Retreat Year 1 Report

Retreat Year 1 Report

Foundations of Medicine and Core Systems Curriculum Retreat

February 5, 2004

Summary report from Foundations of Medicine (Year 1) Breakout Group discussion:    (prepared by Bob Bloodgood)

  1. We took as a premise that the Core Systems course work would end by March 15th (8-9 weeks earlier than is presently the case)

  2. We took as a premise that this loss in time would be accommodated by a mixture of cuts in what is now vacation time and cuts in what is now 1st year curricular material

  3. We recommend that no more than two afternoons per week be utilized for instructional activities in the 1st year.  This will most likely consists of: Semester 1: 1 afternoon per week for Gross Anatomy and 1 afternoon a week for PoM1.  Semester 2: 1 afternoon a week for PoM1 and 1 afternoon a week for the new Exploratory program.

  4. We recommend a 10 week summer period between the first and second years (compared to the current 12 weeks).  This was seen to allow students to participate in the summer research program for 8 weeks while still having a 1 week vacation period both before and after the summer research program.

  5. In order to have a 10 week summer period while accommodating a portion of the 2nd year cuts through lengthening year 1, we recommend that the end of Year 1 be extended by 2 weeks while the beginning of Year 2 is left as is.

  6. We recommend that the 1st year begin one week earlier than will be the case for Fall 2004.

  7. Recommendations 5 and 6 result in increasing the length of Year 1 by 3 weeks but only two of these weeks are a net gain (to be used against the 2nd year schedule cuts) because we recommend the addition of an extra week of vacation in the Spring of Year 1.

  8. Vacation: we recommend that the lengthened Spring semester of Year 1 contain two separate 1 week vacation periods, presumable to coincide with the end of the 1st and 2nd exam periods.

  9. There was a feeling that it would also be desirable to schedule a long weekend for the medical students after the first exam period of the Fall semester.

  10. Assuming that about 6 weeks of 2nd year instructional material were moved to Year 1 and assuming a 2 week net gain in instructional time in Year 1 (above), then approximately 4 weeks of instructional material needs to be cut from the current Year 1 material.  This would represent about 85-90 hours of instructional time.

  11. There was an extensive discussion of targeted versus across-the-board cuts in 1st year instructional time.  Philosophically, the group felt that all of the instructional cuts should be made in a targeted fashion, meaning carefully chosen instructional changes that would have the least negative impact on the curriculum and hopefully even represent improvements in the curriculum.

  12. Identification of targeted cuts and suggested curriculum changes.

    A list of suggested curricular changes from the interim report (to the Curriculum Committee) of the Foundations of Medicine and Core Systems Design and Development were discussed.  The co-directors of the PoM1 course (Dr. Gazewood and Dr. Bargmann) were present and volunteered changes to PoM1 that would yield a reduction in 10-20 hours for that course.  There were no other volunteered cuts made at the meeting; however, some Year 1 course directors were not represented.  The Group was supportive of a recommendation of the D&D Team to remove current overlap between the Human Behavior (Year 1) and Psychiatric Medicine (Year 2) courses.  Students acknowledged both that the Human Behavior course was well taught and well received but that it also had extensive overlap with Psychiatric Medicine.  The cuts were suggested to come from Human Behavior resulting in a trimmed down course that would focus on: communication, culture, families, life cycle, personality patterns, aging, loss and death and dying. This would probably yield another 10 hours.  These changes in PoM1 and Human Behavior would yield, at the very most, a quarter to a third of the 90 hours of cuts that would be needed under this group
    =s scheduling plan.

  13. The group liked the idea of moving immunology from Fall of the 2nd year into the 1st year and to integrate it with Medical and Molecular Genetics.  It was felt that this had the virtues of: 1) getting immunology earlier in the curriculum, 2) providing immunology background prior to the beginning of Pathology and 3) shaping better the background in molecular biology and genetics that is needed for the immunology material.  The immunology material would be staggered relative to some of the molecular and genetic material that needs to precede it. There was also some discussion about whether to integrate Medical and Molecular Genetics (which contains molecular biology that had previously been in the Biochemistry course) with the rest of Biochemistry, but there was not a clear consensus about that.

  14. There was feeling that, to the extent possible, Gross Anatomy should be protected by cuts.

  15. Although not germane to Year 1, there was a discussion of the Epidemiology course.  There have been at least three suggested changes floating around: 1) integrate with PoM2, 2) place within the 6 week Ainterim@ period after classes stop and Clerkships begin or 3) move to 3rd year in order to place the material in a more clinically meaningful context.  The feeling was that epidemiology was needed for USMLE Part I and hence should not be moved to the Clerkship period.  Obvious advantages were noted for integrating Epidemiology with PoM2.

Conclusion: While making some specific schedule and curriculum recommendations, the Foundations of Medicine breakout group did not identify anywhere near enough vacation and/or targeted curricular cuts to accommodate the curricular material proposed to be moved from Year 2 to Year 1.  This will necessitate some combination of the following: 1) more vacation cuts,  2) more targeted curricular cuts,  3) across the board curricular cuts.