M2 Year 2018-01-11T10:51:02+00:00

M2 Courses:

PRCL 627 Clinical Microbiology/Immunology:   4 Credit Hours

Placement in the Curriculum: 
   Year Two
Duration:    August – December

Synopsis:    In Clinical Microbiology & Immunology, students learn the basic properties of medically relevant bacteria, viruses and fungi and how these organisms cause disease.  Clinical aspects of infectious diseases are stressed. In addition, aspects of the immune response such as autoimmunity, hypersensitivity defects in the immune system, and cancer immunology are discussed.  A majority of the important pathogens are covered in detail with emphasis on integrating the properties of the microbe, epidemiology, the mechanisms of pathogenesis, clinical diagnosis, and disease outcome.  The laboratory acquaints students with culture techniques and basic diagnostic procedures. Case study sessions provide problem-solving opportunities.

Competencies:    In the process of completing this course, students acquire the following competencies:
●  Understand the immune response to foreign and cancer cells, auto-immunity allergy, hypersensitivity, and defects in the immune system
●  Correlate specific properties of microbes with the diseases they cause.
●  Identify the most likely agents responsible for particular infectious diseases based on disease symptoms, epidemiological factors, and laboratory tests.

Key Words:    Bacteria, viruses, fungi, parasites, pathogenesis, infectious diseases, immunology, autoimmunity, allergy, hypersensitivity, immunodeficiency

Assessment:    Midterm and final exams, laboratory practical, case studies exam. James Scholar students may demonstrate competence by taking the final exam and the case studies departmental exam

Instructional Features: 
   Lectures, Laboratory, Case Presentations, interactive computer case studies, Teaching/Learning Examinations are available on the website.

PRCL 641 Clinical Pathophysiology I:   4 Credit Hours
PRCL 643  Clinical Pathophysiology II:   5 Credit Hours

Placement in the Curriculum:    Year Two
Duration:    August – April

Synopsis:    The two CPP courses address pathophysiologic alterations that cause signs, symptoms and disease. Taught in parallel with Pharmacology and Pathology, they provide transition between the basic sciences and the practice of general clinical medicine.

Competencies:    In the process of completing these courses, students acquire the following competencies:
●    Demonstrate relevance of basic science knowledge in the practice of general clinical medicine.
●    Identify the pathophysiologic alterations that lead to basic disease states .
●    Begin to relate these alterations to the signs and symptoms that occur in patients with the indicated structural changes.

Key Words:  
  Neoplastic diseases, infectious diseases, diseases of immunity, hematologic diseases, cardiovascular diseases, respiratory diseases, renal diseases, gastrointestinal diseases, hepatobiliary diseases, nervous system, female and male genitourinary, skin, musculoskeletal system, endocrine diseases.

    Exams occur at the approximate mid–point and end of the course.  They are not cumulative.

Instructional Features:
    Didactic lectures, lab exercises and small group discussion.

PRCL 645 Essentials of Clinical Medicine 3: 6 Credit Hours
PRCL 646 Essentials of Clinical Medicine 4: 10 Credit Hours

Placement in the Curriculum:   Year Two
Duration:    August – May

Synopsis:    A continuation of the Essentials of Clinical Medicine (ECM) clinical skills sequence, the M-2 year builds on the interviewing skills acquired in the first year course and is designed to provide comprehensive preparation for clerkships and subsequent clinical activities.  Students learn fundamental skills used in taking a history, performing a physical examination, relating to the patient, clinical reasoning, and recording findings in the patient record.  The course also provides the first concentrated exposure to the clinical activities of physicians and to the structure and function of health care facilities (hospitals and clinics) as well as an expanded experience with an outpatient preceptor.

Competencies:    In the process of completing this course students acquire the following competencies:
●    Skill in conducting an effective interview (including gathering data and  maintaining a good doctor-patient relationship);
●    Skill in recording interview and physical examination data in written form;
●    Skill in problem list development and the development of a hypothesis of a patient’s problem;
●    Skill in conducting a smooth and professional physical examination;
●    Skill in working with a team of colleagues;
●    Skill in the determination of the health practices and risks of a patient, and the ability to work with that patient to develop a plan to improve health risk behavior;
●    Skill in critical reading and clinical problem-solving using principles of evidence-based medicine.

Students will also:
●    Develop the professional behavior of a competent physician, including: active participation and preparation for the tasks at hand; responsibility; good working relationships with colleagues, patients, and their families; self-directed learning; professional behavior even under stressful conditions; professional grooming and attire;
●    Understand how the various members of the health care team work together in the care of patients;
●    Understand the health care environment, both locally and nationally, and  the effect it has on patients and their care;
●    Understand how personal beliefs may affect the care and treatment of  patients;
●    Be able to recognize and integrate the complexity of multiple levels of data as it affects patient care;
●    Be able to understand and appreciate the impact patients’ illnesses have on their lives and the lives of their families.

Key Words:    Clinical skills, history taking, physical examination, communication, interpersonal skills, professional behavior, health risk appraisal, patient records, medical ethics, human values, professional standards, legal standards, epidemiology, biostatistics, prevention, screening, early intervention, predictive value, environmental medicine, health care system, evidence-based medicine

Assessment:    Clinical performance exams utilizing standardized clinical encounters and patients covering interviewing, history taking, physical examination, professional behavior, and clinical reasoning; attendance at and participation in working group sessions; completion of Longitudinal Primary Care experience requirements; papers; clinical case problems, Final essay Examination.

Students in ECM are evaluated using the grading system in effect for clinical clerkships.

Instructional Features:

●    Six weeks of instruction in a hospital setting
●    Workshops and working group sessions in groups of 12-14 students
●    Simulated clinical encounters with standardized patients for teaching and /or assessing clinical and diagnostic skills and professional behavior.
●    Patient instructors for teaching physical examination skills.
●    Harvey Simulator for teaching the cardiac examination.
●    Panels of Patients
●    Films
●    Teaching/Learning Experience

PRCL 626  General/Systemic Pathology I:   4 Credit Hours
PRCL 633  General/Systemic Pathology II:  3 Credit Hours

Placement in the Curriculum:  Year Two
Duration:    August – April

Synopsis:     General & Systemic Pathology is the study (logos) of suffering (pathos) and is a “bridging” discipline involving both basic science and clinical practice.  Pathology is devoted to the study of the structural and functional changes in cells, tissues, and organs that underlie disease.  General pathology is concerned with the basic reactions of cells and tissues to abnormal stimuli that underlie all diseases, and systemic (organ and organ system) pathology examines the specific responses of specialized organs and tissues to more or less well-defined stimuli.  (Adapted from Robbins and Cotran, page 4.  See Instructional below for information regarding this text.)

Through large group sessions and small group discussions and labs, students learn the morphologic alterations of diseased tissues and organs at the gross and microscopic level, as well as how these alterations are correlated wtih the clinical manifestations of the disease.

   By the end of the course, successful students will achieve the level of competence expected of a medical student completing the M2 year, studying for USMLE Step 1, and preparing for the M3 year and patient care responsibilities through the following goals:
Medical Knowledge: 
●  Demonstrate an investigative and analytic approach to clinical and pathological problems.  (See page 4 of Robbins and Cotran.)
●  Demonstrate applied knowledge of Pathology, by describing the  four aspects of the major disease processes covered in the course:
▸Cause (etiology).
▸Mechanisms of development (pathogenesis).
▸Structural alterations induced in the cells and organs (morphologic changes).
▸Functional consequences of the morphologic changes (clinical significance).
●  Apply the basic and clinically supportive sciences appropriate to  pathology, such as anatomy, biochemistry, histology/histopathology, cytogenetics, and molecular pathology, etc.

Patient Care:
●  Gather and apply essential information from patient cases necessary to discuss clinicopathologic processes.
●  Demonstrate the ability to develop a differential diagnosis when caring for a patient or presented with a histopathologic finding.

Practice-based Learning and Improvement:
●  Demonstrate the ability to support self-education (i.e., active learning).
●  Demonstrate the ability to find additional information when confronted with a question or unfamiliar term, particularly when preparing for Small Group Discussion cases.
●  Demonstrate the ability to appropriately use a medical dictionary and to use appropriate terminology.
●  Use information technology to access on-line medical information, as appropriate.
●  Facilitate the learning of peers within the small group discussion format.

Interpersonal and Communication Skills:
●  Exhibit effective listening and communication skills to result in effective information exchange among peers in Small Group Discussions.

●  Demonstrate respect, compassion, and integrity in interactions with peers, faculty, and support staff.
●  Perform assigned duties (such as preparing Small Group Discussion cases) in a dependable and responsible manner.
●  Demonstrate commitment to ethical principles pertaining to the course by adhering to the College of Medicine Honor Code.

Systems-based Practice:
●  Demonstrate an understanding of how the practice of pathology fits within the larger context of medical practice.

Assessment:    Students are assessed based on their performance on team-based learning (TBL) exercises, five progress exams and one comprehensive final exam (the NBME Pathology Subject Exam). Three examinations in the first semester and two examinations in the second semester cover information from large group sessions, associated readings, as well as certain lab experiences, such as CBC lab and renal pathology case studies. The end of semester progress exams (exam 3 and exam 5) also include material from the small group lab sessions from that semester. The first examination tests material only from the Pathology course, while the remaining four progress examinations are combined Pathology and Clinical Pathophysiology tests.

Students also recieve anonymous, narrative feedback from the members of their TBL team. This feedback is formative, and therefore not part of the students’s final course grade.

Instructional Features:    Large Group sessions, including team-based learning (TBL) exercises, Small Group Discussions (including gross and microscopic pathology), Optional Review sessions.  Students receive electronic copies of handouts of all lectures on the course blackboard website. Slides and recordings of most, but not all, presentations are also posted on Blackboard
The required textbook is Robbins and Cotran Pathologic Basis of Disease. 8th Edition.  Philadelphia, PA: Elsevier Saunders; 2009.

Course Integration: 
Topics in Pathology are aligned as possible with other courses in the M2 year.

Additional information:
  Elective clerkships in surgical and clinical pathology are available in M3 (with permission) and M4 to allow study in more focused aspects of pathology, as well as participation in the daily clinical practice of pathology.  The student works and learns under the close guidance of one or more staff members specifically designated for the clerkship.

Key Words:    Pathogenesis of disease; macroscopic (gross) pathology; microscopic pathology; general and systemic pathology

Updated 02/16/14

PRCL 628 Medical Pharmacology I:   3 Credit Hours
PRCL 635 Medical Pharmacology II:  2 Credit Hours

Placement in the Curriculum:    Year Two
Duration:    September – April

Synopsis:    In Medical Pharmacology, students learn how chemicals interact with biological systems.  The year-long course covers general principles of drug action, including drug absorption, distribution, metabolism, elimination and pharmacokinetics.  For each drug category, the course emphasizes:  selected prototype drugs, mechanism of action, pharmacokinetic properties, therapeutics, adverse effects, contra-indications and drug-drug interactions.
Drugs play a major role in almost every modern therapeutic scenario.  Thus, knowledge of pharmacological principles and mechanisms is essential to the formation of a rational therapeutic strategy in almost every clinical situation.

   In the process of completing this course students acquire the following competencies:
●    Describe the following basic processes: drug administration, drug absorption, distribution of drugs in body compartments, drug metabolism, and elimination of drugs.
●    Determine the time course for drug accumulation, duration of drug action, and drug elimination.
●    Recognize the mechanism of action for selected prototype drugs and the ability to correlate the mechanism of action with the various therapeutic uses of each drug.
●    Differentiate and distinguish the pharmacokinetic properties of each prototype drug and how distinct drugs in the same category differ from the prototype drug.
●    Identify the indications, the contra-indications, the potential adverse side-effects, and the potential drug-drug interactions for each prototype drug.
●    Describe how environmental and occupational chemicals interact with the body to produce toxicity and the specific antidote and the pharmacological basis for the antidote’s therapeutic effect.

The course textbooks are to be used to assist in assimilation of lecture material.  Exam questions are derived from course lectures.

Key Words:    General principles, autonomic drugs, cardiovascular and renal drugs, central nervous system drugs, anticancer and antimicrobial chemotherapeutic agents, hormones and endocrine drugs, and toxic substances and poisons.

Assessment:    Sectional exams. (Non-cumulative)
Ph.D. students are required to take an essay examination, in addition to the multiple-choice . James Scholar students may demonstrate mastery by passing the multiple-choice midterm section exams.

Instructional Features:    Lectures, workshops, on-line course materials, and review sessions.

Course Integration:    This course builds upon concepts presented in the M1 Basic Science courses, specifically, Biochemistry, Physiology, Tissue Biology, and Neuroanatomy. By discussing therapeutic mechanisms and principles, it complements disease-oriented M2 courses; specifically Microbiology, Pathology, Clinical Pathophysiology, and Psychopathology.  It prepares students to understand the rational use of drugs in clinical therapy, which they will encounter during the M3 and M4 clerkships.

PRCL 630 Psychiatry:   1 Credit Hour

Placement in the Curriculum:    Year Two
Duration:    March-April (4-5 weeks)

Synopsis:    Psychiatry is designed to introduce students to the epidemiology, pathophysiology, phenomenology, classification, and diagnosis of mental disorders.  This course complements the first-year Behavioral Science sequence, which introduces students to normal human development and behavior. It precedes the third-year Psychiatry Clerkship lecture series, which focuses on treatment of mental disorders.

Competencies:    Students will be able to:
● Be comfortable with the DSM IV-TR in diagnosing mental illnesses
● Understand the multi-axial approach to classification of mental illnesses
● Understand the biopsychosocial model as it relates to mental illnesses
● Understand basic epidemiological data on mental illnesses
● Increase empathy towards individuals with mental illnesses
● Improve the physician-patient relationship and therapeutic alliance
● Demonstrate understanding of above in preparation for national boards
● Demonstrate understanding of above by successful completion of final exam

Key Words:  
  Psychopathology, mental disorders, addiction, biopsychosocial model, mood disorders, schizophrenia, anxiety, somatization, defense mechanism.

Assessment:    Student performance is evaluated by (1) a multiple choice Final Exam, based on the required text and lectures and (2) Team-Based Learning individual and group readiness assurance tests.

Instructional Features:    Lectures are given by instructors from the Department of Psychiatry.  Readings are assigned from a standard text.  Videotaped clinical vignettes and other media aids are used. In addition, a Team-Based Learning session will be required.

A teaching and learning examination will be given with an opportunity for discussion of test answers.

Updated 07/30/12

The second (M2) year provides the transition from fundamentals of molecular medicine to actual clinical experience. The curriculum focuses on developing a fundamental knowledge base that will enable the student to understand and integrate pathology, microbiology and immunology, and pathophysiology of the patient at every age and in states of both health and disease, as well as the pharmacological principles underlying patient response to treatment. As in the first year, the M2 year integrates didactic lectures with laboratory skills and other active learning methodologies, including the use of Team-Based Learning in some courses.  During this year of ECM, students hone their hands-on skills in taking a history, performing a physical examination, and also learn rudiments of clinical decision-making and problem-solving. Clinical experience continues with the physician preceptor, and broadens to include hospital practica spaced throughout the year. Plenary and small group sessions discuss aspects of the profession such as evidence-based medicine, preventive care, health promotion, ethical and legal standards, and the role of both the patient and other health care providers within the larger community.

Click on the links above for a brief synopsis of each course.  The descriptions will include the major competencies students are expected to acquire, and list other essential elements and special features, including assessment. Satisfactory completion of all M2 courses is a graduation requirement.

Medical School–Required Student Testing: Students are required to take various nationally administered tests during the course of their academic studies. The USMLE Step 1 test is generally taken at the end of the 2nd year. In order to continue the four year path, students should try to avoid any delays to taking this exam.