A Process for Curricular Improvement Based on Evaluation of Student Performance on Milestone Examinations.

To identify and address areas for curricular improvement by evaluating student achievement of expected learning outcomes and competencies on annual milestone examinations. Students were tested each professional year with a comprehensive milestone examination designed to evaluate student achievement of learning outcomes and professional competencies using a combination of multiple-choice questions, standardized patient assessments (SPAs), and objective structured clinical examination (OSCE) questions. Based on student performance on milestone examinations, curricular changes were instituted, including an increased emphasis on graded comprehensive cases, OSCE skills days, and use of patient simulation in lecture and laboratory courses.

Rhabdomyolysis in a patient receiving ranolazine and simvastatin.

Purpose: A case of rhabdomyolysis occurring shortly after the addition of ranolazine to a stable simvastatin regimen is reported.

Summary: A 63-year-old Caucasian man with a history of hyperlipidemia and coronary artery disease arrived at an urgent care center with complaints of worsening bilateral lower-extremity weakness over three days. He was admitted to a hospital within 24 hours.