University of Washington School of Medicine

Transcription

1 University of Washington School of Medicine Curriculum

2 Susan G. Marshall, M.D. School of Medicine Curriculum 2010

3 WWAMI Curriculum Overview WWAMI is an enduring partnership between the states of : Washington Wyoming Alaska Montana Idaho Its purpose is to provide access to publicly supported medical education across the five-state region. Students from the WWAMI states are trained with an emphasis in primary care and rural medicine. e

4 Elements of the WWAMI Curriculum First Second Third Fourth Year Year Year Year Basic Science Organ System Required Required & Courses taught in Courses in Seattle Clerkships Clerkship Sites Elective Clerkships each throughout the WWAMI region WWAMI state Clerkship Sites throughout the WWAMI region and internationally Boise, Idaho VI V IVc IVb IVa III II I

5 U N I V E R S I T Y O F W A S H I N G T O N S C H O O L O F M E D I C I N E WWAMI Program Site Map Ferndale Republic Bonners Bellingham Colville Ferry Fam Anacortes Friday Harbor Tonasket Fam Mt. Vernon Sandpoint Whitefish Darrington Fam Omak Kettle X Pt. Angeles W Tulalip Tribes Falls Fam Peds Ob/G Forks Everett Seattle W Pt. Townsend 5 x Fam Chewelah Libby Kalispell 7 x Fam Thompson Falls Bremerton Fam Spokane Chattaroy Polson 2 x A Renton IntMd Fam Fam Plains Shelton Wenatchee IntMd IntMd X Federal Way Auburn Ephrata Fam Ob/G A E. Grays Harbor Fam Enumclaw Coeur d Alene Olympia Puyullap Odessa Superior Peds Tacoma Cle Elum Moses Lake SaintMaries Madigan Psych Psych Westport W Ellensburg US Army Fa m W Othello Surg Plummer South Bend Mattawa W Ob/G Fa m Morton Yakima Colfax Orofino Shoalwater Peds Ob/G Wapato Pullman Moscow Bay Tribe Garfield Peds Peds Fa m Cathlamet Toppenish Peds County Columbia Woodland Mossy Sunnyside Rock County Grandview Walla Walla Longview Pasco Asotin County Lewiston Vancouver Goldendale Ob/G Grangeville Fa m Fam Cottonwood White Salmon Revised 09/02 Nome Bethel Fam Kotzebue Fam Ob/G IntMd Dillingham Anchorage Psyc Peds h Galena Kenai Soldotna Homer Naknek Fam A W Fairbanks Wasilla Palmer W Seward Note: Alaska not to scale Indicates presence of both PHC and RUOP Kodiak Island Fa m Glennallen Valdez Cordova Council Weiser Payette McCall W X Cascade Emmett Fam Caldwell Nampa Meridian A Mountain Home Sitka Haines Prince of Wales Is. Metlakatla Juneau Fam Indicates presence of both Family Medicine Clerkship & Family Practice Residency Boise Fam IntMd Ob/G Psych Surg Fam IntMd Gooding Salmon Eureka Ronan Missoula IntMd Ob/G Challis Heart Butte Stevensville Dillon Conrad Deer Lodge Mud Lake Sun Valley Hailey Arco W Petersburg Wrangell Shoshone Rupert Jerome Butte Blackfoot Cut Bank Choteau Belgrade X Shelby Peds Helena Bozeman Ennis Driggs Pocatello Peds Fam Peds Fam American Falls Montpelier Malad City LEGEND A W Preston 1st Year Sites Area Health Education Center Sites (AHEC) Programs for Healthy Communities(PHC) WWAMI Rural Integrated Training Experience (WRITE) Fort Benton Great Falls White Sulphur Springs A Big Timber Livingston Fam Powell Cody Havre Fam Lewistown Columbus IntMd Thermopolis Jackson Afton Green River Lander Ob/G Clerkship Sites Fam IntMd Ob/G Peds Psych Surg Kemmerer Harlowton X Red Lodge Billings Fam IntMd Glasgow Fam Miles City Colstrip Poplar Wolf Point Glendi ve Sidney Ekalaka Graybull/ Basin Sheridan IntMd Sundance Buffalo Gillette Worland Fam Newcastle Rock Springs Family Medicine Internal Medicine Ob/Gynecology Pediatrics Psychiatry Surgery Riverton Rawlins Saratoga Casper Fam Laramie A Residency Sites Fam IntMd Psych Peds Douglas Torrington Wheatland Family Practice Internal Medicine Psychiatry Pediatrics Cheyenne Ob/G Fam Rural / Underserved Opportunities Program (R/UOP)

6 Curricular Requirements A. Required Basic Science courses in the first and second years 149 credits B. Clinical Curriculum 148 credits Required clinical clerkships in the third year: Family Medicine (6 weeks) 12 credits Internal Medicine (12 weeks) 24 credits Obstetrics/Gynecology (6 weeks) 12 credits Pediatrics (6 weeks) 12 credits Psychiatry (6 weeks) 12 credits Surgery (6 weeks) 12 credits Required clinical Selectives in third or fourth year: Emergency Medicine: (4 weeks) 8 credits Rehabilitation Medicine/Chronic Care: (4 weeks) 8 credits Neurology (4 weeks) 8 credits Surgery (4 weeks) 8 credits Other clinical electives: (16 weeks) 32 credits C. Independent Investigative Inquiry 8 credits D. Non-clinical Selectives (Selected medical school courses in a variety of subjects) 4 credits E. Capstone Courses 4 credits TOTAL 313 credits

7 Physical Exam Clinical Reasoning Four Year Curriculum Overview Professionalism Diagnosis Communication & Ethics Informatics Evaluation College System Y ear 1 Basic Science Courses Year 2 Organ System Courses Year 3 Required Clinical Clerkships Year 4 Clinical Clerkships/Capstone Course Exams Exams OSCE s USMLE 1 Min-CEX Feedback Exams Exams OSCE s USMLE 2 (CK and CS)

8 Medical School Curriculum First Year Basic Sciences, Discipline Based Courses Second Year Basic Sciences, Organ System Courses Third Year Required Clerkships Fourth Year Required & Electives Clerkships

9 Basic Science Courses

10 First Year Courses Anatomy and Embryology Mechanisms in Cell Physiology Biochemistry Introduction to Clinical Medicine Introduction to Immunology Medical Information for Decision Making Microbiology and Infectious Disease Microscopic Anatomy Musculoskeletal System Nervous System Systems of Human Behavior

11 Anatomy and Embryology Provides a broad understanding of the structural organization of the human body at the macroscopic level to provide a foundation for physical examination and functional assessment of the human organism. Integrates embryological development with study of the cadaver and examination of the normal living body. Concentrates on exploration of the thoracic, abdomen, and pelvis and the viscera they contain. There is an emphasis on three-dimensional interrelationships and the general principles of blood and nerve supply rather than detailed anatomy of individual organs. Gross anatomy of skull, pharynx, larynx are presented. Physiological concepts and clinical evaluation related to hearing and balance are covered. Maxillofacial disorders, diseases of nasal passages, nasopharynx, oropharynx and accessory sinuses are introduced. Embryology and general anatomical concepts are presented in lecture format, but most learning takes place in the dissecting laboratory.

12 Biochemistry This course covers classical molecular and cellular l biochemistry, i cellular physiology, and molecular genetics. Metabolic interrelationships as they occur in the individual will be stressed and related to disturbances in disease states.

13 Introduction to Clinical Medicine Instruction in communication skills and interview techniques to form the basis for the doctor-patient relationship The medical history will be introduced and instruction in data collection will begin. The adult screening physical examination will be taught through the use of lectures, audio/visual aids, and small group tutorials where students in supervised settings practice the physical exam on one another.

14 Introduction to Immunology Topics covered include: Basic concepts such as antigens; antibodies; complement B-and T-lymphocyte function, including interactions with each other and with accessory cells Immunological tolerance Major histocompatibility complex and role of these basic concepts in immunopathology (immunodeficiencies, hypersensitivities, autoimmunity, blood transfusion, and transplantation)

15 Medical Information for Decision Making The goal of this course is to encourage critical thought and to teach the tools necessary for practicing EBM. These include: 1) translating patient information into answerable medical questions, 2) searching the medical literature quickly and efficiently for appropriate studies, 3) critically appraising the validity and applicability of that literature, and 4) applying the evidence to the patient being discussed.

16 Mechanisms in Cell Physiology Fundamental cellular events underlying the following topics are presented: Physiology of the cell membrane including ionic and electrical potential gradients, active transport, excitability and action potentials; ti Biophysics of sensory receptors; neuromuscular transmission; Muscle energetics and contractility; spinal reflexes and central synaptic transmission; Autonomic nervous system; energy metabolism and temperature regulation; Epithelial transport; gastrointestinal motility and secretions VI V IVc IVb IVa III II I

17 Microbiology and Infectious Disease This course introduces the pathogenesis and immunity of infectious diseases, and natural barriers. Microbiology, epidemiology, i clinical i l manifestations i and control of representative bacterial, fungal, parasitic and viral infectious diseases are covered. Chemotherapeutics and principles of chemotherapy, sterilization, principles of asepsis, nosocomial and iatrogenic infections are discussed.

18 Microscopic Anatomy (Histology) Lectures and laboratories in microscopic anatomy are designed to provide the principles and concepts of histology, to define the morphological characteristics of the cells, tissues, and organs of the human body, and to relate this information to functional processes studied in concurrent and subsequent courses.

19 Musculoskeletal l l System Gross, surface, applied and X-ray anatomy of system including entire spine but excluding head and neck. Histology of bone, cartilage, tendon-myotendinal junction and joints. Musculoskeletal trauma and healing. Pathology and clinical manifestations of other degenerative, inflammatory, metabolic, nutritional and congenital disorders. d Physical examinations.

20 Nervous System Integrated approach to the normal structure and function of the nervous system, including the eye. Neuropathological examples are presented as well as clinical manifestations of neurological disease

21 Systems of Human Behavior Selected overview of contributions from behavioral sciences to the clinical practice of primary care physicians. ysca s Sensitizes students to the impact of such factors as emotional and physical development, cultural backgrounds, social roles, families, sexual identities, and belief systems upon their effectiveness as physicians. Encourages appreciation of the role of behavioral factors in major Encourages appreciation of the role of behavioral factors in major management problems faced in medical practice; covers physical and psychological development of the individual from infancy through old age; teaches skills in analyzing behavior, defining behavioral objectives, and designing precise treatment strategies to attain these objectives.

22 Second Year Courses Organ System Brain and Behavior Cardiovascular System Cases in Clinical Ethics Epidemiology Gastrointestinal System Genetics Hematology Hormones & Nutrition Introduction to Clinical Medicine Medicine Health & Society Mollecular l & Cellular l Basis of Disease (Pathology) Principles of Pharmacology Problem Based Learning Reproduction Respiratory System Skin System Urinary System

23 Brain and Behavior Major psychiatric disorders are defined and described and a systematic approach to differential diagnosis is presented. Conceptual development, pathogenesis, epidemiology, nomenclature and the terminology used in psychiatry are discussed d

24 Cardiovascular System An interdisciplinary approach to cardiovascular medicine, including anatomy, physiology, radiology, pathology, medicine and surgery. The central theme of this course is the function of the cardiovascular system in health and disease.

25 Cases in Clinical Ethics This course provides exposure to key issues in clinical ethics as well as the tools for ethical reasoning and critical thinking that support the student s current and future work.

26 Clinical Epidemiology and Evidence-Based Medicine Introduction to principles of epidemiology and biostatistics, emphasizing application to clinical medicine. The broad topics include: 1) Health and disease in the community, including assessment of disease risk and mechanisms of epidemic detection, spread, and control 2) Interpretation of research results, including fundamentals of research design, data analysis and sources of bias 3) Clinical epidemiology, including evaluation and application of diagnostic tests, natural history of disease, and quantitative aids for clinical decision making

27 Gastrointestinal System Anatomy of gastrointestinal system; physiology and pathology of digestion and hepatic function; physical and laboratory examination.

28 Genetics The primary aim of the course is to review basic genetic principles in the context of their applications in clinical ca medicine. e Topics include human chromosomal disorders, pathogenesis of hereditary disease, patterns of inheritance, genetic counseling, amniocentesis, monogenic and multifactorial pathogenesis, role of genetics in common diseases, behavioral genetics, drug-gene g interactions (pharmacogenetics), and prevention and treatment of genetic diseases including prenatal diagnosis and population screening.

29 Hematology Familiarizes students with the basic pathophysiologic mechanisms leading to disturbances of red cell, white cell and platelet production as well as abnormalities of hemostasis presenting clinical problems. Pathophysiology, rather than minute details of individual disease, is stressed. Problem-based learning sessions are a significant portion of this course as well as in the musculoskeletal course.

30 Hormones and Nutrients An introduction to principles of human endocrinology, metabolism and nutrition including the physiology and pathophysiology of endocrine systems, glucose and lipid id metabolism, and fluid and salt balance. The importance of proper nutrition in certain disease states is also covered. Clinical and scientific reasoning is taught in lecture and small group format.

31 Introduction to Clinical Medicine II- Linked to Colleges Advanced instruction in interview techniques, history taking and physical examination, with emphasis upon detection of abnormalities. The ICM focuses on teaching at the bedside in this year. Emphasis on the history and physical exam of the specific areas of the body such as heart, lung, abdomen, mental status. Topics covered include: human sexuality, geriatrics, and death and dying. Emphasis upon identification of problems and correlation of findings with pathophysiological mechanisms, and introduction to clinical and laboratory diagnosis are covered.

32 Medicine, Health and Society Addresses interrelationships between provision of medical care and non-biological factors that influence health. Issues include: relative l importance of society, environment and individual choice in determining health status; impact of organizational, economic, and political influences on medical practice and choice; measurement of costs, risks, benefits and efficacy of diagnostic and therapeutic technologies; importance of these concepts in responsible and scientific decision making

33 Musculoskeletal l l System Gross, surface, applied and X-ray anatomy of system including entire spine but excluding head and neck. Histology of bone, cartilage, tendon-myotendinal junction and joints. Musculoskeletal trauma and healing. Pathology and clinical manifestations of other degenerative, inflammatory, metabolic, nutritional and congenital disorders. d Physical examinations.

34 Pathology Patterns of cell and tissue response to injury are introduced. Mechanisms of cell injury, the inflammatory process, immunology, immunopathology, thrombosis, normal and abnormal growth, neoplasia, and clinicopathological correlation are presented. The course then moves to A multidisciplinary approach to some diseases which affect more than one organ system (nervous, cardiovascular, respiratory, etc.) and which h are caused by different mechanisms (congenital, inflammatory, vascular, traumatic, metabolic, neoplastic).

35 Principles of Pharmacology I Includes general principles of pharmacology and the specific pharmacology of major drugs acting on the autonomic and cardiovascular systems. Principles of Pharmacology II Lectures and conferences on Lectures and conferences on drugs acting on the central nervous system. Emphasis on physiological and biochemical mechanisms with consideration of their therapeutic and adverse effects.

36 Problem-Based Learning Teaches students to methodically solve medical problems by ygathering, g sorting, and interpreting data. Students learn life-long self-education and self-evaluation skills. Provides practice working as a health care team by including medical, nursing, and physician assistant students in each group.

37 Reproduction Traces normal development of reproductive function in human beings including formation and maturation of ova and sperm, gamete transport, fertilization, menstruation, implantation, physiology and endocrinology of placenta, intrauterine development and nutritional requirements of growing fetus, normal pregnancy, parturition, lactation and adaptation of newborns to extrauterine life. Provides information concerning infertility problems, family planning techniques and demography of human population.

38 Respiratory System An interdisciplinary approach to the respiratory system, including anatomy of thorax and lungs, ventilation mechanics, blood gas transport, gas exchange, acid-base balance and the physiology and pathology of obstructive, restrictive and pulmonaryvascular diseases.

39 Skin System Gross and microscopic anatomy. Physiology, protection, temperature control, pigmentation and photosensitivity. Pathology and genetics of skin abnormalities including tumors. Introduction to clinical evaluation, including physical examination and illustrating examples of inflammatory, vascular, immunological (including drug hypersensitivity) and neoplastic diseases.

40 Urinary System Anatomy, physiology and pathology of the kidney, ureter, bladder and prostate; pathophysiology and treatment of common fluid and electrolyte problems; renal pharmacology; major clinical i l urinary system syndromes with current diagnostic approaches and therapy.

41 Capstone I Week long, intensive, cognitive and skills based training to prepare students for clinical clerkships in third year.

42 SPECIAL PROGRAMS Independent Investigative Inquiry (III) Third Year Clerkship Educational Tracks WWAMI Rural Integrated Training i Experience (WRITE Program) Native American, Hispanic, Underserved, and Global Health Pathways

43 Independent Investigative Inquiry III Summer between Year 1and Year 2 Selective 1: Selective 2: Hypothesis Driven Research Systematic Literature Review Selective 3: Community-Based Experience (R/UOP) Selective 4: Special Simulation Selective (ISIS) Selective 5: Promoting Community Health in Developing Countries (IHOP)

44 Research Opportunities Medical Student Research Training Program (MSRTP) first year Roadmap TL-1 Many Faculty Based Research Projects Ethnomed.org SCCA International/Global Health

45 Educational Tracks Currently, tracks exist in: -Boise, Idaho -Spokane, Washington -Anchorage, Alaska -Billings, Montana -Missoula, Montana Anchorage, AK

46 The WRITE Program WWAMI Rural Integrated Training Experience Six-month integrated program with an approved preceptor in a rural area during the third year.

47 WRITE Sites Washington: Ellensburg/ Grand Coulee Wyoming: Powell/ Lander Alaska: Juneau/ Wasilla Montana: Lewistown/ Libby Idaho: Hailey/ McCall/ Sandpoint

48 PATHWAYS Indian Health Pathway Global l Health Pathway Hispanic i Health Pathway Underserved Pathway

49 Curriculum Management Provide continuous quality improvement by increasing the authority and responsibility of the course chairs in the process. Sharpen the focus of the curriculum on the knowledge and skills that t are fundamental to the practice of medicine. Enhance the quality of the learning experience during the medical school years.

50 Organization of the Curriculum Committees School of Medicine Dean Faculty Council on Academic Affairs Vice Dean for Academic Affairs Oversight Committee Associate Dean for Curriculum First Year Second Year Required Clerkship Elective Clerkship iculum Committee Curriculum Committee Committee Committee

51 Oversight Committee Oversee the smooth and successful delivery of high quality medical education. Oversee the vertical integration of the curriculum. Ensure the curriculum is in line with national standards of excellence in medical education. Develop recommendations to send to the curriculum committee regarding thematic issues that are cross cutting in scope. Develop formal recommendations regarding policies Develop formal recommendations regarding policies related to the curriculum for submission to the Faculty Council on Academic Affairs.

52 Year-Based Committees Review and request information that will facilitate enhancement of course/clerkship development. Oversee horizontal integration of the curriculum. Review course content and recommend changes as necessary. Review student performance in the curriculum. Make recommendations to the Oversight Committee Make recommendations to the Oversight Committee regarding structural curriculum changes.

53 Hot Topics Class Attendance -Lectures -Small Groups -Labs Faculty Acknowledgement for Teaching Distance Learning Electronic Connections Podcasting & Videocasting

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