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When students come to UVa to study medicine, they learn in a vital and progressive academic community. Our faculty rank among the top in the nation, lead professional medical societies, and participate in forums that inform the national agenda. Likewise, our students are eager and gifted, with a variety of backgrounds and strengths. The result is a medical school that ranks among the best in the nation. Each year, we continue to develop our curriculum, offer new opportunities to our students, and expand our understanding of both the science and the art of medicine.
Educating The Physician of the Future
 How do we best prepare medical students to enter the world of health care? Medicine today is far too complicated and requires far too many diverse skills for a medical school to be able to teach its students everything. Instead, the measure of a good medical education is one that presents the topics most pertinent to 21st century medical practice, blends clinical experience and basic science, demands mastery of new information technologies, and provides students with skills to become independent, lifelong learners. Using these new dictates, we asked not only what students should be taught, but also how they should be taught. Ultimately, we opted for a teaching mix that balances large lecture classes with smaller, problem-based courses. We also increased the use of information technologies in teaching to familiarize students with these tools.
An Innovative Curriculum Prepares Tomorrow's Physicians
Adding the Clinic to the Coursework:
In 2000, UVa first-year students traded in some of their lecture time to begin learning to work with patients. The students see "standardized patients," individuals who have been trained to mimic symptoms that are characteristic of certain illnesses. Students first learn to take medical histories on these "patients," and later practice physical exams. The idea is to make students more comfortable with, and attentive to, patients. The standardized patients are trained to give feedback by noting things students did that put them at ease or that made them uncomfortable. Students are also expected to learn more when the material presented in their textbooks is linked to the actual practice of medicine.
"Faculty members were worried that the students weren't making the connections they could be making," says Donald Innes, M.D., Associate Dean for Curriculum. So now, when they see a standardized patient who complains of symptoms such as numbness in his feet and frequent urination, students fit the two clues together and link to the pathophysiology of a disorder, in this case diabetes. At the same time they learn to consider the social impact of the disease on the patient.
Curriculum changes for first-years also include the introduction of Practice of Medicine, a first-year course that combines lecture and small-group sessions. Students are taught fundamental knowledge, attitudes, and skills in an environment that stresses one-to-one interaction with medical faculty. First-year basic science courses have also been reorganized so that concepts presented (such as how to dissect a shoulder) parallel the concepts presented in Practice of Medicine (such as how to examine a shoulder).
Tapping the Resources of Information Technology:
While no one can teach future physicians everything they will ever need to know, we can teach them where to go for the information they will need. At UVa, our Health Sciences Library provides state-of-the-art information technology for faculty and students alike. Faculty frequently use these resources in their teaching and make assignments that require students to master the use of medical databases.
This emphasis on information mastery by students and faculty is also supported by UVa's Department of Health Evaluation Sciences. The department was the first of its kind among American medical schools to use clinical epidemiology, biostatistics, and informatics to link diagnosis and treatment to clinical outcomes. Findings made through this department are critical to how physicians (and students) relate to clinical challenges.
An Evolving Process:
Curriculum changes continue to be felt across the School of Medicine. Faculty have been surprised by some of the various spinoff benefits. By working in small groups, for example, students are learning to put aside individual goals and work together for the patient. Likewise, students appear to retain more of the basic science they are taught in the context of relevant clinical applications.
For the School of Medicine, the new curriculum changes are just the beginning. Possibilities for the future include an elective "exploratory" program in the first and second years, more simulated learning opportunities, and joint projects with the University of Virginia's School of Nursing and School of Law. The only thing for certain is that the school will constantly be seeking out the best methods to prepare students and faculty for what promises to be a future full of change.
Physician-Scientists - Training to Translate Knowledge into Medicine:
 Few doubt the importance of new scientific discovery to the future practice of medicine. As we learn more about the intricate cellular workings of the human body, we stand to develop increasingly sophisticated ways to treat disease. At UVa, a select group of students trains to develop the full potential of this revolution. They are part of the Medical Student Training Program (MSTP), a six- to seven-year curriculum that combines a medical and scientific doctoral degree (M.D./Ph.D.). Supported by a NIH Medical Scientist Training Grant, the program trains physician-scientists to become leaders in discovering the foundation of human disease and in developing innovative new treatments.
Admission to the program, one of only 39 of its kind in the nation, is highly competitive and attracts students from across the country. Each year, some 150 students compete for the six or so program slots available. Once admitted, students receive highly individualized instruction with tailored assignments and a faculty mentor, while simultaneously completing coursework for their medical and doctoral degrees. They also establish active research programs and, upon completion of the program, pursue additional residency and research training before assuming positions in academic medicine.
"The beauty of the Medical Scientist Training Program is that it gives us the ability to identify key clinical problems, the skills to investigate these problems in the laboratory, and the foresight to apply knowledge gained in the laboratory to patient care," notes MSTP student Meena Kumar. The opportunity to participate in every aspect of this cycle and to possibly change the way medicine is practiced is both exhilarating and rewarding.
The goals and vision of our MSTP students exemplify a primary mission of the School of Medicine," adds MSTP Director Gary Owens, Ph.D., which is to advance the practice of medicine and the quality and scope of care that we provide to our patients by conducting biomedical research.
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