University of California San Diego (School of Medicine)

The UCSD School of Medicine is uniquely positioned to provide a solid foundation for a successful career, whether your focus turns out to be primary care, subspecialty medicine, academia or private practice. We seek to train compassionate physicians and physician-scientists who are highly skilled practitioners, innovators and leaders.

Our educational philosophy is to give students an opportunity to go beyond the core curriculum and pursue electives and independent study, with a wide range of opportunities for second degrees. Students have many opportunities for extracurricular experience, whether working in the laboratory of an internationally prominent investigator, or caring for a family with no health insurance through our superb student-run Free Clinic program.

And for students seeking a dual-degree, we offer a variety of advanced training opportunities, leading to master's and Ph.D. degrees in multiple disciplines. We have expanded our post-graduate opportunities beyond the usual health and science disciplines to support second degrees in areas such as management and the humanities.

There is no better place to find teachers and mentors at the forefront in their fields, whose work in clinical, laboratory and community settings is dedicated to biomedical discovery and advancing health care practice and policy.

The UCSD School of Medicine is consistently ranked first or second in the nation in funding per faculty member, a measure of the faculty's scientific prowess and productivity. UCSD physicians and researchers have been lauded with numerous awards and honors, including the Nobel Prize, Lasker Award and the membership of over 80 faculty members in the National Academy of Sciences and Institute of Medicine. The prestigious Ludwig Institute for Cancer Research and the Howard Hughes Medical Institute are a significant presence on the School of Medicine campus, further enriching the depth of programs and talent at UCSD.

With a community of scholars dedicated to moving quickly from basic research to practical application, and a unique organizational structure encouraging interdisciplinary work, it is understandable that UCSD would excel in translational medicine - the "bench-to-bedside" ethic of those who work at the intersection of science and medicine.

Here, laboratory discoveries lead directly to advances in patient care. UCSD faculty have developed powerful new drugs that effectively treat, even cure, certain cancers. Advances in treating Parkinson’s disease, diabetes, stroke and heart disease have resulted from findings in UCSD laboratories and clinical trials led by UCSD researchers.

UCSD Healthcare is known as a center for leading edge medicine, and outstanding clinical programs. Our physicians are recognized leaders in their professional societies, heading national organizations and committees dedicated to improving care and advancing knowledge about disease. They are prominently listed in publications such as "The Best Doctors in America" and in Good Housekeeping and U.S. News and World Report rankings of outstanding physicians and clinical programs.

For example, the pulmonary thromboendarterectomy (PTE) team is the most successful in the world, utilizing procedures developed and perfected at UCSD Medical Center to restore life to patients who are near death due to chronic pulmonary embolism. Patients from around the country travel to see UCSD orthopedic specialists, experts in a highly refined cartilage transplantation technique that restores the use of damaged joints. UCSD Healthcare sites are home to numerous regional programs, including a Level 1 trauma center, a high-risk pregnancy center and neonatal intensive care unit, the region’s leading AIDS/HIV treatment program, an innovative Stroke Center serving hospitals in San Diego and Imperial Counties that is recognized as a national model, and the UCSD Regional Burn Center which saved so many lives during the recent firestorms that devastated our community.

This region, with its shared international border, provides our physicians, medical students, residents and fellows the opportunity to practice preventive, primary and specialized medicine in a community that is diverse in every respect. We care for the complete spectrum of patients - the insured and the uninsured, the young and the elderly, residents of San Diego's most populous urban communities, people in isolated rural settings and on reservations, and new immigrants from developing countries.

UCSD's hospitals and outpatient centers are based in La Jolla and Hillcrest and we have clinical and training affiliations with hospitals and medical practices throughout the San Diego and Imperial Counties. Our partnership with Children's Hospital and Health Center enables us to treat a significant number of the region's pediatric patients, and relationships with the Veterans Affairs Medical Center and the Naval Medical Center expand our patient base even further. We also have important programs and partnerships with several community-based agencies serving the homeless and needy in San Diego and in Mexico.
The medical campus is constantly evolving to support the exploration of emerging frontiers.

To meet the need for specialized pharmacists and to expand pharmaceutical research at UCSD, we have opened a new School of Pharmacy and Pharmaceutical Sciences.

Our new functional Magnetic Resonance Imaging (fMRI) facility has with four powerful magnets dedicated to studies of the brain, heart and other organs - the largest such facility in the Western United States. Our high-powered Electron Microscopy and Imaging Resource serves the western U.S. We have recently opened a Positron Emission Tomography (PET) facility with a cyclotron, further expanding our abilities to apply the latest imaging technologies to research and patient care.

The Rebecca and John Moores' UCSD Cancer Center is one of a select group of National Cancer Institute-designated comprehensive cancer centers, recognizing its excellence in the multiple missions of patient care, research and community outreach. A spectacular state-of-the-art facility to house its extensive clinical programs and research laboratories will be open on the La Jolla campus in early 2005.

And, in order to further mobilize the many areas of expertise needed to fully capitalize on the new biology of the 21st century, we have created integrated programs such as the Institute for Molecular Medicine and the Cardiovascular Center, which unite basic researchers, clinicians, surgeons and post-graduate students in bench-to-bedside efforts to conquer disease.

UCSD is a top-ranked university with highly respected programs in biological and physical sciences, marine science, biomedical and computer engineering, cognitive science and related disciplines. The School of Medicine was originally designed to capitalize on the strength of the superb basic science departments already established on the general campus rather than duplicate those programs, and after more than three decades this organizational model continues to serve us well.

The interdisciplinary collaboration throughout campus makes for an environment of incredible depth and breadth, vibrant with the excitement of exploration and invention. The synergy among scientists and clinicians, faculty, staff and students, fosters innovation and learning. This approach has resulted in the unprecedented success of the university, its faculty and graduates.

For example, the San Diego Supercomputer Center is a national resource located in the center of campus. The California Institute for Telecommunications and Information Technology (Cal [IT]2), based at UCSD, is a powerhouse in the practical application of wireless technology, and is pioneering an exciting new initiative in post-genomic, digitally-enhanced, individualized medicine. And, UCSD's biomedical engineering program is among the best in the nation, with research efforts spanning the engineering field from technology development to the growth of human tissue.

The UCSD campus is at the hub of one of the most concentrated biotechnology and research communities in the nation. Creative synergy connects scientists from the Salk Institute, Scripps Research Institute, Burnham Institute, and other world-class research institutions based in San Diego, all active participants in UCSD teaching and research programs.

In addition to scientific collaborations, there are many joint training programs with these institutions, providing opportunities for UCSD medical and post-graduate students to pursue their research interests beyond the campus. We benefit from the additional support and involvement of the biotechnology and pharmaceutical industries on the Torrey Pines Mesa surrounding our campus. Many of these private companies are spin-offs, founded and run by UCSD graduates and faculty.

We are further expanding our focus by actively pursuing partnerships with respected academic institutions around the world, focusing on the Pacific Rim. For example, we are broadening educational exchange opportunities with Beijing, China; Singapore and India, to help prepare our students to function on a world stage, since medicine and science are best approached without the constraint of geographic boundaries.

This School of Medicine is deeply invested in the future. We are committed to training physicians and leaders who will forge the new frontiers in medicine and carry us into the 21st century, advancing the health of our community and beyond.

For almost three decades, UCSD School of Medicine and Medical Center's bench to bedside approach to medicine has made it a nationally recognized center for health care, biomedical research, and medical education while consistently ranking among the nation's leading hospitals in a variety of specialty areas. Its faculty of physicians and scientists continues to serve the community by spearheading research, caring for a large patient population, and providing many unique regional services, such as the burn center, the Shiley Eye Center, and the UCSD Cancer Center, to San Diego and surrounding communities.

From cancer to chicken pox, heart failure to headaches, clinical trials are a way of life at UCSD, where some 400 physicians and researchers regularly engage in research involving thousands of participants. But UCSD School of Medicine's research programs reach far beyond campus laboratories and into the heart of the San Diego community.

One of the longer running projects, the Rancho Bernardo Heart and Chronic Disease Study, for example, continues to yield new knowledge about age-related diseases, including Alzheimer's. Under the direction of Dr. Elizabeth Barrett-Connor, an internationally known authority on hormones and their effect on health and disease, three-fourths of the adults in this, the nation's first planned community, have been surveyed for more than twenty-five years; 80 percent of the participants who started with the project are still involved in the study.

Dr. Patrick Lyden, UCSD neurologist and part of the staff of the Veterans Affairs Medical Center, is another researcher widely known for his clinical studies. In 1996, the FDA approved the administration of tissue plasminogen activator, or TPA, the enzyme that dissolves arterial blood clots. The approval came after a nationwide study, which included pioneer research by Lyden. As he continues his research on TPA, Lyden is also focusing on whether new blood thinners work better than aspirin or coumadin in preventing recurring strokes.

Research is definitely a strength of UCSD. And the strength of that research is in molecular medicine, according to Dr. John F. Alksne, former dean of the UCSD School of Medicine. Nyhan, for one, has been tracking rare inherited metabolic disorders in children and diagnosing methods of treatment for three decades. His discovery of a rare genetic disorder caused by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyltransferase, or HPRT, resulted in a disease, Lesch-Nyhan Syndrome, being named after him and an associate.

In addition, the name of Flossie Wong-Staal has become synonymous with AIDS research. While working at the National Cancer Institute in 1984 with Robert Gallo, one of the discoverers of HIV, Dr. Wong-Staal was the first to clone the virus and work out its molecular structure. A professor of medicine and biology at UCSD today, she heads her own lab, where she concentrates on finding a cure and a vaccine for HIV infection.

After investing heavily in the gene therapy program, UCSD began partnering with the Boehringer Mannheim Corporation to create a molecular medicine service center on campus. "We look forward to pioneering therapies in some of the currently untreatable diseases like arthritis, Alzheimer's and cancer. Our school is very well positioned to do that," said Alksne.

The school has long been astride the twenty-first century because of its innovative programs, including PCASSO. That's not a misspelling of the artist's name but an acronym for Patient-Centered Access to Secured Systems On-line, a program that enables providers and patients to view medical data securely anywhere on the Internet. Run by Dr. Daniel Masys, associate clinical professor of medicine and director of biomedical informatics, the program uses multiple layers of encryption to scramble information so it can be viewed only by the intended recipient.

As for informatics, the field of information as applied to health care and medicine, other projects are already taking shape. One, for example, will soon enable scientists to take tens of thousands of data points on genes and sift through them on computer to establish common patterns. While the focus in the past has been on basic research, the school today sees itself fulfilling a unique role in the community. Of all local hospitals, UCSD Medical Center continues to carry the bulk of indigent care - 50 percent of all patient activity. At the same time, these patients are a key component to the teaching system and serve as a ready resource for doctors in training.

UCSD is also the only comprehensive organ transplant center south of Los Angeles providing heart, lung, kidney, liver, pancreas, and combined organ transplants. More than 1,300 kidney transplants have been performed at the medical center since the inception of the program in 1968 and at least two dozen liver transplants are performed each year.

The overall objective of the medical school curriculum at the University of California, San Diego is to instill graduates with the knowledge, skills, behaviors, and attitudes that will lead to their becoming capable, compassionate physicians.

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School of Medicine Medical School Location

School of Medicine Courses

FIRST YEAR COURSES :

* Cell Biology and Biochemistry : CBB is the first block course you will see, and it is the first building block in your professional career. It epitomizes the wisdom that a firm grounding in biological and biochemical mechanisms is crucial to the truly competent physician. The "readings" portion of CBB puts a small number of students together with a distinguished faculty member/biochemist for a dynamic exchange on the material just studied. If you have never experienced an undergraduate biochemical laboratory, you are strongly urged to enroll in the elective laboratory portion. From 1968 to the present, CBB has immersed the student in molecular and cellular principles, traversing the intact organism, down through the cell to the molecule, then back out again. Then you will look at the clinical correlates of these biologies.

* Social and Behavioral Sciences : What do you say to patients who are ill or injured, highly suggestion-prone, overly helpful, ambiguous, and paranoid? How can you best ease the fright of these patients who have brought their suffering to you along with a variety of expectations, myths, stereotypes, and - perhaps most importantly - untapped emotions? During your first quarter at UCSD, you will begin to answer these questions through participation in exercises and small group discussions in the Doctor/Patient Relationship course, the first of four parts of the strip SBS sequence. SBS is a course which looks at the patient as a person, with all that implies, but also as a unique "biopsychosocial matrix," with a history and a future.
SBS will, in its many modes of delivery, stress (1) that the most fluid and evanescent of intangibles - the doctor/patient relationship - to a large extent shapes the patient's suffering and its amelioration; (2) that illness is disharmony at any of three levels - biological, psychological, or social - which in turn disrupts the other two levels; (3) that developmental stages are a good way to look at the changing dynamics in a patient, be it childhood, adolescence, or aging; and (4) that the milieu in which the 'healing arrangement' takes place - the myths and symbols of the culture, the way money is organized and distributed, how the society views its deviant members, death, and sex - incorporates interested parties who refuse to stay out in the waiting room. They must be examined, and accounted for.

* Principles of Pharmacology : Principles of Pharmacology is a course given in the fall, winter, and spring quarters of the first year. In the fall quarter, students learn the fundamentals of pharmacology and the autonomic nervous system. In the winter quarter with concepts in physiology, students learn the cardiovascular system, and smooth muscle, along with the principles of drug disposition. These are taught simultaneously with cardiovascular, renal, and gastrointestinal physiology. In the spring quarter, the pharmacology of central nervous system active drugs is taught parallel with basic neurology.

* Organ Physiology : This is a demanding course because the subject matter is completely new to most medical students. The course deals in turn with the lung, heart, kidney, and gastrointestinal systems and runs parallel with the pharmacology course. Students can get considerable help from the new edition of the physiology textbook that is largely written by faculty teaching the organ physiology course. In addition, Dr. Nora Laiken, who is in charge of tutoring, is ready with supplementary notes and a helping hand for those who need further clarification.

* Introduction to Clinical Medicine : This is a five-quarter course beginning in January of Year I. By the end of the first year, students will have learned to recognize symptoms and signs of disease and will have mastered a basic screening physical examination. Year II emphasizes basic skills of physicianship, including history taking, physical examination, complete patient write-ups, and oral case presentations.
ICM provides a living lab for students to nurture the art of interviewing and diagnosing common disease syndromes in closely supervised bedside work, demonstrations, lectures and conferences.

* Endocrinology-Reproduction-Metabolism : The touchstone of this course is the multi-faceted endocrine system and the hormones by which it regulates growth, sexual development, reproduction, reactions to stress, and many key metabolic processes. Metabolic disorders and poor diet patterns account for a great deal of disease in the U.S. This course covers obesity, diabetes mellitus, and hypercholesterolemia among the more prevalent such diseases. In addition to reproductive endocrinology, the course deals with basic physiology of reproduction, including conception, contraception, aspects of sexuality, and the physiology of pregnancy.

* Basic Neurology : The brain is the center for our thinking and feeling. This course looks at everything from the fine structure of individual neurons to the complex anatomy and physiology of the human nervous system. Throughout the course, there is an ongoing consideration of the brain's higher functions (emotions, behavior) and of the disorders that interfere with the nervous system's normal performance (clinical neurology). To provide instruction of this scope, the course is managed by both basic and clinical neuroscientists.

HUMAN ANATOMY
Anatomy at UCSD's School of Medicine differs in several ways from the course of the same name traditionally found in America's med schools. First, it comes after students have already learned about bodily functions, after OP. Therefore, it can be taught as functional, practical anatomy, not only morphology. It is taught by a team of anatomists, surgeons, and radiologists in a setting that gives heightened emphasis to radiology. "It's important to use all the modern imaging methods to get a feeling for how the organs and tissues show up in those media, and to learn their relationships," says an involved faculty member.

Anatomy is also one of the most popular of all courses here, perhaps because of the close personal contact between instructors and students in the small group seminars and the laboratory.

HISTOLOGY
Taught in conjunction with anatomy, this course is designed to teach the structural basis of normal and abnormal function at cellular and tissue levels. Emphasis is placed on microscopic study conducted in small laboratory groups under close faculty supervision.

EPIDEMIOLOGY/ BIOSTATISTICS
This course describes uses and limitations of biostatistical techniques and of epidemiology and population versus patient data. It includes terminology, study design and analysis, measures of risk, causality, screening, and current knowledge about the epidemiology of selected diseases/conditions and medical interventions. Case studies are used to emphasize understanding of the principles behind statistical tests and understanding statistical jargon used in the medical literature.

HUMAN DISEASE
This course provides the transition from the basic science curriculum to the clinical setting. It is designed to teach the principles of human disease and constitutes an integration of such separate subjects as pathology, pathophysiology, microbiology, and medical therapeutics.

The beginning phase of the course focuses on the general principles of human disease, and subsequently, the course covers diseases of organ systems.

Pathology and pathophysiology deal with causes, mechanisms, structure, and dynamics of diseases. Medical therapeutics addresses principles and some specifics of pharmacologic interventions that are helpful in altering the disease process. Microbiology, which rests on the assumption that living agents of disease are best studied in relation to reactions of the host, is closely coordinated with the same organ system approach.

HEMATOLOGY
This course, taught in the second year fall quarter mini-block, consists primarily of small group discussions and laboratories centered around clinical cases. You will cover the physiology and pathophysiology of blood cells and blood cell-forming organs.

LABORATORY MEDICINE
What are the general principles of laboratory data interpretation? This course covers a basic introduction to these principles and to the systematic use of laboratory tests in evaluating common clinical conditions.

ELECTIVES
Many medical schools do not provide students the opportunity to choose any part of their curriculum in the first two years, but this is definitely not the case at UCSD. Time for electives has been an integral part of the schedule since the school was founded. Throughout the pre-clinical curriculum, two afternoons each week are completely free and may be used for elective courses. The elective curriculum is as unstructured as the core curriculum is structured; myriad opportunities exist to explore areas ranging from the most basic to the cutting edge of science and technology. Clinical preceptorships* are plentiful and popular elective choices. Many students participate in elective community outreach efforts such as DOC (Doctors Ought to Care), teaching middle and high school students about AIDS, alcohol and drugs, or, the UCSD student run free clinic. Others use their elective experiences to learn to speak Spanish or to learn to take a medical history in Mandarin Chinese. There are electives about the politics of medicine, alternative medicine, and the history of medicine. A course in anatomic drawing might also be appealing, but if none of the formal offerings pique students' interest, students may approach any faculty member and design a reading or laboratory course. UCSD students appreciate the freedom and breadth of the elective curriculum, and participation in these courses has led to many memorable experiences.

SECOND YEAR COURSES :

* Hematology : This course covers the physiology and pathophysiology of blood cells and blood cell-forming organs. The format is primarily one of small group discussions of assigned readings and clinical case problems, and includes an introduction to blood cell morphology.

* Human Anatomy : Human anatomy teaches the structural foundation needed for understanding normal and abnormal function. The course fits into the regional orientation of the second year, in contrast to the predominantly cellular-systemic orientation of the first. The use of fresh materials, inclusion and integration of radiology, correlation with the physical examination, and the major role of clinical teachers in the course permit teaching the subject as practical anatomy with all its clinical implications and applications. This orientation is further aided by the inclusion of embryology, a subject matter that supports the understanding of anomalies and of adult structure. Dissection is an important source of reference. Close student-faculty contact is available from a core of full-time faculty and from clinical specialists who teach in regions appropriate to their discipline. Seminars and discussion groups facilitate clinical problem-based learning. Videotapes, anatomical and surgical films, slide collections, casts, models, prepared dissections, and computer-based anatomical information support learning and encourage self-instruction.

* Histology : The major objective of histology is to present the structural basis of normal histology essential for understanding the altered structure and function of cells, tissues and organs in disease. Students are expected to identify the specialized cells, tissues, and organs of the human body and understand the structural basis of their function. Emphasis is placed on microscopic study conducted in a small group laboratory setting supervised by the faculty and supplemented with MedPics, a computer-assisted image bank. This overview of normal histology is essential for understanding the altered structure and function of cells, tissues and organs in disease and is thus a prerequisite for the pathology component of human disease

* Social and Behavioral Sciences-Introduction to Health Care Systems : This segment in the social and behavioral sciences course introduces students to the health care system and helps them define their roles and responsibilities within it. Discussions cover financing, organization, and quality of health care services and workforce issues. Relevant concepts from sociology, economics, anthropology and the law are utilized. Both health professionals and social scientists lecture in the weekly didactic sections and serve as seminar coordinators.

* Epidemiology/Biostatistics : This course describes the uses and limitations of epidemiology and population versus patient data. It includes terminology, study design and analysis, measures of risk, causality, screening, and current knowledge about the epidemiology of selected diseases/conditions, and medical interventions. Also, it introduces medical statistics, probability theory in medical diagnosis, the evaluation of diagnostic tests, small sample statistics, the design of clinical trials, and confounding factors in medical studies using case studies in the medical literature.

* Introduction to Clinical Medicine : In fall quarter of the second year of introduction to clinical medicine, the course is expanded to include history-taking and physical examination of patients with various disease processes. In this quarter, four weeks are devoted to history-taking alone, and a subsequent four weeks to the physical examination. Oral presentations and write-ups will be performed each week.

* Human Disease : This course provides the transition from the basic science curriculum into the clinical setting. It is designed to teach principles of human disease, namely, causes, mechanisms, structure, and dynamics of diseases. Organizationally, the course constitutes an integration of separate subjects traditionally known as pathology, pathophysiology, microbiology, and medical therapeutics. It is taught throughout the entire span of both the winter and spring quarters.
During the winter quarter, the course focuses initially on the general principles of disease, which includes introduction to pathology (cell injury, inflammation), immunopathology, and oncology. Subsequently, the course is organized on the basis of organ systems such as cardiovascular, respiratory, urinary, digestive, reproductive, endocrine, nervous, musculoskeletal, and integumentary systems. Medical therapeutics is integrated with organ system pathology/pathophysiology. Microbiology is closely coordinated with the organ system approach. An appropriate balance is maintained between lectures and small group instruction to encourage close faculty-student interaction. Laboratory instruction is augmented by MedPics, a computer-assisted image bank of diseases.

* Social and Behavioral Sciences-Psychopathology : This segment will acquaint students with techniques of interviewing, concepts of mental illness and normality, basic research in causality of behavioral disorders, and approaches to treatment-all in the context of a bio-psycho-social frame of reference. Format combines a lecture followed by smaller group sessions with a faculty leader. The groups enable students to meet patients with behavioral disorders, to practice interviewing, to develop observational skills, and to discuss material presented in lectures and assigned readings.

* Laboratory Medicine : This course is a basic introduction to laboratory medicine. Emphasis is placed on the general principles of the interpretation of laboratory data and on the systematic use of laboratory tests in the evaluation of the most common and important clinical conditions.

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