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Course Information: Year 1 Courses

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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 Major Basic Science disciplines covered in the Pathobiology and Host Defense Course include Pathology, Microbiology and Immunology. The course provides the necessary introductory background for each topic so that each students knowledge base can be expanded upon during the organ system part of the curriculum.

The lectures, small group sessions and laboratories are generally initiated with a clinical situation. Each student will be encouraged to: develop life-long learning habits, function as a team to construct differential diagnoses and develop an understanding of applicable basic science concepts underlying clinical disease states. We will help 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 which comprise the pathogenesis of disease.

The class will be divided in half for the laboratory exercises, arbitrarily designated above as Group A and Group B. Each student will spend four hours per week in laboratory; examples of topics in the labs include study of gross and microscopic morphology of basic pathologic processes, examination of bacterial or viral cultures or plaque assays, and study of parasites in tissue and in clinical specimens. The students will have a low stake quiz weekly in the lab exercises called a readiness assessment test (RAT) that will let both the student and faculty evaluate the students knowledge on each topic presented and a final lab practical examination.

Assessment is based on performance in the problem based learning exercises (low stake), on the weekly laboratory quizzes (low stake) and on the mid-term and final examinations (high stake) as well as the final lab practical examination.

Neuroscience and Human Behavior

Lectures

There is an average of 7 lectures per week; these will present broad overviews of material which cannot be easily derived from other sources or topics which are conceptually difficult to understand.

Small group tutorials

Groups of 8-9 students will meet for an 4-6 hours per week (five weeks involve 3 days with 2-hour sessions (i.e., 6 h/week) and three weeks involve 2 days with 2 hour sessions (i.e., 4 h/week) to discuss as a group a clinical case in the problem based format (PBL) format. In addition the whole class will meet in a one 1-hour wrap-up session with a clinician to ask questions regarding the case. The small group sessions also have a unique team-based learning (TBL) component.

Laboratory groups

The whole class will meet in the gross anatomy laboratory for an average of 4 hours per week for 5 sessions during which they will watch live video demonstrations by neurosurgeons and neuropathologists, the students will also examine as a small group wet whole brains, brain slices and radiological materials illustrating normal and pathologic neuroanatomy. In addition students will carry out brain dissections under faculty guidance to familiarize themselves with the 3-D organization of the brain.

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

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:

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

http://eclass.utmb.edu (Restricted Access)

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 Fundamentals of Endocrinology and Reproduction Course has been designed to promote student-centered, self-directed and active learning. Problem?based learning is the predominant educational modality. The cases have been carefully designed to highlight the most important aspects of normal and abnormal endocrine function and normal and abnormal reproduction. Substantial unscheduled time is incorporated into the course to allow sufficient time for independent study. Most small group faculty are content experts in some aspect(s) of endocrinology and/or reproduction. However, none are expert in all areas, and all have been charged with using their expertise to ask thought-provoking questions rather than to provide answers.

Major topics of the course include normal and abnormal sexual development, normal and abnormal growth and pubertal development, reproductive endocrinology, infertility, sexually transmitted diseases, normal and complicated pregnancy, menopause, breast cancer, obesity, glucose homeostasis, diabetes, pituitary disorders, thyroid physiology and disease, adrenal disorders, endocrine hypertension, and disorders of mineral metabolism.

In all cases, the following fundamental principles of relevant hormonal systems should be addressed by the students:

  • Molecular principles, including structural relationships among classes of hormones, mechanisms of hormone synthesis and transport, structure and function of hormone receptors (nuclear and membrane receptors), and principles of hormone-receptor interactions.
  • Physiologic principles, including regulation of hormone synthesis and secretion, regulation of receptor activity and/or abundance, the effects of hormones on the metabolic/functional activity, proliferation, and differentiation of target cells, and normal reproductive development and function in the male and female.
  • Anatomic and histopathologic principles, including significant relationships between endocrine glands and other anatomic structures, and normal and pathologic histology of the endocrine glands and reproductive structures.
  • Pathophysiologic principles of excess and deficient hormone secretion, endocrine tumors, and disorders of reproduction.
  • Pharmacological principles of drugs used in the diagnosis and treatment of endocrine and reproductive disorders, including mechanisms of action, pharmacokinetics, indications, contraindications, and side effects.

In addition to these guidelines, several mechanisms are built into the course to allow students to gauge their progress in mastering the relevant material. One or two days after the conclusion of each case, a Case Wrap-up Session is held in the Clinical Science Auditorium to provide a forum for students to ask questions of faculty with content expertise related to that case. In addition, recommended learning objectives will be distributed before the Case Wrap-up Sessions. Finally, "no-stakes" computer-based quizzes will be available through Web-CT every two weeks to allow students to assess their progress.

Computer-based learning modules and lectures are designed to supplement, enrich, and expand on the topics raised by the PBL cases. A new modality, student Clinical Decision Making Exercises, will help students develop and improve skills in literature searching, data analysis, critical thinking, teamwork, and presentation.

A midterm and cumulative final exam will assess students? ability to apply basic principles and utilize information in clinically relevant contexts. Students will receive a grade in each of the three major components of the course (PBL, CDMX, and Exams) –these will be combined to produce the final course grade of H, HP, P, or F. Students must pass all three components in order to pass the course. Standards for assessment will be provided to PBL and CDMX faculty to promote consistent evaluation throughout the course.

Derm/Heme/Musculoskeletal

The Dermatology/Hematology/Musculoskeletal (DHM) course provides an integrated problem-based approach to understanding the pathophysiologic basis of dermatologic, hematologic and musculoskeletal disorders as well as the pharmacological rationale for their therapy. Material is introduced in a stepwise fashion beginning with normal organ-specific anatomy, biochemistry, and physiology, and progressing to the pathophysiology, clinical features and treatment of representative disorders. The course is introductory and as such is not intended to present the topics in exhaustive detail. Instead emphasis will be placed on an understanding of the basic functions of these organ systems and the ways in which abnormal (pathologic) processes lead abnormal function and disease. The learning material will consist of expert lectures, facilitator-managed small group sessions, textbook reading assignments, and computer-based instructional materials. Active participation in small group sessions is required to pass this course.

Great Syndromes

The student will appreciate the complex dimension of clinical judgment, including: Complexities of interactions, involvement of multiple organ systems, examples of major syndromes and diseases, life stages, patient's perspective, and incorporation of basic science knowledge. Predicated on students' knowledge of the basic science organ systems, this course acquaints students with the complexities and integrative dimensions of clinical judgment. Via clinical cases involving selected syndromes, this course will explore content topics including: aging, disability, substance abuse, death and dying, pain management, critical thinking, ethics and professionalism, treatment principles, and situational awareness.

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 12 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.

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