Pre-Clerkship Curriculum

An 18 month pre-clerkship curriculum places foundational knowledge in the context of the practice of medicine and the Rutgers RWJMS 66 Core Clinical Conditions. Clinical cases will be thread throughout the 18 months. Clinical experiences, simulation, objective structured cases, and time for reflection and independent study will follow the foundational and integrated systems courses. Flexibility will be provided for scheduling of Step-1 by allowing students to choose the clinical or clerkship block they would like to dedicate to study and taking of the first licensure exam.

Clinical experience is introduced early in the first year through the Physicianship course and Physicianship Development and Practice blocks. Measurable course objectives and benchmarks have been developed for students in Pre-Clerkship and Clerkship/Advanced phases of the curriculum. A variety of instructional methods, laboratories, and active learning approaches will be utilized throughout the curriculum. Clinical training is enhanced through the use of standardized patients, Objective Structured Clinical Exercises (OSCE), simulations, and individual observation and feedback by the more than 2,400 full time and volunteer faculty. All educational experiences undergo rigorous evaluation by students and faculty throughout the four years.

We provide support for students through wellness programs, meetings and seminars with educational psychologist, peer-tutoring, and many educational resources.

Academic Calendar Academic Calendar

→ Pre-Clinical, Non-Credit Electives

The pre-clerkship curriculum contains six blocks with each block composed of the courses presented below.

Block 1: Physicianship (Physicianship Course and the first half of the Physicianship Development and Practice Sessions)

Block 2: Foundations in Medical Sciences (Foundations in Medical Sciences)

Block 3: Integrated Systems 1 (Cardiovascular System and Pulmonary & Renal Systems)

Block 4: Integrated Systems 2 (Metabolism, Endocrinology, and Reproductive Systems; Gastrointestinal System)

Block 5: Movement, Brain and Behavior (Musculoskeletal and Nervous Systems, Nervous System and Behavior)

Block 6: Physicianship 2 (Physicianship Development and Practice Sessions)

 

A schematic of the calendar can be seen below.

 

Block 1 & Block 6: Physicianship

Physicianship

The Physicianship course introduces students to the profession. It will cover professionalism, medical ethics, humanism in medicine, patient-centered care, population health, health disparities, clinical skills, evidence-based medicine, and health systems science. The course leads off the M1 year and continues with Physicianship Practice and Development sessions over 3 years. Physicianship Practice and Development sessions will reinforce the basic and clinical sciences presented in the preceding courses and provide clinical experiences related to the content learned to date.

Block 2: Foundations in Medical Sciences

Foundations in Medical Sciences

This course covers fundamental knowledge and key basic science concepts needed by physicians to make diagnostic and therapeutic decisions for patients presenting with programs in any organ system. The foundations in medical science course covers the content areas of:

  • Molecular Basis of Genetic Disorders

  • The Cell as a Unit of Health and Disease

  • Basic Concepts of Pharmacology

  • Immunity in Health and Disease

  • Hematopoiesis and Neoplasia

  • Etiologic Basis of Infectious Diseases

Block 3: Integrated Systems 1

Cardiovascular Systems

The Cardiovascular Systems course will cover the medical sciences and the clinical aspects, including pathophysiology, of the cardiovascular system. The overarching goal of this course is to demonstrate the interdependence of the heart and vascular systems and the importance of each in human health and disease. Mastery of electrophysiology, muscle physiology, and several other structure-function relationships, from the molecular-cellular level to the gross anatomical level is required to understand the complexities of integrated cardiovascular function. The course focuses discussion of common presenting symptoms and physical findings

characteristic of the cardiac and vascular organ systems. The course will cover risk factors for disease as well as pathophysiology, pathology, diagnostic and treatment strategies for many disease which affect the cardiovascular system. Key presenting features for each disease will be emphasized. Drugs that are commonly used to treat disorders of the cardiovascular system will be discussed with emphasis on their mechanisms of action, organ system effects, and major toxicities. Anatomy, histology, and embryology studies are integrated within this systems-based course so that students may explore and relate structure to function, disease, and treatment. When appreciate, the clinical uses will be discussed in context of specific disease processes by both clinical and basic science faculty.

Pulmonary & Renal Systems

The Pulmonary and Renal Systems course will cover the medical sciences and an introduction to the clinical aspects, including pathophysiology, of the pulmonary and renal systems. The course will provide a solid foundation of knowledge about common diseases of the pulmonary system. The course will cover risk factors of disease, pathophysiology, pathology, diagnostic (e.g., pulmonary function tests, arterial blood gases) and treatment strategies for a variety of pulmonary diseases. Key presenting features for each disease will be emphasized. Drugs that are commonly used to treat disorders of the lung will be discussed with emphasis on their mechanism of action, organ system effects, and major toxicities.

This course will also provide a solid foundation of knowledge regarding renal physiology and pathophysiology, Common disorders of renal tubular function that disrupt systemic water, electrolyte, and acid-base homeostasis will also be examined, in addition to congenital disorders of the kidney and tumors of the kidney, ureters and bladder. Small group activities utilizing self-directed learning in a case-based format will be used to reinforce clinical concepts of renal pathophysiology.

Block 4: Integrated Systems 2

Metabolism, Endocrinology, Reproductive Systems

The primary focus of this course is hormonal regulation and cellular metabolism. Specifically, cellular pathways important for generating energy and building blocks necessary for maintaining homeostasis in the body will be explored, along with how these processes are tightly regulated by metabolic hormones. The impact of dysregulation of cellular metabolism on human health and associated diseases such as diabetes and obesity will also be examined. As in all the courses, students are guided to develop the necessary skills to be interdisciplinary thinkers and life-long learners who understand and interpret molecular, biochemical and clinical information leading to improved evidence-based medicine.

Additionally, this course will cover the physiology and pathophysiology of the endocrine and reproductive systems. Case-based learning sessions will reinforce the essentials of endocrine and reproductive physiology and pathophysiology and emphasize key features for differential diagnoses. Furthermore, drugs that are commonly used to treat endocrine and reproductive

disorders will be discussed in terms of their metabolism, mechanisms of action, organ system effects, and major toxicities.

In the Physicianship Practice and Development session, we will conduct interdisciplinary sessions on sexual health, sexual behavior and reproductive diseases that will serve as a capstone to the course. There will be panel discussions, small and large group series, and other educational experiences that examine these issues more closely to that we can understand how they impact patient care.

Gastrointestinal Systems

This course will allow students to build, using an integrative approach, a foundation of understating of the structure-function relationships which control GI function. The second year (M2) gastrointestinal disease course will begin with a focused review of normal anatomy and physiology followed by a discussion of the cardinal manifestations of GI disease. Specific attention will be devoted to the organ-based pathophysiology and pathology of the esophagus, stomach, small and large intestine as well as the hepatobiliary system and pancreas, emphasizing the cardinal symptoms in each of these organ systems in the pediatric and adult patient. In addition, therapeutic and pharmacologic interventions are discussed in terms of their metabolism, mechanism of action, organ system effects, and major toxicities. Anatomy, histology, and embryology studies are integrated within this systems-based course so that students may explore and relate structure to function, disease, and treatment.

Block 5: Movement, Brain, & Behavior

Musculoskeletal and Nervous Systems

In this course, students will explore the development, structure and disease of the musculoskeletal and peripheral nervous systems. Study will range from the cellular to gross anatomic levels through a series of large and small group exercises and laboratory experiences, including cadaveric dissection of the back, extremities, head, and neck. Common clinical cases will serve as the basis for discussion of the musculoskeletal system and peripheral nervous system, from the basic science of these structures to the patient presenting with related pain and/or dysfunction.

The Nervous Systems component of the course covers brain anatomy and function as well as the clinical neuroscience underlying normal function, with an emphasis on understanding the basis of the neurological exam. Students learn the basic anatomical structures and cellular mechanisms by which central nervous system controls sensation, perception, behavior, executive functions, homeostasis and movement. A wet laboratory experience is included to familiarize students with brain structures and corresponding neuroimaging. The major disorders, disease and conditions related to the field of neurology are covered. For each class of disease, the principles and pathophysiological mechanisms are covered, together with pathology, symptomatology, and major drug classes used in treatment.

Nervous Systems and Behavior

The overall objective is to familiarize medical students with the principles of normal and abnormal function of the central nervous system. Nervous Systems and Behavior covers Behavioral Science, Psychiatry, child development and the mental status exam. The major psychiatric disorders are introduced with an emphasis on recognizing major features or the disorder and then distinguishing between related disorders. Treatment approaches are covered for each condition, including pharmacological and non-pharmacological treatments.