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GOAL:
The goal of the streams program is to enrich student training experiences by helping students fulfill personal interests or develop knowledge and skills that support career development. By promoting intellectual curiosity, collaboration, and scholarly inquiry, students develop attitudes and skills necessary for lifelong learning.
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HAIL to Pitt—it’s a common refrain in Pittsburgh, and a value statement for our overall Three Rivers Curriculum. Over time, students become healers, advocates, innovators, and leaders. Everyone gets a core minimum of education in these areas. But what if a student wants a more in-depth exploration? That’s where streams come in.
Streams are updated versions of Areas of Concentration (AOCs) in UPSOM’s legacy curriculum—broader, consistent, rigorous, and still flexible for students to engage in parallel to the regular curriculum. Students in good academic standing begin by March of their first year, choosing one of the four focus areas.
Below is a summary of the streams, as well as focus areas (“currents”) within each stream:
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Stream Category
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Overall Description
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Currents (Focus Areas Within Stream)
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Healer
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Expanding key medical knowledge content areas of interest
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Neuroscience
Infectious Diseases
Disabilities
Resuscitation
Reconstructive/Regenerative Medicine
Addiction Medicine
Geriatric Medicine
Women’s Health
Medical Humanities
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Advocate/Activist
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Building additional skills to facilitate socio-economic or political changes relating to medicine
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Global/Population Health
Primary Care/Underserved/Advocacy
Health Systems Science
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Innovator
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Pushing the boundaries of our medical knowledge/skills/practice through discovery/exploration
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Discovery (basic vs. clinical research)
Innovation/Entrepreneurship
Medical Humanities
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Leader
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Gaining further competence in leadership and teamwork skills to advance the field of medicine
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Educator (Medical Education)
Administrator
Organized Medicine
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Students would choose a focus based on both subject matter of interest (current) and how they want to apply that knowledge (stream). For instance, a student who is interested in entrepreneurship could focus on the innovator stream, to learn the skills of how to discover medical breakthroughs and bring products to market. That same student could decide, however, that they are more interested in how to run a biotechnology company, and how to build a scientific or management team—they may be more focused on the leader stream. Advising will support these choices.
Students will be introduced to streams in first-year and can participate in introductory activities from various streams, including journal clubs, seminars, flex weeks, or individual contact with stream faculty/students. Students should sample activities from as many streams/currents as they like to decide on which is the best fit.
By the end of the MS1 year, students would declare their stream through a joint formal application to the stream coordinator. The application includes a brief personal statement outlining the student’s interest. The application will be reviewed by stream leadership and students will be notified of acceptance. Students must be in good academic standing to participate.
A meeting between the student and a stream’s faculty lead is strongly encouraged prior to application.
Students can pick just one stream, because of the significant time commitment and challenges that two streams would entail. They can certainly participate voluntarily in the activities of other streams but would only be eligible for completing one official stream.
Each stream has clear goals and objectives overall, with an outline of how the currents differ within that stream. Every student in streams will be expected to do a set of required activities, particularly during Foundations and Bridges phases of the curriculum (see table below). Stream leads can individualize these activities depending on a student’s interest, and each stream will share a menu of options that allow students to fulfill each required element.
Core activities within a stream should exist, with the expectation that students complete certain essential elements to fulfill that stream’s focus. Currents may have unique activities that allow for differentiation.
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Curricular Phase
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Required Activities
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Foundations
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2 flex weeks or PECs focused on stream content
4 stream workshops
20hrs experiential learning (as approved by stream lead)
2 individual meetings with stream faculty lead (including initial)
Capstone development
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Clerkships
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No required activities. Students may take flex week or elective experiences during this phase if they wish, and such activity would count towards completion of stream requirements.
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Bridges
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2 electives focused on stream content
3 stream workshops
20hrs experiential learning (as approved by stream lead)
2 individual meetings with stream faculty lead (including pre-graduation final discussion)
Capstone completion
150 experience credits
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Each stream offers monthly workshops (seminars, journal clubs, visiting speakers), either remote or in-person. Students would be expected to attend at least four of those, counting events that occurred even before stream entry, or during the summer.
Experiential learning is an ongoing, in-depth experience that requires commitment and mentorship outside the regular curriculum, specific to that stream/current. Typically this includes longitudinal clinical or service activities, but could also include teaching activities, research/lab work distinct from their capstone, or even a longitudinal clinical experience (LCE) in Bridges. For instance, a student in the Healer/Reconstructive stream would meet with their faculty advisors within the stream to talk about what they might do, and if they agreed on a placement in the plastic surgery outpatient clinic, they would be asked to complete five separate four-hour clinic experiences to meet the 20-hour minimum requirement. A student in the Leader/Administrator stream might opt to shadow a medical director at the UPMC Health Plan for three 8-hour shifts. Other experiential learning could include service at Birmingham clinic or Guerilla Eye Service. This could be done at any point but should be distinct from existing electives, PECs, or flex weeks. Students can “double-count” such experiences (e.g., it could count not only for a stream but also for the Social Medicine Fellowship, CAP program, Community Service certificate program, etc.). The placement or activity may change over time depending on availability, interest, or curricular phase but must be mutually agreed upon between the student and the faculty lead.
Streams will share lists of flex weeks and electives that fulfill the goals of that stream. For example, the Leader stream includes:
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Flex Weeks
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Accreditation and Academic Medicine
Health Policy PEC (also would count for Advocate stream)
UPMC Health Plan
Choose Your Own Adventure (with stream lead approval)
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Electives
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Medical Leadership, Management and Administration (FM 5910)
Medical Education: Teaching Foundational Sciences (MSELCT 5140)
Principles of Medical Education (MED 5911)
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Every stream utilizes a credit system for experiences related to the stream but above and beyond the minimum expectations—e.g., seminars, conferences, outreach activities, etc. For instance, if a student was expected to attend four workshops during Foundations but actually attended seven, they would earn additional experience credits for the extra three workshops. Students will log these activities and review the log at their annual meeting with their stream lead. By the end of their Bridges phase, students should have accumulated at least 150 credits. Students can pursue external activities (e.g., national conferences) in addition to internal activities to achieve these experience credits.
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Domain
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Activity
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Credit
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Clinical
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4-hour clinic time
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20
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Educational
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Stream Workshop
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10/hr
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Other non-stream educational activity
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5/hr
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PEC
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25
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Conference
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variable
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Humanistic
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Service/Volunteer
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5/hr
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Schweitzer Fellowship
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25
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Bridging the Gaps
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50
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Other
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Variable
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Total Required
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150
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Every student is expected to complete a capstone project for their stream, which allows for demonstration of mastery and intellectual achievement. Students can fulfill the capstone requirement through their longitudinal research project (LRP), or through some other project (e.g., Master’s or PhD thesis).
For instance, if a student is interested in the Healer stream (Neuroscience current), they may do their LRP on a topic related to brain and behavior. The stream leadership would provide guidance on mentor selection and project design, help support the learner through the process, and vet the project at the end to make sure it is indeed consistent with stream goals and successfully completed.
If a student were doing their LRP in orthopedic surgery, for instance, but wanted to complete the leadership stream, they would be expected to complete some other kind of capstone activity. Non-LRP capstones might include:
- A quality improvement project
- Leadership of a major service, advocacy, or educational activity
- A scholarly product of some kind (e.g., published article, e-module, video)
- A major clinical activity (e.g., global health trip, Longitudinal Clinical Experience in a field)
- New patent/device development
- Creating a business plan for a start-up
A capstone requires sustained effort over time on the part of the student, at least 20 hours of work.
Students can drop out of the streams program at will or change streams if their interests change. Stream changes may not be easily feasible after a certain timepoint—e.g., it may be difficult to complete a capstone project after a certain point, or to fulfill a stream’s requirements. However, given the overlap, efforts will be made to accommodate changing student interests.
Stream students who experience academic difficulty can stay in the stream if they wish, although advisors may encourage them to consider leaving the program to focus on their primary academics. The choice is the student’s.
Students may decide to continue doing activities within a stream even if they are not fully enrolled or will not meet completion criteria.
Students who successfully meet requirements for stream completion will receive a “mark of distinction” on their MSPE, recognizing this unusual commitment to a focus area. When students are prompted to begin composing their narrative, they will be asked to include stream completion as part of the text. The Associate Dean of Student Affairs will post this with an explanation of how streams fit in our curriculum, the additional commitments fulfilled by the student, and the number of students who complete streams. Inclusion in the MSPE in this way is likely to be a powerful statement about a student’s dedication and success.
Students can also include stream completion on their ERAS applications to residencies more directly, on their list of highlighted activities.
Officially, the standard format for labeling this activity would be:
“John Doe completed the longitudinal Innovator Stream program of distinction, with a focus on Entrepreneurship, under the direction of Dr. James Taylor (stream faculty lead).”
Each student would then have individualized language, approved by the stream lead, about what they accomplished: capstone, experiential learning, coursework, service/education, etc.
The Streams program will be lead by a faculty member supported by the School of Medicine, who will assure quality and consistency across the streams, approve/track student involvement, help determine program policies/direction, and rigorously monitor program outcomes.
Each stream will have a faculty lead as well, who will meet with students annually, assure stream direction/quality, and work closely with students and other faculty.
Within each stream, there will be a series of Currents, designated by the stream lead as important. A faculty and student point person will lead each Current.
The Office of Medical Education will also provide an administrative staff person to work closely with stream leadership on process.
The Streams program will work closely with departments to ensure faculty participation and high quality.
The Associate Dean for Medical Education will provide overall oversight of this program.