Community Based Faculty Meeting Curriculum Update

1. Community Based Faculty Meeting Curriculum Update May 10, 2014

2. History of Medical Education Prior to 1920: Apprenticeship 1920-1960: Standardization and scientific investigation • Emphasis on the patient and their presentation • Case studies and case series 1960-2000: Genetic and molecular medicine • Emphasis on laboratory and imaging • Bench research and randomized controlled trials 2000-present: Comprehensive physician • Integration of scientific background and patient presentation • Clinical productivity • Comparative effectiveness, patient safety, ethics

3. Randomized Controlled Trials in PubMed

4. Meta-Analyses in PubMed

5. “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.” • Sir William Osler

6. Our Approach • Block schedule • One of the first medical schools to offer • Intensive, concentrated exposure to each area • Emphasis on patient presentations and management • Flexible afternoon scheduling • Basic science courses scheduled in the mornings

7. Curriculum Goals • Integrate biomedical and clinical science • Promote critical thinking • Develop problem-solving skills • Develop clinical reasoning skills • Apply a biopsychosocial model to patient care

8. Pre-Clinical Years • First two years of study • Hybrid Curriculum • Begin with essential principles of core knowledge • Integrated content based on organ systems • Focus on integrative thinking • Necessary for the clinical years of medical school • Successful modern physicians

9. First Year

10. Discipline Specific • Anatomy • Core gross and microscopic anatomy • Integrated with embryology • Basics that will be further developed throughout the curriculum • Biochemistry & Genetics • Core biochemistry, genetics and cell biology • Biochemical and genetic inheritance • Actual patient clinical correlations of human disease

11. Foundations of Disease, Infection & Therapeutics • Basis of all human disease • Integrated approach • Microbiology • Immunology • Pharmacology • Pathology • True “foundation” on which remaining courses will build

12. Neurosciences • Nervous system functions in health and disease • Integrated approach • Neuroanatomy • Neurochemistry • Neurophysiology • Neurology • Neurosurgery • Ophthalmology • Otolaryngology

13. Behavioral Basis of Medicine • Introduction to psychiatric conditions • Integrated study • Psychiatry • Behavioral science • Pharmacology • Modes of treatment • Pharmacologic • Psychotherapeutic • Psychosocial

14. Introduction to Clinical Medicine 1 • Longitudinal clinical experiences • Communication training and interviewing skills • Practice with “actor” patients, then with actual patients • Small-group seminars • Medical Humanities • Medical Ethics and Professionalism • Developmental Pediatrics • Geriatrics • Cultural and Social Aspects of Health Care • Evidence-Based Medicine

15. Second Year

16. Organ System-Based Courses • Diagnostic and therapeutic approaches to disease • Integrative approach • Pathology • Physiology • Pharmacology • Histology • Radiology • Microbiology/Immunology

17. Integrative Course • Integrate knowledge among organ systems • Analyze multisystem diseases • Review material essential to licensing exam

18. Introduction to Clinical Medicine 2 • Focus on physician skill set • Small group sessions • History-taking • Physical exam techniques • Ultrasound as an adjunct to physical exam • Clinical reasoning skills • Clinical Content • Medical Humanities • Medical Ethics and Professionalism • Cultural and Social Aspects of Health Care • Evidence-Based Medicine

19. Curriculum Comparison

20. Third Year • Broad exposure to major disciplines • Clinical exposure • Integrate pre-clinical learning into patient care • “Art of doctoring” • Balanced experiences • Involvement with patient care • Study • Assimilation of information

21. Third Year Curriculum • Clinical Neurosciences – Neurology & Psychiatry • Two separate four-week rotations • Family & Community Medicine • Four-week rotation • Internal Medicine and Emergency Care • Integrated 16-week rotation in inpatient and outpatient settings • Obstetrics & Gynecology • Four-week rotation • Pediatrics • Eight-week rotation • Surgery • Eight-week rotation

22. Fourth Year • Further development of clinical skills • Prepare for residency in their chosen specialty. • Curriculum • Acting Internships • Two four-week rotations, one primary and one secondary • Advanced Clinical Pharmacology and Anesthesiology • Four-week course • Intern Prep • Practical knowledge of the intern role • Elective rotations • Four four-week rotations • At the University of Kentucky or another approved site

24. Match 2014 • 29, 671 residency positions in the Match • 17,374 US allopathic seniors in the Match • 1,662 previous US allopathic grads in Match • 2,738 US osteopathic students/grads in Match • 5,133 US citizens students/IMGs in the Match • 7,334 non-US citizens in the Match

25. Match 2014 • 40,394 registered for the Match in 2014. • The Match offered 29,671 positions. • Overall match rate was 75%. • 94.4% of US seniors matched into a residency position, with 79% getting one of their top three choices. • 54% US seniors matched to 1st choice. • ~1000 unmatched US allopathic medical students at the end of the match

26. UK Match 2014 • Of the graduating seniors, 37% are entering primary care specialties. Primary Care includes Family Practice, Internal Medicine, Pediatrics and Medicine-Pediatrics. • Of the graduating seniors, 31% elected to remain at UKMC, and another 4% are staying at programs in Kentucky. • Matched into 22 different specialties.

27. UK Match 2014 • Top specialty choices for UK COM seniors were (listed in decreasing chronological order): • Internal Medicine 20% • Anesthesiology 12% • Pediatrics 8% • General Surgery 7% • Emergency Medicine 6% • Med/Peds, Neurology 5% • Radiology, Family Medicine, Orthopedic surgery 4%

33. Charles H. “Chipper” Griffith, MDSenior Associate Dean for Medical EducationUniversity of Kentucky College of Medicinecgrif00@email.uky.edu