Curricular Oversight & Improvement
The undergraduate medical school curriculum at the University of Washington School of Medicine (UWSOM) is designed to provide students with a strong scientific foundation and a comprehensive approach to clinical medicine.
The oversight and management of the curriculum, including the medical school program objectives and competencies, are the responsibility of Curriculum Committees, as established by the Dean for the School of Medicine.
The educational leadership, i.e. block, course and thread directors, teaching faculty, Associate Dean for Curriculum, and the Curriculum Committee and its subcommittees, have responsibility for developing and implementing a curriculum that is appropriate for the education and training of students for the practice of medicine. The curriculum is educationally equivalent at each Foundations site, and common examinations are given to ensure that all students achieve the same level of competence.
Processes are in place to ensure continuous quality improvement in the structure, content and processes of the curriculum. The Associate Dean for Educational Quality Improvement plays a key role in working with the Associate Dean for Curriculum, the Curriculum Committee, and other faculty involved in curriculum to ensure that continuous quality improvement is an ongoing priority.
WWAMI Medical Education Program
The University of Washington School of Medicine medical educational program is a regional, four-year MD program for residents of the states of Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI). The UWSOM respects the universities housing the WWAMI program governance structures while maintaining program comparability and congruence across sites and meeting LCME standards.
The UWSOM’s Academic Affairs administration provides leadership and structure for ongoing communication and dialogue among faculty responsible for curriculum, student learning and evaluation at all sites. Common standards that apply to all WWAMI sites are expected for teaching faculty appointments, evaluation, and retention. Expectations of student participation and contribution to their learning in both coursework and patient care settings will be clearly communicated in a variety of settings. Each Foundation’s site structure is required to include a designated administrative position to manage all aspects of the delivery of the curriculum and support of its students in collaboration with the appropriate Academic Affairs Associate Deans.
The Academic Affairs and Regional Affairs educational leadership manage issues such as expansion of the number of students overall, number of students in Targeted Rural Underserved Track (TRUST), WWAMI Rural Integrated Training Experience (WRITE), city and state based tracks and other special programs, development of additional first year or clinical sites, and the scope of the MD program delivered at all sites. Protocol for establishing and retaining clinical educational sites, including the creation of unique longitudinal sites will be followed.
In addition, the Office of Academic, Rural and Regional Affairs provides individual state legislatures information regarding state funding and programs, such as paybacks, that affect a state’s students. A unified educational planning approach in collaboration with the legislative process will support the maintenance of the standards of the medical student program and assist in developing sound state initiatives aimed at increasing the number of healthcare providers within the WWAMI region.
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.
Foundations Phase Curriculum
The Foundations Phase curriculum is composed of three terms over a 15-month period consisting of seven integrated blocks, two longitudinal programs, a scholarly/research project and Research Methods course. All blocks are designed to integrate basic, clinical, and social sciences. Content in cross-cutting scientific areas, such as pathology/histology, human form and function, 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:
- Molecular & Cellular Basis of Disease
- Invaders & Defenders
- Circulatory Systems (CPR)
- Energetics & Homeostasis
- Blood & Cancer
- Mind, Brain, & Behavior
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 Themes in Medicine 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, interprofessional care, communication and more.
During the fall of first year, students must complete a Research Methods course, which covers epidemiology and biostatistics. During the summer between first and second year of the Foundations Phase, all students complete a research/scholarship requirement (see Academic Requirements Policy for COVID-19 related changes).
After the first three terms, students complete a three-month Consolidation and Transition phase 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.
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-Clinical Knowledge and USMLE Step 2-Clinical Skills examinations (see Academic Requirements Policy for COVID-19 related changes).
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.
During the Explore and Focus Phase, students complete the final portion of the longitudinal Themes in Medicine course.
Any faculty who supervise and assess students must have a faculty appointment.
Requirements, Procedures and Guidelines
The faculty appointment process must be initiated prior to or at the time of a new site application. The process and criteria for appointment are determined by the sponsoring department.
Faculty instructors at WWAMI partner universities (Gonzaga University, University of Wyoming, University of Alaska Anchorage, Montana State University, and University of Idaho) who have a leadership role in the Foundations Phase for WWAMI medical students at their site are expected to have a University of Washington faculty appointment. Their primary faculty appointments are in their home departments, but they should also have affiliate faculty appointments in the appropriate department at the University of Washington School of Medicine. The process and criteria for affiliate appointments are determined by the sponsoring department. The Office of Academic, Rural and Regional Affairs provides oversight of the faculty appointment process for those involved in medical student education and is in charge of tracking faculty appointments for all regionally-based teaching faculty to ensure that faculty status is initiated or in place and is current.
Physicians who have a leadership role in student clinical education are expected to have affiliate faculty appointments in the appropriate department at the University of Washington School of Medicine or be appointed as University of Washington volunteer clinical faculty. Faculty with major teaching responsibility in clinical education are expected to have a University of Washington Faculty/Volunteer Clinical Faculty appointment as soon as possible after beginning their work with students. The process and criteria for affiliate and volunteer clinical faculty are determined by the sponsoring department.
While not all physicians who may interact with a student at a site are required to have a faculty appointment, the primary preceptor and any physicians who will evaluate a student will have a faculty appointment.
Approval of Clerkship Sites for Required & Elective Rotations
Additional training sites for medical students must be developed to accommodate increased class size, new hospital affiliations, and changing patterns of healthcare delivery. Clerkship directors, departments, regional WWAMI deans, and the Office of Academic, Rural and Regional Affairs should work together to determine and meet the need for new clerkship sites. The initial responsibility for reviewing a site’s adequacy as a trial site for a required or elective rotation lies with the department. If the site is outside Seattle, the WWAMI regional clinical dean is also involved in the process. A careful review of course objectives, resources, and general acceptability should be carried out and reported as a recommendation for approval of the new clerkship site.
Ongoing monitoring and oversight of clinical training sites is the responsibility of the Associate Dean for Curriculum, Departments, Regional Clinical Deans and the Curriculum Committee.
Gina Franco, Clinical Curriculum