Texas Tech University (School of Medicine)

Three elements form the basis of the TTUHSC School of Medicine’s mission – teaching physicians, providing top-notch health care for the people of the South Plains and conducting research to unlock continuing medical mysteries. The Health Sciences Center faculty believes balance among these three elements will improve health care for generations of West Texans.

The mission of the School of Medicine is the provision of quality medical education. This effort in each of its four geographically separated campuses encompasses undergraduate, graduate, and continuing medical education and graduate studies. The emphasis is on both primary care for rural and underserved areas of West Texas and highly specialized care. These are enriched by the conduct of relevant biomedical investigations and other scholarly pursuits. The School of Medicine has developed supplemental mission statements for the centers at Amarillo, El Paso, Lubbock and Odessa in order to define the unique role of each campus within the several goals of the institution. The individual mission statements provide the basis for the development plan for each campus.

The development and operation of the overall academic program of the school and its regional conduct on four separate campuses is in strict compliance with the Liaison Committee on Medical Education (LCME) standards for accreditation of medical schools with geographically separate campuses. Each campus provides for an appropriate subset of each of the seven programmatic responsibilities of any School of Medicine: undergraduate medical education, residency training, continuing medical education, biomedical graduate education, research, patient care, and community service.

The School of Medicine was founded in May 1969 by the 61st Legislature of Texas to address the urgent need to train more physicians for West Texas. Many counties at that time had no practicing physicians. The original medical school design included campuses in El Paso and Amarillo with the headquarters in Lubbock.

Almost 40 years later, this founding concept holds true. A campus has been added in Odessa and plans are under way to open new medical school campus in El Paso. The need to train more physicians for West Texas remains at the forefront of our work.

Through June, 2003, the School of Medicine has graduated 2,436 physicians. Over the past ten years, approximately 58% of graduates have remained in Texas to complete residency training, and an average of 24% of School of Medicine graduates have remained in a Texas Tech program for residency training.

Over twenty percent of the practicing physicians in West Texas are Texas Tech medical school and/or residency graduates.

Over the past four years, an average of 50% of all medical school graduates have elected to enter the primary care specialties of Family Medicine, Internal Medicine, Obstetrics and Gynecology, and Pediatrics. In 2003, 47% of graduates elected primary care specialties.

Each of the four TTUHSC campuses has been shown to place the majority of its program graduates who stay in West Texas within a 75-mile radius of the campus. The four campus system, therefore, has a positive impact on the geographic distribution of physicians throughout West Texas.

In the summer of 1998, the School of Medicine began its joint venture with the College of Business Administration for a combined MD-MBA program, one of only two four-year programs in the country. Each year, 8-10 first-year students are admitted into the program. In June, 2001, the School of Medicine graduated its first three MD-MBA students, six graduates completed the combined degree program in May, 2002, with an additional six completing in May, 2003.

The four campuses of the School of Medicine operate 33 individually accredited residency programs and 4 fellowship programs in West Texas. As of November, 2003, these programs had 512 total residents in training, including 18 fellows, of which 317 (62%) were in primary care fields of Family Practice, Internal Medicine, Med/Peds, OB/GYN and Pediatrics. Of the 317 total primary care residents in training, 91 are specifically in Family Practice. The 33 residency programs have 165 first year trainees, and will graduate approximately 153 residents and fellows in 2004.

The four campuses operate a total of 34 clinical departmental units and numerous clinical services and education programs which were previously unavailable in the West Texas region. A partial list of specialty services includes: Care for Women and Infants, including perinatal care and neonatal intensive care (four campuses), Pediatric subspecialty services and intensive care (four campuses), trauma centers and emergency medicine (two campuses), neurology and neuroscience centers (two campuses), a center for pain treatment and research, a regional burn center, a center for Alzheimer's disease, a cancer center and a program for bone marrow transplantation, a border community breast care program, and a rural community mobile mammography program. Recognition has been received for research in such areas as cardiovascular disease, alcohol toxicity, reproductive biology, steroidogenesis, and sick building syndrome.

The patient care programs of the School of Medicine serve as the base for clinical education of medical students and residents, the base for clinical research and as a major source of care for citizens of West Texas. In fiscal year 2003, the combined four campuses of the School of Medicine provided 577,803 clinical visits of care to 214,947 ambulatory patients. The School also served 50,390 inpatients in its affiliated hospitals. The four campuses provided 301,897 clinical visits of charity care to 88,454 patients valued at $63,841,018.

A real-world medical education awaits aspiring physicians at Texas Tech School of Medicine. Changes in the health care system have created a demand for new types of physicians. Managed care and other reforms have created a need for physicians with new skills. Our medical school curriculum addresses these needs. In addition, Texas Tech has initiated a unique program - the combined MD/MBA degree plan where students can receive both degrees in four years.

Since the medical school graduated its first class in 1974, it has produced 2500 physicians. Texas Tech is an institution on rise in virtually all areas of the health sciences and this is particularly true for the School of Medicine. The applicant pool is very competitive to fill a medical class size of 140, a number recently increased from 120.

Specific course requirements have been kept to a minimum to allow and encourage the student to have a broad and well-rounded education. The four-year curriculum provides a broad introduction to medical knowledge while developing the student's analytical and problem-solving skills. Students will have an opportunity for clinical experiences early in the first year through formal class work and mentoring by practicing physicians.

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School of Medicine Medical School Location

School of Medicine Courses

YEAR ONE

The first year is divided into four interdisciplinary blocs: Foundations I, Foundations II, Structure and Function of Major Organ systems, and Host Defense. Running continually throughout this year is Early Clinical Experience, which introduces students to skills for patient assessment.

COURSES :

* Early Clinical Experience : The purpose of this block, which begins in week 1 and extends throughout years 1 and 2, is to provide the framework for the students to learn the fundamental skills of patient assessment. The students in groups of four are assigned to Master Teachers to learn history taking and physical examination. They will grow accustomed to clinical care, its varied settings, and the operations of the health care team. They will master specific skills and learn the essentials of patient care from these first patient exposures. In Year 2 students will move to actual office settings, continue to engage in self-directed learning, and expand their skills in patient care and working with the health care system.

* Foundations of Medical Science I : The Foundation Block 1 curriculum introduces medical students to the knowledge base, skills, behaviors and attitudes necessary to become the knowledgeable, competent, and compassionate clinicians who communicate and collaborate with patients and colleagues in a caring and professional fashion. The curriculum for the Foundations of Medical Science (FMS) component is closely integrated with Medical Gross Anatomy and Early Clinical Experience. Students begin participating in direct patient care during their first week of medical school. This integration will allow opportunities for the students to apply materials learned in FMS and Anatomy components in a direct patient care context; including interviewing patients, physical examination, formulating differential diagnoses and treatment plans. There will be a strong emphasis on professionalism, communication skills, attitudes and medical ethics in the FMS component that will continue through Years 1 and 2. The biopsychosocial model will be utilized in approach to patient care. The Medical Gross Anatomy sessions and experiences were integrated and designed to provide students with fundamental knowledge of anatomical details of the human body, an understanding of how it develops, and an understanding of how different elements interrelate either structurally, functionally, developmentally, or when pathologically altered.

* Foundation of Medical Science II : Foundations II is designed to provide students with fundamental information concerning the traditional areas of biochemistry, genetics, histology and physiology. The principles presented in this course will proceed from molecules to cells and then to tissues integrating structure and function. At the end of the bloc the students will have gained a foundation requisite for the study of the organ systems offered in the following bloc.

* Foundations for medical practice : An introduction to the six core competencies of medical practice as detailed by the Accreditation Council for Graduate Medical Education. This course uses interactive lectures, small, group experiential learning, physician shadowing, basic skills workshops, and reflective portfolio journaling to help students form the foundation of his or her philosophy of patient care in medical practice. This course is taught in both the fall and spring semester of Year One.

YEAR TWO

Year 2 in 2005-2006 continues the department-based courses in the schematic above: Microbiology, Pathology, Pharmacology, Introduction to Psychiatry, and Introduction to Clinical Medicine. Year 2 also builds on and integrates knowledge of the basic sciences through the Integration and Analysis course, where students work in teams to solve interdisciplinary problems. Skills for Patient Assessment provides extensive workshops on physical examination and practice sessions with student partners and with patients on interviewing. Additional coursework focuses on an introduction to epidemiology, biostatistics, and assessing medical evidence. Basic Cardiac Life Support (BCLS) certification is required prior to beginning Year 3.

COURSES :

* Introduction to Clinical Medicine : Describe a general approach to the differential diagnosis of a patient complaint/syndrome, the common clinical presentation of common medical problems. Link the pathophysiology of these conditions to the associated symptoms and signs. Describe the use of history, laboratory, radiology or other tests in the diagnosis.

* Pathology : The role of the Medical Pharmacology course in the overall curriculum is to ensure that the medical student: 1) has a sufficient understanding of the pharmacological basis of therapeutics in order to perform adequately in its application during the clinical years; 2) is able to select and administer drugs in medical practice with sufficient understanding of their mechanisms of actions, potential hazards, possible interactions with other drugs, and with an awareness of the many factors such as age, sex, and disease which can modify the effectiveness or increase the toxicity of therapeutic agents.

* Skills in Patient Assessment : A more detailed introduction to patient assessment. This course emphasizes history-taking and organization skills and teaches the student how to perform a complete physical examination then apply those skills to actual patient care. Small group sessions in both the fall and spring semester are the main method of teaching. This course is taught in both the fall and spring semesters of Year Two.

* Pharmacology : The role of the Medical Pharmacology course in the overall curriculum is to ensure that the medical student: 1) has a sufficient understanding of the pharmacological basis of therapeutics in order to perform adequately in its application during the clinical years; 2) is able to select and administer drugs in medical practice with sufficient understanding of their mechanisms of actions, potential hazards, possible interactions with other drugs, and with an awareness of the many factors such as age, sex, and disease which can modify the effectiveness or increase the toxicity of therapeutic agents.

* Integration & Analysis : The student will be able to: Integrate materials from concurrent course work to evaluate experimental or clinical case scenarios, use basic science and clinical science knowledge to interpret clinical scenarios, work in team formats for development of logical clinical decision-making, present in written and oral form clinically logical arguments for team decisions, use self-directed learning to investigate basic science and clinical information.

* Introduction to Psychiatry : This course includes an overview of normal emotional growth and development and the psychosocial aspects of illness, as well as an introduction to clinical psychopathology and therapies for psychiatric disorders.

* Assessing Medical Evidence : This course provides knowledge and understanding of biostatistics, epidemiological surveillance and vital statistics, probability and inferences from epidemiological data, outcome measures, and disease outbreaks, evaluation of diagnostic procedures, study and data analysis, quality improvement methods, and re-emerging diseases and organism resistance. This course is taught in both Years One and Two.

YEAR THREE

In Year 3 students move to the clinical arena on one of our three campuses, Lubbock, Amarillo, or El Paso. Each student focuses on one clinical discipline at a time, and experiences rotations in two twelve-week clerkships in Internal Medicine and Surgery, and in four six-week clerkships, in Family Medicine, Obstetrics/Gynecology, Pediatrics, and Psychiatry. Our School actively promotes and monitors the quality and comparability of the educational experiences on each of the campuses and maintains equivalent methods of evaluation. Students at each campus are tested at the end of each clerkship with the same external national examination. Our students are thus compared with national norms as well as with each other on the three campuses. The values are well correlated and can be described as a single-campus experience. We also closely monitor the number and diversity of patients seen by students to ensure the necessary breadth of exposure to clinically challenging patients.

During Years 3 and 4, each student has a faculty advisor who assists with decisions about career options and residency plans. The Office of Student Affairs maintains active orientation programs and provides individualized attention and counseling for students selecting residencies. In the past several years, Tech graduates have competed successfully in the National Resident Matching Program with approximately 80% of students being matched with their first, second, or third choice of postgraduate training programs.

COURSES :

* Internal Medicine : Given a set of diagnostic categories for Internal Medicine disease processes, the opportunity to evaluate a minimum of one real or simulated patient from each of these disease categories with completion of a comprehensive history, physical examination, assessment, and treatment plan, and core classes that complement these experiences with patient simulations and/or patient based discussions.

* Surgery : The objectives are : To ensure an understanding of the pathophysiology of surgical disease and injury, To instruct the student in the diagnosis and the management of surgical disease and the role of surgery in health care, To train the student in those manipulative skills required in the pre- and post-operative management of surgical patients and To aid the student in the development of judgment necessary for the proper and sympathetic care of surgical patients.

* Obstetrics & Gynecology : The objectives are : To introduce the 3rd year medical student to the science and art of obstetrics and gynecology, To acquaint the student with the female patient (her unique anatomy, physiology, psychosocial make-up, health and illness issues, To initiate training in procedural skills, in treatment modalities and in preventive medicine that encompasses all aspects of medical care.

* Pediatrics : The student will learn an Appropriate communication skills with children and caregivers, as well as, colleagues on rounds and during formal presentations, appropriate professional behavior, Tolerance of parent and family differences in attitudes, behavior, and lifestyle.

* Psychiatry : This senior clerkship is designed to give students experience in evaluation, diagnosis, and management of psychiatric illnesses in a variety of settings. Students may select Adolescent Psychiatry, Inpatient Psychiatry, or Outpatient Psychiatry.

* Family Medicine : Assess the patient in the ambulatory setting : Demonstrate effective verbal, non-verbal, and written communication with the patient and family, elicit a pertinent history, demonstrate the ability to perform a pertinent physical exam, demonstrate the ability to communicate effectively with other members of the health care team, demonstrate the ability to generate a problem list and appropriate assessment of the problem.

YEAR FOUR

In Year 4 each of the regional campuses in Amarillo, El Paso, and Lubbock offer both required and elective rotations. Elective rotations are also offered in Odessa. Students complete a one-month clerkship in Neurology, two one-month selective experiences chosen from Family Medicine, Obstetrics/Gynecology, Pediatrics, or Psychiatry, a subinternship chosen from Internal Medicine, Surgery, or Pediatrics, and four months of broadly based elective experiences. Each student plans an individualized program that is reviewed by a faculty committee to ensure breadth of general educational experience and appropriateness to the particular student's academic background. In this manner, each student can test or compare various disciplines as potential career choices, can shore up perceived areas of weakness, and can broaden exposures to a variety of experiences and locations.

COURSES :

* Neurology : This clerkship exposes the student to basic principles of diagnosis and management of common neurologic conditions. Students learn skills in conducting neurologic exams, identifying signs and symptoms of neurologic disorders, and integrating signs and symptoms into syndromes. Students learn about basic neurologic disorders and neurologic complications of systemic conditions.

* Electives
* Critical Care Selective
* Ambulatory Care Selective
* Subinternship

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