University of Michigan (Medical School)

The Medical School has been recognized nationally as a premiere site for state-of-the-art research activities, innovative medical education and pioneering clinical care since its inception in 1848. The first professional school at the University of Michigan, the Medical School, admitted its first class of 91 students in 1850 and has awarded almost 18,000 M.D. degrees in the past 150 years as well as educating thousands of residents and biomedical researchers.

The Medical School has 25 academic departments, 19 clinical and 6 basic science, as well as the Unit for Laboratory Animal Medicine and Department of Medical Education. Teaching, research and clinical care often cross traditional departmental boundaries, particularly in the School’s impressive community of interdisciplinary research centers and institutes. The proximity and close relationship between the University Hospitals and the Medical School has fostered opportunities for collaboration between clinicians and basic scientists for more than 100 years.

The Medical School has consistently maintained national prominence in the teaching, service and research missions central to its success. The School has been a leader in the translation of discoveries made in the laboratory into improvements in patient care. Examples of such "bench to bedside" achievements at Michigan include pioneering research in testing the polio vaccine to recent discoveries including novel uses of imaging techniques in the detection and treatment of diseases; advances in tissue engineering through the creation of artificial tissue, organs and bone; and the innovative treatment of non-Hodgkin’s lymphoma through the use of radiolabeled monoclonal antibodies.

In 1999, the Medical School celebrated its Sesquicentennial anniversary by honoring the distinguished tradition of scholarship and service at the University of Michigan. The Sesquicentennial Celebration brought alumni and friends back to the Medical School to help celebrate the influential impact that it has had on its faculty and graduates over the past 150 years.

he University of Michigan Health System comprises the Medical School, the University Hospitals and Health Centers, M-Care HMO, and the Michigan Health Corporation. The University of Michigan established the first University-owned teaching hospital in the nation when it opened University Hospital in 1869. The establishment of this hospital introduced a legacy of providing health care, programs of education and research, and referral support for other health care providers and institutions in Michigan.

Today, there are three hospitals as well as extensive outpatient and ambulatory clinics continuing the tradition of excellence at the University of Michigan Health System. As a teaching resource, the Hospitals are used for the training of students each year in the techniques of modern clinical medicine, including physicians in residency training in all medical and surgical specialties. The Hospitals serve as the core teaching facility for the U-M Medical School and provide the basic clinical experience for medical students.

Over 1,600 faculty at the University of Michigan Medical School work in three main faculty tracks: Instructional Track, Primary Research Track, and Clinical Track. Faculty lead research efforts in a broad scope of basic science and clinical science areas including pioneering work in neuroscience investigation, cancer, bioengineering, geriatric medicine, and molecular genetics, to name just a few. Medical School faculty participate in the education of medical students, graduate students, residents and post-doctoral fellows, as well as undergraduate students at the University of Michigan.

In addition to their work in research and education, faculty in clinical departments provide inpatient and outpatient care at the University Hospitals and Health Centers, where more than one million outpatient visits are conducted each year. The unique combination of medical expertise and direct application of basic science bench research by Medical School faculty within a clinical setting offers patients at the Hospitals the highest quality of care possible.

The Medical School draws from its outstanding faculty, and exceptional, diverse student body to deliver rigorous and challenging educational programs. The School offers a well-rounded preparation for clinical practice in all of the medical specialties, including primary care fields. In 1999, 671 medical school students were enrolled in the M.D. program at the Medical School.

In 1990 the University of Michigan Medical School began a process of review that culminated two years later with the adoption of a completely new curriculum for the M.D. degree, MD21. The MD21 curriculum incorporates instruction in small groups, student-centered exercises, multi-disciplinary conferences, early introduction to patients, and increased experiences in ambulatory and primary care. Of particular note is the development of significant opportunities to participate in community-based learning preceptorships as part of the curriculum.

The Medical School is consistently ranked among the leading medical schools in the United States, whether measured by the quality of its instructional programs, its research accomplishments or the impact of its graduates.

The Medical School has been committed to diversity for more than 100 years. The first woman to graduate from the Medical School was Amanda Sanford in 1871 and William Henry Fitzbutler was the first African-American graduate in 1872.

More recently, the Medical School's commitment to diversity is reflected in its student body. Under-represented minorities comprise 13 percent of the current medical student body, while women represent 41 percent. The Medical School ranks 5th in the nation in the number of minority physicians it graduates each year. The graduate programs also actively recruit exceptional minority and women candidates. As a result, underrepresented minorities make up about 10 percent of the graduate student body, and 41 percent of the graduate students are women. Currently, efforts are in progress to increase the diversity of faculty and residents at the Medical School.

Together, the Medical School and the three University Hospitals constitute the Medical Center campus located on 84 acres of land in more than 30 buildings just north of the University's main campus. The Medical School occupies over 2 million gross square feet of research and education space, 45% of which has been activated since 1985. Clinical care is provided in the adjacent University Hospitals and clinics housed in 20 buildings and over 3.3 million gross square feet.

Recent additions to the Health System facilities include the East Ann Arbor Health Center, which answers a community need for outpatient care in an off-campus setting, and a trio of state-of-the-art biomedical research structures featuring unique configurations to foster investigative collaboration and shared access to common equipment. The Comprehensive Cancer and Geriatrics Center, which opened in June of 1997, houses both the Comprehensive Cancer Center and the Geriatrics Center, and was designed with a great deal of input from patients, families and staff. It continues the patient-focused, multidisciplinary care that both Centers of Excellence have pioneered in their respective fields. The clinical and research floors bring scientists and physicians together to collaborate in new ways, delivering the latest advances from laboratories to the clinical setting even more rapidly.

The Taubman Medical Library, one of the largest medical libraries in the country, serves the School of Nursing, College of Pharmacy, and the Health System at the University of Michigan. The Library receives over 3,300 periodicals and offers search services for more than 100 databases for faculty, staff and students.

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Medical School Medical School Location

Medical School Courses

FIRST YEAR

The first-year curriculum is now interdisciplinary and organ-system based, covering the normal cell, normal organ systems, immunology, microbiology, and infectious diseases. As appropriate and as much as possible, material is presented in a clinical context and supported by brief patient cases that illustrate application of principle concepts. An introductory ÒPatients and PopulationsÓ course provides students with a foundation in genetics and disease, and equips them with the knowledge and skills to construct clinical questions, conduct literature searches, and evaluate the evidence they obtain from these searches and from databases and other sources. These skills are reinforced in a variety of contexts throughout the first and second years.

SECOND YEAR

The second-year curriculum continues to be interdisciplinary and organ-system based, covering the abnormal organ systems. Within most of the organ systems sequences, a longitudinal patient case is introduced and reinforced in the classroom to provide more global understanding of the material to be learned, and discussed in small groups that provide opportunities for students to master important skills and make contributions to learning. These cases are robust and are unfolded to students in three to four progressive segments. Each case includes comprehensive personal, cultural and medical information and is accompanied by intended learning outcomes, specific questions and problems to augment learning, and thought questions to help students understand how patients and families experience illness. Questions are assigned to pairs of students in advance of small group meetings that are scheduled during the sequences; in each small group sessions the pairs present what they have learned in a format that is active and encourages group participation, and with material that is supported by a synthesis of literature searches and other resources. Faculty serve primarily as facilitators, helping students to make connections between the cases and what was learned in the classroom.

Students begin the two-year Family Centered Experience (FCE) early in the first year. Pairs of students are assigned to families that have been recruited as important resources to help them understand how health changes, chronic conditions, and serious illnesses affect patients and those close to them. Students explore important connections between health care and issues such as culture, health beliefs, age, gender, and support systems. They also learn about rapport between patients and their physicians. There are four to five family visits scheduled each year. Students use a workbook with readings, resources, and questions to guide them in their interviews with the patients and families. Thought questions help them reflect on their own experiences with illness and family dynamics and the experiences they are discussing with patients and families. Each visit is focused on a particular theme (e.g., patients and families, patients and their doctors) and is followed by a small group meeting where students share their experiences (personal and with families) in the context of specific assignments related to the theme for that particular visit.

Assessment of student performance in the longitudinal cases and the FCE are designed to cultivate and encourage skills embedded in the Goals for Medical Student Education and implied in many of the intended learning outcomes. In both experiences assessment is based on preparation, creativity and quality of presentations, efforts to facilitate peer learning, depth of understanding and presentations, participation in discussions, and quality of work outside the classroom.

Clinical Foundations in Medicine (CFM) modules are 0scheduled during breaks between the sequences to allow students to focus on clinical and communication skills without distraction. The modules are each one-week long and include clinical observations, hands-on physical examination skills, patient demonstrations, and topic-based small group discussions that include professionalism and the doctor/patient relationship. Writing assignments (often accompanied by readings) are graded and include essays designed to help students with critical thinking and reflective judgment skills. They are presented with difficult issues that constitute personal or professional dilemmas and they are challenged to describe their decisions and how they were reached.

CLINICAL YEARS

The clinical clerkships and electives remain discipline based, and will now include expanded opportunities for career exploration with clerkships designed specifically to introduce students to various disciplines. Required clerkships include Internal Medicine, Surgery, Obstetrics/Gynecology/WomenÕs Health, Pediatrics, Family Medicine, Neurology, and Psychiatry. Emergency Medicine is recognized as an important context for learning how to provide high-quality, multi-disciplinary care in acute situations, thus challenging students to use the skills they are developing for reflective judgment and critical thinking, and will become a required experience. Weekly Seminars in Medicine will continue to provide learning in more complex clinical contexts that crosses disciplines and advances previous learning.

Clerkship assessments will include observation of specific skills, introduced and reinforced in the first two years, that signify continued maturing and development. These include goal setting, self-assessment and self-directed learning, patient presentations, leadership, and independent decision-making in complex situations.

Standardized Patient Instructors (SPIs) remain an integral element within and across the four-year curriculum. SPI exercises help students to master communication skills in challenging contexts such as patients from non-Western cultures with chronic diseases, patients with acute complaints who cannot agree to standard treatments because of religious beliefs, senior patients with unclear mental status, and patients who must be told that their disease has progressed to where palliative care and hospice care must be discussed.

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