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Medical Student Curriculum - Years I and
II
The primary goal of the pathology course is to initiate the medical
student in the study of disease. Without a clear understanding of
the etiology (cause), pathogenesis (development), pathological anatomy,
and pathophysiology of disease, clinical medicine would mean little
more to the student than memorization of clinical syndromes and
the empirical treatments applied to them. These concepts are developed
in close association with the other basic sciences and with the
clinical science that is also being introduced at this time.
The required pathology course is taught during both the first and
second years of this medical school. The general format is to introduce
a topic with a one-hour lecture to the entire class of about 160
students. Following this, the class is divided into seven (Year
I) or eight (Year II) laboratory groups for informal, interactive
sessions in which gross specimens, kodachromes, virtual microscopic
images, and case discussions are utilized.
Last year, the vast majority of this teaching was done by 51 of
our full-time faculty, but 21 of our voluntary faculty and 10 of
our pathology residents also made valuable contributions. In addition
to actual classroom teaching, the lecturer and laboratory instructors
meet for one hour prior to each teaching session to review the teaching
material and to discuss the details of the laboratory so that all
instructors are in agreement. Following this, the laboratory instructors
attend the lecture preceding the laboratory so that they are aware
of the lecture content and can develop continuity between lecture
and laboratory.
Evaluation of the Pathology instructors by medical students has
always been positive and the pathology course is rated as the best
in the basic science years. Our students consistently perform well
on step 1 of the USMLE and usually score about half a standard deviation
above the mean on the pathology component.
General Pathology
General pathology is taught during the second half of the first
semester of Year I (Core Principles of Health and Disease) following
basic gross anatomy, histology, biochemistry, genetics, molecular
biology, physiology, nutrition, pharmacology, and preventive medicine.
It is a 43-hour course that includes lectures and laboratories on
the effects of injury on cells and tissues, the host response to
injury, abnormalities of blood supply, and disorders of development
and growth as well as the associated laboratory medicine.
Organ Systems Pathology
Following the Core Principles of Health and Disease is a sequence
of courses providing integrated basic and clinical science studies
of the major organ systems. Hematology and Clinical Immunology,
Neurosciences, and Musculoskeletal systems are taught in the second
semester of Year I. These are followed by the Cardiovascular, Renal,
Respiratory, Endocrine, Reproduction, Skin and Gastrointestinal-Liver
systems in Year II. The instruction for each of these focuses on
both the normal and abnormal structure and function of the system
under discussion. The integrated presentations for each organ system
are designed and taught by an interdepartmental committee which
includes representatives from the appropriate basic science and
clinical departments. Pathology is an active participant in all
of these and applies the principles learned earlier in the general
pathology course to each of these systems.
Integrated Case Section
The Integrated Case Section is given in the last nine weeks of Year
II. This section has three basic goals - to integrate the basic
and clinical science presented in the preceding organ systems, to
prepare the students for the step 1 examination of the USMLE, and
to prepare the students for the transition to the clinical years.
These goals are achieved by the use of cases which are based upon
a common chief complaint. The students are asked to develop an appropriate
differential diagnosis, evaluate the physical and laboratory findings,
review the pathophysiology and relevant basic science, arrive at
a diagnosis, and formulate a treatment plan. Pathology is included
in each of these cases and takes the opportunity to compare and
contrast the pathologic findings of the various entities listed
in the differential diagnosis.
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