The University of Pittsburgh School of Medicine (UPSOM) has a well-developed curricular infrastructure that combines a lecture- and problem-based curriculum with early and in-depth clinical experiences and an integrated organ systems approach to the preclinical sciences. The clinical years are characterized by an integrated clerkship structure and an emphasis on student flexibility.
The current UPSOM curriculum was implemented in 2004 and features active, participatory learning, a problem-based approach, an early introduction to the patient and the community, and the integration of a rigorous foundation in basic and clinical biomedical sciences with the social and behavioral aspects of medicine. Key subject matter is longitudinally integrated throughout the curriculum, building upon a foundation of prior learning while providing a level-appropriate and well-synchronized introduction of new content.
UPSOM and its Curriculum Committee continuously study and renew the curriculum in order to provide our graduates with the skills to handle the realities of a new era in medicine. An integrated third-year curriculum was successfully introduced in 1999 and continues to evolve.
In 2002, the Curriculum Committee initiated a broad curriculum renewal process. This process began with a reassessment of the overall curricular goals and input from a specially convened curriculum vision task force of senior and leading-edge physicians and scientists. Faculty and student task forces developed comprehensive plans for each curricular block, and course design groups implemented the curriculum design. These groups continue to monitor the progress of the curriculum renewal and provide essential guidance to course directors and the Curriculum Committee.
Scheduled instructional time in the first two years of the curriculum is apportioned approximately as one-third lecture; one-third small group learning (much of which is problem-based learning; the remainder includes demonstrations, faculty-directed problem-solving exercises, skill-practice sessions, and other activities); and one-third activities (which includes observation of and appropriate participation in patient care, community-site visits, experience with standardized patients, high-fidelity simulations, laboratory exercises, and other activities).
The patient focus of the UPSOM curriculum begins on day one, in the introduction to being a physician course. Students interview patients about their experience of illness and experiences with their physicians, and they visit community settings to develop an understanding of their roles as medical professionals. Medical interviewing and physical examination courses follow, along with exercises examining the many facets of physician life—in society, ethical settings, and at the patient bedside. Throughout the first two years, students apply their new skills in local practices and hospitals one afternoon per week. The Basic Science block runs through three-fourths of the first year and provides language and concepts that underlie the scientific basis of medical practice. Organ System block courses integrate physiology, pathophysiology, pharmacology, and introduction to medicine with concurrent courses in the Patient Care and Patient, Physician and Society blocks. Weekly discussions, patient interviews, and examination of hospitalized patients reinforce essential clinical skills.
The third-year curriculum consists of eight required clerkships. They are designed to optimize the balance between out-of-hospital and in-patient learning opportunities, eliminate unintentional curriculum redundancy, and optimize opportunities for student-designed curricula in the junior and senior years. The third year is punctuated by three one-week clinical focus courses.
Every student engages in a mentored scholarly project conducted longitudinally throughout the four-year curriculum. Completion and presentation of the scholarly project is due in the spring of the senior year and is a requirement for graduation. Students pursue their projects through several program options, which may include areas of concentration. An innovative system of Web-based learning portfolios facilitates learner-mentor communication and enriches the possibilities for collaboration within and beyond the University.
UPSOM also has been highly successful in thoroughly integrating new technology into the learning environment. OMED and the Laboratory for Educational Technology maintain the Pitt Med curriculum online on the Navigator system, a family of Web-based applications with domain-specific courseware to support student achievement of course objectives. Students have access to a host of online resources such as digitized images, syllabi, practice quizzes, podcasts, and other material associated with specific instructional units.