Our schools previous 2x2 curriculum, departmentally formulated and controlled, with its lecture-dominated format is now a fully integrated, systems-based one which incorporates significant amounts of self-directed study. The content of years one and two was determined by physicians, retaining only those aspects of the preclinical years that are essential to medical education. Added were more clinically oriented examples, especially in small group sessions. Lecture hours have been reduced drastically, allowing the student to learn in his/her own best way.
Years 1 and 2. Five full integrated core and basic knowledge courses occur in the first four months. Eleven system-based courses in the second half of year one and throughout year two follow. All are run by multi-departmental, multi-disciplinary teams of both clinical and basic science faculty. Each course combines the system-based knowledge for the particular system, (cardiovascular, pulmonary, neuroscience, etc.) and include introductory medicine course material, physical diagnosis skills, standardized patient and clinical patient exposures, plus the usual traditional knowledge based materials (anatomy, pathology, pharmacology, physiology, etc.). Most weeks have a thematic focus, which is triggered at the onset of the unit, and anchored at the end of the week, by clinical cases. Small groups, independent learning, computers/technology-assisted learning and problem solving are stressed.
Years 3 and 4. The traditional newly integrated medicine-pediatrics-family medicine component involves both in- and out-patient experiences. A series of team-taught, core content, multi-disciplinary, acute and chronic illnesses are included. Departments have cooperatively developed core content, team teaching, small group discussions to include problem-solving components and optimized assessment strategies. The acute disorders include asthma and otitis (pediatrics and family medicine) and diabetes mellitus and hypertension (family medicine and medicine). Once the concepts are taught and utilized in this course, students follow patients and have recurrent exposure to these concepts in the Comprehensive Care longitudinal clinic to assure competence and retention of material, with preceptor assessments of their knowledge at patient visits.
Instead of departmental-based courses in year four, there are selective offerings that assure multidisciplinary experiences for all students: 1) an acting internship; 2) outpatient care (including common themes such as office experience, financial related issues, etc.; 3) a community-based experience and; 4) a teaching-education experience in which the students have structured requirements for teaching and assessment of first and second year students, and thereby prepare themselves for their expected house staff experiences.
