Doctor of Medicine, MD

The course of instruction leading to the degree, Doctor of Medicine, extends over a four-year period. A major curriculum renewal effort in 2001 resulted in significant changes in the first two years of school. These changes focused on active involvement of students in small group activities, hands on clinical experiences from day one and introduction of clinical decision making via computer simulations. These changes have resulted in better integration of the basic and clinical sciences by amplifying the clinical relevance of the sciences we teach. They have been uniformly praised by students and faculty alike. Similar changes were made in many other medical schools across the U.S.

The Honors Program is in addition to the regular curriculum and is designed to challenge the exceptional student while stimulating the interest of the individual. It entails an independent research program encompassing both the basic and clinical sciences in pursuit of an area of mutual interest between the student and the student’s faculty advisor. Students who have maintained high academic standards during their first semester in the School of Medicine are eligible for consideration.

The curriculum outlined below indicates the general policy of instruction and is subject to modification at the discretion of the faculty.

The first two years of the curriculum are devoted chiefly to the basic medical sciences and to the following introductory clinical courses: the Science and Practice of Medicine 100 and 200, Introduction to Clinical Medicine 200, Psychiatry and Medicine 200, and Dermatology 200. The details of the curriculum can be found at www.medschool.lsuhsc.edu/spm.

In the first two years, lectures and most basic science laboratory sessions are held in the mornings. Afternoon sessions include small group instruction in “Clinical Forums,” clinical skills laboratories, interactive computer-based simulated clinical cases and clinical experience. These afternoon sessions are designed to stress professionalism, medical ethics, clinical problem solving, clinical skills and public health.

Each student is required to take Step 1 of the United States Medical Licensing (USMLE) Examination after satisfactory completion of the second year of medical school. A passing grade is required. Should a student not pass Step 1 of the USMLE examination, the student may be immediately withdrawn from the clerkship in which the student is currently enrolled so that the student can devote his or her full effort to studying for the reexamination. Further progress in the third year is prohibited until a passing grade is achieved. Such a student will be referred to the Pre-Clinical Promotions Committee for disposition. Failure of the USMLE Step 1 may constitute grounds for dismissal from school. Under no circumstances may a student sit more than three times for Step 1 of the USMLE to fulfill this requirement.

Year three consists of 1 week of ophthalmology and radiology courses followed by 6 clinical clerkships: medicine (10 weeks); surgery (12 weeks); pediatrics (8 weeks); Family Medicine (4 weeks); neurology (2 weeks); obstetrics and gynecology (6 weeks); and psychiatry (6 weeks).

During the fourth year of study, students are required to take both parts of USMLE Step 2 (CK and CS) and achieve a passing score, prior to their graduation.

The final year consists of 32 weeks divided into eight four week blocks. Blocks in ambulatory care, internal medicine, critical concepts, and acting internships are required of all students. All students are also required to take 3 four week electives in the clinical or basic sciences. To end the year, all students take a special-topics course that includes nutrition, geriatrics, drug and alcohol abuse, office management and financial planning. Adequate time is provided for students to travel to interviews at other schools. A catalog fully describing the electives program for the senior year and detailing all elective courses is available on the Medical School web site.

Lectures in the clinical years are intended to present those subjects that cannot be presented adequately by other methods.

Conferences are held at regular intervals in most departments for small groups of students. Both the question and answer and the discussion methods are used. The conferences are correlated with the work covered in didactic lectures and other exercises, and students are urged to use these hours for the elucidation of special points on which they feel the need for further instruction.

Seminars are conducted for the purpose of teaching the student to use intelligently and critically the current medical literature; familiarity with this material should form the basis for continued study throughout active professional life.

Clinical clerkships in all departments are conducted along the same general lines. Students in small groups are assigned to the clinical services in the Medical Center of Louisiana, New Orleans and a number of other affiliated hospitals.

In general, as patients are admitted they are assigned to the students in rotation. The history, physical examination, and laboratory work must be completed within a specified period of time after the patient’s admission. These are checked by the instructor and discussed either with the student, individually, or with the entire patient care team to which the student is assigned. The student also suggests such additional examinations and tests as may be necessary, as well as consultation by various specialists. These consultations, so far as possible, are answered at a time when the student assigned to the case can be present. The student keeps progress notes on the student’s patients, and continues the observation and record until the patient leaves the hospital.

Outpatient clinics are attended in small groups by third and fourth year students, who rotate in each department as may be necessary. During this assignment they take histories, perform physical examinations and routine laboratory tests, institute or perform the necessary diagnostic and therapeutic procedures, act as dressers, and follow up their patients on subsequent visits.

Diagnostic clinics are conducted along the same general lines in each clinical department. Patients from the various clinical services are presented to the class (which consists of third and fourth year students). The history, whenever possible, is presented by the student to whom the case has been assigned. The instructor supplements the history, conducts physical examinations and tests, and illustrates to the students the process of making and confirming a diagnosis. Cases that illustrate both usual and unusual pathologic and diagnostic difficulties are presented.

Research is encouraged, and opportunities to carry on original research under the guidance of a member of the faculty are provided for those students who have the ability and interest.