LCME Element 6.5 -Elective Opportunity
The faculty of a medical school ensure that the medical curriculum includes elective opportunities that supplement required learning experiences and that permit medical students to gain exposure to and expand their understanding of medical specialties, and to pursue their individual academic interests.
Hidden Curriculum
So…as of now…for this element you just need to put in the weeks of electives available (no right or wrong) and then answer this one narrative… Describe how the medical school ensures that sufficient electives are available to meet the educational needs of medical students.
So, how do you know?? Do you have an annual survey question on this? Does it come up at phase or whole curriculum reviews? Better think of something!
And- while not a part of this particular element – remember that there are other places where elective issues sneak up on you. One that seems to trip schools up is that elective choices for every student need approved by someone. Who is doing that at your school? Student Affairs? Learning Community advisors? Make sure there is an official documented way to get this done.
Finally, not really hidden, but good practice – Faculty and peer attitudes, scheduling limitations, or registration challenges can unintentionally send the message that some electives matter more than others, or that certain choices are risky. These unspoken cues can limit students’ sense of freedom and exploration, even when electives are formally available. That’s why it’s important for schools to not only offer electives, but also create a culture that truly supports student-driven learning and interests.
Best Practice
An effective elective program should be broad, student-centered, and intentionally designed to support both career exploration and academic enrichment. Schools can strengthen their approach by offering a diverse catalog of electives across clinical, non-clinical, research, and foundational science areas.
Early and proactive advising is key. Students benefit from structured guidance, such as elective planning workshops or one-on-one advising, during the pre-clerkship years to help align their choices with long-term goals, not just perceived competitiveness. This has been an ISA question that often causes a citation – student unhappiness with elective advising – so yes – start early – even if you think they don’t need it. Students want it. Bad.
Curricular flexibility also plays a role. While LCME does not require electives to span all four years, many schools choose to offer pre-clerkship electives that count toward graduation, helping students engage early and build momentum.
Operationally, it’s a best practice to have the elective catalog reviewed annually by the Registrar’s Office, an Electives Subcommittee, or a similar body. Electives should also be continuously reviewed and approved by the appropriate curriculum governance structure to ensure quality, relevance, and oversight. So don’t forget about them at your phase/whole curriculum reviews. They don’t need the depth of a required course review – an excel sheet that lists all your electives with how many students have signed up for each one and then a couple numerical values representing the average student evaluation of the elective, teaching etc. will suffice.
You MUST ensure that home students are prioritized in elective registration before seats are offered to visiting students. A simple but effective step is to send elective update forms to course directors on a regular schedule (e.g., every six months) to confirm seat availability and maintain up-to-date listings.
Continuous Quality Improvement
To keep elective offerings relevant and student-centered, schools should review them regularly, monitor student feedback, and update course availability with departments. Tracking access and new elective proposals ensures equity and keeps the curriculum aligned with evolving student interests and program goals.
And Just For Fun…A Cool Article…
Medical Student Evaluations of Medical Faculty: Characteristics of Highly and Lower-Rated Teachers.
Jackson JL, Gavinski K, Thompson MG, Storch D, Murphy MG, Nickoloff S, Kuriyama A.
J Gen Intern Med. 2025 Apr;40(5):996-1002. doi: 10.1007/s11606-024-09085-y. Epub 2025 Jan 8. PMID: 39777713
