On changing curricula: lessons learned at two dissimilar medical schools.
Two dissimilar U.S. medical schools--the University of Pittsburgh School of Medicine and the University of Texas Medical Branch at Galveston-changed their curricula for the first two years of medical education from ones that were lecture-dominated and departmentally run to ones that are centrally governed, multi-modal, goal-oriented, and fully integrated, with mechanisms to continue curricular change into the last two years of medical education. The change at each school was in response to national education philosophy, the recommendations of the Liaison Committee for Medical Education after the most recent site visit, and faculty's and students' concerns and interests. The change process took place over a three- to four-year period at each school, involved students, faculty, and administration, and utilized taskcounty jail and a

$2,000 fine. For the reasons that follow, we affirm.

                                     FACTUAL SUMMARY

       On December 26, 2007, United States Customs Officer Ashlie Redfield was traveling on

Transmountain Road in El Paso. At approximately 9:20 p.m., she stopped for a red light at the

intersection of North Desert Boulevard and Transmountain Road. When the light turned green and

Redfield proceeded forward, she saw a large cloud of dust and it quickly became apparent that two

vehicles had just collided. She arrived at the collision site within ten to fifteen seconds