5.1 Curriculum Overview

Curriculum Overview
The curriculum is dynamic and designed to provide students with a strong scientific foundation, a comprehensive, integrated approach to clinical skills and patient care, opportunities to explore various career interests and broaden students’ perspective of medicine and the world in which physicians function.

A defined set of medical school program objectives and core course requirements to meet these curricular objectives provides the framework for the MD program. Since the field of medical science is constantly changing, the graduation requirements for the MD program set forth at matriculation may undergo modifications that will apply to students already enrolled as long as there is adequate time to complete the requirements within the students’ anticipated date of graduation.

Active Learning

Foundations Phase Curriculum
The format of each block course is designed to emphasize active learning processes and minimize the number and length of lectures. Small group sessions and independent learning receive greater emphasis in the curriculum. Learning to work effectively in a small group is an important skill. Each student is expected to share in the responsibility of fostering a productive learning environment in the small group in which a diversity of knowledge and experience can be joined for the common good.

Patient Care Phase and Explore & Focus Phase Curriculum
The Patient Care Phase curriculum emphasizes active student participation on patient care teams and increased responsibility for patient management as the student progresses through the clinical phases of the curriculum. Students are expected to actively engage in independent learning/study about diseases encountered and to attend and participate in conferences. The professional development of students as patient care providers and team members is an essential component of teaching and role modeling within the clinical curriculum.

Students are expected to gain broad educational experience utilizing both the wide-range of primary care and specialty clerkships in clinic and hospital settings across the WWAMI region. Longitudinal clinical experiences within WWAMI underserved rural and urban settings must meet educational requirements equivalent to the standard clinical curriculum.

Online Learning Environment
Foundations Phase blocks use several technologies to facilitate student learning. The School of Medicine uses the Canvas learning management system as the gateway to these resources:

  • Course information, syllabus, presentation materials, etc.: All currently enrolled medical students, including those on leave or pursuing concurrent degrees, should have access to the most up-to-date version of a particular course at any WWAMI site.
  • Discussion boards for discussion with classmates outside of class: In some courses, faculty may actively participate in discussions.
  • Grades: Students will only see their own scores and grades for the course, and access is specific to the course/site in which the student is enrolled.
  • Video recordings: Pre-class assignments often include brief video modules prepared by faculty for students at all sites. Some sites also provide recordings of in-class sessions. In-class recordings from Seattle-based courses are accessible by students at all WWAMI sites.
  • Course-specific tools such as online exams, virtual microscopy, anatomy atlases, etc.: Access beyond the specific course/site offering is dependent on the nature of the resource and any licensing restrictions.

The School of Medicine continually monitors emerging technologies to facilitate student learning and welcomes student input on the evaluation, selection, and adoption of new tools.

Clinical Immersion
All students are required to complete the Clinical Immersion at the start of medical school. Clinical Immersion is a full-time multi-week component of Foundations of Clinical Medicine that focuses on learning basic clinical skills and covering topics relevant to a career in medicine, such as professionalism and patient-centered care.

Foundations Phase Curriculum
The Foundations Phase curriculum is composed of three terms over an 18-month period consisting of nine integrated blocks, two longitudinal programs, and a scholarly/research project. All blocks are designed to integrate basic, clinical, and social sciences. Content in cross-cutting scientific areas, such as pathology/histology, anatomy and embryology, and pharmacology are weaved throughout. Blocks and courses are taught by faculty from the basic sciences and clinical disciplines.

During the Foundations Phase, students must complete the following required blocks as a full-time, intact, continuous curricular schedule:

  • Fundamentals of Medical Science & Research
  • Infections & Immunity
  • Cancer, Hormones & Blood
  • Muscles, Joints, Bones & Skin
  • Cardiovascular System
  • Respiration & Regulation
  • Head, Neck & Gut
  • Mind, Brain, & Behavior
  • Lifecycle

Beginning in Immersion and Orientation, the Foundations of Clinical Medicine (FCM) course is a longitudinal clinical training program focused on clinical skills, primary care, and continuity of care. Students work with physicians, faculty, and other health professionals in outpatient clinical settings, clinical skills workshops, and simulation experiences one day a week in the Foundations Phase. They also participate in hospital tutorials with College faculty and their College mentor group.

Through the four-year longitudinal Medicine Health & Society course, students receive education in theme areas important to the practice of medicine such as health systems, quality and safety, population health, global health, social determinants of health/health equity, diversity, professionalism, ethics, inter-professional care, communication, and more.

Students will come together for seven Integration Weeks throughout the four-year curriculum to develop a holistic framework of basic science, revisit and integrate previous topics, reflect on professional identity formation, practice approaches for self-care, sustainability, life-long learning, and more.

After the first three terms, students complete a three-month Consolidation course in which they prepare for the USMLE Step 1 examination through a combination of structured and independent study, finish their research requirement and complete a Transition to Clerkships series to prepare them for the Patient Care Phase of the curriculum.

Independent Investigative Inquiry (III or Triple I)
All students earning the MD degree are required to complete an independent research or community-based project. This may be met through a data-gathering/hypothesis-driven inquiry, critical review of the literature, experience-driven inquiry, or a special simulation project overseen by a faculty sponsor with whom the student collaborates. The student must be the sole author of the final paper or project, which must be completed on an agreed-upon timeline.

An exception in the Triple I timeline is given to those in the Medical Scientist Training Program (MSTP), for whom a thesis or dissertation in a medical or medically-related field fulfills the III requirement. The thesis or dissertation must be completed during the graduate portion of the program and prior to entering the Patient Care Phase of the curriculum.

Transition to Clerkships
The Transition to Clerkships course serves as a preparation for clinical clerkships. Completion of Transition to Clerkships is required for graduation.

Patient Care Phase
The Patient Care Phase is 12-months and students complete six required clinical clerkships including Internal Medicine, Family Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry and Surgery. Students must also complete the second portion of the longitudinal Themes in Medicine course.

Students should expect to complete a minimum of 24 weeks of clerkships outside of the Seattle area during the Patient Care Phase, and a minimum of 8 weeks of clerkships in Seattle at one of the following hospitals: UW Medical Center, Harborview Medical Center, Seattle Children’s, or Puget Sound VA. (see Time in Seattle Policy for COVID-19 related changes). Additional time is available during the Patient Care Phase to complete clinical electives, intersessions, the Patient Care Phase OSCE, and the USMLE Step 2 examination.

Explore & Focus Phase
The Explore and Focus Phase is 15-months long and designed to allow students to explore potential specialty careers through a combination of required and elective clinical clerkships. Required clerkships include Emergency Medicine, Neurology/Neurosurgery, and two advanced patient clerkships, one of which must be a subinternship. Students are required to complete 40 credits, or 20 weeks, of clinical electives.

Transition to Residency
At the end of the fourth year, prior to the Physician’s Oath and Hooding Ceremony, students return to Seattle to participate in the Transition to Residency course, which is an academic- and skills-based course that prepares students for entering residency training.

Required Examinations
Objective Structured Clinical Examinations (OSCEs)
Objective Structured Clinical Examinations (OSCEs) are clinical simulations, administered periodically throughout the curriculum, to assess the level of knowledge and clinical skills of students. The exams are given at the end of the Foundations and Patient Care phases. If minimum performance standards are not met in any of the OSCEs designed to assess knowledge and skills, the student must successfully complete the recommended remediation plan in order to be approved to continue in the curriculum.

A practice OSCE is administered part way through the Foundations Phase to determine a student’s progress and formative feedback is provided. The summative Foundations Phase OSCE must be completed at the end of the Foundations Phase. The Patient Care Phase OSCE must be completed at the end of the Patient Care Phase irrespective of the student’s plans to expand the fourth year. The Associate Dean of Student Affairs may make exceptions to the timing of the OSCE in individual circumstances.

Failure to successfully complete either exam will require remediation, potentially delaying the student’s progress in the curriculum, and will result in the student’s record being referred to the Student Progress Committee (SPC). The student’s completion status of the OSCEs is noted in the Medical Student Performance Evaluation (MSPE).

The Clinical Skills Steering Committee, chaired by the Assistant Dean for Clinical Curriculum, provides oversight of the OSCE program.

USMLE Step 1 and Step 2-Clinical Knowledge (CK)
All students are required to pass the following United States Medical Licensing Examination (USMLE) examinations in order to graduate: Step 1 and Step 2-Clinical Knowledge (CK). Successful completion of each Step must be accomplished on the timeline established by the Student Progress Committee in order to continue in the medical school curriculum. Failure to successfully complete the exams will result in the student’s record being referred to the Student Progress Committee for subsequent management.

The student’s completion status of the USMLE examinations is noted in the Medical Student Performance Evaluation (MSPE).

Step 1

  • Remediation of unsatisfactory Foundations Phase required coursework must be completed prior to taking USMLE Step 1.
  • Step 1 must be completed in the second year prior to beginning clinical clerkships in the Patient Care Phase.
  • Combined degree students and students entering into research fellowships must achieve a passing score on Step 1 prior to entering/continuing in their graduate/research program.
  • If a student has had academic difficulty and/or marginal performances in the Foundations Phase, including the Comprehensive Basic Science Exam, the Student Progress Committee (SPC) may recommend or require that the student’s entry into the Patient Care Phase be delayed, allowing additional study time for Step 1. At the end of the Foundations Phase blocks, SPC will review students with thread remediation and/or Fail grades to determine if delaying the clerkship start date is necessary.

Step 2-CK

  • Remediation of unsatisfactory Patient Care Phase required clerkships must be completed prior to taking Step 2-CK.
  • Step 2-CK should be taken after completion of the Patient Care Phase and no later than June 30 of the third For students who complete their Patient Care Phase off-cycle from the projected timeline, Step 2-CK should be taken within 12 weeks of completing the required Patient Care clerkships.
  • Successful completion of Step 2-CK will be noted on the MSPE. Delays in taking Step 2-CK beyond the deadline will be noted by the deficiency the exam is taken.
  • Step 2-CK must be successfully completed with a passing score in order to participate in the residency match. Failure to complete either the exam on the established timeline, whether by failure or by delay, may prohibit the student from participating in the residency match.

Contact Information
Curriculum Office