Malcolm X medical program fights for survival

  • By Alex Parker
  • Staff Writer
  • July 14, 2009 @ 7:00 AM

In December 2007, officials at Malcolm X College found that one of the instructors in the physician assistant program lacked the required state medical license.

In May 2008, the college fired the program's director, accusing her of lying about academic credentials on her resume, among other offenses.

The following month, the college fired two instructors for regularly failing to show up for class, according to public records.

And in September, reviewers with a national accrediting body recommended that Malcolm X be stripped of recognition.

Now, instead of welcoming a new class of physician assistant students for the summer, Malcolm X is scrambling to repair the program's tarnished reputation and move forward with a reconstituted staff.

The physician assistant program - one of three in Chicagoland -  supplies county-run facilities, including Stroger Hospital, with a valuable staple of medical professionals.

It is a lifeline for students who can't afford programs like Northwestern University's, and gives local students a chance to enter the profession.

The college's president is confident about a turnaround. But public records show the program faces some serious hurdles.

Numerous mishaps

The trouble began in December 2007, according to documents obtained the Daily News under the Freedom of Information Act. They show Malcolm X officials informed an instructor that he was in violation of standards because he didn't hold the Illinois medical license required to teach classes.

The adjunct instructor was told he needed to get the medical license in order to continue teaching physical science. Documents show he was repeatedly urged to get the license, but failed to do so. He was subsequently terminated in June 2008.

City Colleges officials could not comment on the specific type of license he lacked. The instructor could not be reached for comment.

In January 2008, administrators raised concerns about then-program director Kathy Rayford. There was a perception that Rayford’s leadership was lacking, and that she was not identifying problem areas.

“They were depending on the program director to be their bellwether,” says Dr. John O’Brien, chairman for planning, education and research at Stroger Hospital, which works closely with Malcolm X’s physician assistant students.

In March, the City Colleges human resources office requested her academic transcipts. A hearing found she did not possess a master's degree she included on her resume. In April, she was recommended for dismissal, and formally fired in May 2008.

Rayford, the program’s fourth director in as many years, says she was set up to fail.

A contested dismissal

The previous director, she says, left her with few records, which impeded her progress in drawing up an evaluation of the program.

“They didn’t want me there in the first place,” she says. “I was set up.”

Rayford says she was hesitant to implement changes to the program, and a victim of micromanagement.

In January 2007, the program promoted one of its clinical coordinators to oversee Rayford in drawing up a self-evaluation of the program. Within a week, she says, the clinical coordinator recommended she be replaced.

She says her efforts were further hampered by unruly and unfocused students.

“That was the most unusual class I’d ever seen in eight years there. They cried and whined. They would fight,” she says.

When the college accused her of falsifying her resume, falsifying time sheets and labeling her as a “saboteur,” in her words, she filed an unsuccessful grievance through the City Colleges’ union.

“I have my master’s. I always did,” Rayford says. She says the degree was not a requirement, since the position had previously been offered to a faculty member who had an associate’s degree.

Rayford says she received a master’s in medical science in 2006. The registrar’s office at St. Francis University, in Loretto, Pa., says she was awarded the degree in May 2008, a year after her hire and around the same time she was fired.

Rayford says some outstanding payments held up the release of her transcript, but that she finished the program successfully.

City Colleges officials declined to discuss personnel matters.

Harsh recommendation

In mid-July 2008, the program’s accrediting body, the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), informed the interim program director it would make a special site visit  in August to investigate a number irregularities.

The site visit was the result of ARC-PA's concerns about unstable leadership and the program's request to delay a scheduled site visit pegged for July 2008.

ARC-PA alleged the 22 year-old program was deficient in a number of areas, including faculty credentials and the coursework it offered. In documents obtained by the Daily News, it alleged grade tampering, insufficient faculty and skewered the program for faculty members that missed classes.

In September 2008, following the visit to the West Side campus, ARC-PA recommended the program be stripped of its accreditation.

Losing accreditation would mean students would be unable to sit for the national professional certification exam, known as PANCE. That, it turn, would effectively kill student interest in the Malcolm X program.

Among the concerns of the evaluators were irregularities in grading, which ARC-PA says "bordering on grade tampering."

The organization cited a number of instances where every student in a pharmacology course received 100 percent on a series of quizzes. A subsequent audit by Malcolm X could not determine if the grades were correct because the records were destroyed. 

When ARC-PA’s harsh recommendation came down, “‘How do we fix this?’ was the feeling,” says O'Brien, the Stroger doctor who works with the program.

Shortly after the September recommendation, Tiffany Dobson, the new program director, appealed for ARC-PA to restore accreditation on a probationary basis, forfeiting the class scheduled to begin this summer.

That request was granted in March, following a hearing where program officials detailed the steps they were taking to fix the problems, and contested several points, saying ARC-PA had mischaracterized issues.

ARC-PA worried that the volume of classes missed by instructors was hurting students. Malcolm X officials realized that, too, says O'Brien.

"They had to do a number of make-up lectures because the faculty either didn't show up or were fired," he says. He credits the students for nevertheless performing well on national exams.

Malcolm X had not yet made admissions decisions for the summer semester, so the forfeiture didn't affect students.

Challenges, but a ‘bullish’ future

Steven Lane, associate executive director of the Physician Assistant Education Association, of which Malcolm X is a member, says losing accreditation happens to only one or two schools a year. While damaging to a school’s reputation, he says most potential students probably aren’t aware of the program’s struggles.

“To the school’s reputation, certainly it would imply that they’ve fallen below the minimum accepted standard expected (or) required by the accreditation standards,” he says.  “In terms of our organization, our main criterion for eligibility for membership is that you have to be an accredited program… At this point, they’re still a member.”

In August 2007, ARC-PA director John McCarty was among those who visited Malcolm X to investigate its compliance with accreditation standards.

Rayford says his presence underscored the severity of the problems. ARC-PA was particularly concerned about faculty members not showing up for class and insufficient coursework given to students.

Today, the program awaits ARC-PA’s decision in September, which will either award full accreditation, or remove it.

“The ball’s in their court to make the necessary corrections and things to demonstrate they are now in compliance with the standards,” McCarty says.

Ghingo W. Brooks, Malcolm X's president, is confident the school is taking the right steps to regain its standing with ARC-PA.

“I’m feeling more bullish than ever,” Brooks said. “We’re looking forward to the report. We made some corrections to the report. We’ve responded to it.”

A thorough self-evaluation identified areas for improvement, and gave those involved in the program an opportunity to take a tough look at what went wrong, Brooks says.

O’Brien says the administration is accepting accountability in a way it did not before.

“I really have to say that really bodes well for the program when you have an administration that says, ‘Where did we go wrong and how do we prevent that from occurring?’”

Despite the turmoil within the school’s teaching ranks, recent graduate Jeff Floyd says he was oblivious to the problems, at least until ARC-PA interviewed students for their side of the story.

“My interpretation of why the accrediting body came in was that… every program and every type of institution has a need for change,” says Floyd. "This area deserves this program, and this program is necessary for a lot of people who wouldn't have the opportunities to get into this profession."

Daily News Staff Writer Alex Parker covers public health. He can be reached at 773.362.5002, ext. 17, or alex [at] chitowndailynews [dot] org.

Discuss

AYO MAAT, 07-15-2009

A perfect reason for barefoot medicine to be used to train students to replace physicians who have left or plan to leave and to offset physician shortages. This is what China did in the 1970s--trained 2 million villagers as barefoot doctors, because there was a doctor shortage. Go to www.barefootmedicinesociety.blogspot.com and www.acuwerks.com