Governing Council Report A (A-01)

Medical Student Representation in the AMA House of Delegates: Regional Delegate Elections

Introduction

At the 2000 Interim Meeting, the AMA House of Delegates adopted as amended the recommendations in Board of Trustees Report 19, Medical Student Representation in the AMA House of Delegates. The recommendations were as follows:

1.  That our AMA establish a mechanism for additional delegate representation of medical students in the House of Delegates as follows:

• Recognize the Medical Student Section Regional Section Structure (Regions) as follows:

1. • Region 1: Washington, Oregon, California, Nevada, Utah, Colorado, Arizona, New Mexico, Montana, North Dakota, South Dakota, Idaho, Wyoming, Alaska, Hawaii.
   • Region 2: Minnesota, Wisconsin, Nebraska, Iowa, Missouri, Illinois.
   • Region 3: Kansas, Texas, Oklahoma, Arkansas, Louisiana, Mississippi.
   • Region 4: Florida, Georgia, Alabama, South Carolina, North Carolina, Tennessee, Puerto Rico.
   • Region 5: Michigan, Indiana, Ohio, Kentucky, West Virginia.
   • Region 6: Virginia, Maryland, District of Columbia, Delaware, New Jersey, Pennsylvania.
   • Region 7: Maine, Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York

• Each Region will be awarded one student delegate and corresponding alternate delegate for every 2000 student members, to be elected by the student members of the Region at each Interim Meeting.
• Student candidates for each Regional Delegate Seat will be required to receive written endorsement from their state delegations, and elected students will be seated with their state delegations.
• That state societies are strongly encouraged to provide full financial support to student delegates elected from the Regions.
• That the Regional mechanism for adding student delegates to the House of Delegates be re-evaluated at the end of the fifth year of implementation (Directive to Take Action)

2.  That the AMA supports the full participation of medical student and resident members of the AMA in the activities of the Association and in the policy processes of the AMA House of Delegates. (New HOD Policy)

3.  That the AMA strongly encourage the delegation of each state association to have one resident delegate for each 1000 resident members of the AMA who are included in the base for determining the size of the state association’s delegation. (New HOD Policy)

4.  That AMA Policy H-545.947: "Full Participation of Medical Students and Residents within the Federation of Medicine" and AMA Policy H-545.993: "Representation in the AMA House of Delegates" be rescinded. (Rescind HOD Policy)

Students delegates elected from each of the seven MSS Regions will be elected at the 2001 Interim Meeting. In order to assist the Regions with the election process, and to provide a uniform framework for each Region’s individually defined election process, the Governing Council has considered Recommendation 1 of BOT Report 19, and submits the following guidelines for your consideration.

Background

BOT Report 19 was the result of several attempts by the Council on Long Range Planning and Development and the House of Delegates to develop a mechanism to increase medical student representation in the AMA House of Delegates. Testimony on earlier reports and related resolutions emphasized the importance and value of medical student representation in the House of Delegates, and highlighted the inequity of having 38,000 (currently more than 48,000) members represented by a single delegate. In seeking increased representation for medical students, the Medical Student Section consistently emphasized the value of providing medical student members with increased voice, expanded mentoring opportunities, and increased ownership in our AMA.

The AMA Board of Trustees agreed that increasing the number of students who are full, voting members of the AMA’s House of Delegates is an important step in ensuring continuity and member loyalty within the AMA. Approximately 60% of students in medical schools accredited by the Liaison Committee on Medical Education and the American Osteopathic Association are AMA-MSS members. The Board was in strong support of instituting a mechanism for representation in the House of Delegates that would more closely reflect proportional representation of the student membership segment.

In developing the recommendations in the Report, the Board, in collaboration with the MSS, sought to balance the following:

• Increase student representation in the House of Delegates to more closely reflect proportional representation of the student membership segment
• Ensure a structure that would provide mentoring opportunities for students and integrate students into existing leadership structures
• Maintain state autonomy in selecting individuals to serve on their delegations
• Allow every state the opportunity to benefit from student delegate participation without creating an immediate crisis in the size of the House of Delegates

The Board of Trustees and the House of Delegates believed that working through the existing MSS Regional Section structure to identify and elect student delegates was an equitable way to meet the needs of the MSS, state delegations, and the Association as a whole.

Discussion

The AMA’s Constitution and Bylaws will be modified to reflect the additional delegate seats awarded to medical students based on the Regional structure. The process for identifying delegates that will represent a given state, specialty society, or special section is left to the discretion of that organization, and is therefore not reflected in the AMA bylaws. Accordingly, the process by which we appoint Regional delegates is at the discretion of our Medical Student Section.

In order to accommodate the unique needs of each Region, and to avoid imposing burdensome procedures on the Regions, your Governing Council has decided to establish a framework by which each Region can determine its own method of delegate selection. However, given the large responsibility and visibility regionally elected student delegates will have, your Governing Council proposes a core set of requirements that will govern the individual Regional election processes. These guidelines are intended to define specific parameters of the election process in order to ensure fairness to all states and students interested in gaining delegate representation.

Your Governing Council proposes the following:

• Elections for the Regionally elected student delegates to the AMA House of Delegates will be held at the Interim Meeting of the AMA Medical Student Section (as specified in Recommendation 1b. of BOT Rep 19, I-00).
• Eligibility rules for candidates will be the same as those for AMA-MSS Governing Council members
• Candidates will be required to submit a completed Application and CV to the Department of Medical Student Services by the published deadline each year. The Application will include a signature of the appropriate Dean to verify the individual is a student in good standing, and a Statement of Endorsement from the student’s State Medical Society to be kept on file by DMSS.
• A list of candidates for each Region will be included in the MSS Assembly Agenda Book for each Interim Meeting. Individual candidates are personally responsible for reproducing and distributing copies of their CVs and/or Personal Statements to members of their Region.
• In order to ensure fairness to all states, each state is entitled to a maximum of one delegate, unless there are fewer candidates than available positions. A state may have an unlimited number of alternate delegates.
• All election disputes will be referred to the Governing Council.
• In order to facilitate arbitration by the Governing Council in the event of election-related disputes, Regions must present an outline of their election procedures to the Governing Council by the close of each Annual Meeting.

Recommendations As Adopted

Your Governing Council recommends that the following recommendations be adopted, and that the remainder of this report be filed:

1.  That the AMA-MSS will elect Regional delegates to the AMA House of Delegates, according to the following guidelines:

• Each Region is responsible for selecting its own delegate(s), based on the process identified by the Region and submitted to the MSS Governing Council by the close of each Annual Meeting.
• Elections for the Regionally elected student delegates to the AMA House of Delegates will be held at the Interim Meeting of the AMA Medical Student Section.
• Eligibility rules for candidates will be the same as those for AMA-MSS Governing Council members as outlined in Section IV.C of the AMA-MSS Internal Operating Procedures.
• Candidates will be required to submit a completed Application and CV to the Department of Medical Student Services by the published deadline each year to be kept on file by DMSS.
• A list of candidates for each Region will be included in the MSS Assembly Agenda Book for each Interim Meeting. Individual candidates are personally responsible for reproducing and distributing copies of their CVs and/or Personal Statements to members of their Region.
• Each state is entitled to a maximum of one delegate, unless there are fewer candidates than available positions. A state may have an unlimited number of alternate delegates.
• All election disputes will be referred to the Governing Council.
• Each Region shall be free to institute more stringent requirements consistent with all other AMA and AMA-MSS rules. These requirements shall serve as minimum guidelines to the Regions.

2. That the AMA-MSS Internal Operating Procedures be updated by I-01 to reflect the new AMA Bylaws governing Regional Delegate Representation, and the Guidelines for electing student delegates.