In an effort to best prepare our graduates to work in the 21st Century health care environment, we are transitioning to a new curriculum called “The 3 Pillars of Medicine.” In the first pillar, students will learn the human science basic to medicine integrated with patient cases and regular patient care experiences. Pillar 2 is where students learn core aspects of clinical medicine (family medicine, pediatrics, internal medicine, surgery, psychiatry, obstetrics/gynecology, and neurology) in a new format called “longitudinal integrated clerkship.” The third pillar, Physician Scholar, is a capstone opportunity for students to pursue excellence in clinical medicine, research, and other important professional competencies.
What is a longitudinal integrated clerkship?
The longitudinal integrated clerkship (LIC) is where, instead of spending eight weeks in a block clerkship and then moving on the next, students do all clerkships simultaneously. Simply put, they spend a half-day per week in each discipline. What happens is that students are able to learn clinical and professional skills to a deeper level because they are applying concepts in multiple settings at once, they can establish longer relationships with patients and are able to participate in their care for the course of an illness or pregnancy, and they will establish longer relationships with faculty and experience more meaningful mentoring. The University of South Dakota Sanford School of Medicine has designed a year-long clinical education experience that begins with short clerkship blocks primarily focusing on hospital care, followed by nine months of longitudinal integrated clerkships.
When does the new curriculum begin?
The new curriculum is being phased in beginning in July 2013 for incoming first year students. The new LIC 2nd Pillar is also starting on the Sioux Falls and Rapid City campuses in 2012. The Yankton, S.D., campus was one of the first programs across the nation to develop an LIC and has been using the format for over twenty years.
What makes the new curriculum better?
An important Carnegie Foundation report in 2010 criticized medical schools for being too passive, too long and too inflexible. "Educating Physicians: A Call for Reform of Medical School" and Residency" (Cooke M, Irby DM, O'Brien BC) recommended schools offer more integration in content rather than individual courses, foster habits in scientific inquiry, lead to better professional identity formation for new physicians, and allow students to individualize their learning. These four "I’s" (integration, inquiry, identity, individualize) are key aspects of our new curriculum. As a result of the change, students will identify with their physician role earlier and achieve higher clinical skills by the end of medical school.
Are other medical schools changing their curriculum like this?
Yes, many schools are revising their curriculum in similar ways. We have a history of excellence and innovation in education and our leaders have also visited other schools to learn the very best methods.
Does Sanford School of Medicine (SSOM) have experience in delivering integrated basic science courses? What are the results?
Yes, we have been gradually integrating our course delivery for the past decade. Our students continually perform at or above the national mean on their national board exam.
Does SSOM have experience in delivering the longitudinal integrated clerkship? What are the results?
Yes. We have been using the LIC for more than two decades on our Yankton campus. LIC students perform more independently than other students, are usually more involved in patient care by the end of the program, and perform equally well on national exams.
Do any other institutions use or plan to use the LIC?
The Yankton LIC program has been a model used by many other institutions. Visitors to the campus include medical school leaders from Texas, Colorado, Kansas, North Dakota, Georgia, Arkansas, Florida, California, West Virginia, Missouri, Ohio, Minnesota, Ontario, and China.
I heard SSOM has excellent board pass rates, high scores on the national USMLE board tests taken by medical students, excellent residency placements, and is recognized as a top 10 school in several areas. Will this continue?
Yes, the school will continue to uphold high standards as one of the nation’s best medical schools, and our students have a reputation for being trustworthy, hard-working, and highly skilled in patient care. While other medical schools in the country are revising their curricula, SSOM has the additional history of having successfully delivered the longitudinal integrated clerkship model with excellent results.
When will I see my first patient?
You will see your first patient in the first few months of medical school. By the middle of your first year, you will be experiencing patient care a half-day every week. By the end of your second year, you will have a panel of patients that you help to care for.
Give me some more details. Will there still be basic science training?
Pillar 1 will be eighteen months of integrated basic science in which students will learn anatomy, biochemistry, physiology, microbiology, pathology and pharmacology interwoven into organ-system blocks, such as cardiovascular and gastrointestinal. Education research shows that students learn and retain basic science better when they can apply it to patient care early in their education.
I want to be a primary care physician. How will the new curriculum help me?
The medical school’s curriculum has always emphasized the core skills for a primary care physician and aligns with the school’s mission to provide physicians for South Dakota. The new curriculum will promote further excellence in patient care and guide you to be a better leader in health care.
I want to be a specialist physician (cardiologist, surgeon, etc). How will this help me?
Students at SSOM have always enjoyed excellent access to specialist physicians where they get hands-on exposure to many specialties of medicine. The new curriculum will allow more flexibility in your schedule and earlier opportunities to do unique electives in a wide variety of clinical and research areas.
I’m not sure what I want to do. Will the 3 Pillar curriculum allow for electives?
Elective opportunities will occur earlier and more often, so that you can experience possible career choices early enough to make an informed decision.