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The mission of a general medical education at the Keck School of
Medicine is to enable students to acquire the scientific knowledge,
clinical reasoning skills, humanistic skills and values required
to make decisions concerning the diagnosis, care and management
of patients within their family and community; to lay the foundation
for graduate medical education while providing sufficient flexibility
for students to pursue individual interests in research and specific
clinical areas.
The teaching faculty recognizes that in four years of medical school,
the student cannot be taught all the knowledge and skills that will
be adequate for the practice of medicine, either now or in the years
ahead. Therefore, the student is expected to acquire a basic core
of concepts, skills and patterns of behavior that will lead to the
acquisition of knowledge continually throughout the student's medical
career. To a far greater degree than in the past, the student must
be an active participant in the educational process.
In the curriculum, both basic and clinical sciences are taught
throughout the four years of undergraduate medical education. Basic
sciences are taught both as pure science and in correlation with
the clinical sciences. Close interaction between individual faculty
and students is emphasized.
The student is involved progressively in direct patient care, beginning
with patient contact during the first semester of the first year.
The student's assumption of responsibility increases as knowledge
and skills are acquired. In the fourth year, the student is assigned
responsibility equivalent to that of a first year graduate resident.
Curriculum Calendar
Year
I 2006-2007 Calendar »
Year
II 2006-2007 Calendar »
Curriculum
Timeline
Graphic
Year I-II The first year of the
Year I-II continuum begins with 19 weeks of Core Principles of Health
and Disease, followed by 49 weeks of organ system review, ending
with a nine-week Integrated Case Study section. There is an eight-week
summer break between the first and second years. Students also take
Introduction to Clinical Medicine and the Patient (described below).
Each week of the academic year is composed of approximately 20
hours of lecture and small groups sessions with an additional 20
hours of independent directed study or Introduction to Clinical
Medicine and the Patient. Examinations in all systems throughout
the first two years are graded Pass/Fail. Dean's recognition is
awarded on the basis of year-end comprehensive examinations and
special projects.
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Core Principles of Health and Disease
This 19-week introductory system provides the student with the fundamental
knowledge necessary for the integrated study of the basic and clinical
sciences in the ten human organ systems which follow. Included in
this section are the following major themes: cell structure and
function; the human organism; disease and the body's responses;
prevention and treatment of disease, including evidenced-based medicine;
and introduction to clinical medicine and the patient. This section
is taught in an integrated fashion and includes the use of clinical
case studies.
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Gross Anatomy Cadaver dissection remains
a unique teaching tool by which the three dimensional organization
of the human body is studied. Gross anatomy will begin in the Core
Principles of Health and Disease system continuing in the Hematology/Clinical
Immunology system with the dissection of the body wall and major
body cavities followed by head and neck dissection in the Neurosciences
system and ending with limbs dissection during the Musculoskeletal
system. Continued study of gross anatomy by use of prosected anatomical
specimens as well as computer programs, selected review lectures,
etc., continues throughout the integrated organ systems.
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Introduction to Clinical Medicine and the
Patient (ICM) ICM expresses the strongly patient-centered orientation
of the medical school curriculum. The student is introduced to patients
and is involved in patient care activities from day one. Students
are introduced to the principles of patient care and management
and examine what it means to be a physician and how one becomes
a physician.
The major content areas of the course include communication in
the setting of illness, the unified concept of health and disease
(the biopsychosocial model), basic clinical skills and the correlation
of basic science with clinical medicine.
ICM emphasizes the systematic acquisition of the clinical skills
of interviewing, history taking, physical examination, elementary
clinical problem solving, and medical record keeping. Throughout
the Year I-II continuum, the ICM clinical skills curriculum is integrated
with basic science instruction. Students can therefore learn and
apply basic science knowledge in the clinical setting. By encouraging
a thorough understanding of the direct applications of basic science
research to modern clinical medicine, instructors motivate the student
to learn, use and retain more of the content and concepts presented
in the basic science portions of the curriculum.
A group of five or six students spends from four to eight hours
each week with an instructor from the clinical faculty who remains
with the group for one to two years. As the group deals with basic
medical themes (death, pain and helplessness) and issues (patient
responsibility, learning to live with ambiguity and uncertainty),
instructors help students to cope with their own feelings. This
format opens the door for student-faculty interaction and improvement
of student-faculty communication.
Instructors encourage students to take advantage of the learning
experiences provided by their roles as helping and therapeutic persons.
Students develop their ability to communicate with patients in the
setting of illness and are guided by patient concerns to enhance
their own growing knowledge, skills, abilities and responsibilities.
Students are expected to acquire skills and habits of self-education
and self-instruction which will prepare them for lifelong learning.
The unified concept of health and disease presented in this course
enables the student to comprehend the human organism in all its
complexity. Using their clinical experiences as a teaching model,
students are taught to consider the patient as an integrated whole
and to view the patient's illness or disease as more than simply
a disruption of physiologic processes or a collection of physical
findings.
Additional learning experiences occur through workshops and focus
experiences. ICM workshops provide standardized instruction in history
taking and physical examination, as well as integrated instruction
in areas which cross disciplines. These include physician well being,
substance abuse, domestic violence, and ethics. Through focus experiences,
students are encouraged to explore a variety of practice environments
as well as community based health and social services. For example,
students may visit outpatient clinical settings, a geriatrics long
term care facility, a hospice care facility, or homeless services
organizations.
For further information about ICM, visit their site.
ICM
Web site »
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Organ System Review A sequence of study
presenting integrated basic and clinical science instruction involving
ten human organ systems, Hematology/Clinical Immunology, Neurosciences,
Musculoskeletal, Cardiovascular, Renal, Respiratory, Endocrine/Metabolism,
Reproduction, Gastrointestinal/Liver, Skin follows Core Principles
of Health and Disease.
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Integrated Case Study This section completes
the second year of the Year I-II continuum and will emphasize patient-centered
problems, which integrate the basic and clinical science presented
in the preceding organ systems. Students will explore the multi-organ
effects of disease processes and reinforce diagnostic reasoning
skills. In addition, concepts of pathophysiology, evaluation, and
management that can be applied to any organ system will be included.
This section will also reinforce the appropriate use of medical
information resources, effective self-directed learning skills,
and interpersonal and group communication skills.
Separate review sessions of the important basic science and clinical
concepts covered during the previous two years also occur during
this seven-week section. These sessions will assist students in
preparing to take the United States Medical Licensing Examination
(USMLE) Step 1 examination.
By early spring of the second year of the Year I-II continuum,
students are expected to select their academic clinical advisors
and to begin arranging for the schedule of clerkships to be taken
during the Junior/Senior continuum. By the end of the fall semester,
Year II, each student receives information which describes the curriculum
requirements of the Junior/Senior continuum. Students choose the
area of medical practice which they are most likely to pursue and
an advisor is assigned from that discipline. The advisor counsels
the student on clerkships and opportunities in graduate medical
education.
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Year III-IV Continuum (two calendar years)
The final two years of medical school are designed as a continuum
of two calendar years, beginning in July at the end of Year II.
During the spring of their second year, students schedule clerkship
rotations to be taken during the two years of the continuum. Each
student's program is individually designed with the assistance of
faculty advisors and includes 50 weeks of required clerkships, 16
weeks of selective clerkships and 16 weeks of elective clerkships.
All degree candidates are required to take and pass Step I of the
United States Medical Licensing Examination and prior to entering
the junior/senior continuum and take Step II of the USMLE as a graduation
requirement.
During the continuum each student may schedule 16 weeks of vacation
for personal convenience, remedial work, funded research work and
other non-curricular activities, such as investigating postgraduate
training programs. Although every effort is made to provide flexibility
in the scheduling of each student's program, some inherent limitations
are imposed by the maximum enrollment permitted for each clerkship.
Students are a vital part of the university's medical team, which
provides health care for patients throughout the year, vacations
are therefore subject to some scheduling adjustments.
Required Clerkships
Family Medicine (6 weeks)
General Surgery/Specialty Surgery (12 weeks)
Medicine 1 (6 weeks)
Medicine 11 (4 weeks)
Neurology (4 weeks)
Obstetrics and Gynecology (6 weeks)
Pediatrics (6 weeks)
Psychiatry (6 weeks)
Selective Clerkship
Students are required to schedule 16 weeks of selective clerkships,
chosen from a list of four or six week clerkships approved by the
Clinical Curriculum Committee. Selective clerkships are carried
out at USC affiliated hospitals and encompass virtually all specialty
areas.
Elective Clerkship
The elective period consists of 16 weeks, during which electives
may be taken on campus, at USC affiliated hospitals or at more distant
medical schools or medical centers. Approved on campus electives
which are offered regularly are listed in the elective catalogue.
Proposals for other on campus and off campus electives are reviewed
individually by a committee composed of faculty members and students.
All petitions must be submitted at least six weeks before the beginning
of the rotation. Off campus electives require documentation from
the off campus preceptor, endorsement of the student's medical school
advisor, and prior approval and review by the Clinical Curriculum
Committee. Credit is not given for electives until an evaluation
has been received from the preceptor and a critique of the elective
submitted by the student. Students with an academic deficiency may
not schedule off campus electives.
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Standardized Patient Program The
Division of Medical Education has an active standardized patient
program, which trains actors/actresses to assume the role of patients
for the purpose of instruction and student assessment at USC. The
SP program conducts clinical performance exams for all USC students
matriculating into the third year of medical school and Objective
Structured Clinical Exams for students in various clerkships.
Standardized patients allow cases to be presented in a consistent
manner, targeted for a specific teaching task at a specific level
of the learner. SPs provide feedback on interpersonal and physical
examination skills.
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Humanities, Economics, Art and the
Law (HEAL) This is a four-year curriculum beginning in Year
I of medical school and culminating in Year IV. The plan begins
in Year I with the collaborative discourse about ethical problems.
The students will learn to identify, analyze and resolve clinical
ethical problems. This exercise will be followed by interim skill-building/maintenance
and then instructor-facilitated discussion of videotaped ethics
cases. In Year II, the program continues with the ethical discernment
and action in simulated settings and the human dimensions of medicine.
The first exercise will be using standardized patients to teach
the telling of bad news, followed by learning from the humanities
about patients as persons and finally a forum theater where students
will be acting on one's convictions.
Year III will be devoted to ethics education by clinical role models
and will encompass instruction in the core clerkship by ethical
standard bearers followed by home hospice experience and pain management.
In Year IV, the students will take the last part of the HEAL curriculum
dealing with the physician in society which will be a series of
student retreats on contemporary health care. The goal of the retreats
is for students both to integrate the principles, methods, and bedside
issues covered during the first three years and to apply this learning,
which primarily relates to the micro-level (individual/clinical)
decisions to the ethical dilemmas and policy issues facing physicians
at the mezzo-level (healthcare organizations) and macro-level (profession
as a whole; state; nation). Topics will include issues of professionalism,
allocation of resources, the economics, organization, and societal
oversight of health care, and the care of dying patients.
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Fifth Year Research Option USC
offers students the opportunity to take a full year of research
experience with either a Keck School of Medicine faculty mentor
or an approved faculty mentor at another institution. This program
is open to any student in good to excellent academic standing who
has completed his or her first year of medical school. Students
interested in the option should identify a faculty preceptor and
present a description of the proposed research program and funds
available in support of the program to the associate dean for curriculum.
A stipend, comparable to that received by a graduate student at
the postgraduate level, is available. Application for this program
is made through the Office for Curriculum (KAM 314) and will be
supervised through the Office of the Associate Dean for Student
Affairs (KAM 100E).
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Educational Objectives
1. Fundamental Knowledge Base: Demonstrate mastery of the knowledge
base that represents the core content of the medical curriculum.
2. Effective Communication: Listen and communicate clearly
with patients, families, and health care team members using effective
nonverbal, verbal and writing skills. Establish the rapport necessary
to form and to sustain an effective therapeutic relationship.
3. Using Basic Science in the Practice of Medicine: Recognize
and explain health problems based upon current scientific understanding.
Develop a plan of management that utilizes the current best evidence
in making decisions about the care of individual patients.
4. Basic Clinical Skills: Demonstrate the basic clinical
skills; including obtaining an appropriate history and performing
a skillful comprehensive examination in a variety of patient care
encounters. Correctly select, proficiently perform, and accurately
interpret appropriate clinical procedures and laboratory tests.
5. Diagnosis, Management and Prevention: Diagnose, manage
and prevent the common health problems of individuals, families,
and communities. Develop problem lists and differential diagnoses,
carry out additional investigations, choose and implement interventions
with consideration and referral as needed, determine outcome goals,
recognize and exploit opportunities for prevention, monitor progress,
share information, educate, and adjust therapy and diagnosis according
to results, all within the context of a core "practice profile."
6. Problem Solving: Recognize a problem and take appropriate
steps to address it. Integrate this ability with all other abilities
and employ them in rational decision-making processes.
7. Social and Community Contexts of Health Care: Demonstrate
knowledge of the social and community contexts of health care. Effectively
respond to the many factors that influence health, disease, and
disability including the socio-cultural, familial, psychological,
economical, environmental, legal, political and spiritual aspects
of health care seekers and of health care delivery.
8. Ethical Judgment: Recognize the ethical dimensions of
medical practice and health policy. Identify alternatives in difficult
ethical choices, analyze the conflicting considerations, and execute
a course of action that takes into account the ethical complexities.
Combine a willingness to recognize the nature of the value systems
of patients and others with commitment to his/her own system and
the ethical choices necessary to maintain his/her own ethical integrity.
9. Self-Awareness, Self-Care and Personal Growth: Approach
the practice of medicine with awareness of his/her limits, strengths,
weaknesses and personal vulnerabilities. Assess personal values
and priorities in order to balance personal and professional commitments.
Seek help and advice when needed, develop personally appropriate
coping strategies, and accurately hear and appropriately respond
to constructive criticism.
10. Professionalism: Demonstrates altruism in interactions
with patients, colleagues, faculty and staff. Acts with honor and
integrity in professional and personal life. Demonstrates caring
and compassion for patients and for members of the health care team.
Respects patients' rights and wishes, and acts in a respectful manner
with faculty, colleagues and staff. Acts responsibly and is accountable
for his/her actions in his/her professional and personal life. Pursues
excellence in scholarship, assuming responsibility for addressing
gaps in his/her knowledge. Models good leadership in interactions
with others, and fosters others' development.
11. Lifelong Learning: Be aware of the limits of his/her
personal knowledge and experience. Demonstrate the skills of self-education
and lifelong learning to actively set clear learning goals, pursue
them, and apply the knowledge gained to the practice of his/her
profession.
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