In this issue, the Educational Quality Improvement (EQI) Unit is excited to share updates regarding one of the medical school accreditation citations. The Liaison Committee on Medical Education (LCME) had determined element 12.4, which addresses student access to healthcare services during clinical training, to be in unsatisfactory standing.

The UWSOM supports students’ access to healthcare and strongly encourages them to obtain and maintain health insurance while enrolled at the UWSOM. With the backdrop of the Washington State law that prevents the school from requiring students to secure healthcare insurance, student access to healthcare has been challenging on multiple fronts. These barriers include the following: (1) lack of an appropriate healthcare insurance plan that is accepted across the WWAMI region during clinical rotations; (2) lack of access to timely and accurate information regarding acceptable healthcare plans and lack of timely information for seeking healthcare during clerkship rotations across the five-state region; (3) lack of clarity about requesting time off for seeking healthcare; and (4) students’ perceived fear of harm that requesting time off for healthcare may reflect negatively on them.

In response to students’ input via annual surveys, two major changes have been implemented, which are elaborated below:

1. Policy Changes: These changes are outcomes of the partnership between the Student Committee on Healthcare Access (SCoHA), led by Joely Hannan and Liya Savochka and their predecessors, and Curriculum leadership. It specifies the number of days of time off students can request while on clinical rotations. Two policies were formally approved by all curriculum governance committees in March 2023.
   
   
   1. Attendance and Absentee Policy -Foundations and Clinical Phases (Revised): https://education.uwmedicine.org/md-program-policies-handbook/attendance-absentee-policy/
   1. Policy on Student Access to Anticipated Healthcare- Clinical Phase (New): https://education.uwmedicine.org/md-program-policies-handbook/access-to-healthcare/

• Centralization of Healthcare Information for Student Access:  SCoHA led the initiative of compiling centralized information regarding healthcare insurance, healthcare access, and telehealth access. In partnership with Student Affairs, the compiled information and guidance have been posted for student access via the following Web links:

• Health Insurance: https://education.uwmedicine.org/student-affairs/health-insurance/
• Healthcare Access: https://education.uwmedicine.org/healthcare-access-for-medical-students/
• SOM-Hall Health Telehealth Program: https://education.uwmedicine.org/som-telehealth-program-for-medical-students/

The websites and two policies are shared with students during clerkship orientations.

On November 14^th, 2023, Dr. Joshua Jauregui, the Assistant Dean for Clinical Curriculum, Gina Franco, the Assistant Director for Clinical Curriculum, and Mary Sargent, the Clinical Curriculum and Student Progress Specialist requested all Department Clerkship Directors and Administrators to share the new policy and the Web resources widely with both students and clerkship site leaders.

In order to more closely monitor student satisfaction with adequacy of guidance about accessing healthcare when on clinical rotations, the school is now collecting student satisfaction with guidance in the end-of-clerkship evaluation beginning in June 2023. In the past, data collection relied on annual surveys administered at the end of Patient Care and Explore & Focus Phases. The most recent ratings by MS3s and MS4s from the clerkship evaluations show a marked decrease in student dissatisfaction, dropping from 30% in 2022 to 2% with satisfaction increasing from 24% to 64%.

We would like to extend our gratitude to the outstanding student leaders, Joely Hannan and Liya Savochka as well as Dr. Joshua Jauregui, Assistant Dean for Clinical Curriculum and Dr. Matt Cunningham, Director of Educational Evaluation. Their leadership and support have been invaluable throughout the year of improving students’ access to health care.

Lastly, we thank the MS3 and MS4 classes for your input, especially your candid comments on the survey.

If you have any questions or concerns, please do not hesitate to contact eqi@uw.edu.