Wake Forest University (School of Medicine)

PHASE I : FIRST YEAR COURSES * Human Structure and Development : This 12-week course is an introduction to human structure and development and includes the topics of gross anatomy, embryology, radiographic anatomy, histology, and neuroanatomy. Basic medical terminology, morphology of the human body, and sectional anatomy are introduced in a correlated fashion with the weekly clinical case and the other topics within the course. Lectures, clinical case presentations, and laboratory sessions are utilized to promote achievement of course objectives. Examinations include written and laboratory practical examinations. * Cellular and Subcellular Processes : This 12-week course is an introduction to cellular and subcellular function and includes the topics of biochemistry, molecular biology, immunology, introductory pathology, and genetics. Basic medical terminology, the basic processes of the cell and its subcellular components, and introductory concepts in immunology, pathology, and genetics are introduced in a correlated fashion with the weekly clinical case. Lectures and laboratory sessions are utilized to promote achievement of course objectives, which are assessed by written examination. * Basic/Clinical Science Problems I : This course extends across the entirety of Phase I. Students meet twice per week in small groups of six to seven students and two faculty facilitators to promote development of clinical reasoning skills and acquisition of basic and clinical science knowledge. The case topic serves as the anchor for each week of instruction in correlation with the material presented in the other Phase I courses. The course also promotes development of cooperative and self-directed learning skills, interpersonal skills, and professional behavior. Faculty assessments of student performance are made at the midpoint and the end of Phase IA and Phase IB. Each end-of-phase assessment (IA and IB) contributes to the final course grade given at the end of Phase IB. * Medicine As A Profession : This phase-long course focuses on various aspects of medical culture (defined as the interacting set of concepts, practices, institutions, and traditions that shape healthcare interaction and meaning) and medicine as a professional practice with its own history and culture. Course segments include physician socialization and professional development, ethical decisions in medicine, medical humanities, legal aspects of medical practice, and compassionate, respectful treatment of patients. Sessions alternate between large-group presentations and small-group discussions. Evaluation includes attendance and participation in large- and small-group sessions, examinations, and completion of self-directed learning activities. * Foundations of Clinical Medicine I : This course extends across Phase I and facilitates the development of physical examination skills as well as the interviewing skills and interpersonal skills essential for establishing effective professional relationships with patients. Students alternate on a weekly basis between the doctorpatient (interviewing and interpersonal skills) and physical examination components of the course. Interviews of hospitalized patients are employed to enhance development of students� interpersonal and interviewing skills. Evaluation is performance-based and includes a standardized patient examination. * Population Health/Epidemiology : Because we are in an era of rapid generation of new knowledge, special skills are needed to access, critically review, and efficiently use good evidence from the medical literature in the care of patients and populations. This course extends across Phase I and facilitates students� understanding of medical epidemiology and provides an introduction to evidence-based medicine. Included are an understanding of basic epidemiologic principles, strengths and weaknesses of various study designs, use and interpretation of basic statistics, use and interpretation of diagnostic tests, techniques of efficient literature searching, and framing a precise patient (or population) care question in the areas of diagnosis, prognosis, harm, and therapy. The material will be presented in alternating lecture and small-group formats. Student evaluation includes small-group participation, problem sets, and computer-based examinations at the end of Phase IA and Phase IB. * Community Practice Experience : The Community Practice Experience (CPE) extends across Phase I and Phase II. Students spend eight weeks with a community-based primary care practitioner; 4 weeks are completed during the summer session between the first and second academic years. The goals of the CPE include identification of the resources within a community that relate to health promotion, disease prevention, health maintenance, and recovery from illness or disability; development of professional attitudes and behaviors that are adaptable to different healthcare practice environments; and refinement of skills in interviewing, physical examination, and communication with patients, families, and other health professionals. Students complete a community health project and study learning issues related to patients seen with their preceptor. PHASE II : SECOND YEAR * Systems Pathophysiology A, B, and C: : This course is intended as an introduction to clinical medicine, bridging the Phase I course work with the clinical rotations. Instruction that will integrate basic science (e.g., physiology, pharmacology, pathology, microanatomy) with clinical material is built around nine organbased topics: Phase IIA (9 weeks) � infectious disease/microbiology, hematology/lymph, endocrinology/reproduction; Phase IIB (9 weeks) � cardiovascular, pulmonary, renal; Phase IIC (13 weeks) nervous system, digestive diseases/nutrition, integument, musculoskeletal. The broad course objectives are to define the basic vocabulary and principles of normal and abnormal function; identify normal and pathologic structure by gross, microscopic, and radiologic methods, as appropriate; correlate structure with normal physiology and pathology and be able to explain the mechanism of action, important side effects, and pertinent interactions of pharmacologic agents used for therapeutic intervention; identify causes, symptoms, and treatments of selected diseases of each organ system; and develop and use clinical reasoning skills and professional interactions in standardized patient cases, with the goal of applying fundamental knowledge to patient care. Course material is delivered through didactic lectures, labs, clinical experiences, and self-directed learning. Examinations include weekly quizzes and periodic summative written examinations. * Basic and Clinical Science Problems II :This course is a continuation of Basic and Clinical Science Problems I. In this small-group course that spans the length of Phase II, a group of six to seven students work to resolve basicscience and clinical issues related to a patient scenario that has been written by faculty of the corresponding weekly topic in Systems athophysiology. In Phases IIA and IIB, a faculty facilitator works with each group in a traditional problem-based learning format. In Phase IIC, students work in their small groups together with other small groups in a large conference room, led by roving faculty, in a process known as Team Learning. The major goals of Basic and Clinical Science Poblems II are to use the cases to develop skills in clinical reasoning, group and individual problem-solving, and cooperative as well as self-directed learning, as well as to promote professional behavior and interpersonal skills. Faculty assessments of student performance are made midway through and at the end of Phases IIA and IIB. Performance is measured through student self-assessments and quiz scores midway through and at the end of Phase IIC. Each endof- phase assessment contributes to the final course grade given at the end of Phase IIC. * Foundations of Clinical Medicine II : This course is an extension of the course from Phase I, focusing on doctor-patient relations and development of history-taking, physical examination, and communication skills. Opportunities to perform complete histories and examinations on real patients and to teach clinical skills to Phase I students occur during this phase. * Medicine As A Profession II : The MAAP course in Phase II is an extension of the course in Phase I and supports medical student professional development through curriculum segments on the social impact of medicine as a profession in American society; physician socialization and professional development; ethical decision making; issues of access to and control of medical care; research involving human subjects; medical humanities and the physician/patient relationship; legal aspects of medical practice; and compassionate, respectful treatment of patients. Student performance is assessed through attendance and participation in large- and small-group sessions, examinations, short essays, and completion of self-directed learning activities. PHASE III : THIRD YEAR COURSES * Inpatient Internal Medicine : During this 8-week clerkship, students are assigned to patient care teams and are responsible for the day-to-day care of identified patients. Student responsibilities include obtaining histories and physical examinations, generating differential diagnoses and treatment plans, assessing patients at the bedside, writing daily progress notes to demonstrate level of understanding, presenting patient information to house staff and faculty, and participating actively on rounds by responding to questions of faculty and house staff regarding disease processes and patient care issues. Students are expected to demonstrate evidence of individual reading and use of learning resources to help them fulfill these responsibilities. Differential diagnosis and presentation of clinical data are emphasized throughout the rotation. * Ambulatory Internal Medicine : During this 4-week clerkship, students learn about the scope of outpatient internal medicine through assignments with generalists and subspecialists in a variety of clinics. Experiences with palliative care and Hospice are included in this clerkship. Use of computer-based technology to round out the students� exposure to essential topics is featured, as are case-based conferences. * Surgery : A list of educational goals and objectives for the surgery clerkship is provided to students on the first day of the rotation. Students serve as junior members of the surgical team and are expected to prepare for surgeries they observe by reading about the case and reviewing relevant anatomy. Case conferences, ward rounds, and grand rounds are employed to help students learn about differential diagnoses, diagnosis, and treatment. Students are required to document acquisition of various motor skills/tasks, including establishment of an IV and placement of a nasogastric tube. * Obstetrics/Gynecology/Women�s Health : This 6-week experience provides students with exposure to common topics in women�s health in both the inpatient and ambulatory settings. Inpatient activities include exposure to peripartum problems, operative obstetrics, operative gynecology, and common Ob/Gyn diagnostic and therapeutic modalities. In addition, as part of the high-risk obstetrics team, students are responsible for following patients from admission to discharge, participating in all aspects of care from the initial physical examination to the formulation of a management plan. The ambulatory component focuses on issues relevant to outpatient women�s care. * Pediatrics : This 8-week experience is a blend of outpatient and inpatient clinical activities in pediatric health care. The goal of the rotation is to facilitate the development of communication skills and competency in the physical examination of infants, children, and adolescents; an understanding of the influence of family, community, and society on the child in health and disease; the enhancement of clinical problem-solving skills; and the acquisition of knowledge necessary for the diagnosis and initial management of common acute and chronic illnesses in the pediatric population. Clerkship objectives are met via participation as a member of the inpatient ward team and discussion of case vignettes in a small-group setting. The ambulatory component utilizes outpatient clinical settings to enhance students� skills in synthesis of clinical information, interpretation of physical examination findings, generation of a differential diagnosis, selection of diagnostic tests, and development of a treatment plan. * Psychiatry : This 4-week clerkship facilitates student attainment of knowledge, attitude, and skill objectives including the conduct of a psychiatric interview and the formulation of an initial differential diagnosis for common psychiatric presentations. Students are routinely expected to evaluate patients, read about the diagnostic possibilities raised by the case, synthesize information and present the patient on rounds, pursue further diagnostic testing, participate in planned therapeutic activities, and report and record patients� progress. While on the clerkship rotation, students are expected to read material relevant to their patients� conditions. They are also expected to utilize standard textbooks and review materials to familiarize themselves with clerkship objectives not addressed by their clinical exposure. * Neurology/Rehabilitation : This 4-week clerkship assists students in addressing the primary clerkship objectives relating to the identification of common neurologic diseases, the recognition of emergency neurologic situations, the management of common neurologic problems, and communication with patients and families of patients with motor, sensory, and cognitive deficits. The process of daily rounds and clinic (ambulatory) conferences, as well as weekly grand rounds, provides students with relevant examples of integrated clinical thinking. Students are expected to pursue independent reading on cases encountered on the wards and in clinics. * Family Medicine : The 4-week family medicine clerkship focuses on care in the outpatient clinical setting. The rotation incorporates outpatient clinical experience, small-group case discussion promoting the development of higher-order thinking skills and problem-solving skills, standardized patient educators in a smoking cessation activity, and a videotaped patient interview. Clerkship objectives include comprehensive, coordinated continuous care, psychosocial aspects of patient care, and group communication and presentation skills. * Anesthesiology : The primary objective of the anesthesiology experience is to expose students to the practice of clinical anesthesiology with special emphasis on the clinical application of anatomy, physiology, and pharmacology as students gain familiarity with procedural aspects of anesthesiology, including intravenous access, airway management, and regional anesthetic techniques. Students gain experience in anesthesia management of clinical cases utilizing the patient simulator. * Radiology : The radiology clerkship includes large-group sessions. Topics for self-instructional modules are selected for direct relevance to curricular goals of the medical school. Core biomedical science education is reinforced by the correlations drawn between diagnostic images, development and structure of the human body, pathologic anatomy, and pathophysiology. Clinical skills are emphasized in the modules that introduce and refine image analysis and image interpretation skills. Problem-solving and clinical-reasoning skills are learned in the process of developing imaging-based diagnoses, selecting diagnostic imaging tests, and correlating the results of those tests with other clinical information at hand. PHASE IV : FOURTH YEAR COURSES * Advanced Inpatient Management : Students complete two AIM rotations, each selected from one of the following separate disciplines: surgery, psychiatry, family medicine, obstetrics and gynecology, internal medicine, neurology, and pediatrics. The primary goal of this clerkship experience is the development of students� abilities in complete patient management. Students are actively involved in all aspects of patient care, including primary work-up, development of differential diagnoses, in-hospital patient management, and post-hospital care planning. Goals and objectives for each approved AIM are listed in the Phase IV Program Guide and online. * Emergency Medicine : This 4-week clerkship provides students with experience in the diagnosis and initial management of patients presenting to the emergency department. Students complete eighteen 8- hour shifts during the clerkship and participate in interactive case-study presentations with emergency medicine faculty. EMS (ambulance) experience is available on an elective basis. * Intensive Care : The primary objective of this clerkship is to expose students to patient care in the intensive care setting, with emphasis on patient management issues, such as differential diagnosis, rational laboratory and radiologic testing, and acute and chronic management of patients with multiple medical and surgical problems. Student participate as an integral part of the intensive care team, in the Medical Intensive Care Unit (MICU), Coronary Care Unit (CCU), Neurosurgical Intensive Care Unit (NSU), Cardiothoracic Surgery Intensive Care Unit (CTSU), Pediatric Intensive Care Unit (PICU), Neonatal Intensive Care Unit (NICU), or the Trauma Surgery Unit. Students assume supervised responsibility for patient admission, evaluation, diagnostic testing, and initiation and evaluation of therapy and are exposed to patient-care issues such as end-of-life decisions, patient disposition, and family healthcare dynamics. Students also spend time in the Patient Simulation Laboratory (PSL), where they have the opportunity to learn and practice management skills relating to acute cardiovascular, pulmonary, renal, and neurologic intensive care.

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School name: Wake Forest University (School of Medicine)
Address: Medical Center Boulevard
Zip & city: NC 27157 Winston-Salem
Phone: 336-716-8000
Web: http://www1.wfubmc.edu/school

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