Medicine (MD)

Renewed Curriculum- Effective Fall of 2021

The Keck School of Medicine (KSOM) MD program has implemented a new three-phase Physician-Citizen-Scholar Curriculum beginning fall 2021. The goals of the new curriculum are to ensure that KSOM MD students: 1) gain the medical knowledge and clinical skills to be outstanding physicians; 2) learn through collaboration with other health professionals, patients and our surrounding communities to be respectful and respected citizens who serve and lead and; 3) are trained in methods of scientific inquiry and equipped as lifelong scholars who are able to contribute to new discoveries and to solving problems of patient care and health systems.

Phase 1:  Scientific and Clinical Foundations

• Provides students with a broad and extensive range of knowledge and skills in biomedical sciences and clinical care.
• Composed of blocks of curricular content organized around function.
• Longitudinal instruction in core clinical skills and clinical reasoning is integrated throughout using active and case-based learning.
• Students actively engage in the surrounding community to gain a firsthand understanding of the factors that influence health and health outcomes.
• Service-learning experiences give students the opportunity to work directly with our local communities and to gain exposure to the impacts of social determinants of health while serving the needs of our surrounding population.
• Students participate in Longitudinal Learning Communities with a dedicated faculty coach as part of a curriculum for individualized professional development.

Phase 2:  Clerkship Phase: Clinical Immersion

• Provides students with rich and immersive clinical training in core clerkships: Family Medicine, Internal Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery.
• Students will participate in dedicated course work in Health Justice and Systems of Care.
• Students serve and learn as important contributing members of interprofessional teams.
• Two “Just in Time Training” weeks will prepare students for their subsequent core clerkships and will reinforce application of the basic sciences in clinical medicine.
• Cross-cutting themes in quality improvement and patient safety, geriatric medicine, chronic disease prevention and management and mental health will be integrated throughout.
• Longitudinal Learning Communities for coaching and individualized professional development will continue through the clerkship phase.

Phase 3:  Post-Clerkship: Individuation and Transformation

• Provides students with an extensive array of clinical opportunities to individualize and tailor their education to determine and achieve their postgraduate career goals.
• All students participate in a residency preparation course.
• Students may select an area of emphasis for in-depth exploration. Areas of emphasis include:
• Biomedical Research
• Health Policy and Advocacy
• Medical Education
• Medical Humanities
• Primary Care and Community Engagement
• Health Technology and Innovation
• Clinical Medicine: Practice and Administration
• Students complete a scholarly project related to an area of emphasis or special interest.

Introduction to Clinical Medicine

Introduction to Clinical Medicine (ICM) is a longitudinal clinical skills curriculum integrated with instruction in the Scientific and Clinical Foundations phase. ICM exemplifies the patient-centered orientation of the medical school curriculum. Students are introduced to patients and are involved in patient care activities beginning in the first few weeks of medical school. ICM emphasizes the systematic acquisition of clinical skills and students gain competency in interviewing, history taking, physical examination and medical record keeping.

A group of eight students spend approximately four hours each week learning and practicing basic clinical skills in training sessions in simulated environments and on hospital wards or other clinical settings with real patients. Each group has a single instructor from the clinical faculty who remains with the same group for one to three semesters.

Health Justice and Systems of Care

It is well known that historical and systemic social forces (e.g., poverty, racism, sexism, homophobia, immigration, violence and environmental issues) contribute substantially to a wide range of deleterious effects on health, which disproportionately affect individuals from disenfranchised groups. Physicians are well-positioned to be at the forefront of social change and the Keck School of Medicine has a deep commitment to equity, justice and structural transformation with a goal of ameliorating health disparities and benefiting society. The establishment of a Health Justice Curriculum reflects the commitment of the Keck School of Medicine to social justice and its efforts to impact health equity. The Health Justice curriculum is core content for all KSOM medical students and a certificate in Health Justice is issued at graduation. The goal is to provide KSOM medical students with transformative and immersive educational experiences in Health Justice, which create and sustain future generations of physicians, imbuing them with the knowledge and skills to build practices and organizations that meet the needs of individuals and communities and enabling them to lead policy efforts to address healthcare inequities in society.

Health Justice Curriculum Objectives:

To earn the Health Justice certificate, KSOM students will:

• Build knowledge of theories of justice and explore how interrelated topics such as residential segregation, income, education, gender, food insecurity, and structural racism impact human rights and health disparities.
• Recognize the ways in which socioeconomic systems deny or promote individuals’ realization of human rights based on categories of prejudice or privilege locally and globally.
• Employ skills of communication, community assessment, organizing and mobilization, leadership, and advocacy needed to influence systems and societal structures to cultivate an equitable healthcare system and provide equitable health care.
• Gain insight into the role of community organizing and mobilization in driving policy and practice to respond to the challenges of inequities in health and health care.

Core Content:

The curriculum will progress from an inward look at self, to interactions with others including peers, community members and patients and to understanding societal and legal influences on health and healthcare.

• Implicit bias training
• Theories of justice and human rights
• Health justice ethics
• Cultural humility
• Health care disparities
• Social determinants of health
• Structural competency
• Structural racism
• Access to care
• Healthcare for homeless populations
• Trauma-informed care
• Adverse childhood events
• Community assessment and mobilization
• Advocacy

 

Health Justice Certificate

The establishment of a Health Justice Curriculum reflects the commitment of the Keck School of Medicine (KSOM) to social justice. The Health Justice curriculum is core content for all KSOM medical students and a certificate in Health Justice is issued at graduation to recognize the depth of that work. All KSOM medical students participate in transformative and immersive educational experiences to equip KSOM graduates with the knowledge and skills to build practices and organizations that meet the needs of communities and lead policy efforts to address healthcare inequities in society. The curricular requirements of the Health Justice certificate are fulfilled through experiences in the community and health systems (e.g., patient navigator, street medicine, advocacy project), selected readings and videos, team-based learning sessions, and focused topic meetings with students in round table fashion or in small groups. Skills are taught through mentoring, in which students are given the opportunity to process their experiences in real time through dialogue with community providers engaged in the service experiences and through complementary reflective sessions with faculty.

 

Legacy Curriculum (Effective for the Classes of 2024, 2023, and 2022)

Scholarly Project

The Scholarly Project is a longitudinal learning and experiential course that takes place during the second year of medical school. The objective is to engage medical students in hypothesis-driven research to develop skills and attitudes of critical thinking around evidence-based medicine and research. Students identify a project mentor and are given a timeline that includes the milestones for the course. Students complete the bulk of their “hands on” research during the summer between Years I and II and throughout Year II. All students will submit an abstract and have a poster presentation at the Annual Spring Medical Student Research Forum to meet course requirements.

Year III–IV (two academic years)

Years III and IV are designed as a continuum of two calendar years. Students rotate throughout the Year III/IV continuum in cohort groups of approximately 28 students on required clinical clerkships and selective/elective experiences. When on required clinical clerkships (family medicine, internal medicine, obstetrics and gynecology, neurology, pediatrics, psychiatry and surgery), students are immersed in clinical settings and learn while providing direct care to patients as integral members of interprofessional healthcare teams.

Transition to Clinical Practice

Transition to Clinical Practice is a one-week course at the beginning of Year III designed to prepare students for the transition from predominantly classroom-based instruction in Years I/II to learning while on clinical clerkships. The course provides learning experiences in cultural sensitivity, teamwork, patient safety and quality, and personal resilience and well-being. Students are also afforded the opportunity to acquire skills in basic radiology, EKG interpretation, the presenting and documenting of clinical encounters, the use of aseptic technique, managing airways, and in achieving compliance with different types of isolation requirements. The course culminates in students donning a white coat and a group recitation of the Hippocratic Oath to reinforce the commitment to professional principles as they transition to their new roles as student physicians on healthcare teams.

Required Clerkships

There are nine required clerkships in the Year III/IV continuum. All required clerkships provide comparable experiences across clinical sites and core didactic curricula.

Family Medicine (six weeks)

The Family Medicine Clerkship provides students with individualized opportunities for medical students to explore the breadth of family medicine and understand the role of a family physician. Students will care for patients across the full spectrum of ages within the context of an ongoing personal patient-physician relationship focused on integrated care. This clerkship offers students a close, collegial relationship with their preceptors as they address preventive care, acute and chronic illness, and mental health in the outpatient setting. In addition to outpatient clinic, students may participate in home visits, hospital rounds, nursing home rounds, obstetrical deliveries, volunteer clinics, or sporting events to ensure experiences that cover the breadth of family medicine practice.

General Surgery (six weeks)

The Surgery Clerkship provides students with experiences in caring for patients with common general surgery diagnoses and traumatic injuries. These patients range from infants to geriatric patients. The students are integral members of an inpatient team consisting of a faculty attending, a fellow, a senior resident, several junior residents, one to two interns and three to four third-year students. All student activities revolve around perioperative care. Students participate in the operating room and are active in doing surgical consults, seeing patients in the clinic, and rounding daily with their inpatient teams.

Internal Medicine (six weeks)

The Internal Medicine Clerkship provides students with a comprehensive experience in hospital medicine. The clerkship exposes students to a diverse patient population with a wide range of medical conditions and students become familiar with the role that hospitalists play in providing inpatient care. While a member of the medical team, students gain experience managing complicated medical conditions, interacting with consulting services, and developing specific disposition plans for individual patient needs.

Obstetrics and Gynecology (six weeks)

The Obstetrics and Gynecology Clerkship provides students the opportunity to interact with women in all stages of life, from adolescence through and beyond menopause. Students experience a variety of obstetrical and gynecological conditions in both outpatient and inpatient settings. Students gain an understanding of the primary care mission within obstetrics and gynecology in the outpatient segment, and the inpatient experience provides an exposure to the dynamic aspects of birth, obstetric and gynecologic surgeries, and emergencies.

Pediatrics (six weeks)

The Pediatrics Clerkship addresses issues unique to newborns, infants, children and adolescents by focusing on the health and well-being of the developing human, emphasizing growth and development, principles of health supervision, and recognition and treatment of common health problems. Additionally, the clerkship emphasizes the importance of the interaction of family, community, and society on the complete health of the patient. The role of the pediatrician in prevention of disease and injury, and the importance of collaboration between the pediatrician, other health professions, and the family is emphasized.

Psychiatry (six weeks)

The Psychiatry Clerkship provides students with experiences engaging in the care of patients in several different treatment settings, including inpatient wards, the psychiatric emergency room, outpatient clinics and hospital-based consultation services. Students are exposed to pathology ranging from uncomplicated depression and anxiety disorders to severely decompensated psychotic disorders. Students learn in detail about the biopsychosocial model and a holistic approach to treatment of mental illness, including the use of both psychotherapy and psychopharmacology, and the importance of individualized social interventions. The integration of psychiatry into the broader field of medicine is emphasized, as is the use of bioethical concepts in the treatment of all patients.

Neurology (four weeks)

The Neurology Clerkship provides students with experiences interacting with patients of different ages who have damage to the nervous system of varying types and degrees. Many neurological disorders are insidious in onset with gradual deterioration over time. Students learn to appreciate that neurologic diseases may impair physical functioning and/or can alter the core of what defines individuals as a person, i.e., cognition, memory, and personality. Students learn how to evaluate and treat these patients and their families. Furthermore, because many patients are followed for extended periods of time, students learn how neurologic disease affect, and may restrict, one’s lifestyle choices, family interactions, work, school, living situations and levels of activity.

Internal Medicine Sub-internship (four weeks)

The Internal Medicine Sub-Internship enables Year IV students to work directly with attending physicians and residents in the provision of patient care in an inpatient, sub-internship experience. Students are integral members and contributors to the patient care team and assume a more advanced level of responsibility under the supervision of the resident and attending physician.

Intersessions I and II

Intersessions I and II are one-week-long sessions delivered early in Year III (Intersession I) and late in Year III (Intersession II) that enable students to pause, reflect and consolidate the many and varied clinical/educational experiences in which they participate during Year III. The sessions provide experiences in advanced clinical skills, professional development, evidence-based medicine, patient safety and quality, health policy, ethical decision-making, the business of medicine and the residency application process.

Selective Clerkships

Students are required to complete 16 weeks of selective clerkships chosen from a list of four-week clerkships. Selective clerkships are always exactly four continuous weeks and are under the direction of USC faculty members at USC affiliated hospitals and encompass virtually all specialty and subspecialty areas. Students are required to take one critical care or acute care (emergency medicine) selective, a medicine or pediatric subspecialty rotation, and two additional selectives from the above designations or other specialties.

Elective Clerkships

The elective period consists of 16 weeks, during which students may complete research and a combination of approved rotations at KSOM, other medical schools, or other medical centers in the United States or abroad.

Track Mentor Program

The KSOM Year III Track Mentor Program capitalizes on the KSOM structure of student cohorts to promote the continued development of professional attributes and a positive learning environment. Each Year III student cohort group meets with their assigned mentor (who is not involved in the evaluation process) six to seven times during the academic year. The mentors facilitate discussions on topics such as professional development; ethical, professional, and cultural challenges; student health and well-being; and collaboration and team development.

Humanities, Ethics, Arts, and Law (HEAL) Curriculum

This four-year curricular thread is integrated into a variety of courses throughout medical school including ICM, required clerkships and Intersessions. The curriculum begins in Year I with collaborative discourse about ethical problems to help students learn to identify, analyze, and resolve clinical ethical problems. The program then focuses on ethical discernment and action in simulated settings and the study of the human dimensions of medicine. Year III includes ethics education by clinical role models as an integral part of the core clerkships. During Intersessions, the program includes a series of sessions that focus on the humanities, arts, contemporary health care and systems issues, and the physician-in-society.

Fifth-year Research Option and Dean’s Scholars

USC offers students the opportunity to take a full year of research experience with either a Keck School of Medicine faculty mentor or an approved faculty mentor at another institution. This program is open to any student in good academic standing who has completed his or her first year of medical school. Students interested in the option identify a faculty preceptor and present a description of the proposed research program and funds available in support of the program to the director of the fifth-year research option. A stipend, comparable to that received by a graduate student at the postgraduate level, is available for selected dean’s research scholars pursuing this option.