CURRICULUM RENEWAL
FSM will mentor and educate students to
become exceptional, compassionate and
innovative physicians, educators, and
researchers
We expect our students to be inquiry-driven
team leaders who will serve patients, society
and the profession
March 2011 Update
CURRICULUM RENEWAL
100 faculty
15students
200faculty
25students
Sept 2009
Retreat
Oct 2010
Kick-Off
March 2011 Update
Sept 2011
Aug 2012
Phase 1
Plan Completed
Phase 1
Implementation
~April 2013
Phase 2
Implementation
~April 2014
Phase 3
Implementation
Curriculum Development
organization, content
113faculty
25students
Instructional Design to deliver content
Faculty Development to facilitate content delivery
Assessment Design to evaluate student learning outcomes
Curriculum Evaluation and Continuous Quality Improvement
Collaborative
Collaborative
Multidisciplinary
& Inter-professional Teams, Societies, Colleges
Colleges
Evidence-Based
Active Learning Learning
PBL, TBL, Simulation, PBL
Virtual Reality
Content
Competency-Based
Science in Medicine
Content
AOC, Competency, PPS
PPS,,MDM
MDM
Learner-Centered
Inquiry-Driven
Professional Development
4 Curricular Elements
content
threads
Clinical Medicine
•Prevention, Diagnosis, Treatment, Rehabilitation, Palliation
(Prevention includes nutrition, lifestyle medicine, behavioral change, wellness
(Diagnosis includes Hx & PE, laboratory medicine, imaging)
(Treatment includes therapeutics and technical skills)
(Rehab includes transitions of care)
(Palliation includes end of life care)
•Medical Decision-Making & Clinical Reasoning
(MDM includes Info Acquisition & Management, EBM, Cost- Effectiveness)
• Communication (oral, written, counseling, teaching)
Professional Development
•Area of Scholarly Concentration, “Pathways”, Professional Goals
•Personal Awareness and Self-Care
•Professional Behavior and Moral Reasoning
•Teamwork & Leadership
Health & Society
•Biopsychosocial determinants of Health and Disease (Healthy People 2020)
• Health Disparities, Equity and Advocacy
•Health Economics and Health Systems
•Global, Community and Public Health Perspectives
•Patient Safety and Quality Improvement
Science in Medicine
•Foundational Sciences (cellular processes, genetics, metabolism
inflammation and infection)
•Normal Structure and Function
• Mechanisms of Disease, Diagnosis, Therapeutic Interventions,
Disease Prevention
•Organ-based, lifecycle / developmental framework
Curricular Model
CURRICULUM RENEWAL
March 2011 Update
Continuity
Organizing principles
Current Curriculum
Year 2
Year 1
SF
Year 3
SBM
Normal
Year 4
Clinical Medicine
Abnormal
Patient, Physician, Society
Proposed Curriculum
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
CURRICULUM RENEWAL
March 2011 Update
CURRICULUM RENEWAL
March 2011 Update
I
II
Prologue
CV
Renal
Pulmonary
CV
CM
H&S
PD
Competency-Based, Gateway Assessments with Portfolio Reviews
Spring Break
Integration & Synthesis Modules
Oncology
Hematology
Dermatology
Break
X XI
Reproductive/Urogenital
Holiday Break
Endocrine
VIII IX
Gastrointestinal
Integration & Synthesis Module
Psychiatry/Behavioral Science
VI VII
Neurology
Summer Break
Area of Concentration
Head & Neck, Ophthalmology
III IV V
Spring Break
Musculoskeletal
Integration & Synthesis Module
SiM
Holiday Break
Phase 1
XII XIII XIV
CURRICULUM RENEWAL
Sept 2009
Retreat
Oct 2010
Kick-Off
March 2011 Update
Sept 2011
Aug 2012
Phase 1
Plan Completed
Phase 1
Implementation
~April 2013
Phase 2
Implementation
~April 2014
Phase 3
Implementation
Curriculum Development
organization, content
Instructional Design to deliver content
Faculty Development to facilitate content delivery
Assessment Design to evaluate student learning outcomes
Curriculum Evaluation and Continuous Quality Improvement
CURRICULUM RENEWAL
March 2011 Update
SCIENCE IN MEDICINE
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
I
II
Prologue
CV
Holiday Break
CV
CM
H&S
PD
Competency-Based, Gateway Assessments with Portfolio Reviews
Spring Break
Integration & Synthesis Modules
Oncology
Hematology
Dermatology
Break
X XI
Reproductive/Urogenital
Holiday Break
Endocrine
VIII IX
Gastrointestinal
Integration & Synthesis Module
Psychiatry/Behavioral Science
VI VII
Neurology
Summer Break
Area of Concentration
Head & Neck, Ophthalmology
III IV V
Spring Break
Musculoskeletal
Integration & Synthesis Module
Renal
Pulmonary
Phase 1 Sequence - Science in Medicine Modules
XII XIII XIV
EXAM & PORTFOLIO
ASSESSMENT
IMMUNOLOGY
October
MICROBIOLOGY
PHARMACOLOGY
CELL INJURY
September
HUMAN BODY
GENETICS
CELLS, RECEPTORS, MEMBRANES
Prologue - Sequence of Science in Medicine (Weeks)
Fall 2012
November
Prologue Sequence of SiM - Weekly Calendar
September 2012 Calendar
Mon
3
LABOR DAY
Tue
4 INTRO,
THEMES,
THREADS
Wed
5
November 2012 Calendar
Thu
6
Fri
Mon
Tue
Wed
CELLS, ORGANELLES, MACROMOLECULES
CELLS, 11RECEPTORS,
MEMBRANES
12
13
14
10
Thu
5
6
7
8
9
MICROBIOLOGY
CELLS, CONT.
RECEPTORS, G PROTEINS, MEMBRANE TRANSPORT, CHANNELS RNA & DNA VIRUSES, BACTERIA, FUNGI, PARASITES, THERAPEUTICS
17
18
19
20
12
21
CHROMOSOMES, CELL CYCLE, STEM CELLS, MUTATION, INHERITANCE
24
GENETICS
26
27
25
13
14
GENETIC VARIATION, PEDIGREE, AUTOSOMAL & CHROMOSOMAL DISORDERS
IMMUNOLOGY
20
IMMUNOPATHOLOGY,
INFLAMMATION
26
PROLOGUE
EXAM
EXAM
27
1
Tue
2
Wed
3
Thu
4
GENETICS
Fri
5
Mon
3
Tue
4
GENETIC DISORDER DIAGNOSIS, SCREENING & THERAPEUTICS, SPECIFIC DISEASES
8
9
10
METABOLISM, PATHWAYS, MITOCHONDRIA
11
12
10
16
HUMAN BODY
HUMAN BODY: BONE, MUSCLE
BLOOD,
CIRCULATION
18
AUTONOMIC,
SOMATIC
NERVOUS SYS.
22
24
25
23
17
CELL INJURY
CELL ADAPTATION & INJURY, APOPTOSIS, TUMORS, CANCER
29
30
31
PHARMACOLOGY
PHARM: DISTRIBUTION, EXCRETION, METABOL.,
KINETICS
19
EMBRYOGENESIS
26
PHARMACOLOGY:
ABSORPTION,
TRANSPORT
16
22
23
THANKSGIVING
December 2012 Calendar
Wed
5
6
CARDIOVASCULAR MODULE
30
Thu
Fri
7
CARDIOVASCULAR
12
13MODULE
14
11
CARDIOVASCULAR MODULE
HUMAN BODY: EPITHELIUM, CONNECTIVE TISSUE
15
21
28
29
CARDIOVASCULAR MODULE
October 2012 Calendar
Mon
15
INTRO
IMMUNOLOGY
ANTIBODIES, T CELLS, EFFECTOR FUNCTIONS, AUTOIMMUNITY, TRANSPLANTS
19
28
Fri
1
2
PHARMACOLOGY:
INTRO
KINETICS
MICROBIOLOGY
7
17
24
31
18
19
20
CARDIOVASCULAR MODULE
21
26
27
28
25
<===============HOLIDAY BREAK===============>
CHRISTMAS
<===============HOLIDAY BREAK===============>
Prologue Sequence of SiM - Weekly Topics
Mon
3
Tue
September 2012 Calendar
Wed
Thu
Fri
Mon
November 2012 Calendar
Wed
Tue
Thu
4 INTRO,
THEMES,
THREADS
5
10
11
12
CELLS, CONT.
RECEPTORS, G PROTEINS, MEMBRANE TRANSPORT, CHANNELS RNA & DNA VIRUSES, BACTERIA, FUNGI, PARASITES, THERAPEUTICS
17
18
LABOR DAY
6
CELLS, ORGANELLES, MACROMOLECULES
19
13
5
14
20
CHROMOSOMES, CELL CYCLE, STEM CELLS, MUTATION, INHERITANCE
24
26
25
27
6
12
21
GENETIC VARIATION, PEDIGREE, AUTOSOMAL & CHROMOSOMAL DISORDERS
13
1
Tue
2
October 2012 Calendar
Wed
3
Thu
4
Fri
5
27
Mon
9
10
METABOLISM, PATHWAYS, MITOCHONDRIA
11
12
3
4
10
11
17
18
HUMAN BODY: EPITHELIUM, CONNECTIVE TISSUE
15
16
HUMAN BODY: BONE, MUSCLE
BLOOD,
CIRCULATION
18
AUTONOMIC,
SOMATIC
NERVOUS SYS.
22
24
25
23
17
CELL ADAPTATION & INJURY, APOPTOSIS, TUMORS, CANCER
29
30
31
PHARM: DISTRIBUTION, EXCRETION, METABOL.,
KINETICS
19
EMBRYOGENESIS
26
PHARMACOLOGY:
ABSORPTION,
TRANSPORT
9
15
INTRO
IMMUNOLOGY
16
24
31
21
22
23
THANKSGIVING
28
29
CARDIOVASCULAR MODULE
Tue
GENETIC DISORDER DIAGNOSIS, SCREENING & THERAPEUTICS, SPECIFIC DISEASES
8
8
14
20
IMMUNOPATHOLOGY,
INFLAMMATION
26
PROLOGUE
EXAM
Mon
7
ANTIBODIES, T CELLS, EFFECTOR FUNCTIONS, AUTOIMMUNITY, TRANSPLANTS
19
28
Fri
1
2
PHARMACOLOGY:
INTRO
KINETICS
MICROBIOLOGY
7
December 2012 Calendar
Wed
30
Thu
Fri
5
7
12
13
CARDIOVASCULAR MODULE
14
19
20
CARDIOVASCULAR MODULE
21
6
CARDIOVASCULAR MODULE
26
27
28
25
<===============HOLIDAY BREAK===============>
CHRISTMAS
<===============HOLIDAY BREAK===============>
Example: Prologue SiM Week 5, Hourly Topics
Fall 2012
Monday
October 1
Tuesday
October 2
Approaches to
genetics
disorders
Development,
pattern
formation,
homeobox genes
Contiguous gene
deletions,
uniparental
disomy
Prenatal
diagnosis
Mitochondrial
genetics &
diseases
Treatment of
genetic disorders
Wednesday
October 3
Thursday
October 4
Friday
October 5
Genetic
screening,
prenatal, cancer
risk
X chromosome:
inactivation,
pseudoautosomal
regions, Turner
syndrome
Behavioral
genetics
Neurofibromatosis
Marfan syndrome,
hemiglobinopathy,
PKU
Tasks ahead:
1. Improve coordination and communication across SiM topics
2. Integrate the daily and weekly schedule with other curricular
elements - clinical medicine, health and society, professional
development
3. Develop stimulating, interactive learning experiences that engage
students in large and small groups
CURRICULUM RENEWAL
March 2011 Update
CLINICAL MEDICINE
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Professional Development
TUESDAY 5PM :
CLINICAL MED STEERING COMMITTEE
•
•
•
•
•
•
•
•
•
•
•
Ben Singer
Julia Corcoran
John Butter
Warren Tourtelotte
Rama Gourenini
Jen Trainor
Stephanie Kerns
Nicholas Volpe
Donna Woods
Margaret Duggan
Kristine Gleason
•
•
•
•
•
•
•
•
•
•
•
Bob Tanz
John Vozenelik
Jay Thomas
Michael Fleming
Alex Korutz
Daniel Katz
Joseph Brown
Kate Kinner
Kelly Walker
Aarati Didwania
Amanda Zick
TUESDAY 12NOON :
CLINICAL MED SUBCOMITTEE #1
•
•
•
•
•
•
•
•
•
•
Eric Terman
Arv Vanagunas
Lori Goodhartz
Cristine Park
Toshi Uchida
Boye Ogunseitan
Stevie Mazyck
Gary MacVicar
Marie Crandall
Jen Bierman
•
•
•
•
•
•
•
•
•
Todd Davis
Karen Mangold
Alexander Sandu
Sharon Unti
Mike Moore
Susan Santacaterina
Nicole Wysolcki
Cherina Cyborski
Donald-Lloyd Jones
THURSDAY 8AM :
CLINICAL MED SUBCOMMITEE #2
•
•
•
•
•
•
•
•
•
•
Bob Brannigan
Tania Saroli
Michael Angarone
Rick Lee
Amer Aldeen
Jyothy Puthumana
Edgar Black
Darius Loghmanee
Danielle Smith
Julie Stamos
•
•
•
•
•
•
•
Tina Tan
Melissa Brown
Natasha Wheaton
Allison Hammer
Stephanie Miller
Jay Sarthy
Jared Mendelson
CLINICAL MEDICINE ELEMENT GROUP:
• Tuesday 12noon subcommittee:
– Task: organize the clinical medicine curriculum
horizontally almost done mapping broad goals,
assessment methods, & learning strategies
• Thursday 8am subcommittee:
– Task: integrate clinical medicine vertically into the CV
unit Focused Clinical Experience (FCE) initiative
• Tuesday 5pm steering committee:
– Task: think tank for “big picture” & reactor panel
developing a longitudinal student/patient experience
Current Curriculum
Year 2
Year 1
SF
Year 3
SBM
Normal
Year 4
Clinical Medicine
Abnormal
Patient, Physician, Society
Proposed Curriculum
Phase 1
Science in Medicine
F
C
E
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
SINGLE DOSES
OF EARLY CLINICAL MEDICINE…
THE FCE CONCEPT:
• Find a lecture
•
https://fsmweb02.northwestern.edu/emerg/
• Pick 2-3 objectives
• Find real-world examples
where the lecture content
is applicable
• Embed students in a clinical area.
Aims: provide context, apply & synthesize knowledge and inspire
PROVIDE THE “WHY” & INSPIRE INQUIRY
COULD IT WORK?
First FCE pilot Dr.
Puthumana’s echo
lab experience…
•
•
•
•
“Experience was wonderful”
“the lecture material really
came together”
“Cardiac echo, E/A & E’
definitely seemed more relevant
after the exercise”
“It was certainly inspiring and I
would definitely do it again- for
other units”
What’s up next:
•
•
•
•
•
•
•
•
•
•
NMH valve surgery (R. Lee)
CMH heart biopsy (T.Saroli)
Heart transplant (E.Black)
Cardiac cath lab (J.Flaherty)
CCU pharmacist (K. Gleason)
ED ecg’s (Aldeen, Wheaton)
CCU nurse shadow (M.Duggan)
Cardiac MRI imaging (A.Korutz)
Stress test lab (J.Puthumana)
Cardiac autopsy (J.Lomasney)
• Any volunteers?
A MAINTENANCE DOSE OF
CLINICAL MEDICINE…
Because understanding the
social/environmental determinants of
disease & the chronic care model
requires… more than 4 weeks!
CONTINUITY
Patients
(continuity of
care)
Preceptors
(continuity of
supervision)
Peers
(continuity of
teamwork &
collaboration)
SO WE NEED TO CREATE AN EDUCATIONAL
EXPERIENCE WHERE:
• A team of health professionals, coordinated
by a longitudinal physician, working
collaboratively to provide high levels of care,
access and communication, care
coordination and integration, and working to
improve care quality and safety.
• This is the AAFP, ACP, AAP, AOA 2007 consensus definition of a
Patient-Centered Medical Home
SIMPLE & ELEGANT
ALL RESIDENTS &
ATTENDINGS CAN
UNDERSTAND A
CONTINUITY CLINIC
CONCEPT
CONTINUITY
Panel of 100 patients with
Q4 mth visits would be ~6
patients/wk, +add 1-2 acute
slots as needed
Panel of 100
Patients
1-2 Faculty
Facilitators
Recruit vulnerable patients with
one or more of 20 core conditions
such as: heart disease, cancer,
stroke, COPD, obesity, trauma/SCI,
dementia, DM, ESRD, mood
disorders, asthma, HIV, SLE,
cirrhosis, CHF, high-risk OB, cystic
fibrosis, sickle cell, chronic pain,
and OA
Team of 10
Students
(2-3 per class)
SIMPLE DESIGN, INFINITE FLEXIBILITY
• All students have a clinic (simple concept)
• But within their clinic- many chances for
“layered individualization” & adaptability:
•
Panel of 100 patients allows students to focus (“own”) the patients
with conditions they find most interesting
•
Multiple visits with 1 patient over 4 years allows for “deep learning”
rather than just superficial initial encounters
•
Multiple levels of learners allows students to operate at exactly their
“true” level. M1’s who are ahead of the curve can start doing more
DDx and M3’s who are struggling can work more on PEx skills or Hx
•
M3 students could recruit the inpatients that inspire them
NEW RESOURCES SINCE 1993:
• Ability to track patient
progress when not
physically at the clinic
• And increasing ease of
data-mining to assess
quality across sites
OTHER SCHOOLS CAN MEASURE THEIR
CURRICULAR REFORM EFFORTS WITH
STUDENT SATISFACTION SURVEYS
Our educational outcomes could be:
97% of student CAD patients on B-Blkrs & Aspirin
Average Hgb A1c dropped 1.0% compared to entry
80% patients up to date with cancer screening metrics
No racial disparities detectable in screening rates
Mean BMI of patient panel dropped over 4 years
RHINOCEROS– WHY WERE YOU SO INSPIRING?
• Students owned the project
• Students worked as a team and had a goal
• The project was simple but yet integrated
everything they had been learning in class
(reading, writing, math, art, weather,
geography, biology, health/nutrition)
• The project inspired inquiry & deep learning
• Professionalism, responsibility were required
• Can’t we aspire to compete with 1st graders??
Current Curriculum
Year 2
Year 1
SF
Year 3
SBM
Normal
Year 4
Clinical Medicine
Abnormal
Patient, Physician, Society
Proposed Curriculum
Phase 1
Science in Medicine
F
C
E
Phase 2
Phase 3
Clinical Medicine
PCMH
Health & Society
Professional Development
• Imagine working with
these 4 FSM students
over 4 years and seeing
what they could do with a
panel of their OWN
patients
• Imagine the PR campaign &
recruitment impact…
•
Improving Medical Education by
Improving Chicago’s Health
CURRICULUM RENEWAL
March 2011 Update
HEALTH & SOCIETY
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
Health & Society CEG
Healthy People 2020 www.healthypeople.gov
Prologue:
Students learn about themselves
• Health Risk Appraisal (HRA)
– Lifestyle factors and readiness to change •
Biometric and laboratory results • Compliance
with recommended preventive screenings •
Existing chronic conditions • Future disease risk
factor • Personal environment
– Personal and group results
• Behavior Change Plan (BCP)
– Reanalysis of HRA results
– Personal and group results
Prologue:
Students learn about others
• Textbook Chicago
– Chicago bus tour of 6 communities to assess the 4
determinants of health (social environment,
physical environmental, health services, individual
behavior)
– SES • Racial/ethnic demographics • Built
environment • Health care access & delivery •
Prevalence of selected health conditions
– Presentations and discussion of health outcome
disparities regarding determinants of health
Overarching themes
• Determinants of health
• Disparities in health
outcomes
• Public health
• Community and global
health
• Health service delivery
• Physician roles
• Professional well-being
• Advocacy
• Communication /
motivational
interviewing/ behavior
change
• Interdisciplinary
learning
• Lifestyle Medicine
Thread
CURRICULUM RENEWAL
March 2011 Update
PROFESSIONAL DEVELOPMENT
Phase 1
Science in Medicine
Phase 2
Phase 3
Clinical Medicine
Health & Society
Professional Development
Professional Development
Curriculum Renewal Update
March 2011
Overview
A curricular element that encompasses:
– An Area of Scholarly Concentration (AOSC)
– Professional Behavior and Moral
Reasoning/Medical Ethics (PBMR)
– Personal Awareness and Self-Care (PASC)
– Teamwork and Leadership (TL)
Accomplishments: November 2010
- Area of Scholarly Concentration task force:
Report on activities of other schools and
recommendations for FSM
- Professional Behavior and Moral
Reasoning Competency Committee:
Education and assessment blueprint
- Personal Awareness and Self-Care
Competency Committee: Education and
assessment blueprint
Progress: November 2010-March 2011
1. Convened sub-committees for four areas of
Professional Development.
2. Agreement on goals, teaching activities and
assessment strategies for Prologue/Phase 1.
3. Development of Pilot projects for Fall, 2011.
Broad Goals for Prologue/Phase 1...
•
DISCUSS basic theories of teamwork and leadership (TL).
•
ANALYZE team structure and roles for a team that they are
currently on (TL).
•
UNDERSTAND basic research designs in biomedical research
(AOSC).
•
DEVELOP a 4 year plan for an area of scholarly concentration in
research, education or community service (AOSC)
•
IDENTIFY, ANALYZE and JUSTIFY appropriate ethical and legal
choices in the care of patients and their families (PBMR)
…Broad Goals for Prologue/Phase I
•
IDENTIFY, ANALYZE, and JUSTIFY ethical choices in the
healthcare systems in which they work, including issues of
access to care and conflicts of interest (PBMR)
•
BEHAVE with honesty, integrity, respect, and compassion
toward all patients, families, students, faculty, and other
healthcare professionals (PBMR)
•
CREATE a 4 year plan for personal awareness and self-care
(PASC)
Pilot Projects for 2011…
1. Teamwork and Leadership:
- Course with Northwestern Center for Leadership
on teamwork & leadership for medical students
- Develop structure/ framework for team analysis of
a current team
2. Professional Behavior and Moral Reasoning:
- Develop new assessment for current ethics and
values course (M1)
…Pilot Projects for 2011
3. Personal Awareness and Self-Care:
- Develop guidelines for mentor/student 4
year plan for personal awareness and selfcare.
4. Area of Scholarly Concentration:
- Update medical decision-making (MDM)
course to reflect goal of developing a
research project/plan with a preceptor.
- Convene one regular AOSC interest group
to meet monthly.
Ongoing challenges and opportunities
• Integrate with Clinical Medicine and the
Patient Centered Medical Home:
– Opportunities for PBMR, TL, PASC
• Integrate with Health and Society: PASC
• Make one assessment “count” for multiple
competencies/curricular elements
CURRICULUM RENEWAL
100 faculty
15students
200faculty
25students
Sept 2009
Retreat
Oct 2010
Kick-Off
March 2011 Update
Sept 2011
Aug 2012
Phase 1
Plan Completed
Phase 1
Implementation
~April 2013
Phase 2
Implementation
~April 2014
Phase 3
Implementation
Curriculum Development
organization, content
113faculty
25students
Instructional Design to deliver content
Faculty Development to facilitate content delivery
Assessment Design to evaluate student learning outcomes
Curriculum Evaluation and Continuous Quality Improvement
Steering Committee
Student
Assessment
Science in Medicine
Subcommittees
Steering
Professional
Development
Synthesis &
Application
Modules
FAME
Prologue /
Foundations
Health
& Society
Faculty
Development
Curr Element Groups
Thread Subcommittees
Curriculum Outcomes &
Evaluation
Curriculum
Committee
Clinical
Medicine
Competency
Committee
Instructional Design
& Technology
AWOME
GHSL
FAME
Reactor Panels
Thanks
for your contributions toward a
the courage to
change
the imagination to create
the excitement and resolve to continue into
the resilience to
shared vision
recover
uncharted areas
from a mistake
http://goo.gl/L5oZK
http://twitter.com/#!/FSM_curr
Phase 1 Sequence of Science in Medicine
Modules
H/On Re/U
c
G
D/int
Re/U Endo
G
c
AO
C
D/int H/On
c
H/On Re/U
G
c
Endo
c
AO
C
D/int
Endo
c
AO
C
Break
AO
C
D/int
H/On Re/U
c
G
AO
C
D/int
H/On Re/U Endo
G
c
c
Endoc = Endocrine
Re/UG = Reproductive/Urogenital
H/Onc = Hematology/Oncology
D/Int = Dermatology/Phase 1
Integration
Competency-Based, Gateway Assessments with Portfolio Reviews
Spring Break
Gastrointestinal
Endo
c
Integration & Synthesis Module
Psychiatry/Behavioral Science
Neurology
Summer Break
Area of Concentration
Head & Neck, Ophthalmology
Spring Break
Musculoskeletal
Renal
C
V
Integration & Synthesis Module
SiM
CM
H&S
PD
C
V
Pulmonary
Prologu
e
Holiday Break
Variable module sequence