Changes to BUSM I-IV Curricula in the 2008-09 Academic Year
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- Description of changes to BUSM I
- Description of changes to BUSM II
- Description of changes to BUSM III
- Description of changes to BUSM IV
In response to recommendations from the LCME and initiatives of the Medical Education Committee and Preclinical Curriculum Subcommittee, the first-year curriculum has been under revision by the BUSM I course managers with a two-year implementation plan. In the first phase, 2007-08, the start date was shifted two weeks earlier to mid-August for an orientation program on medicine as a profession, its ethical foundations, and the analytical tools for the practice of evidence-based medicine. A second major innovation was implementation of Bacus virtual microscopy for teaching histology, which allowed for more flexibility in curricular scheduling. In the second phase, 2008-09, BUSM I will begin with the White Coat Ceremony on the first day, August 11. The new curriculum will introduce students to Biochemistry and Cell Biology early in the first year (rather than in the second semester), along with Gross Anatomy, Human Behavior in Medicine, Integrated Problems, and Introduction to Clinical Medicine (ICM 1). In part because of an increase in the number of weeks in the fall semester, the neuroscience course will begin in December with an exam prior to intersession and then end in January. It is anticipated that this schedule will serve to decompress this intense integrated systems course. The Histology course will be shifted to the spring semester and coordinated with the courses in Physiology, Genetics, Immunology and Integrated Problems in an organ system-based context (cardiovascular, gastrointestinal, respiratory, hematologic, renal, endocrine). Also in the spring, a core curriculum for ICM 1 will include eight online modules on the patient-doctor encounter and interview techniques, as well as introductory physical exam workshops and clinical visits. Physical exam videos have incorporated review of anatomy and other curricular components. The enhanced coordination of the first-year curriculum will allow for increased independent study time and an earlier end date for the first-year (May 22, 2009). The planning includes changes in the corresponding GMS courses for pathway and MA students to continue the option of advanced standing on BUSM I enrollment.
The second-year curriculum has been restructured to integrate the study of disease (its pathophysiology, infectious etiologies, and pharmacologic management) in an organ-based context. A new yearlong course, designed by the second-year course managers, will replace the previous courses of Microbiology, Pathology, Pharmacology, and Biology of Disease. This course, Disease and Therapy (DRx), will begin with an introduction to the fundamental concepts of microbiology, pathology and pharmacology. The second section will address the microbiological basis of infectious disease and its pharmacologic treatment. The subsequent blocks will address diseases of the cardiovascular system, lungs, kidneys, gastrointestinal system, skin, endocrine and reproductive organs, joints and connective tissue, and central and peripheral nervous system. A new block in oncology has been coordinated with hematology. Health law, policy, and management systems, which were previously taught in the first year, have been incorporated into this curriculum. The Integrated Problems course will be coordinated with the concomitant organ-based blocks to reinforce students’ analysis of case-based issues. The Introduction to Clinical Medicine course also will be coordinated with the ongoing didactic topics to develop students’ diagnostic skills in clinical settings. To accommodate changes in the third and fourth-year schedules, the second year will begin and end earlier (August 18, 2008-April 24. 2009), leaving the usual time (5.5 wks) for USMLE Step 1 and a break, prior to the start of the third year.
The new curriculum allows third-year students to choose two from the following three offerings: Neurology Clerkship, Radiology Clerkship or an elective. The new third-year curriculum has been restructured to allow students to experience eight of their nine required clerkships all in their third-year. Prior to the restructuring, students were only able to enroll in six of their nine required clerkships in their third year with radiology, neurology and geriatrics offered only in the fourth year. The clerkship directors feel this change has two major advantages for our students. First this will allow students interested in either neurology or radiology to experience these clerkships prior to their setting up residency interviews in their fourth year. In addition, experiencing these electives in the thrid year will hopefully better prepare students for their USMLE Step 2 examination at the end of their third year. This transition of neurology and radiology into the thrid year of the curriculum from the fourth year will occur over the next four years. The restructuring will also allow the students an opportunity to take a one-month elective in their third year. Third-year students had previously been allowed only a two-week elective, which due to its short duration severely limited choices in electives and also did not allow any student the possibility of earning an honors grade.
The above changes were made possible by reducing the Medicine and Surgery Clerkships from eleven weeks to eight weeks in the third year. Students will pick up those weeks now in their fourth year (see below in BUSM IV). Also new is the pairing together of certain clerkships with related content to allow better content integration. The pairing includes the following: Pediatrics with Obstetrics & Gynecology, Family Medicine with Psychiatry, and when possible Medicine with Neurology, and Surgery with Radiology.
At the conclusion of the third year, (clerkships end on 5/17/09) there will be a two week Intercession, followed by a week vacation. This Intercession is planned to better prepare our students for Step 2 of the USMLE exam. The Intercession will start with a weeklong structured review of all the clerkships and intensive exam preparation. That week will conclude with a registered on-line practice Step 2 examination that will assist students in identifying areas to focus on in their study. The next two weeks students will have time for self study and vacation. Students are encouraged to take Step 2 after the Intercession but are required to take the examination before December 1, 2009. The students will have two weeks of vacation, 12/25/08 to 1/4/09 and 3/23/09 to 3/29/09. The third year ends on 6/7/09.
The fourth-year curriculum has been restructured to include both a four-week Medicine Clerkship and a four-week Surgery Clerkship. Students will be able to select these clerkships from a variety of medicine and surgical subspecialties, so as to tailor their choice to their career goals. For example, students applying to Orthopedics may choose to do an Orthopedic surgical clerkship in their fourth year. The students will have two weeks of vacation, 12/25/08 to 1/4/09 and 3/23/09 to 3/29/09. The fourth year will end on 5/17/09 with graduation.
