John Sealy SOM Educational Affairs - Instruction Management Office

Course Information: Year 1 Courses

• META: Mindfully Evolving, Thriving & Advocating

  Course Information Year 1 Courses: META: Mindfully Evolving, Thriving & Advocating

  Goals: Meta is a six-week long course that prepares students for the more rigorous academic responsibilities of a medical school curriculum. The overall goal of this course is to equip students to thrive in medical school. During the course, students will gain exposure to basic clinical skills (examination and interview skills, written communication) and social determinants of health. They will learn skills to help them learn in medical school, including how to make use of feedback, the central tenants of clinical reasoning and illness scripts that they will use during classes and into the wards, and what resources work best for them to learn. We will review career-advising resources to ensure that all students are aware of opportunities to help them decide on their ultimate career choice of specialty, learn about different tracks that are available at UTMB, and know the competencies expected of them as they move through the different milestones of the curriculum. META will introduce students to concepts and tools students need for the journey through medical school and beyond, especially with regard to wellness, identity formation as a healer, learning in medical school, preparing to be a physician, and being one’s best self.

  Although in Greek Meta- means “after” or “beyond,” the first and beginning course of medical school is called META to invoke the abstraction of the concept of the physician and the metatheory foundations and methods of learning how to be a physician.  We intend to give students a birds-eye view of what is to come in their metamorphosis to becoming a compassionate and exceptional physician.

  Pedagogy: META will introduce the students to each type of instruction they will experience during medical school. Content is delivered in large group lectures (utilizing active discussion as possible), Team-Based Learning, Problem-Based Learning, hands on active practice (role-play interviews, physical exam skills), experiential learning (such as the poverty simulator), small group discussion, self-reflection, peer and near-peer teaching, peer and self-assessment, assigned readings, and simulation. Students will be oriented to these different teaching modalities.

  Self-Study: Significant blocks of time are unscheduled each day for independent use of educational materials such as video and other online content, recommended readings, and prompted self-reflections. The required textbook is Peter Wei & Alex Chamessian’s book Learning in Medicine: An Evidence-Based Guide (ISBN-13:9780996153300).

  Assessment: Student performance on all activities will result in an accumulation of points. Depending on the activity, the points awarded are based on student participation/preparedness or quiz scores (for example, with Team-Based Learning). There are no mid-term or final exams for this course. Class rankings are NOT reported at the end of the course, only the grade category for each student (Pass, Fail, etc.).

• Gross Anatomy & Radiology: Overview

  Goals: Gross Anatomy and Radiology (GAR) is an 8 week long course and runs concurrently with the Practice of Medicine Course (POM) in Module One. Because GAR is the first basic science course presented in the curriculum, its prime goal is to provide the students with a basic understanding of the gross anatomy and radiology of the entire body which will serve as a solid foundation for the remainder of the student's medical education and future profession. Second, this course was designed to alert the student to the clinical relevance of anatomy for the diagnosis of clinical disorders. It will further promote the development of student-directed problem solving skills, while encouraging team work. As a side benefit, this course will introduce the student to the majority of nearly 10,000 terms commonly used in medicine today and will provide foundations for the correct language in descriptive anatomy. In addition the course will provide basic anatomy-physiology correlations. The anatomic knowledge learned in this course will be reinforced in later organ system blocks.

  Anatomy Laboratory: The laboratory experience will consist of several highly interactive, small group activities designed to integrate structure identification with anatomical relationships and clinical significance. At least 40% of the scheduled time for the course will be devoted to a dissection lab (four, two hour sessions per week). Students, working in teams of four or five, will dissect the entire body by anatomical regions. The understanding of anatomical relationships will be reinforced with the use of cross-sectional, radiographic and computed imagery. In addition, students will be introduced to the medical concept of "anatomical variations". To accent the clinical significance of the dissections, students will be guided by invited specialists in recognizing common pathology found on the cadavers.

  Lectures: Approximately four anatomy and two radiology lectures will be offered weekly to the entire class as learning resources. In general, speakers will be encouraged to structure the contents of their lectures around challenging clinical scenarios aimed at stimulating active student participation. Lectures will typically be overviews, with emphasis on concepts rather than being overly detailed. Radiology lectures will also stress the value of modern sectional imaging techniques.

  PBL: This course will also incorporate the interactive problem-based learning concept. There will be three small group sessions each week ranging from 1 to 2 hours in length. In general, each week will begin with the presentation of a clinical case. Students, working in groups of nine or ten, and under the guidance of faculty facilitators, will determine the learning objectives for each case and actively work to resolve the case(s) by the end of the week. These activities will further emphasize the relevance of anatomy on clinical practice and will hopefully demonstrate to the student the need for continuous medical education as future physicians. There will be a wrap-up session by an expert faculty at the end of each case.

  Self-Study: Significant blocks of time are unscheduled each day for independent, self-directed use of educational materials such as videotaped demonstrations, practice exams, interactive software, the Internet, and text books.

  Assessment: Student performance on all activities will result in an accumulation of points which will determine the student's Fail/Pass/High Pass/Honors status for the course. Depending on the activity, the points awarded will be based on student participation/preparedness and test scores. No-stakes, practice, computer-based exams will be available for students to test their progress. High-stakes, midterm and final tests will be given in the form of laboratory practicals and written exams. Class rankings are NOT reported at the end of the course, only the grade category for each student (Pass, Fail, etc.).

• Molecules, Cells, and Tissues

  There are two broad aims of this 8-week course module. The first is to help students obtain knowledge, at an introductory level, of relevant concepts that deal with the normal structure and function of the body at the cellular and molecular levels. This includes acquiring knowledge of fields traditionally classified as Cell Biology, Microscopic Anatomy (or Histology), Biochemistry, Molecular Biology, Genetics, Cell Physiology and Pharmacology. The second aim is to help and encourage students to obtain experience in applying these basic science concepts to understand human diseases.

  The course is divided into six thematic topic areas organized within 8 weeks. The course examines development at the cellular and tissue levels and major functions of the cell such as signaling, energy metabolism, contractility, and membrane transport and excitability. Structure and function of DNA and proteins and their translation to molecular and Mendelian genetics are discussed. Influences on the cell and the individual are discussed in terms of pharmacology and pharmaco-genetics. The topic areas progress from an overall view of the molecules that constitute the cell, to basic cellular functions, to mechanisms that allow cells to function as tissues and then to the organism's response to external influences and its susceptibility to outside factors. Their clinical relevance is highlighted throughout the presentations. The course can be described as a brief journey through human life starting from embryonic development to adulthood including aging and death and exploration of various scientific aspects of this journey. The course is introductory in nature, emphasizing basic concepts rather than facts. The topic areas relating to the basic sciences will be expanded and reinforced in subsequent components of the curriculum, especially in the organ systems portion during the second year.

  There will be three major activities for each theme. One activity involves problem-solving in small groups, which will generally consist of three two-hour sessions per week focusing on clinical cases. The second activity will be lecture presentations emphasizing concepts in basic science that impact heavily of the practice of medicine. The third activity is laboratory based learning activities relevant to that week's theme. The remaining time assigned to this course will be study time. Review activities, formal and informal, as well as discussions with expert faculty can also be scheduled during this time. Whenever possible, the themes touched upon in the Molecules, Cells, and Tissues course will be coordinated with those addressed in the Practice of Medicine 1 course.

  We anticipate that students have ample time to: (a) study course materials prior to the lectures in order to flesh out the concepts presented; (b) prepare and study the clinical cases; and (c) integrate the knowledge obtained from these two sources.

  Student assessment is directed at testing both their progress in developing problem-solving skills and their acquisition of basic knowledge.

• Pathobiology & Host Defense

  The Pathobiology and Host Defenses Course provides MS1s the opportunity to acquire fundamental knowledge in 4 broad areas including Pathobiology, Immunology, Basic Pharmacology and Microbiology. PHD builds on the material covered in GAR and MCT with a. focus on host defense as a theme for understanding pathogenic processes, consequences and treatment approaches. Completion of the course provides the necessary introductory background for each broad topic to prepare students for the subsequent organ system curriculum. In PHD, through PBL, lectures, on-line Bricks and active laboratory sessions, the students sharpen observational skills, organize sets of data to support differential diagnoses and/or pathogenetic sequences, differentiate normal from abnormal organs, grossly and microscopically, develop a system for categorizing general pathologic processes that underlie diseases in all of the organ systems and outline and describe chains of causality for basic pathophysiologic mechanisms that comprise the pathogenesis of disease.

• Neuroscience and Human Behavior

  NHB is an organ-based course integrating basic neuroscience ​with clinical neurology and psychiatry. Students will attain ​a fundamental knowledge of the structure, as well as both the normal & abnormal function of the brain. Student will understand the fundamentals of behavior and become familiar with treatment options for costly neural injuries and disease processes, as well as current limitations to our understanding of the body’s largest and most complex organ.​ Students will discover these remarkable aspects of the brain through Problem-Based Learning (PBL), interactive (Poll Everywhere)​ sessions, dissection laboratory sessions, Retrieval-Based Learning (RBL), Team Based Learning (TBL) and collaborative testing (PBL Quizzes) as well as biweekly formative quizzes (Qmax).

• Practice of Medicine

  "Think Like a Doctor"
  
  The Practice of Medicine is the fundamental course in the medical school curriculum that addresses the development of knowledge, skills, and behaviors that are necessary to practice both the art and science of medicine in an optimal manner. In order to obtain this ability, an excellent physician requires integrity, compassion, and knowledge. The course has been designed around four integrated components based on a series of standardized patient cases and actual patients evaluated by the students in various clinical settings:

  1. History: The development of optimal questioning, listening and communication methods for effective medical interviewing and history taking
  2. Physical: Clinical skills acquisition for the performance of a complete and accurate physical examination.
  3. Ethics & Professionalism: Understanding the ethical and professional, as well as cultural, age, gender, and ethnic issues of patients and the relevance of these to optimal patient care.
  4. Clinical Decision Making: Development of abilities in clinical reasoning, including formulation of clinically relevant questions and ability to obtain and critically evaluate scientific evidence pertaining to basic science and clinical studies. This will include interest in and ability to conduct life-long, self-directed learning

  Course Objectives

  1. Perform a full medical history and basic physical examination
  2. Formulate Problem Lists, Differential Diagnoses, and identify preventive medicine issues and patient education opportunities on a variety of simulated and actual patient cases
  3. Communicate information about patient cases accurately and thoroughly, both in oral and written presentation formats
  4. Reflect upon common professionalism and ethical considerations that impact patient care, with attention to relevant cultural, age, and gender specific issues.
  5. Cultivate intellectual curiosity, learning to construct useful clinical background and foreground questions for every patient and how to access and interpret the resources available to answer them

Course Information: Year 2 Courses

• Cardiovascular & Pulmonary

  This course covers the circulatory and the respiratory systems. It attempts to integrate normal structure and function with pathology, pathophysiology, therapeutics, and diagnostic techniques. Teaching modalities include lectures, case-based small group sessions, and laboratories.

  Components: Given in more detail on course website http://eclass.utmb.edu (restricted access)

  Learning Goals: The content of the course is established in a set of tables called Weekly Learning Goals. Students are expected to learn the information suggested by these weekly goals. Suggested sources for study are provided. Lectures will cover most, but not all, of the weekly learning goals.

  Lectures: Lectures are occasions that can help students understand and remember portions of the required information. The primary source of information is not lectures, but books. Lectures will feature discussion of important concepts and, as much as possible, be interactive.

  Problem-Based Learning (PBL): For PBL, the class will be divided into groups of nine or ten students each. Six hours of PBL are scheduled per week. These six hours are divided into three two-hour periods to be held on each Monday, Wednesday, and Friday. A 1-2 hour period (usually on Friday) is scheduled for PBL clinical wrap-up. The problems will be clinical cases (three per week) that relate to the content of the weekly learning goals. The first hour of each period will be used to discuss learning issues generated in the previous PBL period. The second hour of each period will be used for presentation and discussion of a new case, and for generating new learning issues. A list of case-specific learning issues will be distributed at the end of each case. Exams will include questions based on these learning issues.

  Laboratories

  Pathology labs: Microscopic and gross specimens will be examined and correlated to real clinical cases

  Diagnostic techniques: Electrocardiography and pulmonary function tests will be performed.

• Renal, Fluid & Electrolytes

  The renal course is designed to understand the normal functions, physiology, anatomy/ histology, and pathology of the kidney. The first half of the course contains anatomy, physiology, and pathophysiology of renal function and hypertension. During the latter half, the focus is on the relationship of pathology of glomerular and interstitial diseases, embryology, tumors, microbiology, immunology, and pharmacology to renal function. A major emphasis is placed on self-directed learning by use of problem-based cases that emphasize the important and relevant basic science issues of renal function and fluids and electrolyte homeostasis from a clinical viewpoint. Lectures are provided to supplement these self-directed learning exercises by providing a broader picture in which to incorporate new knowledge, emphasizing priority areas for learning issues, and clarifying difficult-to-understand concepts. Computer-based exercises in urinalysis, anatomy and histology, and acid-base disorders are provided to supplement the lectures, reading materials, and problem-based exercises.

• Gastro-Intestinal/Nutrition

  The Gastrointestinal/Nutrition (GIN) course provides an integrated approach to understanding the pathophysiologic basis of gastrointestinal, hepatic and nutritional disorders as well as the pharmacological rationale for their therapy. The structure and function of the gastrointestinal tract and associated organs are explored at the physiological, cellular, molecular and biochemical levels in both health and disease. A variety of traditional, interactive and online tools are used throughout the course, with special emphasis paid to laboratory sessions in pathology and related disciplines. At the same time, students are introduced to the clinical approach to these disorders, including clinical, laboratory, and radiographic findings.

• Endocrine/Reproduction

  The Essentials in Endocrinology and Reproduction Course (EER) is designed to ensure that medical students build up a critical mass of knowledge in the way that hormonal systems: 1) regulate many of the body’s metabolic processes in health; 2) help the body respond to various maladies by adjusting appropriate metabolic parameters; and 3) promote the genesis of reproductive cells, the fertilization of an ovum, the development of a fetus, and parturition. Medical students also will build knowledge in how derangements in organs that make or respond to hormones can lead to pathologic conditions, infertility, and the inability to complete a pregnancy. EER builds upon the Molecules, cells and tissues (MCT) course in integrating cell-biology and molecular-pathway principles into clinical presentations. Since hormones affect most cells in the body, there is some overlap with all other organ-based courses. There are scientific advancements in therapies (pharmacologic, nonpharmacologic and procedural), so in our course students learn the process of undertaking and interpreting clinical trials and learn about the regulatory process in the development of such therapies.

• Derm/Heme/Musculoskeletal

  In the Dermatology-Hematology-Musculoskeletal course, students are exposed to three discrete organ systems: 1) the skin and its associated adnexal structures, 2) the blood and lymphoreticular systems, and 3) the musculoskeletal system. By applying concepts from previous courses, including microbiology and immunology (PHD), anatomy (GAR), histology, cell biology, biochemistry, and pharmacology (MCT), to these organ systems, students will gain an integrated understanding of their pathophysiology. They will then apply this understanding in clinical scenarios through problem- and team-based learning.

• Practice of Medicine

  Year 2 (Module 5 - 9)

  The Practice of Medicine is comprehensive multidisciplinary course that will address the development of knowledge, skills, attitudes and behaviors that are necessary for the physician in order to practice the art and science of medicine.

  The course will follow the organ-based design of the integrated medical curriculum.

  The course has been designed to enhance the following areas: history taking skills, physical examination skills, communication skills, counseling skills, ethical issues and finally professional behavior.

  A variety of settings are provided to meet the course objectives.

  At least two hours a week will be devoted to small group sessions with individual faculty where primarily clinically oriented, problem based cases will be used to enhance clinical skills.

  These sessions may also be used to demonstrate or practice specific skills, such as simulated patient interviewing, or practicing the physical examination. Laboratory sessions may also be utilized to develop skills.

  The course will also present two didactic lectures per week.

  Last, the students will make approximately 10 clinical site visits throughout the academic year. These visits will include sites such as the hospital wards and various clinics. The purpose of the clinical site visits is to enhance history taking and physical examination skills.