The evolution of UMass Medical School’s new medical student curriculum continues following unanimous approval of the third year of the Learner-centered Integrated Curriculum (LInC) by the Educational Policy Committee yesterday. The LInC Core Clinical Experiences (CCE) model will begin in 2012, with third-year medical students rotating through three coordinated 16-week clinical sections, each of which highlights an important theme—Care of Adults, Perioperative and Maternal Care, and Care of Families. Each thematic section has basic science section leaders whose responsibility is to work with the clerkship directors to integrate basic science materials in a thoughtful and clinically relevant manner throughout the section.
“This new model is exciting because it combines the traditional clerkship disciplines into coordinated sections, led by both clinicians and basic scientists, which allows for specific linkages to the foundational curricula of years 1 and 2, and threaded longitudinal curricula on themes such as professionalism, quality improvement and health care systems,” said Melissa Fischer, MD, MEd, associate professor of medicine and associate dean for undergraduate medical education. “We’ve also integrated our new learning communities structure throughout and worked with the Graduate School of Nursing to bring more interprofessional training into this clinical year.”
The Care of Adults section of CCE includes two 4-week inpatient medicine rotations—one at UMass Memorial Medical Center University campus and the other at a community hospital—to provide students with a diverse hospital-based experience. It also includes a five-week section shared by neurology and adult primary care. This pairing allows for coordinated teaching of shared content in these two areas, as well as discipline-specific teaching. Students will split these last five weeks between a general internal medicine office or clinic, and inpatient and outpatient neurology settings. As in all CCE sections, assessment of skills will include performance-based, objective structured clinical exams.
The Perioperative and Maternal Care section is divided into two 4-week surgery rotations and one 5-week obstetrics/gynecology rotation. The perioperative portion will teach students how to recognize and diagnose common surgical diseases, as well as the basic science concepts pertaining to surgical disease and management of surgical patients, and introduce them to surgical procedures and techniques. In the maternal care rotation, students will become familiar with routine prenatal care and management of common obstetric complications, as well as medical and surgical treatments for infertility, cancer, incontinence and women’s health throughout the reproductive cycle. As with all CCE sections, students will have opportunities for both formative and summative assessment, skills-development through simulation training, and direct observations by faculty.
The Care of Families section includes five-week rotations in psychiatry, pediatrics and family medicine, with emphasis on areas such as maternal depression, delirium in elderly patients and adolescent substance abuse; domestic violence, nutrition and exercise across the life span and treatment of depression in primary care; and treatment of ADHD in children, reporting of child abuse and neglect and adolescent risk assessment. Coordinated didactic sessions will focus on areas of overlap between these disciplines, providing additional longitudinal opportunities.
Threaded throughout the year, a new “interstitial curriculum” will provide developmentally appropriate threaded content. Interstitial days will allow for focus on important topics that cross all disciplines, interprofessional education, learning communities and journal club sessions.
“We’re very excited that this CCE model includes a self-directed learning month that allows students to identify their own learning needs and fulfill them through four one-week-long elective blocks in their third year. Combined with an early start to CCE in May of the academic year, this allows students significantly more elective choice earlier in their education to better support their career development and residency planning,” said Dr. Fischer.
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