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Preclinical Curriculum: Year 2

Curriculum Organization (35 weeks)

Introduction to Clinical Medicine II (ICM) - Year Long

Introduction to Clinical Medicine includes Physical Diagnosis and sessions on ethics and medical economics and other topics. Physical Diagnosis specifically assists the medical student in making the transition from graduate student to physician and is part of the foundation upon which the clinical experience of the physician begins to take form. Students learn to master fundamental clinical skills and begin to synthesize the principles learned in the basic sciences with the information derived at the patient's bedside. With careful guidance and instruction, students acquire the skills to perform a thorough history and comprehensive physical examination by meeting with preceptors in groups of two or four throughout the year to interview, examine, and present verbally and in writing their evaluations, as well as with physicians in various specialties to learn more specialized examination techniques. Students take two written exams and complete an entire history and physical examination both at the mid course and at the end of the year on standardized patients.  

Foundations of Disease - (2 weeks)

Block VI - Host Defenses and Infectious Diseases (9 weeks)

Host Defenses and Infectious Diseases is the first course of the second year. The course is divided into three sections: (1) immunology, (2) bacteriology, (3) virology/parasitology/mycology. This integrated course focuses on topics including the general principles of immunology and serves to introduce infectious diseases caused by bacteria, viruses, fungi and parasites. The format consists of lectures, small group discussions (coordinated by the Microbiology and Immunology basic science faculty), clinical small group conferences (coordinated through the Department of Medicine), PBL sessions, computer-based sessions, as well as demonstrations and self-instructional material. There will be increased participation of faculty from the Departments of Pathology and Pharmacology and Experimental Therapeutics, particularly the immunology section, with the aim of achieving a more integrated coverage of major topics. 

Block VII - Pathophysiology and Therapeutics - I (9 weeks)

This course begins with basic and clinical neuroscience (including neuropharmacology, neuropathology, and psychiatry), followed by biostatistics and epidemiology, oncology and the pulmonary system. The six-week neuroscience unit first examines the various receptor systems that affect both nerve, cardiac, smooth and skeletal muscle, placing the material within a clinical perspective. The material is later examined along with non-pharmacologic treatment within the central nervous system and psychopathology portion of the unit. The mechanism and actions of centrally acting drugs are considered from a therapeutic viewpoint as well as in the context of drug abuse. The pathological processes that underlie the more prominent central and peripheral diseases are presented in lecture and case studies using histopathologic and radiologic approaches. The biostatistics-epidemiology unit emphasizes epidemiologic principles on the basis of a statistical examination of lung cancer and leads directly into a general study of neoplastic development. Finally, the subject area of pulmonary begins with discussions of pulmonary neoplasia and then other disease entities affecting the pulmonary system (asthma, hypertension, infections). Students are also exposed to complementary and alternative medicine and the potential use of herbal agents in treating various disease processes. 

Block VIII - Pathophysiology and Therapeutics - II (11 weeks)

Pathophysiology and Therapeutics II begins with a four-week unit of cardiovascular disease and hypertension. This unit examines the common cardiovascular diseases, their pathophysiology and therapy and is integrated with cardiac physical diagnosis. This is followed by 1-to-2 week sections on the pathophysiology of renal, hematologic, gastrointestinal, endocrine, reproductive, dermatologic and musculoskeletal diseases. In the various systems, principles of pathology, pharmacology, epidemiology, radiology and clinical medicine are emphasized in lecture and reinforced by small group clinical case studies. Concepts and principles taught in Pathophysiology and Therapeutics I serve as building blocks for Pathophysiology and Therapeutics II. 

Study for USMLE Step 1 Exams (5 weeks)

The United States Medical Licensing Examination (USMLE)

Students are required to take and pass Step 1 of the USMLE prior to the start of 3rd year clerkships or within 8 weeks of completing year 2 coursework if students are not immediately beginning clerkships. This applies to all students even if they are transitioning into dual degree program work or beginning a leave of absence. Students who take Step 1 and are awaiting the results will be permitted to start junior rotations, LOA or graduate work until grades for Step 1 have been reported. Students failing the exam will contact both the Director of Academic Development and a Student Affairs Dean to discuss:

  • an individualized study plan
  • the timing of leaving the current clerkship (after completion or leaving immediately and repeating it in its entirety at a later date)
  • The impact on their LOA or graduate work

In the event of a second failure of Step 1, students will not be permitted to resume their studies until the examination has been passed. Students on clerkships will meet with a Student Affairs Dean to discuss being placed on leave of absence or registered for the USMLE Review special elective until the exam has been taken and passed.  Students engaged in graduate work will discuss the implications with a Student Affairs Dean, the Director of their dual degree program and their graduate school Program Director with the understanding that they may be pulled from coursework or investigative work until the exam has been passed.  Students on LOA will discuss the implications and further plans with a Student Affairs Dean. 

Students who delay taking USMLE step 1 beyond the above parameters without permission from the School of Medicine will be required to report a passing grade before starting rotations or beginning graduate work or a leave of absence.  Additionally, to coordinate the student's rotation with the School of Medicine schedule and to avoid creating any incentive for a student to delay taking Step 1, the student will not be able to begin rotations for a minimum of 12 weeks.  All students in this situation will be discussed at the Advancement Committee and risk being placed on disciplinary probation.

All gaps in the curriculum must be explained in the Medical Student Performance Evaluation, and this delay in taking USLME step 1 will be described as the result of a student preference in the scheduling of the exam without the support of the School of Medicine.  Further, students should be aware that this curricular interruption may interfere with their ability to graduate in the expected time frame.  Requests to delay step 1 outside of any of the above parameters should be presented in writing to the Office of Student Affairs and will be discussed with the Office of Academic Development. The request will then be considered by the Medical Education Advisory Committee, and all decisions of this group will be final.  


Last Revision: January 29, 2013