The Practice and Science of Medicine
At the University of Virginia, we believe that art and science should be blended in medical education. Our mission is to confer scientific knowledge and skill and to convey an appreciation of the interpersonal qualities of comfort, care and understanding essential for a complete physician-patient relationship. Humanism in medicine and biomedical ethics are emphasized in the context of clinical cases.
Throughout the four years, the curriculum combines the practice and science of medicine. Patient contact begins early in the first year and increases throughout the four years. The curriculum is a thoughtful balance of large lecture courses, problem-based small-group activities, hands-on laboratories, and hospital and community-based clinical experiences. At the center of the curriculum is the patient, the science of medicine, and the physician’s role in improving the health of individuals and communities. A variety of modalities, e.g. lectures, small case discussion groups, self-study notes, text or computer-based materials are provided to accommodate students’ varying learning styles.
Cells to Society: An Introduction
In the first three days of medical school at the University of Virginia, students take a mini-course called Cells to Society. The course examines one disease from the cellular level, to the patient, to the societal impact of the disease. Students interview patients, visit research labs, attend a resource fair, and develop presentations for their classmates on various aspects of the disease – from cells to society. Students also experience the different types of learning situations they will experience throughout medical school: patient interactions, lectures, small group discussion, clinical problem solving, and self-chosen projects. The course is a model of the entire curriculum with its emphasis on all aspects of the physician’s role in patient care - from cells to society.
Foundations of Medicine
In the first year, students develop an understanding of normal human biology and its relationship to the practice of medicine. Instruction in physiology, histology, genetics, biochemistry, anatomy, and neuroscience present the scientific core of the physician’s knowledge base. At the same time, the students’ advancing scientific knowledge is integrated with clinical applications in the Practice of Medicine-1 course. The course is taught in small groups of six students with two faculty members. Students interview patients in hospitals and in other health care settings and learn to take patients’ histories and conduct physical examinations.
During the first or second semester, students are placed for 30 hours of service learning with a community organization as part of the Social Issues in Medicine course. Students learn about the social, economic and cultural context of the practice of medicine and identify and understand the interrelationships between the socio-cultural environment and the occurrence, prevention and treatment of disease. Students also identify and begin to nurture the values that characterize a humanistic practice of medicine and an ethic of service.
First year students are also involved in the Patient Clinician Encounter Program where they work individually with clinicians and patients in clinics and the hospital.
The Foundations of Medicine Program ends in April, and there is a May Term which begins the Core Systems Program. After the May Term there is a summer break. Many students participate in a research project during the summer period.
The coordinating theme of the Core Systems Program is provided by the problem-based course, Practice of Medicine-2. This course consists of clinical case studies which students solve in weekly small group tutorials of six students led by a physician. During the year, students also work on a one-to-one basis with physicians to develop their skills in taking medical histories and conducting physical exams. Other courses such as epidemiology, introduction to psychiatric medicine, microbiology, pathology and pharmacology are coordinated with the Practice of Medicine-2 course to emphasize the clinical correlations between medical science and clinical practice. The organization is by organ systems, i.e., cardiovascular, endocrine, gastrointestinal, infectious diseases, pulmonary and neurological.
The Core Systems program ends in March of the second year. There is a month break before clerkships begin in May.
Beginning in May of their second year, students take 40 consecutive weeks of core clerkships in family medicine, internal medicine, neurology, obstetrics and gynecology, pediatrics, psychiatry, and surgery. There is extensive direct contact with patients. Students work with a well-balanced patient population, which includes primary, secondary, and tertiary care. Teaching is related to the patient on rounds and in small tutorial seminars, lectures and group discussions. Emphasis is given to the principles of prevention, diagnosis, treatment, and the continuing integration of clinical medicine with medical sciences and the psychological factors which influence health.
Students work in small groups and rotate among many clinical services, gaining practical experience under supervision in the wards and outpatient clinics of the University of Virginia hospital, the Roanoke Memorial Hospital, the Veterans Administration Medical Center in Salem, Virginia, Western States Hospital, and Fairfax Hospital in Northern Virginia. The teaching programs at the affiliated hospitals allow students to observe the practice of medicine in multiple settings and gain exposure to a somewhat different spectrum of illnesses than that seen at the University of Virginia
Two months of clerkships are devoted to ambulatory family medicine and internal medicine. Students work individually in physicians offices in medical practices throughout Virginia. In addition, students return to the University during these clerkship months to participate in workshops taught by UVA faculty such as information mastery, motivational interviewing, point-of-care clinical problem-solving and EKG reading.
The Core Clerkships end in February of the third year, and the Selective and Electives Program runs for the final 15 months of the medical school curriculum.
Selectives and Electives
The selectives and electives program allows students to pursue their own interests. Under the guidance of a faculty advisor, students choose clinical rotations, basic science and humanities electives, and research activities. Students chose from a menu of selectives in internal medicine, obstetrics and gynecology, psychiatry and surgery. An advanced clinical elective, or acting internship, is required, Clinical rotations are available at sites in Roanoke, Salem, Fairfax, and Charlottesville. Programs are tailored to meet individual interests and needs, including a selection of programs in other domestic and foreign settings, in appropriate community medicine programs, or in other activities of suitable educational merit.
Two additional courses, Basic Science for Careers and RxDx: Health Care System, prepare students for future practice,.
In the Selectives and Electives period, there are 12 weeks of selectives, 32 weeks of electives including the Advanced Clinical Elective, and 4 weeks of the two courses listed above. Students also have ample time and opportunity to explore career options.
For more information, see the Curriculum web site: http://www.healthsystem.virginia.edu/internet/som-curriculum/
Medical Student Research Programs
Medical students are encouraged to participate in the research programs of the School of Medicine. There is an active summer research program following the first year of medical school, and further research activities are available thereafter during elective periods.
Medical students may also elect to extend their medical education to include a year of basic science or clinical research without paying additional tuition. A research proposal outlining the hypothesis for the project, methods, and a time schedule must be approved by a research supervisory committee. The student will present the initial proposal and a final report in the format of a scientific paper. Recognition for the research will appear on the student’s transcript.
Time Limit for Completion of the M.D. Degree
Students must complete the requirements for the M.D. degree within six years of matriculation in the School of Medicine.