Washington Medical Science Institute · Students complete the integrated basic sciences at the Washington Medical Science Institute in Saint Lucia. The basic sciences are integrated

WMSI: BASIC SCIENCE CURRICULUM 2017

Washington Medical Science Institute

AN OVERVIEW OF THE WMSI BASIC SCIENCE CURRICULUM


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MISSION:

The mission of WMSI is to prepare physicians to provide high quality care to patients and

society with compassion, passion for knowledge, commitment, tolerance and dedication to life-

long learning. The overarching goal of the Medical program is providing a broad education in a

culturally diverse environment.

PROGRAMME DESCRIPTION

The Medical Education Program at WMSI strives to be a program of choice for modern

education and learning. Our curriculum is delivered through a balanced model that supports life-

long learning and quality.


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• achieve excellence in the practice of safe, high-quality care;

• follow innovative educational methods to train Medical Doctors to meet the future health

care workforce needs;

• Partner to provide health care initiatives that improve the health of the communities we

serve.

MD Program COMPETENCIES

The WMSI graduate will

Medical Knowledge:

Demonstrate and integrate the normal structure and function of the human body

Demonstrate knowledge of the pathology, pathophysiology, and appropriate investigations in

identifying diseases

Use medicines rationally

Integrate pathology, pathophysiology and effects of medicines with the structure and function

of human body

Use evidence based approach and self-directed learning to assimilate, and apply knowledge

appropriately

Patient care:

Obtain a satisfactory medical history, perform a physical examination, order appropriate

investigations, analyze data to derive appropriate differential diagnosis and effective

management plans.

Apply evidence based information to learn clinical knowledge and apply the same into

clinical decision making

Educate the general public on prevention of diseases

Demonstrate awareness to multidisciplinary system of health care and work as a team

member.

Demonstrate constant self-evaluation and life-long learning skills

Social context and Well-being:

Demonstrate knowledge of and respond to the social, behavioral and economic factors in

health, disease and health care.


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Apply the principles and concepts underlying normal behavior and mental illness to promote

and maintain well-being.

Serve as an advocate to protect and promote the health of individuals and the community

Communication:

Demonstrate effective and compassionate communication skills towards patients and their

families for effective medical care

Demonstrate communication skills for effective exchange of information and collaborative

work with health care and health care-related professionals

Provide information and counselling to patients and their families in a clear and organized

manner

Professionalism:

Demonstrate ability to respect the patient’s dignity, confidentiality and privacy in the

delivery of health care

Demonstrate knowledge of and respect the context in which the patient’s condition presents

and develop the ability to manage patients from diverse cultural backgrounds

Demonstrate commitment to carrying out professional responsibilities and adherence to

ethical principles.

Life-long Learning and Self-improvement

Recognize the need to engage in lifelong learning to stay abreast of relevant scientific

advances.

Recognize personal educational needs and to select and utilize appropriate learning

resources.

Critically appraise the medical literature.

CURRICULUM PLAN

The curriculum covers all the important knowledge and practical areas that are

necessary for students to pursue their licensing examinations and to function

adequately as future physicians. Interactive Lectures, small group sessions and


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practical work are integrated in the syllabi. Students are required to participate in

medical camps/health fairs, which are planned to be organized on a regular basis.

The medical camps are being planned with the objectives of strengthening early

clinical exposure of the students and providing medical care to the community. The

planning and conduct of the health camps will be a joint undertaking of the faculty

and students. The faculty involved in teaching-learning of clinical skills and early

clinical exposure will play an important role. The students and faculty will conduct

medical camps usually on Saturdays in collaboration with local organizations. A

minimum of two health camps will be conducted during a trimester. Students and

faculty will participate at least in one camp per trimester. The MD1 and 2 students

will be involved in general organization and conduct of the camps while the MD3 and

4 students will take a history from the individuals participating in the camp. The MD5

and 6 students will conduct the physical examination and counsel patients in the

presence of faculty members. The camps will develop the organizational and

leadership abilities of the students, promote team work and also help in strengthening

the communication and physical examination skills of students. They will strengthen

the students' knowledge of the basic sciences, provide a clinical perspective and

improve their communication and other skills and thus interfaces with both various

organ systems being taught, holistic health and healthcare quality being learned

during various semesters.

Organ systems at WMSI are proposed to be organized according to the plan mentioned

below. Each organ system will be under the direct supervision of a System Chair who

will have primary responsibility for facilitating student learning in that organ system. The

system chair will be assisted by a Deputy System chair, as required. WMSI will hire local

physicians to provide clinical learning opportunities for students in each system. The

local physicians will be involved in interactive sessions, small group learning sessions,

case discussions, problem stimulated learning and practical clinical experience. We plan

to recruit family physicians, Internal medicine specialists, psychiatrists, OBGYN

specialist, radiologists and surgeons among others to work as clinical integration

specialists. Each organ system will also be utilizing the services of a content specialist

who will be providing external resources, virtual learning resources and support to

support student learning. The other systems (Holistic Health and Healthcare Quality) will

be supervised by a System chair.

Layout of course of study:

MD I: Fundamental Concepts, Musculoskeletal System, Holistic Health,

Healthcare Quality I

MD II: Nutrition and Metabolism, Nervous System, Holistic Health II, Healthcare

Quality II


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MD III: Respiratory System, Gastrointestinal System, Holistic Health III, Healthcare

Quality III

MD IV: Cardiovascular System, Hematopoietic System, Holistic Health IV,

Healthcare Quality IV

MD V: Renal system, Endocrine and Reproductive system, Infectious diseases,

Holistic Health V

MD VI: Integrated basic sciences in clinical practice

CLINICAL

For the student to be eligible for the clinical rotations he/she must have successfully completed

the Comprehensive Basic Science exam conducted by the National Board for Medical Education

(NBME) at the end of the 6th Semester of the IBMS program and the USMLE Step 1.

CLINICAL COURSES – SUMMARY

Course Number

and Title

Credit

Hours

Contact

Hours

TOTAL

Surgery (8 weeks)

320 320

Internal Medicine (12 weeks)

480 480

Pediatrics (6 weeks)

240 240

Family Medicine (6 weeks)

240 240

Psychiatry (6 weeks)

240 240

240 240


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Obstetrics &Gynecology (6 weeks)

SUB-TOTAL NO. OF CREDIT HOURS

FOR CORE ROTATIONS

1760 1760

SUB-TOTAL NO. OF CREDIT HOURS

FOR ELECTIVES (7 electives)

1120 1120

TOTAL NO. OF CREDIT HOURS 2880 2880

Core Rotations: 44 weeks

Electives: 28 weeks (7 electives@ 4 weeks each)

TEACHING AND ASSESSMENT METHODS

Interactive teaching (slides, access to internet in all classes, audiovisual presentations, labs, direct

observation, case presentation, case write-up, participation in conferences, case discussions and

rounds)

Assessments (examinations (oral and written), class quizzes; clinical competency examinations;

presentations; lab/group work; assignments; attendance and participation)

Please see the Table of teaching and assessment methods later in the manuscript.

RESOURCES

Textbooks, internet, computer-assisted learning, library, movies, labs. Additional after class

tutorials for smaller class groups are available to facilitate better grasp of class material and

promote better performance of students.

Grading system: %

90 – 100 Honors

70-90 Pass

<70 - Fail

PROMOTION

Students will be evaluated on the basis of their academic performance at exams and, as well on

their overall participation in class and communities (case presentations, in-class presentations

and community service). The Student Promotion Committee is responsible for assessing the


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performance of each individual student and for sanctioning their promotion to the next level of

studies.

See promotion policy and role of student promotion committee.

GRADUATION

Students will be eligible for graduation after having successfully completed the required

curriculum for the Medical Program (Basic Medical Science and Clinical Rotations)

See promotion policy and role of student promotion committee.

COURSE DESCRIPTIONS

INTEGRATED BASIC SCIENCES

Students complete the integrated basic sciences at the Washington Medical Science Institute in

Saint Lucia. The basic sciences are integrated and there is a strong emphasis on the social and

behavioral sciences, learning to deal with ethnically and culturally diverse populations, early

clinical exposure and learning about evidence-based practice. During the first five semesters

students learn about various organ systems in the body in an integrated manner. Small group

active learning strategies are widely employed and the development of self-directed learning and

the skill of reflection are encouraged. Students learn about systems-based practice, quality

improvement and patient safety. Community health fairs are frequently conducted strengthening

links with the local community. Eminent clinicians are regular visiting faculty offering students

exposure to the latest knowledge and techniques in medicine.

First Semester Duration (weeks) Credit Hours

Fundamental Concepts 7 12

Musculoskeletal System 8 13

Holistic Health I 15 3

Healthcare Quality I 15 CR

Second Semester

Nutrition and Metabolism 4 4

Nervous System 11 16

Holistic Health II 15 3

Healthcare Quality II 15 CR

Third Semester


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Respiratory System 7 10

Gastrointestinal System 8 12

Holistic Health III 15 4

Healthcare Quality III 15 CR

Fourth Semester

Cardiovascular System 9 14

Hematopoietic System 6 8

Holistic Health IV 15 4

Healthcare Quality IV 15 CR

Fifth semester

Renal and Metabolic system 4 6

Endocrine and reproductive system 8 12

Infectious diseases 3 5

Holistic Health V 15 4

Sixth semester

Integrated basic sciences in clinical

practice

15 18

For all the systems about 20% of the time will be devoted to small group activity-based

sessions and 15% of time to self-directed learning.

First semester:

An orientation program is conducted for the newly joined students to familiarize them with the

institution, the faculty, the curriculum, the student handbook and strengthen their learning skills.

Students are also introduced to the MD program educational objectives, Time management

skills, rules of conduct and discipline, and to working in small groups. The students will get to

know each other and the faculty and are introduced to problem-based learning. Dealing with the

stress of medical education and of being away from family is also discussed. Students are

introduced to self-directed learning skills, and are given tips on how to succeed at medical

school. They are also provided an outline of the assessment format which is followed. Students

are introduced to early clinical exposure and the various opportunities available to strengthen

their clinical skills during the basic sciences. They are also introduced to the health humanities

module which is offered at the institution. Library resources are introduced to the students.


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SYSTEM NAME: Fundamental Concepts

COURSE CODE MD 101

COURSE: Basic Science

DURATION: 7 weeks

NO. OF CREDIT HOURS 12

Fundamental Concepts is the first organ system offered to students. Students are introduced to

important concepts and terms which will be useful for them to understand the different organ

systems which will be covered subsequently. At the beginning of each organ system the system

chair provides students with an overview of the system. The system syllabus, assessment

formats, and other information are available on the learning management system. At the end of

each organ system students complete a reflective writing assignment and submit it to the system

chair for feedback and comments from faculty members. Every two or three weeks an integrated

quiz is conducted which mainly uses single response multiple choice questions modeled after the

United States Medical Licensing Exam (USMLE) pattern. Extended matching questions and

short answer questions are also sometimes employed. Each student gets a faculty member as an

academic mentor.

This course is intended to provide basic information and experiences upon which future

knowledge and experiences can be solidly based. As such, in addition to usual class quizzes and

exams, we will have small group tutorial sessions, class discussions and written assignments.

SYSTEM NAME: Musculoskeletal System

COURSE CODE: MD 102


DURATION: 8 WEEKS


The musculoskeletal system will introduce students to the skin, bones, joints and muscles of the

human body, their structure, function and the different diseases which can afflict this system and

their management. Integrated learning sessions will be introduced during this system. Common

diseases will be chosen as clinical problems. In addition to the scientific issues social and

behavioral issues will also be emphasized during small group work. A small group session on


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social issues in use of medicines will be conducted.

SYSTEM NAME: Holistic Health I (HH I)

COURSE CODE: MD 103


DURATION: 15 WEEKS


Holistic Health I (HH I) will run throughout the 15 weeks of MD I. This system will have

various components like Epidemiology and Biostatistics, Introduction to study of medicine,

critical analysis and judgment (CAJ), early clinical exposure, and health humanities.

Good communication skills are integral to medical and other healthcare practice. Communication

is important not only to professional-patient interaction but also within the healthcare team. The

benefits of effective communication include good working relationships and increased patient

satisfaction. Effective communication may increase patient understanding of treatment, improve

compliance and can lead to improved health. It can also make the professional-patient

relationship a more equitable one. Good communication engenders meaningful and trusting

relationships between healthcare professionals and their patients. This is accepted as fundamental

to effective patient care.

Early clinical exposure

In all doctor-patient interactions, a variety of communication skills will be required for different

phases of the consultation. During the start of a consultation, doctors must establish a rapport and

identify the reasons for the consultation. They must go on to gather information, structure the

consultation, build on the relationship and provide appropriate information. Additionally, special

situations arise which require the application of learnt and practiced skills, for example in the

“breaking of bad news”.


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This course will begin with a general discussion of the importance of good patient-doctor

relationships. Next, we shall describe history taking as part of the medical interview process and

the reporting of the history. Exploration of the fundamentals of verbal & non-verbal

communication shall be tackled next.

Critical appraisal and judgment (CAJ) will be offered during all five semesters. The objective

is to help students better understand and interpret scientific literature and provide them with the

skills necessary to practice evidence-based medicine. During the first two semesters the

emphasis will be on analyzing the quality of published original research articles. During the third

semester students will learn to analyze and interpret published randomized clinical trials while

during semesters four and five the emphasis will be on interpreting published systematic reviews

and meta-analysis

SYSTEM NAME: Healthcare quality I

COURSE CODE: MD 103


DURATION: 15 WEEKS

NO. OF CREDIT HOURS CR

Healthcare quality will also be offered during the first four semesters. The online course

offered by the internationally acclaimed Institute for Healthcare Improvement (IHI) introduces

students to health systems management, patient safety and other important issues. A faculty

member will serve as the chair for this system and provides students with support and an

opportunity to discuss what they learned online. Ethics topics will also be addressed within this

system and students will learn to deal with culturally diverse populations.

Second semester:


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SYSTEM NAME: Nutrition and metabolism

COURSE CODE: MD 201


DURATION: 4 WEEKS

NO. OF CREDIT HOURS/Week 4

Recognizing the vital importance of nutrition to maintain health and prevent disease a nutrition

and metabolism system is offered to second semester students. The system also plans to

incorporate the online Nutrition in Medicine module offered by the University of North Carolina.

SYSTEM NAME: Nervous system

COURSE CODE: MD 202


DURATION: 11 WEEKS


Nervous system will occupy a major part of the second semester. The normal and abnormal

aspects of the system will be taught together in an integrated manner. The teaching-learning at

the institution will be constantly evaluated through student feedback, inputs from external

experts and research studies. To promote integrated learning an integration meeting of the faculty

teaching in the system, will be held every two weeks. During the nervous system the expertise of

neurologists practicing on the island will be available to students.

SYSTEM NAME: Holistic Health II (HH II)

COURSE CODE: MD 203


DURATION: 15 WEEKS


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Holistic Health II (HH II) will run throughout the 15 weeks of MD II. This system has various

components like Epidemiology and Biostatistics, Introduction to study of medicine, critical

analysis and judgment, and early clinical exposure. HH which will be offered through all five

semesters of the basic sciences will provide students with a unique perspective on the patient-

doctor relationship.

SYSTEM NAME: Healthcare quality II

COURSE CODE: MD 203


DURATION: 15 WEEKS

NO. OF CREDIT HOURS/Week CR

Third semester:

The Respiratory and the Gastrointestinal system will be covered during this semester. During

the third semester students will continue to visit local general practitioners, clinics and the

hospital. Holistic health and Healthcare quality improvement will be offered throughout the

fifteen weeks. There will be an increased emphasis on clinical case presentations, learning from

standardized patients and on history taking and physical examination skills. An objective

structured clinical examination (OSCE) will be conducted at the end of each organ system. The

encounters will be video recorded providing students with an opportunity for detailed self-

reflection and for the faculty to provide detailed feedback.

Medical ethics will be offered through all five semesters and students are introduced to ethical

practice. The clinical faculty and visiting faculty will strengthen the teaching-learning of clinical

subjects and practical aspects of medicine.

Fourth semester:


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During the fourth semester students will learn the Cardiovascular and the Hematopoietic

system. Computer assisted learning will help students explore the cardiovascular system in

greater detail. A cultural diversity module will also be conducted. The module will use small

group activities to introduce students to the challenges of dealing with a diverse population.

Fifth semester:

Renal and metabolic system, endocrine and reproductive system and infectious diseases

will be the organ systems offered during this semester. Infectious diseases provide students an

opportunity to recapitulate their concepts of infection and immunity. They also learn about

antimicrobial agents and the growing problem of antimicrobial resistance. During the fourth and

fifth semesters students are provided more opportunities for self-directed learning.

The institution encourages student research. Every year an annual research day will be conducted

and faculty and students may present research papers. Prizes are awarded for the best student and

faculty research paper. Students who present their completed research and who publish their

research are provided additional credit.

The school will organize regular health fairs providing students with valuable practical

experience and opportunities to interact with the local; community. Various organizations exist

for students interested in family medicine, research and other subjects. There will be strong

emphasis on learning prescribing skills and on understanding and responding to

pharmaceutical promotion.

The sixth semester will be devoted to preparing for the USMLE) step 1 and to preparing for the

clinical rotations. Students will attend lectures, interact with faculty members and complete

different standardized examinations which help them in preparing for step 1. At the end of this

semester students will be evaluated using a comprehensive standardized examination. They

should pass this examination before they would be deemed eligible to appear in step 1. They will

also have to pass a comprehensive OSCE with cases from different organs systems.


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WMSI will offer students a state of the art, integrated curriculum with emphasis on self-directed

learning, early clinical exposure and the social and behavioral sciences to prepare students for

success in licensing exams, residency positions and in future practice.

Summary of proposed teaching/learning methods and assessment methods:

Learning/ Teaching methods in Basic

Sciences

Assessment methods/Tools

Interactive lectures

Small group sessions

Self-study

Assignments

Clinical vignettes

Clinical case presentations

Construction of Concept maps

Laboratory sessions

Small group sessions

Seminars

Clinic visits

Peer learning using principles of self-

directed learning

Summative assessment

Multiple Choice Questions

- Quizzes

- Exam

Modified short answer questions

- Assignments

Practical exams

- Objective Structured Practical Examination

(OSPE)

- Objective structure Clinical Examination

Formative assessment

Case-based discussions

Case presentations

Interactive lecture

Small group activity-based sessions

Concept maps

Clinical vignettes

Illness scripts


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Mechanistic case diagramming

Learning/ Teaching methods in

Clinical rotations

Assessment methods/Tools

Exposure to inpatient and outpatient

setting

Self-directed learning

Direct observation of skills and

procedures with feedback

Conferences

Ward round case presentation

Weekly bedside teaching sessions

Self-study

Assignments

Peer learning using principles of self-

directed learning

Learning in a team

Summative assessment

Multiple Choice Questions

- Quizzes

- Exam

Essays and Short Answer

Questions (SAQ)

- Assignments

Practical exams

- Objective Structured Practical Examination

(OSPE)

- Objective structured Clinical Examination

- Short and long cases

Formative assessment

Case-based discussions

Case presentations

CPC (Clinicopathological correlation)

Interactive lecture

Concept maps

Clinical vignettes


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Illness scripts

Mechanistic case diagramming

Documents

Washington Medical Science Institute · Students complete the integrated basic sciences at the Washington Medical Science Institute in Saint Lucia. The basic sciences are integrated