Medical Doctor Program of Study
The four years of the medical curriculum comprise two years of pre-clerkship foundational instruction and two years of clinical clerkships, sub-internships and electives.
For a visual depiction of the curriculum, see this Curriculum Map.
Pre-Clerkship Years
Year 1
MED 810 - Coaching For Adaptive Learning
Course Goal: Cultivating and strengthening a growth mindset, seeing challenges as opportunities to learn, adapt, and grow is increasingly important to 21st century medical education.
In the Coaching For Adaptive Learning course students develop foundational knowledge and skills in self-regulation and adaptive learning. Self-regulation concerns self-initiated and self-monitored activities, practices, and behaviors that learners engage in to pursue academic mastery. Adaptive learners observe, appraise, and adjust their practices in response to learning challenges. Students will gain competence in habits of mind necessary for overcoming contemporary academic struggles, and which also foster lifelong learning in medicine. These habits of mind help students make connections between formal knowledge and experiential learning – including important skills of curiosity; engaging and building rapport with peers; leadership of self and others; external and self-appraisal that allows comprehension of gaps in knowledge or attitude and the need to change; personal and professional development-seeking to gain new expertise; giving and receiving feedback that enables oneself and others to thrive and excel; setting priorities and planning for learning; mastering time management; and balancing fulfillment of personal and curricular responsibilities.
MED 811 - Foundations of Medicine I
Course Goal: The goal of Foundations of Medicine (FOM) I is for students to achieve foundational knowledge in the medical sciences, with an emphasis on gaining a detailed understanding of common and representative illnesses. By the end of Year 1, students are knowledgeable in human biology and the impact that psychological, social, cultural and economic forces have on human health. They are able to discuss the epidemiology and prevention of major medical conditions. Knowledge gained in FOM I will be reinforced and expanded the following year in FOM II.
The course is divided into foundational and organ system blocks with horizontal and vertical integration across the blocks and with the Clinical Arts and Sciences and Scholarly Reflection and Concentration Capstone courses. The QU Netter longitudinal themes of pharmacology, nutrition, behavioral and social sciences, biomedical ethics and epidemiology are integrated throughout the curriculum as they relate to specific organs and diseases addressed in each block.
The course is taught through a variety of instructional methods including lectures, team-based learning, and small group events that use case-based learning activities. Dissection-based anatomy is integrated across all of the organ system blocks in the first year.
MED 812 - Clinical Arts and Sciences I
Course Goal: Clinical Arts and Sciences (CAS) I is an innovative introduction to clinical medicine course that aims to teach foundational clinical skills in a collaborative environment that entails experiential learning in both real and simulated clinical settings. Learners also begin the QU Netter longitudinal curricula in narrative medicine and ethics.
Foundations of Clinical Care (FCC): This curriculum is dedicated to clinical skills learning with active practice in small group settings of eight learners guided by two clinical faculty members. Learners actively practice patient-centered communication, history taking, and physical examination skills, as well as clinical reasoning, medical documentation and oral presentations. Basic procedural skills, telemedicine, and interprofessional activities centered around ultrasound training also provide significant experiential learning opportunities.
Simulated practice with standardized patients (SPs) is a major instructional method in FCC. Clinical skills are assessed by formative objective structured clinical examinations (OSCEs) and a summative OSCE. The course also promotes learners’ growth in professionalism and professional identity formation with self-assessments such as video review and goal setting opportunities, in addition to peer feedback and feedback from the SPs and faculty.
Medical Student Home (MeSH): In MeSH, learners spend one afternoon a week in the physician’s office-based practice. Students are paired with a practicing community physician with the purpose of providing each medical student with a supervised environment to practice the foundational clinical skills learned in FCC.
MED 813 - Scholarly Reflection & Concentration Capstone I
Course Goal: Scholarly Reflection and Concentration/Capstone (SRCC) is a four-year course focused on seven core domains: Evaluating Information Sources, Critical Appraisal of the Literature, Interacting with and Interpreting Data, Self-Reflection, Personalized Curriculum, Responsible Research Practice, and Scholarship.
SRCC allows learners to personalize their curriculum and prepare for scholarly endeavors during residency and future practice. Students design and execute a capstone project in an area about which they are passionate. Learners use narrative medicine and their experience of being mentored to develop personally and professionally. They gain both conceptual understanding and practical skills in research methods, epidemiology, medical informatics, biostatistics, evaluating information sources, and critical appraisal of medical literature. Information presented in the SRCC course is integrated whenever possible with material in the Foundations of Medicine and the Clinical Arts and Sciences courses, to enable learners to apply biostatistics, epidemiology and medical informatics to community and public health, medical literature interpretation and clinical decision-making.
Year 2
MED 821 - Foundations of Medicine II
Course Goal: Building on the foundation provided by the FOM I curriculum, the goal of FOM II is for medical students to attain essential knowledge and skills related to the pathophysiology and epidemiology of diseases. In addition, students develop a broad understanding of treatment paradigms for common medical disorders. The QU Netter longitudinal themes of behavioral and social sciences, biomedical ethics, epidemiology, pharmacology and nutrition are interwoven into curricular content in FOM II.
Problem-based learning (PBL) is a major instructional component in FOM II and integrates active and self-directed learning with the development of clinical reasoning skills in the assessment of patient histories, symptoms, signs and laboratory findings. Collaborative and professional participation in this activity are essential components of PBL.
MED 822 - Clinical Arts and Sciences II
Course Goal: Clinical Arts and Sciences (CAS) II continues the active, small group, and real and simulated community practice-based clinical skills curriculum begun in Year 1. Students build on skills from CAS I, where clinical reasoning and problem-focused history taking and physical exam practice becomes a greater emphasis. Preparation and readiness for the clerkship curriculum is a deliberate focus in CAS II, with sessions dedicated to different clerkship specialties and advanced communication skills including sharing medical information and delivering unwelcome news. CAS II includes FCC and MeSH curricular experiences.
MED 823 - Scholarly Reflection & Concentration Capstone II
Course Goal: Scholarly Reflection and Concentration/Capstone (SRCC) is a four-year course focused on seven core domains: Evaluating Information Sources, Critical Appraisal of Literature, Interacting with and Interpreting Data, Self-Reflection, Personalized Curriculum, Responsible Research Practice, and Scholarship.
SRCC allows learners to personalize their curriculum and prepare for scholarly endeavors during residency and future practice. Students design and execute a capstone project in an area they are passionate about. Learners use narrative medicine and interactions with their mentors to develop personally and professionally. They gain a conceptual understanding and practical skills in research methods, epidemiology, medical informatics, biostatistics, evaluating information sources, and critical appraisal of medical literature. The information presented in this course is integrated with material in the Foundations of Medicine and the Clinical Arts and Sciences courses to enable learners to apply biostatistics, epidemiology, and medical informatics to community and public health, medical literature interpretation, and clinical decision-making.
MED 830 - USMLE Step 1 Self-Study Review
Course Goal: Medical students pursue self-directed independent study with faculty support and resources in preparation for the USMLE Step 1 Examination. Students will (1) identify strengths, deficiencies and limits in knowledge of the pre-clinical medical sciences; (2) set specific, measurable, attainable, realistic and timely goals to plan for learning; (3) select, engage in and complete learning activities that address one's limits in knowledge of the pre-clinical medical sciences; and (4) reflect on learning progress using informed self-assessment and external feedback and adjust learning strategies accordingly. This course is a dedicated 6-week period during which no concurrent courses are scheduled.
Clerkship Years
Year 3
MED 839 - Longitudinal Multi-specialty Clerkship (LMC)
LMC Goals: The LMC experience provides Year 3 clinical clerkship education in six core areas (internal medicine, obstetrics-gynecology, pediatrics, primary care, psychiatry and surgery) over a 44-week period. The LMC consists of two 22-week Clusters. Each cluster consists of 20 weeks of clinical learning and a 2-week period devoted to focused study and the NBME subject exam.
Cluster A consists of four 5-week blocks that encompass internal medicine, primary care and surgery and Integrated Block A (IB-A). IB-A provides two 2-week blocks of clinical experiences in additional specialties and subspecialties including anesthesiology, radiology, neurology and medical and surgical subspecialties. The middle week of IB-A consists of virtual educational activities related to imaging, reflective writing and health equity, and two unscheduled days (Monday and Friday) for wellness and self-directed learning.
Cluster B consists of four 5-week blocks that include obstetrics-gynecology, pediatrics, psychiatry and Integrated Block B (IB-B). IB-B consists of a week of newborn nursery, a week in a subspecialty in obstetrics-gynecology, psychiatry and/or pediatrics, and three weeks dedicated to work on students’ SRCC capstone project.
Scheduled learning activities include academic sessions designed to promote application of knowledge and enhance clinical reasoning. Academic sessions include:
- Academic Half Days – Core sessions in the specialty block with some cluster wide sessions integrating the three cluster disciplines.
- Teaching Attending Sessions – Small group sessions focused on enhancing clinical reasoning
- Longitudinal Clinical Clerkship Curriculum (LC3) – Cross-cutting sessions which include sessions in health equity, narrative medicine and diagnostic reasoning in radiology.
Assessment of students includes clinical evaluations by preceptors, direct observation with feedback, teaching attending evaluations, national board (subject) exams, self-assessments, objective structured clinical exams (OSCEs) and additional specialty-specific assessments. Students receive regular feedback throughout each clinical block and take practice shelf exams. Students receive two weeks of dedicated study time at the end of each cluster to prepare for the specialty-specific subject exams. All students are required to take the USMLE® Step 1 exam before starting their Year 4 clinical rotations.
Year 4
Students complete a four-week required selective in emergency medicine or critical care, a four-week sub-internship in family medicine, internal medicine, obstetrics-gynecology, pediatrics, psychiatry or surgery, and electives of their choosing. Students also complete and present their Capstone project and take the USMLE® Step 2 Clinical Knowledge examination. There is ample time to meet with career advisers and work on residency applications and interviews during this year. At the end of Year 4, there is an optional residency prep course to ensure readiness for internship.
MED 841 - Emergency Medicine
Selective Goals: In the four-week Emergency Medicine selective students learn to gather information, formulate differential diagnoses, and propose evidence-based management for patients with common presentations in an emergency department setting. They also learn to recognize emergent medical conditions and initiate a stabilization plan as well as demonstrate proficiency with basic procedural skills. By the end of the selective, students are expected to demonstrate knowledge in managing the following conditions: chest pain, shortness of breath/respiratory distress, abdominal/GI emergencies, fever/infections/sepsis, endocrine/electrolyte emergencies, altered mental status, trauma, intoxication, psychosis/agitation, stroke/TIA, critical patients requiring ACLS and pediatric acute concerns.
MED 842 - Critical Care
Selective Goals: In the four-week Critical Care selective, students learn to gather information, formulate differential diagnoses, and propose evidence-based management for patients with common presentations in an intensive care setting. Students learn to provide direct care to patients with critical illness and injury, including life-threatening multi-system organ failure. By the end of this rotation, students are expected to demonstrate knowledge in managing the following conditions: shock, acute respiratory failure, acute renal failure, acute GI hemorrhage, diabetic ketoacidosis/hyperosmolar hyperglycemic state, strokes/seizures, sepsis, healthcare associated infections, and end of life care/delirium. They also learn the skills of resuscitation, laryngoscopy and intubation techniques, ventilator management and basic bedside procedures.
MED 843 - Scholarly Reflection & Concentration Capstone III & IV
Course Goal: Scholarly Reflection and Concentration/Capstone (SRCC) is a four-year course focused on seven core domains: Evaluating Information Sources, Critical Appraisal of Literature, Interacting with and Interpreting Data, Self-Reflection, Personalized Curriculum, Responsible Research Practice, and Scholarship.
In Years 3 and 4, students use short, dedicated periods of time to focus on completing and disseminating their capstone projects.
MED 844 - Internal Medicine Sub-I
Sub-I Goals: In the four-week Internal Medicine Sub-Internship, students provide autonomous patient care to hospitalized patients to develop competence and readiness for clinical practice as an intern. Students are an integral part of the team and actively participate in care transitions for patients including admission, transfer between services, sign-outs between various teams, and discharge from the hospital, as well as cross-coverage roles. At the end of the Internal Medicine Sub-Internship, students are expected to be able to gather information, formulate differential diagnoses, and propose evidence-based management for patients with common conditions in an inpatient care setting, including but not limited to the following: atrial fibrillation, COPD/asthma exacerbation, acute/chronic/end stage renal disease, electrolyte disorders, community acquired pneumonia, GI bleed, stroke and alcohol withdrawal.
MED 845 - Pediatric Sub-I
Sub-I Goals: The Pediatric Sub-Internship is a four-week inpatient experience (3 weeks of days, 1 week of nights) that serves as a bridge between the Pediatric Clerkship and Pediatric Residency. During this rotation, students will be acting in the role of an intern with few exceptions. They will acquire the skills to perform efficient histories and physicals, while balancing the acuity and multiple priorities of an inpatient unit. Students will formulate a differential diagnosis, implement a therapeutic plan, communicate effectively with patients, families, and the team, and engage in self-directed learning. By the end of the sub-internship, students are expected to describe the epidemiology, pathophysiology and clinical findings, and implement the diagnostic evaluation and management of common pediatric conditions that require hospitalization.
MED 846 - Surgery Sub-I
Sub-I Goals: The Surgery Sub-Internship is a four-week inpatient based experience designed to help students develop the knowledge and skills required to diagnose and to manage surgical conditions at the level of a surgical intern. The primary focus of the Surgery Sub-I is to foster student development through direct patient care, exposure to increased complexity of patient conditions, and self-directed learning. Students are expected to formulate comprehensive assessments, diagnostic and therapeutic plans for common acute and chronic surgical conditions, demonstrate the ability to perform common and necessary surgical skills and work collaboratively to coordinate surgical patient care in a variety of healthcare delivery settings.
MED 847 - Family Medicine Sub-I
Sub-I Goals: The Family Medicine Sub-Internship is a four-week primarily inpatient experience, blended with a few half days of outpatient experience, to develop competence and readiness for clinical practice as a family medicine resident. Students participate in care transitions for hospitalized patients including admission, transfer between services, sign-outs between various teams, and discharge from the hospital, as well as cross-coverage roles. Students are expected to provide high-value, evidence-based care for patients with common family medicine conditions including, but not limited to, abdominal pain, acute kidney injury, chest pain, congestive heart failure, diabetes mellitus, electrolyte imbalance, hypertension, sepsis, shortness of breath and urinary tract infections.
MED 861 - OB-GYN Sub-I
Sub-I Goals: The Obstetrics & Gynecology Sub-Internship is a four-week experience either on the Maternal Fetal Medicine (MFM) or the Gynecology Oncology service. Students work in both inpatient and outpatient settings and participate as an integral member of the team. Students on the MFM service learn about the care of high-risk ob-gyn patient conditions including but not limited to: gestational diabetes mellitus, fetal macrosomia, premature rupture of membranes, critical care in pregnancy, multifetal gestation, fetal aneuploidy and prenatal diagnosis of genetic disorders as well as learn ultrasound in pregnancy. Students on the Gynecology Oncology rotation learn about the care of patients with gynecology malignancies including symptoms, presentation and diagnosis; treatment and outcomes, including pelvic surgery, radiation and chemotherapy; and post-operative, inpatient and outpatient management. During this sub-internship, students improve their basic procedural and surgical skills to prepare them for internship.
MED 862 - Psychiatry Sub-I
Sub-I Goals: The Psychiatry Sub-Internship is a four-week experience designed to give medical students an opportunity to integrate their academic knowledge and clinical experience into practice on both the adult and child/adolescent inpatient units. The goal is to provide future physicians the opportunity to treat a variety of patients with a diverse range of mental illness to develop competence in diagnosing and treating mental illness across the spectrum. By the end of this sub-internship, students will be able to develop an empathic doctor-patient relationship, conduct a clinical interview and perform a complete mental status exam, apply basic science knowledge of neurobiology and psychosocial experiences in the pathogenesis and treatment of psychiatric illnesses, formulate a diagnosis based on DSM-V, understand the different treatment approaches of major psychiatric syndromes, and practice as an effective team member in a multi-disciplinary team.
Electives
Students take a minimum of 28 weeks of electives. Electives can be taken at the QU Netter School of Medicine or as away rotations. Elective choices encompass diverse clinical learning experiences, research electives, as well as skills development in areas such as teaching or leadership. Students may design custom electives under the guidance of the Year 4 Electives Director. Electives in global health are also available, including an exchange program in neurology with Oxford University in the UK. Students are assisted in the selection of electives and the design of their fourth year curriculum by career advisers, specialty-specific advisers and the Student Affairs deans.