Curriculum
[see LCME 7.x, 6.8]
Overview
The Renaissance Curriculum at the University of Maryland School of Medicine (UMSOM) was first implemented in August 2020. The 150-week curriculum is designed to be completed in 4 academic years, though students may delay completion to participate in research, acquire additional academic degrees, or participate in programs to obtain specialty choices.
The curriculum's aim is to prepare our students to be successful residents within the framework of the Physician Competency Reference Set, which serves as the overall program goals. In addition, the curriculum is designed to prepare our students to achieve the mission statement of the Renaissance Curriculum: to be life-long learners who are clinically excellent and possess humanism, professionalism, scholarship, leadership, critical thinking, and attention to social justice and diversity.
The preclerkship phase of the curriculum is an integrated, systems-based curriculum, that teaches normal and abnormal processes at the same time. Earlier interactions with patients allow students to connect and link relevant scientific material to clinical conditions. The pedagogical approach in this phase combines lectures, small-group discussion, laboratory sessions, and patient experiences with attention to active and collaborative learning strategies. In addition, the preclerkship phase of the Renaissance Curriculum includes a longitudinal course entitled Practice of Medicine where students learn about the doctor-patient relationship and the psychosocial aspects of patients, organized medicine, and society to enable them to optimally treat a diverse group of patients.
The clinical phase of the curriculum provides students a series of required and elective experiences to allow them participation in a broad range of medical specialties and settings, as well as the opportunity for focused areas of clinical activity as they prepare for their career choices. The Practice of Medicine course continues in the clinical phase with particular emphasis on simulation, ultrasound, bedside teaching, and culminating with specialty specific-residency preparation and a look back into the biomedical sciences and their integration into clinical medicine.
[see LCME 6.1, 8.2]
Program and Learning Objectives
The medical education program objectives were developed by the CCC with input from the Office of Medical Education and Office of Student Affairs. They were reviewed and approved by the CCC in 2022. All objectives are stated in terms of the AAMC Physician Competency Reference Set (PCRS).
Outcome measures are linked to program objectives by each course and clerkship leadership. The medical school ensures that the outcome measures selected are appropriate through review by the Preclerkship Committee (PCC) for preclerkship courses and by the Clinical Years Committee (CYC) for clinical courses with ultimate approval by the CCC. The PCC formally conducts peer review of each required course on a rolling basis. This review provides the course director, and PCC, feedback on areas for improvement and integration between courses. The CYC formally conducts peer review of each required clerkship, allowing focused review of each clerkship's objectives and evaluation methods and providing feedback on areas for improvement through collaborative development of action plans.
The faculty, working through the CCC, PCC, and CYC, has framed all course and clerkship goals and objectives within the PCRS taxonomy. Both preclerkship and clinical years' goals and objectives; however, are ultimately driven and linked to the main University of Maryland School of Medicine educational program objectives. The individual course/clerkship directors formulate goals and objectives for each educational program unit with the input of departmental faculty and leadership. These goals and objectives are then reviewed and approved by the CCC and its subcommittees. In this review process, the faculty ensures that the learning objectives of individual courses/clerkships meet the overarching program objectives.
Faculty members within each course and clerkship receive the program and learning objectives from the course or clerkship director, who is tasked with ensuring that those objectives are disseminated in the most effective way for that particular group of instructors.
Medical Education Program Objectives
[see LCME 8.3]
Managing the Renaissance Curriculum
The CCC continuously monitors the effectiveness and cohesion of the entire curriculum; in addition, formal review of outcome measures and student feedback is undertaken annually. Outcome measures evaluated include the review of student performance on the National Board Examinations, shelf exams, Graduation Questionnaire, faculty evaluation of student competency through direct observation (e.g., mini-CEXs). Other outcome measures such as match results (frequency per specialty, perceived quality of matched programs, student ability to obtain residency of choice) are tracked. Residency program directors complete a survey at the end of the graduate’s internship to provide feedback to the School of Medicine on the graduate’s competency in achieving expected milestones. The results of this review are reported to the Medical Education Advisory Committee and the Dean; changes to the curriculum are proposed to address identified deficiencies.
[see LCME 8.1]
Developing and reviewing the educational program objectives
The CCC and its two subcommittees, working closely with the Chief Academic Officer (Senior Associate Dean for Academic Affairs) and the Medical Education Advisory Committee (MEAC), develop and periodically review and revise institutional objectives, ensure the use of appropriate teaching methods and evaluation, and monitor the effectiveness and quality of teaching. There is periodic review of goals and objectives, which undergo revision as the result of discussion and deliberations in both subcommittees and the CCC.
Ensuring that there is horizontal and vertical curriculum integration (i.e., that curriculum content is coordinated and integrated within and across academic years/phases)
Since the implementation of the Renaissance Curriculum, the PCC and MECQI have monitored the successful integration of the preclerkship courses. The PCC and CYC include faculty representing continuous themes in the student education (embedded content leads), such as anatomy, radiology, genetics, anti-racism, nutrition, pharmacology, pathology, and infectious diseases. Many themes run vertically through the curriculum: examples include clinical concepts and skills which are omnipresent in the first two years, both in the form of Practice of Medicine 1 & 2 and in every preclerkship course in the form of lectures and small group sessions devoted to clinical significance of the concepts covered. The course/clerkship directors, the Year 1/Year 2 Committee, the CYC, and the CCC constantly work on better integration of content taught throughout the curriculum.
Monitoring the overall quality and outcomes of individual courses and clerkships
Both the PCC and CYC conduct ongoing course and clerkship review; this review includes, for example, review of student performance on internal examinations as well as the results from national examinations. Each course engages in a peer review process where course directors from other courses sit in on aspects of the course under review, evaluate all student feedback, and generate their own evaluation of the course quality/effectiveness. The peer reviewers meet with the course director to discuss their observations and suggestions. The overall review is also brought to the PCC or CYC. In addition, both subcommittees regularly review the results of peer evaluation of teaching effectiveness, student evaluation data, as well as outcome measures.
Monitoring the outcomes of the curriculum as a whole
Outcome monitoring includes the review of student performance on the National Board Examinations, shelf exams, Graduation Questionnaire, as well as faculty evaluation of student competency through direct observation (e.g., mini-CEXs). A significant outcome measures is the result of the NRMP match (i.e., frequency per specialty, perceived quality of matched programs, student ability to obtain residency of choice). Residency program directors complete a survey at the end of the graduate’s internship to provide feedback to the School of Medicine on the graduate’s competency in achieving expected milestones.