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Pre-Clinical Curriculum Component II
Within each sequence, detailed consideration is given to the physiology of a particular organ system, the pathology of important diseases of that system, immunologic and microbiologic aspects of those diseases, and the pharmacologic approach to them. Course material is presented in a variety of formats, including case presentations, lectures, small group discussions, laboratory sessions, computer exercises, and a range of student-centered exercises. Occasional quizzes continue in Component II, however, each quiz is focused on the sequence taught at that time. At the end of each sequence a final exam is administered. The grading scale in the second year is Honors, High Pass, Pass and Fail. Each sequence is graded separately and grades are based on quizzes and exams. Following are the second-year sequences, in the order they are completed by the students. Infectious Diseases
(I.D.): (4 weeks). Having mastered the basics
of microbial life in the first year, students start immediately reviewing
the vast array of bacteria, viruses and parasites that play a role in
human disease. The microbiology of each organism is examined in concert
with its manifestations in the human body and treatment. Lectures are
complemented by small discussion groups facilitated by infectious disease
experts, hands-on laboratory experiences to gain necessary skills in culture
and staining techniques, and a computer practicum to master vaccinations.
The ID sequence serves as the foundation for infectious processes in every
organ system to be studied throughout the second year. Hematology: (3 weeks). Among the topics studied are anemia, leukemias, lymphomas, blood dyscrasias and solid organ tumors. Lectures are complemented by small-group discussions led by hematology and oncology experts in which patient cases are discussed. There are also laboratory sessions in which students master the skills of deciphering a blood smear and recognizing the histopathology of cancers. Oncology: (1 week). The molecular basis of neoplasia and fundamental principles of tumor cell biology are presented in a patient-focused format. Lectures are combined with patient presentations and case-based pathology laboratories. Cardiovascular: (3 weeks). A brief review of cardiovascular physiology precedes this series of presentations on essentials of cardiac pathology. Topics studied include congestive heart failure, arrhythmias, valvular disease, atherosclerosis, hypertension and shock. Pharmacologic therapy and histopathology complete the sequence. Computer simulations assist the students in an introduction to learning heart sounds and electrocardiography. Respiratory: (2 weeks). Directed by a faculty member who invented ECMO (extracorporeal membrane oxygenation), the respiratory sequence focuses on disease states in the respiratory system, including asthma, lung cancer, chronic obstructive pulmonary disease, cystic fibrosis and adult respiratory distress syndrome. The basics of mechanical ventilation are discussed and important skills including analyzing blood gas values are introduced. Laboratory sessions complete the histopathology portion, and students spend a day in the hospital, rotating through intensive care units and pulmonary function labs where they gain experience with the clinical relevance of the material studied in the sequence. Renal: (2.5 weeks). Students learn about the characteristics and mechanisms of renal disease including such diseases as lupus, glomerulonephropathies, renal cell carcinoma and nephrolithiasis. A brief introduction to urologic disease is also included. Histopathology slides are available on the internet and complement the laboratory sessions. Dermatology: (1 week). One of the goals of this sequence is to expose the students to a broad array of skin diseases and dermatologic manifestations of systemic disease. Lectures are complemented by laboratory sessions and a very popular session in which students rotate through clinical examination rooms, meeting patients with dermatologic symptoms and conditions. With each patient is a dermatology faculty member who explains the patient's skin manifestations. Gastrointestinal: (2.5 weeks). Topics include gastroesophageal reflux disease, gastric colon and esophageal cancers, diarrheal diseases, inflammatory bowel diseases and others. Small group discussions reviewing case studies with gastroenterology faculty and histopathology lab sessions are integral parts of the sequence. Neurosciences: (7 weeks). The sequence begins with a review and expansion of neurophysiology topics. Laboratory sessions begin with a more in-depth study of neuroanatomy, which was initially studied in the first-year anatomy course. Preserved specimens, plastinated specimens and extensive computer programs are all available for study in addition to laboratory exercises mentored by neuroanatomy faculty. The sequence progresses to cover neurologic diseases such as stroke, aneurysms, cancers, and degenerative processes. A significant part of the sequence focuses on psychiatry. A “special senses” (hearing and sight) section of the course finishes the sequence. The laboratory sessions conclude with a review of the histopathology of the spectrum of neurologic disease. Endocrine: (2 weeks). Topics studied include thyroid disease, parathyroid disease, diabetes and growth hormone disorders. Lectures are complemented by extensive small-group sessions with endocrinology faculty in which case studies are discussed. Histopathology laboratories complete the curriculum. Reproduction: (2 weeks). Students study normal reproduction, building upon the foundation presented in the first-year Embryology course. Infertility is discussed in addition to various gynecologic diseases. Histopathology is presented in the laboratory sessions. Musculoskeletal: (2 weeks). Topics presented include rheumatologic disease, degenerative myopathies, and cancer of the musculature and skeleton. Histopathology is covered in the laboratory sessions. Students learn a detailed rheumatologic exam in afternoon sessions tutored by trained patients with rheumatologic disease. The program, which has received national recognition, is rated very highly by the students. Introduction to the Patient (ITTP): (all year). In the second full year of this course students master the complete history and physical examination under the tutelage of individual clinical faculty who serve as clinical skills instructors. Classic cardiac and pulmonary findings are demonstrated using ambulatory patients. Male genito-urinary and female pelvic examinations are taught with the help of simulated patient instructors, who are individuals trained to portray patients in scripted encounters with medical students. Topics related to medicine and society, sexuality, behavioral medicine, and violence in society are also presented and discussed. Multidisciplinary Conference (MDCs): (throughout the year). Each Friday during Component II multidisciplinary conferences are presented by faculty from numerous departments to enhance and place in a clinical context the content learned during the week. Conferences are presented in a variety of active formats, including case presentations and panel discussions. Simulated Patient Instructor Sessions: The UM Medical School has a four-year longitudinal program of clinical skills instruction using simulated (also known as standardized) patient instructors (SPIs) with whom medical students interact throughout medical school. SPIs are non-physicians who are trained to play a patient role in encounters with medical students, and who then provide feedback to the students. These encounters are generally one-on-one but can occur with small groups of students. Medical students meet with SPIs in progressively demanding encounters designed to teach them content and process skills, and communication skills they will need to provide efficient and appropriate health care to patients. Some of the encounters are:
Medical students have prepared the following descriptions of the Component II year and sequences and experiences. |
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(c) copyright 2003 Regents of the University of Michigan |
There
are no departmental courses in Component II.The year is organized into
twelve organ system and disease-based sequences, each of which is planned
and taught by an integrated multi-disciplinary planning team. The sequences
are presented one at a time so that students can focus on a particular
system before moving on to the next. Pathology lab sessions run concurrently
with class and small-group activities and focus on content carefully correlated
with the sequences. 