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    Louisiana State University Health Sciences Center at New Orleans
   
 
  Sep 21, 2017
 
 
    
Catalog/Bulletin 2017-2018

Doctor of Medicine, MD


The course of instruction for the degree, Doctor of Medicine, extends over four years.  Planning for a curriculum renewal began in 2012-13.  Changes in the first year curriculum were implemented in 2015-16, and changes in the second year curriculum will be implemented in 2016-17.  The primary goals of curriculum renewal are 1) to improve students’ critical thinking skills through additional active learning sessions, 2) to decrease the time spent in lecture by eliminating unnecessary redundancies, 3) to provide better integration of clinical and basic sciences, and 4) to provide students with more opportunities for early clinical involvement and career exploration.  Other goals include additional instruction in specific content areas such as genetics, behavioral science, interprofessional education, cultural competence, epidemiology, biostatistics, and health systems.

  

The first year curriculum begins with time devoted to professionalism, diagnostic reasoning, and how to ‘learn’ in medical school.  Most of the year comprises foundational courses in gross anatomy, physiology, cell biology, and biochemistry. These courses have been reorganized, and integrated with clinical education.  Students take a full dissection gross anatomy course in the first semester, as this has been an area of strength in our curriculum.  Biochemistry was moved from the spring to the fall semester.  Physiology and cell biology are taught in the spring, and there is considerable synergy between these disciplines.  Separate short courses in genetics, behavioral science, immunology, and population medicine (including epidemiology, biostatistics, disease prevention, and the structure/financing of the healthcare system) have been added. These are foundational sciences of increasing importance in modern medicine.  Finally, the Clinical Skills Integration (CSI) 101 and 102 courses span the entire year.  This course is fully integrated with the basic science courses, and emphasizes skills instruction and skills assessment. This includes the skills of clinical reasoning, interviewing, physical examination, basic procedures, and critical thinking.  Themes such as cultural competency and medical ethics are also discussed throughout the CSI 101 and 102 courses.

 

In the summer between first and second year, students may elect to engage in clinical or basic science research under the guidance of faculty members.  Numerous opportunities and stipends are available. 

Students who want a more intensive research experience may apply for the Honors Program.  This 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 an area of mutual interest between the student and the student’s faculty advisor. Students who have maintained high academic standards during their first year are eligible for consideration.  After intensive research during the summer between the first and second year, these students continue to work on their research project throughout the second, third, and fourth years of school.  Honors program students submit a manuscript that is worthy of publication in order to complete the program and be recognized at graduation.  Students may also choose to take advantage of our AHEC preceptorship program in the summer between first and second year.  These students work in a clinical setting with a primary care preceptor for 4-weeks.  Stipends are available.

 

The second year curriculum has been reorganized.  The discipline based courses of pathology, microbiology, and pharmacology will be fully integrated into organ system courses that reinforce the clinical context of all instruction.  The year begins with a course called Foundations of Disease and Therapy, which provides the basic concepts and nomenclature from these basic disciplines.  After this course, the remainder of the year will be organized around organ system courses: hematologic system, neurologic-psychiatric systems, musculo-skeletal & dermatologic systems, cardiovascular system, pulmonary system, renal system, gastro-intestinal system, and endocrine-reproductive systems.  The teaching of pathology, microbiology, and pharmacology will be integrated in each course, and will be organized in a way that emphasizes disease process and management in a clinical framework.  The Clinical Skills Integration 201 and 202 courses span the entire year.  These courses emphasize instruction and feedback in skills that will be important during the junior year clerkships.  This includes physical exam training on clinical rounds in the hospital, history and physical examinations on hospitalized patients, patient write-ups for evaluation, presentations of papers from the medical literature, and continued work on interviewing skills.  Students are also required to explore an area of clinical or research interest in more depth, and to begin thinking about career choices.   

 

Each student is required to take Step 1 of the United States Medical Licensing Examination (USMLE) 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 withdrawn from the clerkships in order to 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.  Repeated failures of the USMLE Step 1 may constitute grounds for dismissal from school.

 

Year three begins with a 2-week clerkship preparation course, and then students begin their clinical clerkships in the following disciplines: internal medicine (10 weeks); surgery (9 weeks); pediatrics (8 weeks); Family Medicine (4 weeks); neurology (3 weeks); obstetrics and gynecology (6 weeks); psychiatry (6 weeks); and a career planning elective (2 weeks).  Clinical clerkships in all departments are conducted along the same general lines. Students in small groups are assigned to the clinical services in University Medical Center-New Orleans, or in our affiliated hospitals.  Students may be assigned to one or more rotations at our affiliated hospitals in Baton Rouge or Lafayette.  Some students may elect to move to Baton Rouge for their clinical rotations, in which case they do all of their third year and fourth year clerkships at our branch campus in Baton Rouge.  

 

In general, as patients are admitted to the hospital, they are assigned to the students on the rotation. Students may be responsible for the history, physical examination, and tracking the laboratory work on assigned patients.  These are checked by the attending physician and discussed with the patient care team.  Students write progress notes on their assigned patients, and see them on a daily basis while they are in the hospital.  On most third year clerkships, students also attend outpatient clinics.  Students see patients, present them to the faculty attending, discuss treatment plans, and write notes in the chart.  They may be able to follow these patients on subsequent clinic visits.

 

Lectures and conferences are incorporated into the third year clerkships. Conferences may be held for students and residents, or just for students.  The conferences are typically focused around discussion of specific patients, and students are urged to use these hours for the elucidation of special points regarding patient care and patient safety. 

 

The fourth year of medical school consists of 32 weeks divided into eight four week blocks. Acting internships, ambulatory care, internal medicine, and a critical concepts course are required of all students. All students are also required to take 3 four-week electives in the clinical or basic sciences. Some of these electives may be taken at other schools.  This gives students the opportunity to explore programs that they might be interested in for residency training.  There is adequate time in the fourth year for students to travel to interviews at other schools.  At the end of the year, all students take a special-topics course.  This course includes lectures on practice management, financial planning, wellness, and common problems seen during internship. This course also provides certification in Advanced Cardiac Life Support.  During the fourth year of study, students are required to pass both parts of USMLE Step 2 (CK and CS).  A passing score on both exams is required prior to graduation.