In anticipation of any questions current and prospective students and faculty may have had about the curriculum transformation at the time of the June 2015 faculty vote, the Curriculum Policy Committee created the following list of Q&As.
We acknowledge that UMMS graduates are finding success in matches and receiving good feedback from residency programs. We anticipate that the directed professional development portion of the new curriculum (Branches) will extend the competitive advantage of our graduates in this respect even further. We also have to acknowledge that health care is in need of change, and medical education has the responsibility to produce the physician leaders capable of leading change in health care.
The new curriculum is designed to graduate physician leaders who can affect positive change in health care. There are four major aspects to the curriculum that contribute to the development of an excellent physician who is also oriented toward leading change.
- Scientific & Clinical Foundation. Focuses on foundational scientific knowledge and clinical experiences. Also develops learning and thinking skills for students to be lifelong learners.
- Longitudinal Learning Community. Supports the development of the student’s clinical skills and professional identity within a small-group, mentored learning environment.
- Directed Professional Development. Provides meaningful choices and learning experiences based on the professional direction of the student.
- Applied Leadership Education. Prepares students for leadership in the general clinical environment and for specialized contexts (e.g. health care policy).
The new curriculum has a fundamentally different structure from the current curriculum. So it's hard to compare them side-by-side. For example, the new curriculum will teach science in all (four) years, with the content adaptive to the clinical direction of the student. Also, there will be more foundational clinical experiences up front to set the context for learning within medicine.
No. Science is a cornerstone to modern medicine, and the School is committed to the learning of science and scientific thinking. It is important in the learning of science not to focus solely on memorizing facts. With the explosion of scientific knowledge, we must also develop the ability to access and manage information. In the new curriculum, science will be taught every year (not only in the first two), with the opportunity to deliver scientific content relevant to the professional and developmental context of the student.
In developing physician leaders, it's very important for students to develop strong professional identities and to make meaningful choices of professional direction. The early portion of the curriculum will focus heavily on providing the experiences and the mentoring support needed to make informed choices. Students will have the some flexibility to change “Branches” if they so choose.
At the beginning of 2013, the School began the process of developing a forward-looking curriculum that will allow our graduates to thrive in the rapidly changing health care environment. We have been implementing small-scale educational innovations as a part of this effort. We have identified a suitable curricular model and are designing the structures and content within the model.
Students who matriculate in 2015 will have a similar architecture to the current curriculum. The major architectural changes to our program will begin in 2016 and be progressively changing over the ensuing 3 to 4 years.
With this new proposed curriculum, we believe every medical student who graduates from the University of Michigan will be able to lead change in health, health care, and health care science. Leadership for our students encompasses being able to work effectively in teams, communicate at all levels and provide influence, problem solve, and understand and navigate health care systems. The capabilities of the graduate will continue to center on an outstanding foundation of knowledge and skills, with a demonstrated commitment and excellence in patient care. In addition, the graduate will develop the habits of lifelong learning, driven by a passion for inquiry and discovery. Learn more about our vision for the graduate.
The primary differences are threefold:
- The new curriculum has 8 different components, as opposed to only a preclinical and clinical phase;
- The new curriculum provides an integrated foundation in the first two years, with both science sessions in the clinical setting, and early clinical experiences from day one that will drive learning;
- The new curriculum provides opportunities for students to rigorously explore their interests and passion in depth through Professional Development Branches and Paths of Excellence, progressing at a flexible pace that is determined by their capabilities and specific achievement toward the goals of graduation.
See current curriculum diagrams.
Leadership events, initial Paths of Excellence, and an interprofessional course have been put in place the past two years. In fall 2015, we launched the M-Home and new Doctoring course, new Paths of Excellence, Initial Clinical Experience (now Interprofessional Clinical Experience) for M1s, and an early version of the learning Portfolio. The newly renovated medical education center in the Taubman Health Sciences Library also opened. The structure of a 2-year preclinical and 2-year clinical curriculum will remain in 2015. In August 2016, the proposed new structure with a foundational Trunk of integrated science and clinical experiences will launch, accompanied by expanding Leadership and Paths of Excellence programs, a new Assessment system, a maturing M-Home, and more Interprofessional Education offerings. The second year of the Trunk will be implemented in September 2017, and the full set of Professional Development Branches will be offered in Fall of 2018.
Absolutely not. The approach to the new curriculum will be competency-based, meaning that students will be able to graduate from medical school after they have not only completed requirements, but also can show that they are ready to enter supervised practice in residency. This will be done through the measurement of their capabilities through assessments that are based on what is expected to enter a profession, and what students must be able to do on day 1 of residency. We fully expect that the majority of students will be able to complete their requirements in 4 years, but some may be able to finish in 3.5 years, and some may require longer than 4 years.
No. Science is a cornerstone to medicine and the School is committed to the learning of science and scientific thinking in all phases of the new curriculum. The new curriculum will teach science in all years with the content adaptive to the clinical direction of the student, with an added emphasis on developing the ability to access and manage information. Science instruction will happen in both the Trunk and Branches. Students will develop a foundation of scientific understanding in Year 1 of the Trunk in lectures and small groups. This progresses to specific scientific learning that is driven by clinical experiences in Year 2 through seminars and small-group sessions. Students will then deepen their understanding of the science in the clinical setting as they develop through their chosen Branch, encountering science-specific rotations, performing research, and being deliberately taught about the scientific underpinnings of illness in their subinternships and bootcamps.
Foundational Science experiences initially occur in the Scientific Trunk (Year 1 of the curriculum), beginning in August 2016, lasting through September 2017 (13 months total). After an Overture (where students begin the year with 2 weeks to experience their learning community and the health system), students will encounter a sequence of “building block” courses, including Science Foundations, an Introduction to Diagnostics and Therapeutics, and an Immunity and Defense course. Students will work through organ system-specific “fused” courses where science is presented in the context of normal and abnormal processes. Finally, these courses will be interspersed with Chief Complaint modules, part of a year-long course where students will dive into clinical problems that stimulate clinical reasoning, inquiry habits, and application of science in the case discussions.
Student will encounter a more consistent schedule to each week, with a heavier emphasis on small group active learning sessions (i.e., labs, case discussion) on specific half days, and time allocated to prepare for these sessions.
See current curriculum diagrams.
The Clinical Trunk (Year 2 of the curriculum) is slated for launch in Fall of 2017. Students will transition into this component through 2 phases. The goal of Phase 1 of the Clinical Trunk (3-4 months) is to provide structured, deep scientific learning in the clinical setting. Students will rotate through interdisciplinary, organ-system specific clinical experiences (e.g., cardiopulmonary), where they will work directly with patients and also have deliberate time to learn about the science connected to the patients and illnesses they encounter. In Phase 2 of the Clinical Trunk (8-9 months), students will learn through departmentally organized clinical rotations, working in teams to learn and provide patient care in the inpatient, outpatient and emergency settings. Unlike the current clerkship model, coordination of education and clinical encounters across the different rotations will be greatly enhanced. Heavy emphasis will be placed on scientific learning and debriefing of key issues in health care that students encounter in their patient care activities. Phase 1 and Phase 2 will differ in their standardized weekly schedule, reflecting their different goals. Students will then enter the clinically rigorous experiences in the Branches in Year 3 with a greater ability to care for patients, and learn from their care.
See current curriculum diagrams.
A large percentage of our students participate in research in medical school; expect that to continue and even grow. Medical students will continue to have the opportunity to participate in our Student Biomedical Research Program, supported by both our NIH T-35 grant and additional funds in the Dean’s Office. There will be a summer break towards the end of Year 1 of the curriculum. In addition, all students will be required to complete a capstone project by graduation, as part of their Path of Excellence, the large percentage of which we expect will include research. Finally, students will have time to engage in inquiry-based research during their chosen Professional Development Branch. Capstone projects will need to be rigorous, and also written or presented as a scholarship artifact.
As a core element of the new curriculum in 2016, the medical school is allocating dedicated time and a program structure to maximize our medical students’ success in this component. First, there are 4-6 hours per month of required classroom time in the M1 year dedicated to the foundational material across Paths of Excellence. Second, students will be expected to spend approximately an equal amount of time outside of the classroom engaged with their own PoE curriculum. Third, Path-specific learning communities will periodically come together in all years (during M-Home time) to enhance shared reflection and learning. Finally, it is anticipated that most students will take at least one block “course” within their PoE during the Branches to work on their capstone experience. An additional elective course during the Branches will be available for students when their capstone warrants it.
Professional Development Branches are scheduled to be launched in Fall 2018. Currently, there are 4 different types of pilot Branches:
- Patients & Populations: Focus on community based care and population management.
- Systems-Focused and Hospital-Based Practice: Focus on care within hospitals and large health systems.
- Procedures-Based Care: Focus on comprehensive care of patients and systems as they come together through the perioperative journey.
- Diagnostic and Therapeutic Technologies: Focus on the diagnosis of disease and the role of advanced technologies in health care.
All students will work with their mentor to develop an individualized learning plan towards the beginning of the Branch, driven by educational goals and needs. Each Branch will have core elements or requirements that provide clinical training and exploration. These will include a clinical experience in the Emergency Department, intensive care unit, and Branch-specific sub-internships. Each Branch will have opportunities to pursue professional interests, chosen based on milestone assessments and their individualized learning plan. Each Branch will have rigorous scientific learning with clinical practice, designed to complement a student's’ professional development, comprised of science rotations, experiences that bring science to the bedside, and the opportunities to deepen their research activities. Finally, each Branch will have time for developing a professional intention with a plan, designed by the student and their mentor to develop a broad range of skills to become leaders in medicine. This will include residency prep courses and capstone experiences where learners develop their specific readiness for residency and the professional domain they will be entering.
We do not anticipate a change in the timeline in which students must declare a career choice. Branches are being designed to support all students who decide at different times in their education. There will actually be a significant increase in the amount of time that students have for career exploration (nearly 10 months, up from 4 months currently), both to pursue their goals, and also to determine if their own abilities are a good “fit” for that field. Students will have to declare a Branch to pursue, but not until after a period of exploration in the early phase of the Branch, nor will a Branch decision preclude applying to any field, and student will also have the opportunity to switch Branches.
The M-Home, as the new longitudinal learning community, will serve as a home base for each of the students. Each house will have consistent, clear support structures that will engage students from Day 1, including a House Director, Doctoring faculty, counselors and a learning specialist. The integration of support within the Houses over the entire curriculum will allow for the enhancement of student wellness during periods of stress that naturally happen. In addition, students will be able to connect with each other in small groups over time, providing more individual attention. Finally, there will be integration with students in other years to foster meaningful engagement, support and mentoring.
Learn more about the current M-Home.
Every physician leads. Leadership is required to bring about positive change in health care in all of its domains. Leaders must work in teams, influence and communicate effectively, understand systems of care, and solve health care problems. These are the four domains we will focus on in our Leadership Development program for this new curriculum. Our curricular program will develop students through large events (like visioning, competing values activities, improvisation work and messaging training), small group interactions, and didactics. There will be a strong emphasis on practical application of leadership principles in all components of the new curriculum, and in extra-curricular settings. In addition, leadership coaches will help students with reflection and personalized professional growth.
Learn more about the current Leadership Program.
Students will be part of the Initial Clinical Experience (now Interprofessional Clinical Experience) from Day 1, immersed in the clinical setting as part of the Overture, and then biweekly during Year 1 in the Longitudinal Clinical Experience. In both of these settings, students will have four activities – to inquire, observe, reflect, and analyze.
Students will focus on:
- Models of communication among health care providers in teams and with patients.
- Roles of other health care providers in the patient care setting.
- Systems of care delivery in different settings.
The ICE will foster a Patient-Centered approach to systems and teams, and will stimulate habits of inquiry among students.
Learn more about the current Interprofessional Clinical Experience.
