On May 9, 2025, members of the Heersink School of Medicine Medical Education Committee (MEC) met for its annual retreat to discuss directions for the undergraduate medical education curriculum. The MEC’s primary responsibility is to plan and oversee the curriculum and the communication of curricular changes to wider faculty, student, and administrative audiences across Heersink’s four campuses and instructional sites. The retreat opened with a welcome from Craig Hoesley, M.D., senior associate dean for Medical Education, and Teresa Wilborn, PharmD, Ph.D., MEC Chair, who emphasized the goal of continuing to foster a supportive and effective educational environment for students and faculty. The presentations and organized discussions throughout the day facilitated the beginning of conversation around the future of undergraduate medical education. No decisions have been made at this time, but the sessions allowed for crucial and impactful ideas to be explored.
Undergraduate medical education curriculum overview
Winter Williams, M.D., assistant dean for Clinical Education, presented the first session entitled Promoting Clinical Excellence. He provided a comprehensive overview of the undergraduate medical education curriculum, outlining key milestones and requirements across all four years of training. His presentation highlighted recent innovations, including the launch of the Clinical Reasoning and Integrated Skills Program (CRISP) and the adoption of a competency-based medical education (CBME) model. These initiatives are designed to support a progressive, patient-centered approach to clinical education – from foundational information gathering to diagnosis, management, and treatment.
Dr. Williams then shared several future directions aimed at advancing clinical excellence at the Heersink School of Medicine. These included a proposal to create a clinical commendations recognition to celebrate students who consistently demonstrate clinical excellence and professionalism throughout their training. He also emphasized the use of digital tools to enhance feedback delivery and the integration of Objective Structured Clinical Examinations (OSCEs) as milestones for assessing competence and providing formative feedback. Ultimately, he underscored the school’s commitment to advancing precision education – an approach that personalizes learning based on each student’s needs. He noted that the foundation for this shift is already in place and encouraged continued efforts to meet learners where they are to maximize their growth.
A.I. in Medical Education
Meagan Malone, Ph.D., joined the retreat as a guest speaker to discuss A.I. Pedagogy. Malone, an assistant professor in the UAB Department of English, has dedicated the last few years of her career to researching and understanding the incorporation of generative A.I. in education. In August 2025, she will begin offering sessions through the UAB Center for Teaching and Learning to explore these topics further.
She discussed the development of large language models, and how they’ve evolved in recent years. She highlighted how they now rely on neural networks and deep learning to act similarly to next word prediction models. They are trained by humans, which lead to ethical implications. She noted their current iterations are effective at brainstorming, summarizing research, translating, evaluating and producing text, and producing code. Their current limitations include producing wrong or outright fake information, called “hallucinations.” According to Malone, these hallucinations occur because Large Language Models (LLMs) don’t have an internal state or core of beliefs; they rely on training data and accessible sources. If given competing or erroneous sources, they cannot discern between factual or false information. They also show a tendency to create quotations that do not exist within sources. Malone acknowledged this is a significant limitation.
Malone presented peer university medical schools that have already taken steps to integrate A.I. responsibly, including a required pre-learning module and a four-hour reflective workshop for first-year students. The University of Miami, for example, is establishing an office of A.I. The University of Florida uses A.I. to review alignment of course content with state learning objectives, and its IT department creates bespoke LLMs for specific tasks and departmental needs.
While she acknowledges the concern about introducing medical students to using A.I. before they’re able to grasp the concepts on their own, she urges educators to recognize that students will use the tools whether or not they are trained to. She stressed the importance to teach students to use the tools both ethically and effectively.
Student mistreatment mitigation efforts
Nick Van Wagoner, M.D., Ph.D., associate dean for Students, led a session discussing the reporting of student mistreatment. He explained our school is still functioning under a citation from the LCME regarding mistreatment. He discussed efforts to mitigate mistreatment and improve the learning environment. These include faculty and resident education about mistreatment, improving policies to better define mistreatment, and better monitoring of mistreatment through addition of questions on the end of clerkship evaluation. Dr. Van Wagoner and Dr. Hoesley have or will soon meet with each clinical department and have charged them with creating mistreatment mitigation plans for their department.
Van Wagoner discussed how mistreatment is most commonly reported in the clinical years of medical school and specifically during clerkships. He cautioned faculty that even commenting negatively about a patient or other individual in the presence of a student can be considered mistreatment because it distracts from a positive and effective learning environment. Reminders about mistreatment policies are sent out monthly in the school’s Guidelines for Working with Medical Students email. In addition to ReportIT, students are asked about mistreatment in their graduation questionnaire. Van Wagoner has worked closely with Caroline Harada, M.D., and communications to include data from ReportIT in communications campaigns to students twice a year. He said his team would be working on a more effective mechanism for faculty to be able to report mistreatment on behalf of students.
Challenges resulting from Step 1 P/F structure
Todd Peterson, M.D., assistant dean for Students, followed with a session discussing the current landscape for clinical students applying to residency. He highlighted the paradigm shift that took place after Step 1 went to P/F. Previously, students received numerous opportunities in preclinical years for objective indicators of their level of competitiveness in specialties relative to their peers. The indicators and feedback from Step 1 scores helped inform students prior to the clinical years where they stood. The shift of Step 1 to P/F, paired with a preclinical curriculum that is also P/F, removes many of those objective indicators. Under the P/F paradigm, the majority of crucial competitive indicators is shifted to the MS4 year.
Peterson likened this paradigm to a prospective NBA player finding out two months before the NBA draft if they are 6’10” or 5’8”.
He highlighted the challenges students face who need to delay Step 1. While students who delay Step 1 by 2 months are technically able to complete the components of a residency application, they have no time to consider more than 1 specialty or time to do away rotations. A student delaying Step 1 by 3 months likely mean delaying entering the Match by a year. Our current curriculum limits doing 2 or more visiting rotations before residency applications are due. Peterson also noted that our schedule leaves no room to pivot if Step 2 exam goes poorly for a student. Peterson’s message was that, regardless of form a curriculum change takes, our students need more time between completing clerkships and submission of residency applications to fully explore specialties and submit their application.
Student testimonials
A panel of students then shared their testimonials and recent experiences preparing for Step exams. Some of the students reported that being on the Tuscaloosa campus has relieved some of the stress other students experience because they build flex time into the MS3 year that gives them the opportunity to meet with advisors and explore potential directions. Other students reported financial and mental stresses when transitioning between parts of the curriculum, and those stressors often fall on them when trying to study for Step exams. The students proposed the concept of adjusting the preclinical curriculum to provide more flexibility during the clinical years.
Curriculum restructure data from peer institutions
Anne Zinski, Ph.D., associate professor in Medical Education, further explored this concept in a session discussing curriculum structure. She presented Heersink School of Medicine admissions and academic performance data relative to peer institutions who maintain preclinical curriculums mirroring our own. She also discussed her research into schools who have restructured their curriculum, highlighting key differences in academic metrics of matriculants and exploring subsequent student outcomes. According to Zinski, the published outcomes about shortening the preclinical phase are mixed, and no peer institutions currently employ an abbreviated preclinical model.
Summary of group brainstorming sessions
The retreat wrapped with group brainstorming sessions, group members bringing information presented throughout the day to discuss options for shortening preclinical curriculum to give more flexibility in clinical curriculum. Groups presented their ideas, many of them noting similar benefits and challenges. One group proposed moving some of the basic science information to the clinical years, shortening the preclinical years. Other groups highlighted challenges that would affect regional campus students or pipeline students if not thoughtfully incorporated. Remediation would also be affected by the compression. Other proposals included combining repro and endocrine and finding additional spots to compress fundamentals. Discussion also touched on developing a longitudinal curriculum to span all 4 years. There was also mention of building a student-centered program instead of a program-centered program, where students met milestones instead of timelines. Concerns were raised around how we would review and determine success under this model.
Conclusion
Hoesley and Wilborn addressed the gathered faculty to close, stressing that these discussions are only beginning the process of this topic. Nothing at this point is set in stone. They explained the next step is to hear from schools that have already made these changes and from schools who looked into making the change and decided not to. We want to gather as much data from both sides of the argument before looking at decisions for ourselves.