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Community Based Faculty Meeting Curriculum Update
May 10, 2014
History of Medical Education
Prior to 1920: Apprenticeship
1920-1960: Standardization and scientific investigation Emphasis on the patient and their presentation Case studies and case series
1960-2000: Genetic and molecular medicine Emphasis on laboratory and imaging Bench research and randomized controlled trials
2000-present: Comprehensive physician Integration of scientific background and patient
presentation Clinical productivity Comparative effectiveness, patient safety, ethics
Randomized Controlled Trials in PubMed
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Meta-Analyses in PubMed
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“He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.”
Sir William Osler
Our Approach
Block schedule One of the first medical schools to offer
Intensive, concentrated exposure to each area Emphasis on patient presentations and
management
Flexible afternoon scheduling Basic science courses scheduled in the mornings
Curriculum Goals
Integrate biomedical and clinical science
Promote critical thinking
Develop problem-solving skills
Develop clinical reasoning skills
Apply a biopsychosocial model to patient care
Pre-Clinical Years
First two years of study
Hybrid Curriculum Begin with essential principles of core knowledge Integrated content based on organ systems
Focus on integrative thinking Necessary for the clinical years of medical school Successful modern physicians
First Year
Anatomy
Introduction to Clinical
Medicine 1
Biochemistry & Genetics
Foundations of Disease, Infection & Therapeutics
Neurosciences
Behavioral Basis of Medicine
Discipline Specific
Anatomy Core gross and microscopic anatomy Integrated with embryology Basics that will be further developed throughout the
curriculum
Biochemistry & Genetics Core biochemistry, genetics and cell biology Biochemical and genetic inheritance Actual patient clinical correlations of human disease
Foundations of Disease, Infection & Therapeutics
Basis of all human disease
Integrated approach Microbiology Immunology Pharmacology Pathology
True “foundation” on which remaining courses will build
Neurosciences
Nervous system functions in health and disease
Integrated approach Neuroanatomy Neurochemistry Neurophysiology Neurology Neurosurgery Ophthalmology Otolaryngology
Behavioral Basis of Medicine
Introduction to psychiatric conditions
Integrated study Psychiatry Behavioral science Pharmacology
Modes of treatment Pharmacologic Psychotherapeutic Psychosocial
Introduction to Clinical Medicine 1
Longitudinal clinical experiences
Communication training and interviewing skills Practice with “actor” patients, then with actual patients
Small-group seminars Medical Humanities Medical Ethics and Professionalism Developmental Pediatrics Geriatrics Cultural and Social Aspects of Health Care
Evidence-Based Medicine
Second Year
Musculoskeletal & Integumentary Systems
Introduction to Clinical
Medicine 2
Hematologic & Lymphatic Systems
Endocrine & Reproductive Systems
Renal & Urinary Systems
Cardiovascular System
Respiratory System
Gastrointestinal System & Nutrition
Multisystem & Integrative Concepts
Organ System-Based Courses
Diagnostic and therapeutic approaches to disease
Integrative approach Pathology Physiology Pharmacology Histology Radiology Microbiology/Immunology
Integrative Course
Integrate knowledge among organ systems
Analyze multisystem diseases
Review material essential to licensing exam
Introduction to Clinical Medicine 2
Focus on physician skill set
Small group sessions History-taking Physical exam techniques Ultrasound as an adjunct to physical exam Clinical reasoning skills
Clinical Content Medical Humanities Medical Ethics and Professionalism Cultural and Social Aspects of Health Care Evidence-Based Medicine
Curriculum Comparison
M1 Year M2 Year
Anatomy
Histology
Biochemistry
Genetics
Neuroscience
PhysiologyInfection,
Immunity & Disease
Pathology(included Psychiatry)
Pharmacology
Introduction to Clinical Medicine 1 ICM 2 ICM 3
M1 Year M2 Year
Anatomy
Biochemistry
&Genetic
s
Foundations of Disease
, Infectio
n & Therape
utics
Neuroscience
Behavioral
Basis of Medicin
e
Musculoskeletal &
Integumentary
Hematologic & Lymphat
ic
Endocrine &
Reproductive
Renal & Urinary
Cardiovascular
Respiratory
Gastrointestinal
& Nutrition
Multisystem
/Integrative
Introduction to Clinical Medicine 1 Introduction to Clinical Medicine 2
Third Year
Broad exposure to major disciplines
Clinical exposure Integrate pre-clinical learning into patient care “Art of doctoring”
Balanced experiences Involvement with patient care Study Assimilation of information
Third Year Curriculum
Clinical Neurosciences – Neurology & Psychiatry Two separate four-week rotations
Family & Community Medicine Four-week rotation
Internal Medicine and Emergency Care Integrated 16-week rotation in inpatient and outpatient settings
Obstetrics & Gynecology Four-week rotation
Pediatrics Eight-week rotation
Surgery Eight-week rotation
Fourth Year
Further development of clinical skills
Prepare for residency in their chosen specialty.
Curriculum Acting Internships
Two four-week rotations, one primary and one secondary Advanced Clinical Pharmacology and Anesthesiology
Four-week course Intern Prep
Practical knowledge of the intern role Elective rotations
Four four-week rotations At the University of Kentucky or another approved site
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Match 2014
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29, 671 residency positions in the Match
17,374 US allopathic seniors in the Match
1,662 previous US allopathic grads in Match
2,738 US osteopathic students/grads in Match
5,133 US citizens students/IMGs in the Match
7,334 non-US citizens in the Match
Match 2014
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40,394 registered for the Match in 2014.
The Match offered 29,671 positions.
Overall match rate was 75%.
94.4% of US seniors matched into a residency position, with 79% getting one of their top three choices.
54% US seniors matched to 1st choice.
~1000 unmatched US allopathic medical students at the end of the match
UK Match 2014
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Of the graduating seniors, 37% are entering primary care specialties. Primary Care includes Family Practice, Internal Medicine, Pediatrics and Medicine-Pediatrics.
Of the graduating seniors, 31% elected to remain at UKMC, and another 4% are staying at programs in Kentucky.
Matched into 22 different specialties.
UK Match 2014
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Top specialty choices for UK COM seniors were (listed in decreasing chronological order): Internal Medicine 20% Anesthesiology 12% Pediatrics 8% General Surgery 7% Emergency Medicine 6% Med/Peds, Neurology 5% Radiology, Family Medicine, Orthopedic surgery 4%
Charles H. “Chipper” Griffith, MDSenior Associate Dean for Medical
EducationUniversity of Kentucky College of
