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STUDY AIDS AND TUTORS
Help with study and test taking skills, as well as tutors, is available through the Academic Development Office, M203A Scaife Hall, (648-2039).
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Students may save a considerable amount of money by shopping around before making purchases, but it is advised that students be sure to buy good quality instruments.
Dissection Instruments: Necessary for the Basic Science Core
White Coats: First-year students should have long coats for the anatomy lab and short coats for clinical conferences. One short white coat will be provided during orientation.
Stethoscope, Oto Ophthalmoscope, Reflex Hammer and Tuning Fork.
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INSTRUMENT AND BOOK INSURANCE
Many students insure their books and equipment against possible loss while in medical
school. Coverage is offered by
Kramer-Warner Associates each year to the incoming
freshmen class. The rates are reasonable because the policy is sold at group prices and
service is reliable. Mr. Warner has been dealing with medical students at this school for
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FIRST AND SECOND YEAR COURSE DESCRIPTIONS
Listed in Numeric Order
FUNDAMENTALS OF BASIC SCIENCE BLOCK – SECTION 1
Section 1 of the Basic Science Block introduces major themes from anatomy, as well as providing an introduction to imaging and radiology. Instructional modalities in this intensive course include lecture, dissection and problem based learning exercises. There are written and laboratory examinations following each of the three segments of the course, and a comprehensive final examination.
FUNDAMENTALS OF BASIC SCIENCE BLOCK - SECTION 2
Section 2 of the Basic Science Block is a multidisciplinary section that introduces students to core principles and terminology of cell and tissue biology and pathology, genetics and metabolism. It introduces students to the biochemical and molecular basis of cell function in the context of normal physiologic function, and to the processes of disease at the cellular level. Cellular, individual and population genetics builds on this course and study of the principles governing energy metabolism of cells and organisms necessary to maintain homoeostasis complete this sequence of courses.Lectures, workshops, laboratory exercises and small group problem-solving sessions comprise this section.
FUNDAMENTALS OF BASIC SCIENCE BLOCK - SECTION 3
Section 3 of the Basic Science Block begins with a segment that elucidates the systems of communication that are activated upon challenge by disease causing organisms and physiologic stressors (Immunology). The final course in this section is the study of disease-causing organisms, their occurrence, preferred hosts and the diseases they cause. Evaluation is based on laboratory exercises, problem-solving sessions and written examinations.
ORGAN SYSTEMS PATHOPHYSIOLOGY BLOCK - SECTION 1
This first course of the organ systems block, Neuroscience, provides a detailed, comprehensive survey of nervous system structure, function and dysfunction. Topics include sensory and motor systems, learning and memory, language, sleep and epilepsy, as well as brain imaging methods, vascular disorders, neoplasms, and infections of the central nervous system. Material is integrated across multiple disciplines including neurophysiology, neurology, pharmacology, neuropathology and neuroradiology. The goal is to provide a mechanistic understanding of normal and pathological brain function, and to teach methods of identifying and localizing major disease processes. The learning formats are lectures, laboratories, PBLs, case-based neurology conferences and self-study. Student evaluation is based on two written exams and PBL participation.
The second course in this section, Introduction to Psychiatry, introduces students to common psychiatric illnesses and their assessment and treatment. There is a written exam and a final paper or presentation due at the end of the course. Student group attendance and small group participation are also included in the overall course grade.
PATIENT, PHYSICIAN AND SOCIETY BLOCK - SECTION 1
This first section of this block consists of two courses: 1) Introduction to Being a Physician has case problems on public health and medicine, breast cancer, cystic fibrosis, Geriatrics and HIV/AIDS with patient interviews, group exercises, lectures, independent study and self-directed learning; 2) Ethics, Law and Professionalism addresses the basic concepts and methods for analysis of ethical and legal issues in the physician-patient relationship. The sessions in this course are structured as seminars with both didactic and interactive components. Videotapes, web-based case discussions, and classroom discussion and debate complement the lectures. Readings are assigned and there is a final examination at the end of the course.
PATIENT, PHYSICIAN AND SOCIETY BLOCK - SECTION 2
Section 2 of this block consists of the course – Behavioral Medicine - which is a multi-faceted consideration of human behavior from the perspectives of both the patient and the physician. The course uses the biopsychosocial model to consider defining elements of the patient-physician relationship, showing how neurobiological, behavioral and social factors can have determinative and interactive impacts in the causation and course of human disease, how they contribute to health, and how they can be modified. . Topics are introduced in large group format via patient interviews, videos and panel discussions, each followed by breakout small group sessions featuring case-based scenarios to further the understanding of this complex topic. Student evaluations are based on small group participation, a writing assignment and an exam.
SCIENTIFIC REASONING IN MEDICINE BLOCK - SECTION 1
The first course of this block, Introduction to Medical Decision Making, teaches critical thinking regarding diagnosis, treatment and prevention of disease as well as statistical methods applicable to clinical studies. This course uses lecture, small group, problem-solving sessions, and final, individual presentations by students. There is a written examination at the end of the course.
SCIENTIFIC REASONING IN MEDICINE BLOCK - SECTION 2
The second section of this block is the first part of a two-year course intended to provide students with the skills needed to read and use medical literature. These skills will also contribute to their own studies conducted during their mentored, scholarly project. In this segment, students will use the tools and skills obtained during the preceding course to analyze seminal literature in science and medicine. Evaluation is based on student critiques of assigned papers as well as on a formal presentation to their small group, of a problem of interest to them, methods of approaching it and feasibility of their proposed approach.
INTRODUCTION TO PATIENT CARE BLOCK - SECTION 1
The first course in this section, Medical Interviewing, develops medical interviewing skills using standardized patients (SPs). The second course, Introduction to Physical Examination, is designed to provide the first introduction to the techniques of performing a physical examination. By practicing on peers, students learn the skills of a normal physical examination and how to conduct an exam in an orderly fashion. Emphasis is on technique and normal findings with very little discussion of pathophysiology. Use of the stethoscope, oto-ophthalmoscope, reflex hammer and tuning fork are demonstrated and practiced. The goal is to familiarize students in the use of their instruments and prepare them for experiences in physician offices during the remainder of the first year.
INTRODUCTION TO PATIENT CARE BLOCK - SECTION 2
The Advanced Physical Examination Course of the Introduction to Patient Care Block is an extension of the Introduction to Physical Examination course. During this course, which spans the first two years, students will expand their knowledge of history taking and physical examination skills by examining patients both in adult medicine and in the pediatric setting. Pathophysiology and its correlation to history and physical examination skills are stressed. Students are also expected to record and synthesize the information collected during the clinical encounter as a written history, physical exam, and patient assessment. The goal is to prepare students to do complete and accurate history-taking and physical examinations during their clerkships. This course is integrated with the Clinical Experience Course. There are seven, month-long sessions, four of which will be physical examination sessions and three will be the Clinical Experience rotations described below. There is a written examination, a clinical performance grade from instructors, and a required performance-based assessment at the end of the course.
The Clinical Experiences Course is designed to familiarize students with how physicians practice medicine in their offices and to expose students to the various aspects of health care delivery in the community. Each student will be scheduled for three, month-long rotations, one month of one afternoon a week in a physician's office, one month of once a week afternoon visits to an assigned community site for underserved populations, and one month with a student-selected ambulatory sub-specialty office or an additional month at a primary care physician’s office. There will also be full class sessions on health care disparities, alcohol and substance abuse, and health care to the underserved. No textbook is required but a syllabus is provided. Completion of weekly Teaching and Learning logs is required. Grading is determined by attendance and passing the Final Examination.
. See Transportation Statement below
PATIENT PHYSICIAN AND SOCIETY BLOCK – SECTION 3
This course will focus on health systems and the delivery of health care and health care finance, quality control. Major objectives will examine a.) How the health care system works-or doesn’t; b.) Patient safety; c.) Quality; and d.) Information technology and communications. Each segment of the course will consist of lectures, followed by small-group, problem-solving sessions. Educational formats include lectures, panel discussions, group exercises and invited speakers. Evaluation will be based on a written examination and on the presentation given in the small group exercise.
SCIENTIFIC REASONING IN MEDICINE BLOCK - SECTION 3
The third section of this block is the second part of a two-year course intended to prepare students for their four-year, mentored scholarly project. In this segment, students will use the tools and skills obtained during the preceding course to analyze seminal literature in science and medicine. Evaluation will be based on student critiques of assigned papers as well as on a formal presentation, to their small group, of a problem of interest to them, methods of approaching it and feasibility of their proposed approach.
ORGAN SYSTEM PATHOPHYSIOLOGY BLOCK - SECTION 2
This second section of the Organ Systems Pathophysiology Block consists of four segments: a week long study of principles of pharmacology, followed by courses on the cardiovascular, renal, and pulmonary systems. The course is interdisciplinary. In addition to the basic science components, the subject matter includes clinical aspects of diseases and their medical management. The learning format is in small groups, laboratories, lectures, tutorials/conferences and self-study. Student evaluation is based on written exams and small group problem-solving participation.
ORGAN SYSTEMS: PATHOPHYSIOLOGY BLOCK - SECTION 3
This third section of the Organ Systems Pathophysiology Block consists of four segments: Endocrine and Digestion and Nutrition cover normal structure and function of the digestive and endocrine systems as well as introduction to diseases of both systems. Reproductive and Developmental Biology covers material in a chronological fashion from fertilization through aging. Hematology covers the physiology of the major blood forming organs and an introduction to common hematologic diseases. The learning format is small groups, clinical pathologic correlation sessions, laboratories, lectures, tutorials/conferences and self-study. Student evaluation will be based on written exams and small group problem-solving participation.
ORGAN SYSTEMS BLOCK - SECTION 4
This course begins with the neuroscience segment OS 1 and runs through all of the courses in Organ Systems 1, 2 and 3, including a concentrated week of principles of pharmacology with an emphasis on adrenergic pharmacology at the beginning of OS2. At appropriate times in those courses, basic mechanisms of pharmacologic agents are taught in the context of each organ system. This course covers classes of agents, mechanisms and drug targets as well as potential side effects and future developments. The format is primarily lecture with some workshops, as well as material incorporated into problem-based learning sessions.
ORGAN SYSTEMS BLOCK - SECTION 5
The course objective of this fifth section of the Organ Systems Block is to apply information acquired during the first two years to patient cases as presented on the computer, further developing independent active learning and data acquisition skills. In addition, the course serves as a bridge to the direct patient responsibilities of the final two years of medical school. The format is exclusively problem-based learning. There is no final examination. The course is honors/pass/fail based on small group participation.
INTRODUCTION TO PATIENT CARE BLOCK - SECTION 3
The Advanced Physical Examination
Course of the Introduction to Patient Care Block is an extension of the
Introduction to Physical Examination course. During this course, which spans the
first two years, students will expand their knowledge of history taking and
physical examination skills by examining patients both in adult medicine and in
the pediatric setting. Patho-physiology and its correlation to history and
physical examination skills are stressed. Students are also expected to record
and synthesize the information collected during the clinical encounter as a
written history, physical exam, and patient assessment. The goal is to prepare
students to do complete and accurate history-taking and physical examinations
during their clerkships. This course is integrated with the Clinical Experience
Course. There are seven, month-long sessions, four of which will be physical
examination sessions and three will be the Clinical Experience rotations
described below. There is a written examination, a clinical performance grade
from instructors, and a required performance-based assessment at the end of the
The Clinical Experience Course is designed to familiarize students with how physicians practice medicine in their offices and to expose students to the various aspects of health care delivery in the community. Each student will be scheduled for three, month-long rotations, one month of one afternoon a week in a physician's office, one month of once a week afternoon visits to an assigned community site for underserved populations, and one month with a student-selected ambulatory sub-specialty office or an additional month at a primary care physician’s office. There will also be full class sessions on health care disparities, alcohol and substance abuse, and health care to the underserved. No textbook is required but a syllabus is provided. Completion of weekly Teaching and Learning logs is required. Grading is determined by attendance and passing the Final Examination. See Transportation Statement
INTRODUCTION TO PATIENT CARE BLOCK - SECTION 4
The first four weeks of the final section of the Introduction to Patient Care Block will be the Advanced Medical Interviewing Course. This course is designed to move students from the basic patient interviewing skills that were introduced in the first year Medical Interviewing Course to a higher skill level in patient communication which will be required during the clinical clerkship years. Using standardized patients, and with guidance from a faculty facilitator and peers in small groups, students will learn and practice “hard to ask questions” and deal with specific “content-sensitive” cases (e.g., abuse, anger, drug use and sexuality).
The last four weeks of the Introduction to Patient Care block will consist of the Clinical Procedures Course that introduces students to basic diagnostic, therapeutic, invasive, and non-invasive procedures commonly performed in clinical medicine. This course gives students the opportunity to practice clinical procedures in a laboratory setting, through interactive small-group sessions with the faculty, using equipment and supplies normally found on patient care units. The goal is to familiarize students with basic clinical procedures that they may be asked to perform on patients during their clinical rotations.
The course is honors/pass/fail based on small group participation, completion of a brief set of questions after each session and a comprehensive final exam.
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Medical schools have recently recognized that students need educational experiences beyond those available in teaching hospitals. In answer to this educational need, ambulatory sites, rehabilitation centers, geriatric facilities, nursing homes, health centers, and other venues have been introduced to provide a comprehensive exposure to a broad range of patients, illness, and care. At the University of Pittsburgh School of Medicine, we are arranging teaching in more locales than before, and we have therefore felt the need for a transportation statement.
University of Pittsburgh students are responsible for arranging their own transportation, including that to and from their clinic sites. These sites, usually, are accessible by public transportation from the medical school.
When a clinical site is inaccessible by public transportation, students should be
encouraged to seek out fellow students assigned to the site with whom they might car pool.
Failing that, students are advised to take public transportation to the nearest point to
their site, and to take a cab the rest of the way. The student would be responsible for
paying all transportation costs incurred.
Students who choose to take cars to their sites are responsible for covering all gas and parking fees incurred by that mode of travel. Again, car pooling - and cost sharing - with fellow students is recommended whenever feasible.
Students who consider themselves unable to afford the cost of transportation
to a clinical site should be referred to their financial aid advisor. The
average cost of travel to clinical sites is included in the standard student
budget used to assess financial need. If, however, a review of the student's
financial aid case reveals that he/she qualifies for further assistance,
adjustments in the aid package may be made by the financial aid office. (518 Scaife Hall).
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THIRD AND FOURTH YEAR COURSE
The official University transcript records a grade of Honors/High Satisfactory/Satisfactory/Low Satisfactory/Unsatisfactory (H/HS/S/LS/U).
THIRD YEAR COURSE DESCRIPTIONS
ADULT INPATIENT MEDICINE CLERKSHIP
This course is an (8) eight-week interdisciplinary
clerkship divided into two blocks of four (4) weeks each. During each block, the
student is assigned to an inpatient rotation either at UPMC Montefiore Hospital,
the Oakland VA Medical Center or UPMC Shadyside Hospital. On the first day
of each block, the student is required to attend didactic sessions given by the
faculty in Emergency Medicine and Geriatric Medicine. During this inpatient
rotation students are assigned their own patients and are taught, under
supervision, to apply their acquired skills to the clinical situation. Students
learn how to take an accurate and pertinent history, conduct a physical
examination, recognize patterns of illness and acquire approaches to disease
management. The students will have four (4) sessions learning the techniques of
Critical Care Medicine during the rotation.
Teaching rounds with staff physicians are held daily, Monday through Saturday on each ward service. In addition, students are assigned to a Student Teaching Attending at each hospital site and meet four (4) times a week. Rounds with the Chairman are held once a week for all students.
The student is expected to do reading in the general internal medicine textbooks, as well as Emergency Medicine, Geriatric Medicine and Critical Care Medicine along with the current literature in order to understand major disease processes and therapy. A majority of students use one of the following textbooks of medicine as an initial reference: Principles of Internal Medicine, by Harrison; Textbook of Medicine, by Cecil; and Internal Medicine, by Stein. These books should be supplemented by reading in appropriate medical journals.
On the nights that the Admitting Team is on "long call", the student is expected to remain in the hospital until 9 PM. This is an opportunity to see the early stages of acute illness and to help in providing "cross-coverage" of patients. At the end of the rotation, a two-hour USMLE in Medicine is given, as well as a combined examination in Emergency Medicine and Geriatric Medicine. a two-hour USMLE in Medicine is given, as well as a combined examination in Emergency Medicine and Geriatric Medicine.
COMBINED AMBULATORY MEDICINE AND PEDIATRICS CLERKSHIP
The eight (8) week Combined Ambulatory Medicine and Pediatrics Clerkship provides two four week experiences in the disciplines of Internal Medicine and Pediatrics. One half-day per week the students participate in a multi-faceted, interactive didactic session learning advanced skills and discussing issues common to both of these disciplines. The clinical experiences in Internal Medicine and Pediatrics are at office or clinic sites where students are exposed to the spectrum of care that is provided in the ambulatory setting. Sites may include hospital-based practices and community locations.
Suggested resources for students are:
Internal Medicine Essentials for Clerkship Students 2008-2009. Alguire PA. ACP Publication
Harrison’s Principles of Internal Medicine. 16th edition, Edited by Dennis Kasper et al, 2005.
Nelson Essentials of Pediatrics. RE Behrman & RM Kliegman (most recent edition)
Students evaluate their preceptors and the clerkship, are evaluated by their preceptors and take a National Board of Medical Examiners (NBME) subject exam and a performance-based examination (OSCE). One grade is given for the entire eight week rotation, although performance summaries from each discipline and preceptor comments are forwarded to the Associate Dean of Students for possible inclusion in the Dean's Letter for residency applications.
This four (4) week clerkship emphasizes the reproductive
health issues important for all physicians. Students will rotate through
outpatient services (emergency department, outpatient clinics), obstetrics
(labor and delivery suite), and surgical gynecology (private service and
university service). Daily schedules include teaching rounds, evaluation of
outpatients, preparation of patients for surgery and assisting at surgery and
deliveries, postoperative and postpartum care.
Specific objectives have been prepared for each of the services. All students at Magee-Womens Hospital participate in small group seminars with two faculty mentors to examine and discuss important topics expressed in a problem-based learning mode. At the end of the clerkship, students write a two hour examination. General Objectives are: 1) Understand and apply knowledge of the normal and abnormal menstrual cycle to clinical situations; 2) Learn to perform a competent gynecologic and obstetrical history and physical exam, with special reference to the pelvic exam, cytologic screening and appropriate cultures; 3) Understand and apply information about normal and abnormal pregnancies; 4) Become familiar with important issues in the care of postmenopausal women; 5) Be aware of common gynecological problems and their differential diagonsis.
The recommended textbook are: Obstetrics and Gynecology, 4th Edition by Beckman et al or Essentials of Obstetrics & Gynecology, 4th ed., by Hacker & Moore. Interested students may wish to consult William’s Obstetrics 22nd Edition, 2005, by Cummingham, et al, and Comprehensive Gynecology 4th Edition, 2001, by Stenchever et al. for further depth information.
PEDIATRIC INPATIENT MEDICINE CLERKSHIP
This is a four (4) week clerkship, which introduces students to inpatient pediatric medicine. We have five (5) general pediatric medicine teams (Red, Blue, Purple, and Limited Stay Unit - LSU), each team consists of patients between the ages of newborn to 21 years of age. Most students will rotate with the same team all four (4) weeks - those placed on LSU will rotate after two (2) weeks, switching with other students on the other teams.
STUDENTS ARE REQUIRED TO:.
Participate in all aspects of patient care and management including:
Performing histories and physical examinations,
Writing progress notes and
Communicating with other members
of the medical team, attending physicians, referring physicians, consultants,
families and patients.
STUDENTS ARE EXPECTED TO:
Read the current literature
Read the standard pediatric textbooks in order to understand childhood growth and development, and major pediatric disease processes and therapy.
Attend conferences, lectures and rounds that are held throughout the four-week (4) block.
As part of the inpatient rotation, students work as part of the floor medical team and thus take call every fourth (4th) evening (not overnight).
Each student is expected to work two non-consecutive weekend days (8 am - 6 pm).
Each student is expected to attend and present a patient at Case Conference (held on Wednesday and Thursday afternoons).
Each student is expected to work through formal web-based clinical cases (CLIPP cases).
Each student is expected to turn in four (4) formal patient write ups to their teaching attending for evaluation and feedback.
At the end of the rotation, a three (3) hour, 100 question multiple choice exam is given.
Several textbooks are recommended for study, e.g., Nelson’s Textbook of
Pediatrics, Behrman’s Textbook of Pediatrics,
Rudolph’s Pediatrics, and the Zitelli Atlas of
Physical Diagnosis. Further details regarding on-line resources will
be provided at orientation.
In order to pass the clerkship, all required components (clinical performance, attendance, morning report presentation and participation, CLIPP cases, written examination) must be successfully completed.
CLINICAL NEUROSCIENCES CLERKSHIP
A combined Neuroscience Clerkship that integrates the
teaching of Psychiatry, Neurology, Neuropathology and Neuroradiology. The clerkship is structured within an eight (8) week block of
five (5) weeks devoted to Psychiatry and three (3) weeks dedicated to Neurology.
Clinical teaching will be within the inpatient and ambulatory settings.
Students are also expected to attend neuropathology workshops, psychiatric emergency room visits, electroconvulsive therapy sessions, and an AA/NA meeting. Students will also attend integrated teaching sessions on Wednesday afternoons.
Teaching sessions will consist of psychiatry and neurology core material as supported by evidence-based medicine along with integrated case conferences, involving psychiatry and neurology topics that highlight clinical conditions common to these areas of medicine. More emphasis will be placed on performance-based evaluation of the student’s clinical performance.
Students will also be graded on both the Psychiatry and Neurology National Board of Medical Examiner’s shelf examination. Criteria for grading are explicitly provided to students at the beginning of each experience and to those faculty members responsible for their evaluation.
Recommended readings for this clerkship include:
Introductory Textbook of Psychiatry, 4th ed., by N. Andreasen & D.W. Black, American Psychiatric Press, Inc., 2006
Clinical Neurology, by M.J. Aminoff & R.P. Simon, Appleton & Lange, 1999.
Reference book recommendations are:
Synopsis of the Comprehensive Textbook for Psychiatry, 8th ed., by H.I. Kaplan & B.J. Sadock, Williams and Wilkins, 1998
Principles of Neurology, 6th edition, R.D. Adams, McGraw Hill, 1997
Merrits’ Textbook of Neurology, L.P. Rowland, Williams and Wilkins, 2000.
SURGERY & PERIOPERATIVE CARE CLERKSHIP (SPCC)
COURSE DIRECTORS: Peter F.
Ferson, MD, Professor, Department of Surgery (email@example.com)
Michael Mangione, MD, Associate Professor, Department of Anesthesiology (firstname.lastname@example.org)
This 8-week clerkship covers the disciplines of general surgery and anesthesiology. Students are assigned to general surgery (3 weeks each on two different services) and to anesthesiology services (2 weeks). Teaching with attending physicians and residents occurs in conferences, on rounds, in the operating room, at the bedside, and in small groups.
The goals of the clerkship are for students to develop skills to evaluate patients in the perioperative period and to optimize patients' medical conditions in preparation for surgery. Students learn the natural history of common surgical diseases and the proper evaluation, operative management, and postoperative treatment for these diseases. to assist in the determination of correct diagnoses and management of the surgical patient, use of radiology and pathology services is encouraged. Additional goals include developing skills in the management of acute pain and postoperative complications. Overall, the course is designed to familiarize all students with the clinical presentations and management of common surgical problems, and effects of anesthesia and surgical interventions, in order to prepare them to assume the role of a primary care physician, perioperative consultant, surgeon or anesthesiologist.
Clinical sites include: UPMC Children's Hospital of Pittsburgh, UPMC Magee-Womens Hospital, UPMC Presbyterian, UPMC Shadyside, UPMC South Side Hospital, Oakland VA Medical Center, Western Psychiatric Institute and Clinic, and UPMC St. Margaret's Hospital. Every student participated in hands-on simulation sessions at the WISER Center, where they gain experience in airway and tying, suturing and basic laparoscopic skills.
Workshops Ward rounds
Evaluation is based on surgery evaluations by faculty and residents (60%), anesthesia evaluations by faculty and residents (12.5%), a National Board exam for surgery portion (15%)an in-house exam for the anesthesiology portion, composed of multiple-choice and essay items. (12.5%)
Grading: The clerkship is graded, Honors, High Pass, Pass, Low Pass and Unsatisfactory
Samuel Tisherman, MD, Franklyn Cladis, MD and William McIvor, MD, are recipients of the Clerkship Preceptor of the Year Award. Brian Zuckerbraun, MD is a recipient of the Charles C. Moore House Staff Teaching Award. William McIvor, MD is the 6-times recipient of the Peter F. Winter Award for Excellence in Medical Student Training. In addition, the following faculty are members of the University of Pittsburgh School of Medicine, Adacemy of Master Educators: Samuel Tisherman, MD; Michael Mangione, MD; Peter Ferson, MS; Kevin Garrett, MD; William McIvor, MD and Rita Patel, MD.
SPECIALITY CARE CLERKSHIP
The Specialty Care Clerkship is a four (4) week rotation that includes a combination of one week experiences in the disciplines of ENT, Ophthalmology, Adult Emergency Medicine and Pediatric Emergency Medicine. In addition to four weeks of clinical time, students will also attend weekly lectures, workshops and lab activities.
The Specialty Care Clerkship begins with orientation and a suturing and splinting session the first morning followed by a simulation-based session in phone communication (how to best communicate medical information over the phone to patients).
Each Tuesday morning there will be an Ophthalmology lecture and each Thursday morning an ENT lecture. Additional Wednesday morning workshops include Dermatology, EKG Cases, Dizziness and Audiology, Musculoskeletal Exam and Rehab and Musculoskeletal Radiology. Following those, the students will go to their clinical responsibilities.
Students are evaluated by each specialty area based on clinical performance and will take an on-line proctored examination. Students will evaluate their preceptors and the clerkship and take an on-line proctored examination. One grade will be given for the entire four week rotation.
FAMILY MEDICINE CLERKSHIP
is a first contact, continuous primary care discipline that encompasses the
comprehensive and longitudinal care of patients with a special emphasis upon
care of individuals in the context of families and communities. As such, Family
Medicine covers an extraordinary variety of problems and ages making for an
interesting and challenging clerkship. Preventive health measures are stressed.
The Family Medicine Clerkship has four components: Community-based Clinical
Experiences; Whole Group Learning Sessions; Virtual Family Practice Classroom
Exercises, and a required Family and Community Assessment. These components will
be fully explained during orientation on the first day of the clerkship.
Students are expected to read about clinical problems encountered while on the
Rotation assignments are usually located away from the Oakland campus. All clinical assignments may include experiences at multiple locations, including private offices, teaching clinics, outlying hospitals, nursing facilities, patient homes and other locations. Students will need to assure arrangements for transportation are made well in advance of the rotation.
Multiple evaluation tools will be used for assessing student performance during this rotation and assigning a grade for the rotation. Evaluation tools will be fully explained on the first day of the clerkship. Students are also responsible for keeping a log of patient encounters throughout the clerkship and completing a preceptor/community site evaluation the end of the clerkship.
All other issues will be discussed at the orientation on the first day if the clerkship
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ADDITIONAL CLINICAL FOCUS COURSES
PRECLERKSHIP CLINICAL FOCUS COURSE
As an introduction to the combined clinical years, students will participate in a five day curriculum designed for rising third year medical students to help ease the transition to the clerkships and provide students with necessary skills and information.
The daily sessions include large and small group formats. Below is an overview of the schedule of the week.
All students are required to complete online modules on confidentiality (HIPAA) and safety prior to starting their clerkships. Notice of the required modules will be sent to students prior to the course.
First day topics will include: an Introduction to the Combined Clinical Years, Industry Relations, Communication Skills, Roundsmanship, Honor Council, Infection Control, Clinical Logs, and General Rules for a Successful Clerkship. Small group clerkship skills workshops with the clerkship directors include an introduction to the students’ first assigned clerkship and fourth year students presenting student-to-student information about the clerkships. The Office of Student Affairs coordinates other administrative details for new clerkship students (i.e., TB testing, UPMC photo IDs, scrubs machines and cards, health and dental info, pagers, and electronic records user name distribution).
The second day is spent on Cerner computer training and an introduction to EpicCare. Additional exercises includes instruction on writing prescriptions, orders, and SOAP (subjective data, objective data, assessment, and plan) notes; directions on finding pharmacology information on the Infonet; and homework assignments for the fourth day sessions including prescription writing and error detection, order writing, and history and physical write-up reviews.
The third day features a hands-on hospital simulation on Pandemic and Disaster Preparedness, Patient Assessment Workshops and Interdisciplinary Teamwork presentations (Allied Health Professional Presentation and Panel, and a Clinical Presentation on Resident Team/Nursing Support).
The fourth day consists of a half day of Clerkship Skills Workshops with clerkship faculty to review the homework from the second day, reading the TB tests, and a half-day CPR Recertification course, with respiratory N95 mask fit testing to be used in pandemic and disaster control situations.
Day five begins with a lecture on Professionalism followed by Humanism Honor Society Group Read Vignettes presented by student members of the Watson Humanism Honor Society. Faculty facilitators then conduct Humanism in Medicine small group sessions. The day ends with a Pinning Ceremony and Reception for the entire class.
Attendance at all sessions is required to satisfactorily complete the course. Grades will be based on attendance, course participation, and completion of homework assignments.
Students who miss this course week are required to make-up any clerkship assignments and online modules as specified by the course directors. This requirement is also for third year students returning to the class later in the academic year or incoming transfer students.
CLINICAL FOCUS COURSE
The week-long Geriatrics and Oncology course focuses on the critical issues of aging and cancer. This course is placed in the curriculum at the mid-point of the third year, which is a unique teachable moment where students can benefit from focused instruction on key topics which are commonly encountered during the core clerkships. The coverage of both topics is designed to build on the clinical exposure that students have had – both to the impact of the aging population on clinical practice as well as the pervasiveness of cancer as a medical challenge. Both topics address practical issues related to care of these patients, recent advances in clinical care, and also have an experiential component. Students visit with patients at the Hillman Cancer center during the oncology segment and visit one of three local nursing homes to meet with the patients and the people who care for them during the geriatrics section. Conferences follow these experiences to allow faculty-guided discussions of the experience.
One grade [honors/pass/fail] is given for the entire five-day course and is based on student attendance at all sessions, participation in small group learning sessions, an acceptable case presentation to peers and faculty, and a passing grade on the written examination.
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FOURTH YEAR COURSE DESCRIPTIONS
The Fourth Year comprises the final twelve months of the curriculum and consists of both elective and required experiences. In some cases, courses are listed with prerequisites and/or requirements. It is the student’s responsibility to assure that these are met.
This segment of your education is the final portion of the
Medical School experience. You should choose courses that will further
strengthen your strong points and fill in deficiencies, where such deficits
exist. Your goals for this year could be expressed as follows:
1) Broaden and deepen experiences in varied areas of medicine;
2) Provide a general basis for specialized training;
3) Increase independent learning;
4) Feel more responsibility as a member of the health care team.
Each senior should attempt to design a year whose goal is to round out their medical education; not to gain skills which will be retaught in postgraduate training. Sharpening one's skills in history taking, physical examination and writing detailed notes, continued learning of a humanistic approach to patient care, and attempting to deepen one's understanding of pathophysiology will last a lifetime. This year is one-fourth of your formal undergraduate medical education and should be both academically strong and enjoyable.
Curricular Requirements for the year:
1) Four weeks of an acting internship in Family Medicine, Internal Medicine, Pediatrics or Surgery;
2) Four weeks of Integrated Life Science; MED 5710, 5715; OBGYN 5725; PEDS 5720; SURG 5700, EMED 5735, NSURG 5705
3) Maximum of three out-of-town elective periods;
4) Maximum of two (2) months research, without specific permission;
5) Electives must be taken in a minimum four-week block per course; in accordance with the senior academic calendar
Students are expected to participate for the entire elective in the time frame specified. Holidays are allowed at the discretion of the course director. Time off for interviewing during an elective period is granted at the discretion of the course director, in advance. Be prepared to make up time and work missed.
REQUIRED ACTING INTERNSHIP: An acting internship (sub-internship) of four-week duration is required during the senior year. An A.I. is a clinical rotation offered on an in-patient service where one or more attending physicians have overall responsibility for coordinated patient care. The service will be structured with both attending staff and house staff. The acting internship should include the assignment to the student of specific groups of patients upon whom he/she completes an initial history and physical examination, constructs a differential diagnosis, formulates a treatment plan, writes orders and carries out necessary therapy, all under careful supervision. Acting Internships that fulfill this requirement are offered in FAMILY MEDICINE, (5401); INTERNAL MEDICINE (5401, 5402); PEDIATRICS (5401); and SURGERY(5401). Acting internships in other departments or out of the city will not fulfill the "AI" requirement.
REQUIRED INTEGRATED LIFE SCIENCE COURSE: This four week elective is designed to revisit the basic sciences through specially designed courses. All students are required to schedule one course from the following selections: MED 5710, 5715; OB/GYN 5725; PEDS 5720, SURG 5700, EMED 5735, NSURG 5705.
RECOMMENDED ELECTIVES: In order to
provide diversity, it is strongly recommended that you take at least one
elective in each of the following blocks:
A. Medicine or neurology;
B. Pediatrics, pediatric neurology, pediatric pathology, pediatric surgery;
C. Surgery or surgical subspecialties, obstetrics & gynecology;
D. Ambulatory care, community medicine or psychiatry
ELECTIVE SCHEDULING PROCESS: To help you structure your fourth year, the faculty is committed to an advisory system. You will choose this advisor from a list provided to you. These faculty have agreed to serve in this capacity and have been instructed on the philosophy and scheduling requirements of the fourth year curriculum.
You must notify the Office of Student Affairs of your advisor choice so that he/she may be sent the appropriate material. The selection form will be made available to you with a specific deadline indicated. You will meet with your advisor as needed until your schedule is satisfactory to you both. The advisor must approve and sign your plan before it is eligible for the scheduling process. Your senior year advisor need not be your advisor for residency advice. He/she will be sent a copy of your schedule as arranged through the lottery and all changes will be approved by him/her.
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LEAVE OF ABSENCE POLICY
Leave of Absence from the School of Medicine may be granted for a variety of reasons differentiated in the following policy. While a student is on Leave of Absence he or she is not responsible for tuition payment nor eligible for any financial aid from the School of Medicine except as specified below:
1. Academic Failure
With the concurrence of the Committee on Promotions, the Associate Dean for Student Affairs has an option to grant a Leave of Absence, to be specified in duration, for a student who has failed two sections in the first term of the freshman or sophomore year. This Leave of Absence shall be for the pursuit of remedial studies and the student shall return to repeat the entire first or second year as specified by the Promotions Committee.
A student who has health problems with limited or impaired function and is in good academic standing, shall be granted a Leave of Absence (not to exceed one year) at the discretion of the Associate Dean of Student Affairs. The Associate Dean shall collect pertinent data from the treating physician and may request a second opinion from an administratively appointed physician to document the necessity for such leave. If the opinions of the two physicians differ, the Associate Dean and the student shall accept the opinion of the appointed physician.
3. Academic Study
Students seeking dual degrees (Master's or Doctorates), or those pursuing research fellowships by virtue of being a School of Medicine student shall be granted a Leave of Absence as required for the pursuit of either degree or fellowship. During such leaves the student will be considered a student in good standing of the School of Medicine even though tuition payments shall not be made as a professional student.
Extensions of specific Leaves of Absence shall be given only under extraordinary circumstances of family or financial hardships. Such extensions shall be presented to the Dean of the School of Medicine whose decision shall be final.
5. Return from Medical Leave of Absence
A letter from the treating physician certifying the student's fitness to resume study shall be required a minimum of one month prior to reentry. The associate Dean for Student Affairs may require a second opinion from an administratively appointed physician and this opinion shall also be in writing. If the opinions of the two physicians differ, the Dean and the student shall accept the opinion of the appointed physician. If the physician's opinion is that, for any reason, the student should not return, the opinion shall be binding on the student and the student may not reenter. If the student reenters after Leave of Absence and is unable to function so as to meet department standards whether academically or clinically, he or she shall be dismissed on recommendation of the Committee on Promotions to the Dean. All official medical records in the Office of Student Affairs shall be shared with the Committee. If the student wished to pursue his or her medical education after dismissal, he or she must make application to the Admission Committee for advanced standing. The Admissions Committee shall include in its consideration all official medical records pertaining to the student candidate.
Revised: 01/85 Approved: George A. Huber, Esq. 01/21/85 Approved: Thomas Detre, M.D.
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LEAVES OF ABSENCES AND OTHER OPPORTUNITIES
A website, http://www.medschool.pitt.edu/studentaffairs/Opportunity.html, as well as a reference binder of opportunities are maintained in the Office of Student Affairs for the use of our students. They are kept up-to-date as information is received. Feel free to peruse this information which includes summer research and clinical positions, opportunities for dual degree programs (MD/MPH, MD/MA in Medical Ethics, other), international and community source programs, and areas of concentrations. Should you have a desire to take a longer period of time away from school, you should make an appointment with the Dean of Students to discuss your idea. Listed below is information you may find helpful.
LEAVE OF ABSENCE FOLLOWING SECOND OR THIRD YEAR
Following the second or third year are appropriate times for students to arrange a year of research or pursuit of a second degree program. The Dean of Students may grant a year's leave of absence to any student in good academic standing. Anyone desiring to arrange a leave of absence should make an appointment to meet with the Dean of Students no later than three (3) months before the start of the next year. A letter outlining the intent for the year must be prepared along with any other required documentation. All request packets must be turned in at least two (2) months prior to the start of the next year. These shall include a letter of acceptance from a degree program or from a well-documented, competitively reviewed Student Research Fellowship Program. This documentation for a Research LOA must be approved by the Dean of Student Affairs in consultation with the Student Research Committee, at least one month prior to the leave. Final arrangements should be done through the Coordinator after the meeting with the Dean of Students. In those cases where a student has been awarded a competitive fellowship, an official application for leave of absence should be returned to the Coordinator with an award letter attached. When the Dean of Students approves the leave, he/she will be registered as a student for the following year. Research on-campus will be assessed all fees; research off-campus will be no fees. This is important for loan deferral purposes. Any questions on leave of absences should be discussed with the Medical School Registrar. (See Leave of Absence Policy).
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PHYSICIAN SCIENTIST TRAINING PROGRAM (PSTP)
The Physician Scientist Training Program (PSTP) is a five-year MD program designed for exceptionally talented individuals interested in an academic medicine career. The fifth year provides additional scientific training.
MD/PSTP - PHYSICIAN SCIENTIST TRAINING PROGRAM ACADEMIC REQUIREMENTS
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TRAINING PROGRAM (MSTP)
A Medical Scientist Training Program, offered jointly by the University of Pittsburgh and Carnegie Mellon University, is available to a limited number of highly qualified applicants. This program prepares physician-scientists for careers in academic medicine and research.
Usually, studies toward a PhD degree begin after completion of the second year of medical school in addition to required clerkship rotations. MSTP students re-enter medical school following completion of PhD studies.
Medical students interested in the MSTP Program may apply for admission during the second year of medical school. The admission process for the program requires an application. Additional information on the MSTP may be obtained from the program office which is located in 526 Scaife Hall.
MD/PhD JOINT DEGREE PROGRAM - MEDICAL SCIENTIST TRAINING PROGRAM (MSTP) ACADEMIC REQUIREMENTS
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CLINICAL SCIENTIST TRAINING PROGRAM (CSTP)
The Clinical Scientist Training Program (CSTP) is a program of study for medical students leading to either a Certificate or Master of Science in Clinical Research. Some applicants are accepted to the joint program at the time of admission, others are admitted during MS-2 or MS-3. The MD/CSTP program was approved by the University Council on Graduate Studies and the School of Medicine Curriculum Committee in November 2003.
MD/CSTP JOINT DEGREE PROGRAM - CLINICAL SCIENTIST TRAINING PROGRAM (CSTP) ACADEMIC REQUIREMENTS
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ORAL AND MAXILLOFACIAL SURGERY/MEDICAL DEGREE
ORAL AND MAXILLOFACIAL SURGERY/MEDICAL DEGREE
Research Opportunity at Pitt
The summer after the first year is open for medical students to seek employment. Many medical students choose to take advantage of the opportunity to conduct research with a faculty member in the School of Medicine.
Enrichment Program website on the Student Affairs page is a
wonderful resource. Listings include: Areas of Concentration
Student Research Programs
Community Service Opportunities
Funds to support medical student research can be sought from two sources. The first is the Medical Student Summer Research Scholarship Program directed by Stephen L. Phillips, PhD and supported principally by the Medical Alumni Association of the University of Pittsburgh. Applications are available in November and December. Those interested in seeking funds through this program may obtain an application in the Office of Student Affairs in the School of Medicine. Individual faculty program research funds are also occasionally used to support summer research projects. The availability of research grant funds for summer research projects is determined by individual project directors and varies from year to year.
National Institutes of Health (N.I.H.)
The NIH offers a Summer Research Fellowship Program. With the guidance of preceptors from the institutes, students conduct research in selected areas of laboratory investigation. Click on the National Institute of Health heading to view their website.
Western Pennsylvania Health Preceptorship Program (WPHPP)
Western Pennsylvania Health Preceptorship Program (WPHPP)
This program was initiated in 1969 by Pitt medical students working with faculty members from the Department of Family Medicine and Clinical Epidemiology, and continues to be entirely student-administered. The purpose of the program is to expose post first year students from Pitt and other medical schools to health care delivery in a community setting. The program is not designed to provide merely a rotating externship in a hospital--this is available elsewhere. For an eight (8) week period, each student is assigned to physician-preceptor(s) at a community hospital. The student works with the preceptor(s) in the office and the hospital. Students also have contact with a variety of other hospital personnel and spend some time visiting community health agencies. There are a limited number of positions available each summer at hospitals throughout Western Pennsylvania. Each participant receives a stipend for the eight (8) weeks and, in some cases, room and board are provided. For further information, access their website by clicking on the heading above.
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