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USFCOM Curriculum

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Winter GRIPE 2007. USFCOM Curriculum. Year II: Integration Through Collegiality ... and laboratory medicine including laboratory hematology and cytopathology. ... – PowerPoint PPT presentation

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Title: USFCOM Curriculum


1
USFCOM Curriculum Year II Integration Through
Collegiality
  • USF College of Medicine
  • Don E. Wheeler, MD
  • Associate Professor
  • Pathology and Cell Biology

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1st Year Curriculum atUSF College of Medicine
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1st Year Curriculum
  • Professions of Medicine - This three-week course
    at the beginning of the medical school curriculum
    will introduce students to principles that will
    be used through the entire medical school
    education and beyond.
  • Basic scientists and clinicians present it in an
    integrated approach. Topical areas include
  • The use of information resources Library and
    Computer
  • An Introduction to Evidence Based Medicine
  • Effective Study Techniques
  • An Introduction to the Physical Examination
  • Cultural Diversity and Competency
  • Ethics and Professionalism
  • State of the Arts Presentations with Associated
    Basic Science Correlations

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1st Year Curriculum
  • Ethics and Humanities
  • Molecular Medicine
  • Physical Diagnosis I
  • Colloquium I
  • Anatomy
  • Imaging for Anatomy
  • Physiology
  • Longitudinal Clinical Experience I
  • Medical Neuroscience
  • Introduction to Behavioral Medicine

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3rd year curriculum
  • What if you bypassed the traditional
    department-based clerkships, but instead
    determined what the expected competencies and
    objectives students should achieve, and then
    designed the 3rd year around that?

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3rd Year Curriculum
  • Primary Care and Special Populations
  • (16 weeks)
  • Integrated Internal Medicine-Pediatrics
  • (8 weeks)
  • Newborn and Maternal Health
  • (4 weeks)
  • Emergent and Urgent Care
  • (4 weeks)
  • Neuropsychiatry
  • (8 weeks)
  • Surgical Care
  • (8 weeks)

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Primary Care and Special Populations (16 weeks)
  • This interdisciplinary clerkship introduces
    students to the various specialties involved in
    primary care, and teaches the principles of
    ambulatory care in the primary care setting.
  • Core clinical work includes ½ day each week in a
    continuity clinic experience with a family
    physician, general internist, and general
    pediatrician (for a total of three sessions per
    week).
  • It also provides experiences with patient
    populations that might require special care or
    consideration, including
  • adolescents,
  • patients with disabilities,
  • geriatric, and
  • gender specific diseases.
  • ambulatory gynecology,
  • a mens health clinic.
  • Contributing Departments Family Medicine,
    Internal Medicine, Pediatrics and Ob/Gyn

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Integrated Internal Medicine-Pediatrics (8 weeks)
  • Introduces students to the basic principles and
    practices of hospital-based internal medicine and
    pediatrics.
  • Students participate as a member of a hospital
    ward team, take overnight calls with their team,
    and are responsible for direct care of both adult
    and pediatric hospitalized patients.
  • Didactic essentials are taught in an integrated
    life-spectrum approach.
  • The clerkship has a special emphasis on
  • medical ethics,
  • the practice of evidence-based medicine, and
  • the promotion of and evaluation of
    professionalism.
  • Contributing Departments Internal Medicine and
    Pediatrics

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Newborn and Maternal Health (4 weeks)
  • This interdisciplinary clerkship is designed to
    expose students to the unique maternal fetal unit
    within the context of obstetrics and newborn
    health.
  • Three weeks of this rotation focuses on the
    Womens Health Care obstetrical component.
  • An emphasis is placed on achieving clinical
    skills and a fund of knowledge across the
    continuum of ante partum, labor and delivery, and
    post partum care.
  • The rotation is complimented by incorporating
  • a pediatric knowledge base of skills and efforts
    at the time of delivery,
  • newborn exam, and
  • relevant aspects of the newborn nursery and NICU.
  • Contributing Departments Pediatrics and Ob/Gyn

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Emergent and Urgent Care (4 weeks)
  • This clerkship is an introduction to Emergency
    Medicine, integrating clinical skills and
    evidence-based medicine through
  • didactic lectures,
  • observation,
  • performance of clinical procedures,
  • hands-on clinical experiences and
  • direct interaction with faculty, individual
    patients, and families.
  • Students
  • will learn and practice on mannequins,
    simulators, and in a cadaver lab.
  • will learn patient management through the team
    approach, which involves EMTs, nurses, and
    physicians.
  • are expected to evaluate patients, address their
    presenting complaints, initiate workups, and
    provide definitive therapies.
  • This rotation will develop history-taking
    abilities, physical exam assessment, and
    diagnostic and management skills.
  • This clerkship emphasizes a caring,
    compassionate, and empathetic attitude in dealing
    with patients and their families.
  • Contributing Departments Emergency Medicine

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Neuropsychiatry (8 weeks)
  • This interdisciplinary clerkship includes the
    following experiences
  • 4 weeks on a general psychiatry adult inpatient
    service,
  • 2 weeks on the psychiatry consultation liaison
    service, and
  • 2 weeks general neurology.
  • The psychiatry portion is designed to provide the
    student with opportunities
  • to become comfortable interacting with patients
    with psychiatric illnesses and
  • to gain proficiency in obtaining a psychiatric
    history and performing a mental status
    examination.
  • The experiences for the neurology portion are
    designed
  • to help students recognize major neurological
    diseases,
  • be able to take a history regarding neurological
    symptoms, and
  • demonstrate proficiency with performing a
    neurological exam.
  • Contributing Departments Neurology and Psychiatry

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Surgical Care (8 weeks)
  • Surgical Care is an interdisciplinary clerkship
    with core experiences in general, subspecialty,
    and gynecologic surgery.
  • This clerkship provides the student with an
    opportunity to acquire the fundamental principles
    of surgery in addition to learning basic
    procedures.
  • There is an emphasis on
  • gaining knowledge of common surgical diseases,
  • performing common procedures,
  • developing communication skills and
  • professionalism.
  • Core clinical competencies include the
  • initial assessment of acutely ill patients,
  • observation and participation in a variety of
    surgical procedures, and
  • ward management of patients.
  • At the completion of the clerkship, students are
    expected to identify, understand, and management
    basic surgical problems in addition to being able
    to perform basic surgical procedures.
  • Contributing Departments Surgery and Ob/Gyn

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4th Year Curriculum
  • Skin Bones 4 weeks
  • Interdisciplinary Oncology 4 weeks
  • Critical Care 8 weeks
  • 5 Required Electives
  • 8 weeks unscheduled
  • Residency Interviews/USMLE Prep

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Skin and Bones (4 weeks)
  • This innovative, interdisciplinary senior
    clerkship is designed to meet a nationwide
    curricular need for improved musculoskeletal
    education for graduating medical students.
  • Students develop a familiarity with the diagnosis
    and treatment of common musculoskeletal and
    dermatologic conditions as well as with
    indications for referral in more complex cases.
  • Clinical experiences include
  • orthopedics,
  • primary care sports medicine,
  • rheumatology,
  • dermatology, and
  • physical therapy.
  • Students also get hands-on workshops on
  • casting and splinting,
  • joint injections, and
  • physical examination skills.
  • Contributing Departments Family Medicine,
    Internal Medicine, Dermatology, Orthopedics,
    Physical Therapy

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Interdisciplinary Oncology (8 weeks)
  • An innovative, interdisciplinary senior clerkship
    in which the fundamental principles of oncology
    and the interdisciplinary approach to the care of
    cancer patients, from prevention, diagnosis,
    treatment, rehabilitation, and end-of-life care
    are taught.
  • Students will rotate in one of the clinical
    programs at the H. Lee Moffitt Cancer Center and
    will participate in a core curriculum consisting
    of student "mock" tumor boards, journal clubs,
    seminars, and evidence-based presentations.
  • They will be exposed to all cancer treatment
    modalities including
  • surgery,
  • radiotherapy,
  • chemotherapy,
  • immunotherapy, and
  • endocrine therapy.
  • One unique experience is a role-playing exercise
    designed to teach students how to convey
    difficult news.
  • Contributing Departments Interdisciplinary
    Oncology

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Critical Care (8 weeks)
  • This interdisciplinary senior clerkship is
    designed to foster acquisition of the foundation
    of critical care knowledge, skills, and
    attitudes.
  • The clerkship curriculum is grounded in a
    philosophy that emphasizes problem solving and
    clinical skills to be taught at the bedside.
  • Through simulation technology, the student is
    afforded a unique opportunity to combine
    biomedical and clinical sciences through applied
    human physiology, pharmacology and disease
    states.
  • Regardless of future career path, knowledge and
    skills attained during this clerkship will be
    invaluable to the appropriate care of critically
    ill patients in the future.
  • Contributing Departments Anesthesiology,
    Internal Medicine, Surgery, Pediatrics (Basic
    Sciences)

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Courses in the Sophomore Year
  • Principles of Medical Immunology and Infectious
    Diseases
  • Pharmacology
  • Pathology and Laboratory Medicine
  • Evidence-Based Medicine
  • Clinical Diagnosis and Reasoning
  • Physical Diagnosis II
  • Clinical Problem Solving
  • Longitudinal Clinical Experience II
  • Colloquium II

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Division of the Sophomore Year
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Pharmacology (Pharm)
  • provides a learning experience designed to
    provide a current knowledge base and to promote
    and encourage life-long learning in pharmacology.
  • Methods utilized to stimulate and to evaluate the
    knowledge base of students in the discipline of
    pharmacology include
  • Lectures,
  • clinical conferences,
  • laboratory demonstrations,
  • problem-solving sessions,
  • interactions with faculty, and
  • examinations.
  • In an effort to provide a cohesive approach to
    the learning process, prototypical agents in each
    class of therapeutic compounds are presented and
    discussed in detail, emphasizing
  • the pharmacokinetic profile,
  • mechanism of action,
  • therapeutic use,
  • pharmacological and
  • toxicological effects, and
  • contraindications of these compounds.

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Principles of Medical Immunology and Infectious
Diseases (PMIID)
  • This course consists of lectures, laboratory, and
    small-group conferences in which principles of
    infectious disease are presented with emphasis on
    both
  • the characteristics of the causative agent and
  • the host response to colonization activities.

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Evidence-Based Medicine (EBM)
  • An essential course for learning the principles
    of applied clinical epidemiology and how to use
    an evidence-based approach to the practice of
    medicine.
  • Evidence based medicine is the integration of
    best research evidence with clinical experience
    and patient values
  • Sackett, Straus, et al Evidence Based Medicine
    How to Practice and Teach EBM, 2nd Ed.

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Clinical Diagnosis and Reasoning (CDR)
  • to provide the student with the opportunity to
    "think like a physician."
  • to provide the venue to integrate clinical
    diagnostic and reasoning strategies with
    complementary aspects of clinical problem
    solving, physical diagnosis, and evidence based
    medicine.

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Physical Diagnosis II (PD2)
  • In this course, students gain knowledge of the
    physical exam
  • using a Web-based course that contains lecture
    material, assessment tools and online testing.
  • participating in small group sessions to develop
    physical exam skills.
  • second-year students learn advanced skills,
    maneuvers, and techniques, building on the
    foundation skills taught to first-year students

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Clinical Problem Solving (CPS)
  • multidisciplinary course offered during the organ
    system blocks.
  • students learn clinical reasoning through
    tutorial sessions and student case conferences

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Longitudinal Clinical Experience (LCE)
  • The mission is to introduce students to clinical
    medicine during the first two years of medical
    school.
  • The program pairs first and second year medical
    students with faculty and private medical
    practice preceptors, for ½ day each week in a
    clinical setting.
  • Over the course of two years, each student works
    with three different preceptors, beginning in
    observation mode and working up to evaluating
    patients at a pace determined by the preceptor.
  • Preceptors represent specialty areas as well as
    primary care which provides students with a
    unique opportunity to explore medicine in a
    variety of practice areas early in their medical
    education

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Colloquium II
  • During years one and two, the colloquia
  • will emphasize clinically relevant topics related
    to the basic sciences and areas of medicine that
    cross-traditional boundaries.
  • Sessions will involve interaction between year
    one and year two students.

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Pathology and Laboratory Medicine (PLM)
  • to provide the students with
  • basic concepts of general and systemic pathology,
  • general principles of clinical pathologic
    correlation, and
  • principles and interpretation of laboratory
    tests.
  • The course involves integrated lectures in
    pathology and laboratory medicine including
    laboratory hematology and cytopathology.

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PLM
  • The course includes
  • lectures all video-streamed on demand
  • general and systemic pathology
  • laboratory medicine
  • case presentations lecture hall presentation of
    unknown cases to students to help synthesize
    material and sharpen skills at generating
    differential diagnoses
  • clinicopathologic conferences autopsy
    presentations emphasizing the differential
    diagnosis and encouraging further study
  • laboratory sessions that involve the
    Clinical-case based study of gross and
    microscopic (glass slide) pathology
  • small group discussions case based
  • Autopsy Experience
  • man in the pan
  • Medical Examiner's office.

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PLM
  • Grading
  • 84 average from total questions from 9 blocks
  • 15 Pathology Shelf Exam
  • 1 CPC paper
  • Group Scores
  • Pathology-specific Evaluations after each block
    via BB

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Opportunities for Integration in the 2nd year
  • The Calendar
  • Question review sessions
  • Interdisciplinary Conferences
  • Blackboard
  • Attendance at each others lectures

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Opportunities for Integration in Development
  • Post-Mortems after each block to look for
  • Unplanned redundancies
  • Open up time for other teaching modalities, such
    as team-based learning
  • Omissions of important material
  • Further opportunities for integration
  • Focus on specific blocks each year for close
    examination and possible changes.

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Pathology Integration in the 3rd and 4th Years
  • 1st year
  • Pathology in the dissecting lab
  • Histopathology correlations throughout anatomy
    course
  • 3rd and 4th years
  • Introduction to Clerkship
  • Medical Examiner and Death Certificate
  • Surgical Care Clerkship
  • Pathology integrated in some surgical teaching
    cases
  • Critical Care Clerkship
  • Basic Science seminar patient with Congestive
    Heart Failure

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Integration by Collegiality
  • Enhancing integration while maintaining separate,
    generally department based courses
  • Takes a lot of careful planning and time, but
    worth every minute.

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  • PLM wouldnt be the awesome course it is at
    USFCOM, except for the efforts of . .
  • Dr. John Balis
  • Dr. David Rowlands

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USFCOM Curriculum Year II Integration Through
Collegiality
  • USF College of Medicine
  • Don E. Wheeler, MD
  • Associate Professor
  • Pathology and Cell Biology
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