Preparing Physicians for Medical Practice in the 21st Century

EDUCATIONAL PHILOSOPHY

Every new student walks through the doors of medical school for the first time dreaming of what the next four years will hold. Medical school is an intense process that unifies personal, professional, and academic development resulting in the creation of trained physicians who impact lives and communities for the better. The University of Louisville School of Medicine is designed to support and amplify each student’s dream into reality during this transformative change.

Our curriculum is structured to ensure that all students will be well prepared and competitive for residency, yet flexible enough to accommodate the most ambitious or specialized career aspirations. MD candidate students can choose to complete the standard curriculum, or pursue additional Distinction Track training in Research, Global Health, Medical Education, or Business and Leadership. Students admitted to our school enjoy a supportive, collegial environment with faculty and their peers, and benefit greatly from direct career and personal guidance and mentoring as well as supplemental programs to meet every student’s educational needs.

Expertise in the best use of technology and emerging bioscience to empower medicine is emphasized in both the classroom and clinical work. Training in critical thinking and appraisal of evidence as well as an emphasis on humanistic patient-centered care starts the first week and continues throughout all the courses in the curriculum. A variety of teaching methods are used to reach every type of learner and allow practice, expert observation, and feedback to students as they develop their knowledge and skills.

EDUCATIONAL GOALS

Three overarching goals drive the design, development, implementation and evaluation of our curriculum:

1. Integration of basic and clinical sciences across all courses and years.
2. Teaching techniques that put the learner in the center of the learning process; problem-based learning, team-based learning, web-based tutorials with self-assessment, and case-based discussions.
3. Expanded use of technology to support teaching and learning, including human simulator training, virtual patients, and in-class audience feedback in teaching.

The medical school curriculum engages students directly in their learning activities. Faculty deliver basic content and then provide students with learning opportunities that challenge students' problem-solving abilities, require that they apply basic science concepts to clinical situations, and prepare them for clinical practice and licensure examinations. Students take responsibility for their learning and work in teams with faculty and their peers to maximize their success.

Students work with state-of-the-art educational technology in the Paris Simulation Center and the Standardized Patient Clinic. All incoming students receive the necessary hardware, software programs, and other technology resources to assist in clinical decision making and patient care.

AN OVERVIEW OF THE CURRICULUM

A Year-by-Year Description

The primary goal of the medical education curriculum is to provide each student with the basic knowledge, skills, and attitudes considered essential to all 21st century physicians.

Year 1 begins with the normal anatomic structures and their embryologic development, and then explores the molecular basis of life and molecular mechanisms of disease, infection, and immunity.  A fall, winter, and spring break are included in the curriculum to ensure students pace themselves and maintain healthy attitudes towards learning and study. Students can apply to enter Distinction Tracks in global health, medical education, or business and leadership during the spring semester of their first year or in research at the beginning of their second year.

Introduction to Clinical Medicine 1 starts in week 1 and runs throughout the year, using standardized patient teaching, online modules, and community preceptorships to teach the basic aspects of communicating with patients, taking a medical history, foundations of medical ethics, and culturally competent patient-centered care. Advanced humanism and communication skills training takes place in the Longitudinal Standardized Patient program, a unique aspect of the UofL medical curriculum. Students meet "their" Longitudinal Standardized Patient in the second semester of the curriculum, and continue to take care of that same patient over multiple Standardized Patient Clinic visits in the first two years of the curriculum.

The first integrated basic science course in the year is Clinical Anatomy, Development, and Examination (CADE) and encompasses the fundamentals of Human Embryology, Gross Anatomy, Neuroscience, and physical exam skills instruction and assessment. This 18-week, 20.5 credit hour course runs for the entire fall semester and includes significant time in Gross Anatomy cadaver dissection as well as team-based peer teaching, problem-based learning, online cases and tutorials, and standardized patient clinic teaching and assessment.

The next integrated course begins in the spring semester and is named Molecular Basis of Life, Defense, and Disease. This 16-week, 15 credit-hour course integrates foundational biochemistry, medical genetics, immunology, tissue and body fluid physiology, pathology, and pharmacology to introduce immunologic function in disease and health; normal cellular and tissue histology in health, injury, and healing; foundational microbiology; and mechanisms, diagnosis, and treatment of neoplastic and hematologic diseases. This course uses in-class active learning exercises, problem-based learning, team-based learning, patient interviews and laboratory teaching allow students to apply knowledge and assess their readiness for learning prior to summative examinations.

The Biostatistics and Evidence-Based Medicine course is presented during the last two weeks of the spring M1 semester and contributes 2.5 credit hours. This course concentrates principles of biomedical research, foundational statistics, medical informatics, and application of evidence to patient care.

Ten weeks off are provided to students between first and second year. Many students choose to complete electives, overseas medical mission trips, or complete our National Institutes of Health-funded Summer Research Scholars Program.

Year 3 trains students in the clinical environment, teaching them the fundamental knowledge and practice of all the major clinical fields of medicine across multiple hospital-based and outpatient sites. Additional time is available for vacation or completion of career exploration electives in a specialized field. Students also experience caring for underserved populations by completing rotations at urban or rural Area Health Education Centers (AHEC) located throughout the state. A special program allows a small number of students to complete their clinical training during the third and fourth years at our regional campus training site in Madisonville, KY.

Year 4 is the most flexible in the curriculum, designed to allow students who have chosen their field to complete multiple elective rotations while interviewing for the residency of their choice. Students are required to complete clinical selectives in Palliative Care, Intensive Care, Ambulatory Care, and an Acting Internship that ensures their preparedness to enter residency. Completion of an Advanced Cardiac Life Support (ACLS) course is also required.

Year 2 begins with Systems in Health and Disease 1, an 18.5 credit hour Course that explores the normal physiologic function and structure of each organ system and then the abnormal structure and function that occurs in diseases of that organ system and their treatment. This course runs the full semester and uses the same teaching techniques present in the earlier medical science courses in the curriculum. In the Spring semester, this teaching continues through the remaining organ systems, including behavioral health, in the 15-credit Systems in Health and Disease 2 course.

The Introduction to Clinical Medicine 2 course runs throughout this year as well, focusing on more complex communication techniques, specialized physical examination skills, advanced medical ethics, and evidence-based medicine. A fall, winter, and spring break are included in the school year, which ends in mid-April so that students have time to study independently for USMLE Step 1.

INITIATIVES THAT SUPPORT STUDENT LEARNING

Standardized Patient Program: Beginning in the first year of medical school, standardized patients (individuals trained to present as patients) assist in training students to perform a complete physical examination, take a medical history and communicate effectively with a diverse patient population. Students log more than 60 teaching and assessment encounters with standardized patients during their four years as medical students. The Longitudinal Patient Program allows students to provide care to the same standardized patient throughout the first two years of the curriculum.

Paris Simulation Center:  This Center provides hands-on, realistic, risk-free opportunities to learn about high-risk patient encounters and unusual and rare patient cases and to engage in interactive, self-directed, small group and networked learning. Students log approximately 40 hours in the Simulation Center during their four years as medical students. Students may increase their exposure and conduct research in specific areas of interest by becoming members of the Simulation Center Interest Group.

National Leadership in Innovations in Medical Education: ULSOM students are offered unique opportunities to learn via grant-funded curriculum and educational experiences that establish the school as a national leader in innovative and impactful clinical and classroom medical education. ULSOM curriculum faculty are currently grant-funded to develop and study the effectiveness of medical school curricula in the following areas: obesity prevention and treatment, geriatric interdisciplinary care, improving the care of LGBT and DSD patients, identification and rescue of patients from human trafficking, development of accelerated tracks to the MD degree, development of a physician workforce for rural areas, and the care of adults with intellectual and developmental disabilities.

Learning and Curriculum Management System (RedMed): Faculty from all required courses post syllabi, web links, articles, discussion questions, notes, handouts, slides, study guides and examination grades on RedMed. Content from all courses is available to all years of students. New Innovations is the evaluation software used to collect evaluations on students in all four years as well as save examples of student work to their portfolio.

Academic Advising and Board Preparation Program: All students are provided access to individualized learning assessments and counseling, with tutoring available for students in academic difficulty. Second year students are provided additional support via assigned small groups led by fourth year students to hone their test-taking skills and their ability to respond to clinically-based questions.

Rural Medicine Option: The Trover Campus at Baptist Health Madisonville provides a select group of medical students the opportunity to complete their third and fourth year of medical school in Madisonville, KY.

Integrated Computer-Based Examinations: All examinations are completed on student computers using the ExamSoft testing program. This program provides reports to the student on his/her longitudinal strengths and weaknesses to better help them prepare for boards at the end of year 2.

Wireless Network and Technology: Students are able to access the Health Science Center's wireless network via smartphone or laptop. Beginning August 2017, all first year students will be provided with a laptop loaded with all of the required software necessary to guide their learning.

Technology-Enhanced Classrooms and Study Rooms: All classrooms and study rooms include flat-screen monitors and charging stations for group study. Large format teaching rooms are able to communicate and project to small group rooms, and vice versa. The team-based classroom on the first floor seats students in groups of six, with a shared monitor for group-generated work and another monitor to view instructor materials.

Advisory Colleges System: Each incoming medical student is assigned to one of six Advisory Colleges. College members share group lounge space and faculty mentors, building camaraderie and providing each student with additional support and mentoring.

OPPORTUNITIES OUTSIDE THE CLASSROOM

Service Learning Clinics: In their second year, students have the opportunity to work in clinics that treat underserved patient populations, for which they earn elective course credit. The students do everything necessary to run the clinics, from greeting the patients to taking medical histories to recording vital signs, running lab tests and performing physical exams.

Summer Research Scholar Program: Rising second year medical students are eligible to participate in the Summer Research Scholar Program for ten weeks. Students have the opportunity to choose a faculty member to work on a specific research project and receive a stipend for their work. Participating students will prepare and present a poster at the Research!Louisville conference.

Distinction Tracks: Distinction Tracks enrich medical school training without prolonging it. All tracks are a longitudinal, faculty-mentored experience culminating in a scholarly project. The Distinction in Research (DIR) track is in its fifth year; it is a program that provides a group of medical students with meaningful and productive research experiences and includes contact with mentors and research groups, development of research-oriented skills, and the completion of a scholarly research project in third/fourth years. Global Health, Medical Education, and Business and Leadership tracks started in spring 2013. Successful completion of distinction track requirements are noted on the student's transcript and in the Medical School Performance Evaluation (MSPE) letter for residency application. Students are also acknowledged at the Senior Honors Banquet and receive a certificate at graduation. Approximately 20% of our medical students are currently enrolled in a distinction track.

International Clinical Experiences: Students are encouraged to participate in study abroad opportunities. To facilitate students' participation, an annual workshop is held for medical students on study abroad. Students then work with the Office of Student Affairs and the faculty to apply for specific international experiences.

Pediatric Sophomore Summer Externship Program: The Department of Pediatrics offers an externship summer program for rising sophomore medical students interested in pediatrics as a career. This program introduces and increases the awareness of general pediatrics and its specialties under the mentorship of full-time faculty members of the Department of Pediatrics.