|First Year||Second Year||Third Year||Fourth Year|
The University of Kentucky College of Medicine's new curriculum for the first and second years is built on the following: a growing appreciation of the foundational sciences as a defining requirement of sound physician practice, especially in an age of genomic medicine; the identification of integrated learning as a more efficient and effective means of mastering and retaining information, especially in light of recent expansions in medical information; and an understanding of the four years of medical education as a continuum rather than a strict demarcation between basic sciences education and clinical learning.
The curriculum is best described as a hybrid systems-based structure. The first year builds a solid structural and cellular/metabolic foundation through disciplined-based courses (anatomy, biochemistry, cell biology), with an overlay of the principles of disease (inflammation, immunity), as preparation for instruction in specific systems.
The systems-based courses integrate foundational disciplines. For example, students in a cardiology systems course learn the anatomy, physiology, histology, pathology, microbiology, and pharmacology of the heart, in the clinical context of associated conditions and treatments.
The systems courses in both years include neurosciences, behavioral/psychiatry, musculoskeletal (including rheumatology and dermatology), hematologic, cardiology, pulmonary, gastrointestinal/nutrition, renal, endocrine, and reproductive health. The second year culminates in a multisystem and integrative course that brings all of the systems-based knowledge together into a comprehensive perspective on the patient.
Anatomy – examines the core gross and microscopic anatomy of the torso, spine and head. This course, integrated with embryology, builds a foundation for the understanding of human anatomy to be further developed throughout the curriculum.
Biochemistry and Genetics – provides students with the knowledge and understanding of human biochemistry, molecular biology, and genetics and their relationships to human health and disease states. The course also integrates relevant aspects of biochemistry, molecular biology, and genetics with an emphasis on problem solving and clinical situations, with the goal of equipping students to be outstanding physicians.
Foundations of Infection, Disease and Therapeutics – focuses on the basis of all human disease, integrating the core disciplines of microbiology, immunology, pharmacology, and pathology. This course provides the foundation for the subsequent systems-based courses.
Neurosciences – includes the study of neuroanatomy, neurochemistry, neurophysiology, neurology, ophthalmology, neuropsychiatry, and neurosurgery to help students understand how the nervous system functions in health and disease.
Behavioral Basis of Medicine – includes the study of psychiatry, behavioral science, and pharmacology. Students are introduced to psychiatric conditions, to the observations that lead to a psychiatric diagnosis, and to exemplars of pharmacologic, psychotherapeutic, and psychosocial modes of treatment.
Introduction to Clinical Medicine I – provides students with opportunities to develop the knowledge, skills, and attitudes necessary to practice patient-centered and evidence-based care in today’s health care environment. Using active learning approaches and portfolio-based assessment, students in small-group seminars facilitated by behavioral and clinical faculty preceptors work through topic areas that include Medical Humanities, Medical Ethics and Professionalism, Developmental Pediatrics, Geriatrics, Nutrition, and Cultural and Social Aspects of Health Care.
Organ System-Based Curriculum - these courses cover the normal physiology and histology of the following systems; the pathophysiology of diseases and disorders of these systems; and the medical and pharmacologic approaches to diagnosis and treatment:
Introduction to Clinical Medicine II – serves as a bridge between the basic and clinical sciences by teaching students the knowledge and skills necessary to develop into excellent diagnosticians. The course focuses on the following skills: the ability to perform a history and physical examination; integration of basic laboratory and radiographic data; and differential diagnosis formulation.
Multisystem & Integrative Concepts - serves as the capstone course for the first- and second- year organ system-based curriculum. Primarily a clinical case-based course, students will have opportunities to formulate their own differential diagnoses and plan of care and check their conclusions against the actual approach of master clinicians. Through the application and review of knowledge within clinical cases, the course will prepare students well for USMLE Step 1. In addition, the course prepares students for the clinical reasoning skills essential for third-year clerkships.
Third year provides the clinical exposure students need to integrate their earlier learning into the care of patients and experience the “art of doctoring.” Individual rotations balance the need for adequate exposure to and involvement with patient care with the time needed for study and assimilation of information. Student learning occurs in hospital facilities and ambulatory settings. Students are required to complete one rotation at a rural site through UK’s Area Health Education Center (AHEC) program during third, and may elect to do an additional rotation during fourth year.
The third-year curriculum provides the student with broad exposure to the major medical disciplines. The required third-year clerkships are as follows:
Clinical Neurosciences: Neurology and Psychiatry – This block consists of two separate four-week rotations of neurology and psychiatry, including child neurology, stroke service, and inpatient psychiatry care, with an integrated lecture series.
Family and Community Medicine – The specialty of Family and Community Medicine has a long history of caring for people of all ages in their communities. During this four-week clerkship, students work with practicing family physicians in a variety of outpatient settings, where patients are at the center of all learning activities.
Internal Medicine and Emergency Care – This 16-week integrated clerkship combines inpatient and outpatient Internal Medicine and two weeks of Emergency Medicine. Students are an integral part of UK and Veterans Affairs inpatient teams, and work in continuity clinics with the same clinician one afternoon per week in either a UK, VA or community-based practice for the duration of the clerkship. Students also gain experience in both the intensive care unit and emergency room settings, and receive training and certification in Advanced Cardiac Life Support. Additional clinical experiences occur in subspecialty clinic settings and diagnostic laboratories (endoscopy, cardiac catheterization). Finally, students explore a number of topics relevant to the practice of medicine such as professionalism, service learning and ethics in weekly small-group learning experiences.
Obstetrics and Gynecology – This four-week rotation allows students to participate in the care of women; assist in prenatal care, birth and follow-up with mothers; and focus on the family unit. This clerkship offers the opportunity to care for women in both clinic and hospital settings. Students spend two weeks in Labor and Delivery, one week in Benign Gynecology and one week in Gynecologic Oncology. Students also observe in a gynecology operating room setting.
Pediatrics – This eight-week rotation gives students four weeks of ambulatory pediatrics and four weeks of inpatient pediatrics. Students participate in well-child visits and see patients with a wide variety of illnesses, including rare pediatric diseases. Students learn through direct patient care, small groups, lectures, and one-on-one mentoring. The ambulatory rotation may be completed at a Kentucky AHEC location, where students spend the entire month with a community-based physician.
Surgery – This eight-week clerkship presents surgical approaches to adult disease. Students learn through direct involvement in patient care, as well as weekly conferences and clinical skills workshops. Students rotate on a general surgery service for four weeks and on two two-week surgery specialty services. Students may opt to complete one four-week specialty rotation. During the General Surgery clerkship, students participate in Trauma Call and function as part of the Trauma Surgery Team. This rotation is designed to give all students an exposure to a wide variety of general surgery patients and problems.
The fourth year of study is designed to allow students to further develop and demonstrate their clinical skills and prepare for residency in their chosen specialty. In addition to the requirements listed below, students complete 16 weeks of elective rotations at the University of Kentucky or another approved site.
Acting Internships – Students must complete two four-week acting internships where they learn the responsibilities of first-year residents on clinical rotations.
Transition to Residency – This four-week course encompasses the foundational disciplines, clinical skills, and practical knowledge students will apply in residency. Students practice skills necessary for medical practitioners in realistic clinical scenarios using standardized patients and high fidelity simulators.