Mission

UCSF School of Medicine educates physicians and physician- scientists to advance health worldwide.

Overview of current curriculum

UCSF medical students commence with the 18-month Essential Core, a series of 7 interdisciplinary block courses complemented by the longitudinal Foundations of Patient Care course. In the spring of year 2, students embark on the Clinical Studies, which consists of the third-year core clerkships and fourth-year rotations. Throughout, the curriculum emphasizes student-directed learning, connections across disciplines, and competency-based advancement.

From the first day, students also have rich opportunities to explore areas beyond the core curriculum and to engage in in-depth training and inquiry in areas such as basic or clinical research, community and global health, and medical education, through the innovative Pathways to Discovery Program.

Future of our Curriculum: A Vision for the New Decade

This vision of our curriculum grew out of two years of curriculum planning activities and culminated in the June 2009 CCEP retreat. Five components of the vision serve as the guiding blueprint for future curriculum innovation:

1. Clinical experience as an intentional core – early clinical skills learning; early clinical immersion; longitudinal clinical experience featuring developmentally progressing authentic roles in patient care, engagement with teams and communities, and monitoring health outcomes for a panel of patients.
2. Modular design of the curriculum - horizontal and vertical learning cohorts, interdisciplinary perspectives, and Pathways integration.
3. Pedagogy – collaborative learning and accountability, on-line learning and networking, limited lectures and small groups, team-based and project-based learning with interprofessional components
4. Assessment –periodic, comprehensive competency-based assessments; testing for synthesis and application
5. Fourth year – individualized, coherent learning plans that integrate Pathways/research or more sub-Internships with responsible roles; early entry to residency possible.

Background

The 2009 UCSF School of Medicine curriculum retreat was held at the San Francisco Zoo on June 4 to discuss and advance recommendations from two working groups about the future of medical education at UCSF.

Specific Recommendations

The specific recommendations that were seen as the strongest ideas were:

1. Early clinical immersion with upfront introduction of clinical skills
2. Horizontal and vertical cohorts of learners
3. Modular structure to curriculum
4. Emphasis in assessment on synthesis and application over rote memorization
5. Assessment individualized to advanced areas of interest
6. Longitudinal clinical experience with authentic roles in patient care from the outset and engagement with teams and communities as well as monitoring health outcomes for a panel of patients.
7. Students acquiring factual knowledge outside of classroom and collaborative problem-solving in the classroom
8. Competency-based assessment with developmental benchmarks
9. More sub-internships with responsible roles for patient care
10. Academic/programmatic elective opportunities including PRIME, Pathways, MSTP

Action Plan

Moving forward toward this vision while respecting the current financial crisis and LCME preparations, we recommend the following:

• In the coming two years, complete LCME preparation before addressing major change in the clinical experience and modular design of the curriculum. Pilots will be encouraged to gain experience with key design elements over the next two years and this will be prioritized for Academy Innovation Funding along with the following recommendations.
• Use existing curriculum committees to advance work already in progress:
• Pedagogy and efficiency- Working across the curriculum to identify ways to reduce costs and increase efficiency of teaching and learning while maintaining our commitment to active and self-directed learning.
• Assessment- Implementing the competency-based assessment practices recommended by the assessment subcommittee to measure student performance and development using the MD Portfolio.
• Fourth year – Improving the quality of learning in the fourth year by assessing needs for greater opportunities for deeper or broader engagement in Pathways to Discovery and/or clinical experience.

CCEP approval on September 16, 2009:

CCEP unanimously endorses the five-point vision for curriculum innovation with the caveat that implementation will need to proceed with care given the current financial circumstances.