Pre-Clinical Years

Clinical experience is introduced early in the first year through the Patient Centered Medicine course. Measurable course objectives and benchmarks have been developed for students in Pre-Clerkship and Clerkship/Advanced phases of the curriculum. Clinical training is enhanced through the use of standardized patients, Objective Structured Clinical Exercises (OSCE), 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.

Academic Calendar Academic Calendar

→ Pre-Clinical, Non-Credit Electives

Year 1 and Year 2

M1

Foundations of Medicine

Biomedical Science

The goal of Biomedical Sciences course is to provide our students with an understanding of the scientific basis of medicine and to integrate biochemistry, genetics, epidemiology, and cellular and molecular biology both to normal structure and function of the human body and to disease states that result when these become abnormal. In this course, we aim to help students 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.

Structure and Function

In Structure and Function, students will explore the musculoskeletal and peripheral nervous systems from the cellular to gross anatomic level through a series of large and small group exercises and laboratory experiences including cadaver dissection. Students will begin to use anatomical terminology and the language of medicine in communication with their peers and faculty. Common clinical cases will serve as the basis for discussion of peripheral nervous tissue, muscle and bone from the basic science of these structures to the patient presenting with related pain and/or dysfunction.

Maintaining Homeostasis

Cardiovascular Systems

The Cardiovascular Systems course will cover the medical sciences and an introduction
to 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. The Cardio course relies upon the
foundational information presented in the Biomedical Sciences and Structure-Function courses.
Mastery of electrophysiology, muscle physiology, and several other structure-function
relationships, from the molecular-cellular level to the gross anatomic level, is required to
understand the complexities of integrated cardiovascular function.

Pulmonary and 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
overarching goal of this course is to demonstrate the interdependence of these systems, and the
importance of each, in human health and disease. This course is in fact a continuation of what
will be discussed in the Cardiovascular Systems course, and thus relies heavily upon mastery of
that material.

Endocrine and Reproductive Systems

The Endocrine and Reproductive Systems course will cover the medical sciences and an
introduction to the clinical aspects, including pathophysiology, of the endocrine and reproductive
systems. The overarching goal of this course is to demonstrate the interdependence of these
systems, and the importance of each in human health and disease. This course is in fact a
continuation of what was discussed in the Cardiovascular Systems and Pulmonary and Renal
Systems courses, and thus relies heavily upon mastery of that material.

Digestive Systems, Nutrition and Metabolism

The goal of the Gastrointestinal, Metabolism and Nutrition course is to build, using an integrative approach, a foundation of understanding of the structure-function relationships which control GI function. This information will be integrated with the study of the metabolism of key nutrients and why these homeostatic mechanisms when perturbed lead to disease states affecting the GI and other systems such as intestinal malrotation, gastroesophageal reflux, cholelithiasis, glycogen storage disease, malabsorption disorders, alcoholic liver diseases, celiac disease, nutritional deprivation and other selected ailments. As in all the courses, students are guided to develop with 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.

Mechanisms of Disease and Defense

Immunity

This course provides a foundation for the understanding of the general pathology of diseases and the normal workings of the immune system. Students will study the mechanisms of the pathology of disease states at the molecular, cellular, tissue, organ, and organismal levels. This will include cell injury, inflammation and tissue repair. Students will become familiar with the normal workings of the immune system, including the molecules, cells and organs responsible for its functioning in the defense of the human body. In addition, the course will cover the most common drugs which affect the functioning of the immune system.

Microbiology

This course provides an introduction to the biology of common human bacterial, viral, fungal and protozoan pathogens which cause human disease. Students will analyze the interactions of the pathogens with our immune system. In addition, students will be able to apply the principles of the biology of these pathogens to predict their response to major therapeutic agents and explain emergence of drug resistance. This course will demonstrate how knowledge of microbiology will help in diagnosing and treating infectious diseases.

Patient Centered Medicine I

Patient Centered Medicine I is an experiential and skill development block which enables students to explore issues of humanism and professionalism, cultural and ethical sensitivity and the influence of one's own socio-cultural and personal beliefs on the practice of medicine, as well as the importance of balance in one's personal and professional lives. Through teaching scenarios with standardized patients and clinic visits, students practice communication skills for establishing rapport and a therapeutic alliance with patients, for eliciting a medical history and understanding the biopsychosocial and environmental context.

M2

Diseases and Therapeutics

Foundations of Diagnostic and Therapeutics

The initial two-week course focuses on fundamental skills needed by physicians to make diagnostic and therapeutic decisions for patients presenting with problems in any organ system. Major topics are introductory pharmacology, laboratory medicine, and clinical decision-making. Skills will be applied in two problem-solving sessions at the end of each week.

Neuron, Brain and Behavior

This block is composed of two courses (NBB1 and NBB2). The overall objectives of the block are to familiarize medical students with the principles of normal and abnormal function of the central nervous system. The major classes of neurological and psychiatric diseases and disorders are covered. The emphasis is on understanding the major clinical features from a mechanistic point of view. Pathological findings are covered together with major drug classes used to treat many disorders.

Cardiovascular Diseases

The Cardiovascular Diseases course is designed to provide a solid foundation of knowledge regarding common diseases of the heart and vasculature. Review of relevant M1 material will open the course, followed by a discussion of common presenting symptoms and physical findings characteristic of thecardiac and vascular organ systems. This material will be correlated with instruction and examination workshops in PCM 2. The course will cover risk factors for disease as well as pathophysiology, pathology, diagnostic (e.g. ECG) and treatment strategies for: coronary artery disease and hypertension, valvular and congenital heart disease; congestive heart failure and cardiomyopathies, shock and other topics.  Key presenting features for each disease will be emphasized. Drugs that are commonly used to treat disorders of the heart will be discussed with emphasis on their mechanisms of action, organ system effects, and major toxicities. When appropriate, the clinical uses will be discussed in the context of specific disease processes by both clinical and basic science faculty.

Pulmonary Diseases

The Pulmonary Diseases course is designed to provide a solid foundation of knowledge about common diseases of the lung and airways. Review of relevant M1 material will open the course, followed by a discussion of common presenting symptoms and physical findings characteristic of lung and upper airway diseases. This material will be correlated with instruction and examination workshops in PCM 2. The course will cover risk factors for disease, pathophysiology, pathology, diagnostic (e.g. pulmonary function tests, arterial blood gases) and treatment strategies for: obstructive and restrictive lung diseases, pulmonary hypertension and adult respiratory distress syndrome; sleep apnea; lung cancer; pulmonary infections and other topics.  Key presenting features for each disease will be emphasized. Drugs that are commonly used to treat disorders of the lung (e.g. asthma medications; drugs to treat lung cancer) will be discussed with emphasis on their mechanisms of action, organ system effects, and major toxicities.

Renal Medicine - Hematology

First, the course aims to provide a solid foundation of knowledge regarding diseases of the kidney.  This material will open with an in-depth review of renal physiology, followed by a discussion of parenchymal diseases of the kidney and urinary tract. Selective 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.  We will close with a discussion of risk factors for chronic kidney disease and the impact of kidney dysfunction on erythropoiesis, calcium homeostasis and acid-base status. Drugs that are associated with renal toxicity will be discussed in terms of their metabolism and mechanisms of action by both clinical and basic science faculty.

The renal medicine section will be followed by the section on hematology. We will begin by briefly reviewing the biology of Hematopoiesis, with a focus on the control of blood cell proliferation and differentiation, and the consequences of dysregulation of these processes. The presenting problems and pathophysiology of blood diseases, as well as the microscopic correlates, will be discussed for the following disorders: anemias, hemoglobinopathies, hematologic malignancies, myeloproliferative and myelodysplastic disorders. Congenital and acquired bleeding disorders, and the prothrombotic disorders (“hypercoagulable states”) will also be covered. Drugs that are commonly used to treat hematologic disorders – including biologics- will be discussed in terms of their metabolism, mechanisms of action, organ system effects, and major toxicities.  Additionally, transfusion medicine, bone marrow and peripheral stem cell transplantation will also be covered either in lecture or by e-book.

Diseases and Therapeutics 2

Endocrine and Reproduction Disease

This course will cover endocrine disorders and disorders of male and female reproductive tracts, including gynecologic and male reproductive tract oncology. The normal physiology of pregnancy, labor and delivery will also be presented.  In all cases, the sections will lead off with a review followed by a discussion of the systemic manifestations of disease.

 Case-based learning sessions will reinforce competency for these topics and emphasize key features for differential diagnoses. Additionally, 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. 

 Following the final examination, 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 that examine these issues more closely so that we can understand how they may impact patient care.

GI, Liver and Biliary Tract Diseases

The 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 symptoms in the adult and the pediatric patient. In addition, therapeutic and pharmacologic interventions are discussed in terms of their metabolism, mechanisms of action, organ system effects, and major toxicities.  Correlation with Patient-Centered Medicine sessions will guide the development of history taking skills and physical examination of the patient who is suspected to have diseases of the alimentary tract or the hepatobiliary system.

Muskoskeletal and Skin Diseases

The objectives of the course on Musculoskeletal, Joint and Skin Diseases are to cover two important areas of clinical medicine.

First, disorders of the musculoskeletal system and skin are prevalent throughout the world, affecting all ages and ethnic groups. This course will cover review the functional anatomy and physiology of the bones, joints, and skin. Common disorders of the bones, joints and skin, including infectious, structural and traumatic injuries, will be examined. The mechanisms of disease, diagnostics and therapeutics will be reviewed.

Second, we will discuss the principles of immunology as a segue into the discussion of rheumatologic disorders of the joints, skin and vasculature along with their investigation and various therapies. We will examine the myriad of clinical manifestations of some key systemic rheumatologic diseases.