the Trover Campus, the faculty to student ratio is much higher. The students also experience the value of small group learning by participating in problem-based learning sessions twice a month, facilitated by the Trover Campus Associate Dean, a family physician.
A small number of TRT students have the option to be considered for the Rural Medicine Accelerated Track (RMAT) which leads to completion of their medical degree in a total of three years.
Students indicate their interest in placement at the Trover Campus, apply, visit the campus, and are interviewed. Click here to visit the U of L Admissions office. The selection committee ranks the candidates and offers are made to the selected students. The goal is 8-12 students per class (16-24 for both years).
This process has drawn national attention, with recent publication of the Trover Campus experience in the premier peer-reviewed journal concerning rural medicine (1). The Trover Campus was also ranked second nationally among all similar programs by a HRSA report. Trover Campus-based students are reimbursed one-time moving expenses from Louisville after the M-2 year and receive a Loman C. Trover, MD Rural Scholarship during the M-3 year. These Trover Rural Track Students also participate in special activities during the M-1 and M-2 years.
The goal is for the quality of the Trover Campus M-3/M-4 medical training to meet or exceed the quality of the training available at the downtown Louisville campus. The curriculum, learning materials, evaluations, examinations, and grading system for the Trover Campus are identical to those used on-campus. In terms of quantity, patient logs kept by Trover Campus students reveal that they see 2-4 times as many patients on most rotations as their on-campus colleagues, and record 2-10 times as many procedures.
One measure of quality is the "paper and pencil" measure of National Board Examinations. On Step Two of the USMLE (United States Medical Licensing Exam), taken during the M-4 (last clinical year) of medical school, first time pass rates of Trover Campus students are comparable to those on the Louisville campus. Step Three of the USMLE is taken during the first year of residency training, and 100 percent of Trover Campus graduates have passed on the first attempt.
Another measure of quality of training is the standardized patient examination. In this measure, an actor is carefully trained and validated to present a clinical scenario to the student. The student knows the "patient" is acting, but must use all the skills learned to date to "connect" with the patient, understand the issues, make a correct diagnosis, and convince the "patient" to follow the treatment plan.
Considered by many to be a better measure of clinical competence than paper and pencil exams, this examination has now become part of National Boards testing for licensure. The campus has become a model for other newly developing regional campuses (2) and the experience with the first 10 years was reported in the premier medical education journal Academic Medicine.
Dr. Gina Wesley, former Director of the U of L Standardized Patient program, said "I worked with U of L's medical students on both the Louisville and Madisonville campuses for many years. The students in Madisonville consistently demonstrate clinical and communication skills that are equivalent to those of the students at the top of the class on the main campus. Their most marked strength is a strong comfort with talking with patients in a compassionate and professional manner."
Another pertinent measure of the Trover Campus quality is the perception of how these graduates perform in subsequent residency training. The residency program directors of the programs having Trover Campus graduates are surveyed each year concerning their evaluation of Trover Campus graduates' performance.
The summary reveals that the Trover Campus graduates show better scores when compared with non-Trover Campus graduates. The Directors note that the Trover Campus graduates are especially well-prepared in the categories of interview skills, oral presentations, overall patient management, clinical judgment, self-directed learning, and interactions with patients. Most Trover Campus graduates report that they matched to their first choice residency program.
- Crump WJ, Fricker S, Barnett D, "A Sense of Place: Rural Training at a Regional Medical School Campus". Journal of Rural Health, January 2004:20(1):80-84.
- Crump WJ, Fricker RS, Wiegman DL. A 10-year Evaluation of the Trover Campus: Lessons learned for addressing the need for more rural physicians. Journal of the Kentucky Medical Association 2010, 108(5):137-143