Preclerkship education at the College of Medicine provides students with abundant and diverse opportunities to:
- acquire an appropriate knowledge base in the biological, behavioral and population sciences;
- learn examples of the applications of this knowledge to diagnosis, treatment and prevention of human disease;
- acquire an appropriate knowledge base in the mechanisms of human disease;
- understand and appreciate the importance of non-biologic factors that influence health and disease in patients and populations;
- acquire competence in communication and clinical examination skills.
In addition to the goals and objectives delineated separately, another goal of both the formal and informal preclerkship curriculum is the nurturing of students' human values and elimination of whatever undesirable behaviors might have been developed in the intensely competitive premedical environment. In medical school, as in medical practice, cooperation - not competition - is the desired behavior.
During the 1990's, changes in structure, content and process of the preclinical curriculum were implemented in order to help students: obtain a more integrated view of normal and abnormal biology; become more effective in applying knowledge of biological, behavioral and population sciences to the solution of clinical problems; and become successful self-directed learners with excellent information retrieval skills.
The preclerkship curriculum structure consists mainly of interdisciplinary courses that reflect major unifying themes and concepts of modern biology, linkages between different biomedical science disciplines, and applications of basic knowledge to diagnosis, prevention and treatment of human disease. For example, a first-year course in Molecular and Cellular Foundations of Medicine has been constructed from previously separate courses in cell biology, biochemistry, immunology, genetics and general physiology. A second-year course in Nervous System and Human Behavior has been fashioned from former courses in neuroscience, neuropathology, psychopathology and that section of the pharmacology course dealing with the central nervous system. Most organ system courses that once consisted mainly of topics in pathophysiology and anatomic pathology also include the relevant organ system physiology, pharmacology, radiology and epidemiology. The Microbiology and Infectious Diseases course provides an integrated view of microbial biology and disease together with an understanding of pharmacologic interventions; anatomic pathology correlates of certain infectious diseases have also been incorporated into the course. Epidemiology, Population Health and Evidence-based Medicine (EPHEM) introduces students to concepts and problems in population health, epidemiology, clinical epidemiology and evidence-based medicine. The goal of the course is for students to develop the skills needed to critically interpret the medical literature. While the focus of EPHEM I is on populations and EPHEM II on individual patients, both courses aim to integrate population and patient perspectives.
The preclerkship curriculum process focuses on case-based conferences, with group sizes ranging from 10 to 25, in almost all courses. Although conducted in different ways ranging from the problem-based to case method approach, all case conferences require students to prepare, collaborate and participate. The aim is for students to work cooperatively toward the solution of clinical problems of varying complexity, with assistance from faculty facilitators when necessary, and in so doing acquire and hone skills needed for lifelong self-directed learning.
About half of the preclerkship curriculum consists of case conferences plus laboratory sessions, clinical encounters and other interactive educational strategies. The mix of lecture- and student-centered strategies is, we believe, a reasonably balanced one, providing each student the opportunity to express his/her own learning style and achieve course objectives through the utilization of different learning approaches.
Although all biomedical science courses expose students to clinical issues and problems in varying degrees, it is in the Introduction to Clinical Medicine (ICM) program where students begin to acquire the knowledge and skills needed for effective interaction with the patient and the health care system. Hallmarks of the course during the first year are the clinical experiences and small-group discussions that enable students to develop history-taking and interviewing skills. In the second year, the focus shifts to the clinical examination. In addition to teaching knowledge and skills, the ICM program aims to nurture attitudes needed for respectful and compassionate interaction with patients and their families, help students to understand and appreciate the sociocultural context of illness and disease, and teach students the principles and concepts needed to deal effectively with issues and dilemmas in medical ethics.
Some recent developments in the preclerkship curriculum include:
- The first year Principles of Preventive Medicine Course and second year Evidence-based Medicine courses have merged to become "Epidemiology, Population Health, and Evidence-based Medicine I & II" (see above).
- In order to reflect a greater emphasis on topics and issues in global medicine, the second year course in Parasitology has been renamed "Parasitology & Global Medicine".
- A mini-course in Disaster Medicine and Bioterrorism has been integrated into two second year courses - Pulmonary Medicine and Microbiology & Infectious Disease.
- The curriculum in Biomedical Ethics has been expanded.
The first year of the curriculum includes elective mini-courses in Preventive Medicine/Population Health, and Medical Spanish. Spanish language training in the first year is provided at beginning, intermediate and advanced levels.
|Clinical and Developmental Anatomy
|Molecular and Cellular Foundations of Medicine
| Principles of
|Introduction to Clinical Medicine:
Introduction to the Patient/The Clinical Experience
|Epidemiology, Population Health and Evidence-based Medicine I
In the second year, all students are required to take instruction in Cardiopulmonary Resuscitation (CPR) with certification by the American Heart Association. The Medical Spanish elective course continues with offerings at beginning, intermediate and advanced levels.
In addition, interdisciplinary courses integrating Physiology, Pathobiology, Pharmacology, Epidemiolgy, Population Health, Evidence-based Medicine, Biomedical Ethics and Radiology are required.
|Nervous System and Human Behavior
|Parasitology and Global Medicine
and Human Sexuality
||Musculo- Skeletal Disorders
||Microbiology and Infectious Diseases
||Introduction to Clinical Medicine: The Clinical Examination
|Epidemiology, Population Health and Evidence-based Medicine II