University of Southern California (Keck School of Medicine)

Located in Los Angeles, the Keck School of Medicine of the University of Southern California trains tomorrow’s leaders in patient care and biomedical research and provides advanced health care to the people of Southern California. Increasingly, the Keck School is expanding its biomedical research enterprise and, in so doing, raising its profile as a premier medical school.

Keck School leaders have embarked upon a remarkable transformation, reinventing the school for the new millennium. Already, leaders and faculty have seen major growth in school research dollars, philanthropic funds and patient care revenue. Planning and construction on three new research facilities is complete and has allowed the recruitment of scores of new faculty members, culled from the country’s elite scientists and physicians.

At present, the Keck School of Medicine ranks among the nation’s top 25 percent of medical schools in federally sponsored research (Association of American Medical Colleges, 2003). Keck School departments have risen to national prominence, with ophthalmology, pediatrics and preventive medicine consistently ranked among the top ten in the country. Keck School physicians are known as experts in advanced medical care and research. More than 175 Keck School faculty members are listed among the “Best Doctors in America” (Woodward/White, 2004) and 84 are listed in “America’s Top Doctors” (Castle Connolly, 2004).

In education, faculty members have modernized the curriculum, providing students with a more relevant education in face of an explosion of biomedical knowledge and rapid changes in the health care system.

Research programs in genetics, cancer, neurogenetics, transplantation medicine, and other key areas—have attracted national recognition. The school’s dual commitments to collaborative interdisciplinary research and rapidly translating scientific findings from the lab bench to the patient’s bedside have proved pivotal in its continuing success in research.

The Mission of the Keck School of Medicine of the University of Southern California is to improve the quality of life for individuals and society by promoting health, preventing and curing disease, advancing biomedical research and educating tomorrow's physicians and scientists.

By 2010, the Keck School of Medicine will rank among the top private research medical schools. This will be achieved through groundbreaking discoveries in basic science and clinical research targeted to prevent and relieve human suffering and enrich the human mind and spirit. Excellence in the School’s education of the next generation of academic clinicians and basic scientists. The delivery of advanced university-level patient care, measured by breakthroughs that fundamentally change the practice of medicine, will be the fruit of success in the School’s patient care mission and will secure its reputation for excellence. Many see the 21st Century as the golden age of biomedical research. The Keck School will position USC for leadership at the dawn of this new era.

The Keck School of Medicine provides a unique research setting that extends from the investigation of basic and fundamental processes to the solution of complex clinical problems in one of the most ethnically diverse and populous regions on earth. In the basic sciences we investigate biological questions at the molecular and cellular levels. In the clinical sciences we utilize basic science advances and cutting-edge technologies to discover the cause of disease and develop new diagnostic procedures, therapies and
approaches to prevention. This bench-to-bedside process is translational research—for which medical schools are uniquely well-positioned.
One example of translational research as it applies to neuroscience is genetics.
Neurologists can now correlate clinical observations with genetic defects. Scientists can then recreate and study these same defective genetic sequences in lower animals and apply the findings to humans.
The School’s location in Southern California, with its wealth of biomedical research and development resources, makes it well-positioned to achieve its research mission. The area’s vast and diverse pop-ulation make it an ideal laboratory for the unique strengths of USC. As one of only two major uni-versity medical schools in the area, the School’s potential for growth and impact is unlimited.

To achieve preeminence in these prioritized areas we will:
• Become a world leader in neurogenetics through basic science and related disciplines and their application to the treatment of neurological diseases, especially neurodegenerative diseases afflicting the elderly. The School will draw from geriatric and gerontological resources at University Park and Rancho Los Amigos. The human brain is the great frontier in science and the Keck School will be a leader in its study.

• Enhance the Institute of Genetic Medicine—the focal point of genetics research encompassing informatics, in cooperation with computer scientists at University Park;
molecular biology, including structural biology and signal transduction; applied gene therapy, combining basic science efforts in genetics, biochemistry and vector
development with clinical activities.

• Increase the Keck School’s international leadership in cancer research, therapy and prevention, expanding the role of the USC/Norris Cancer Center, particularly in the areas of translational research, epidemiology and prevention research.

• Build upon the School’s clinical strengths in heart, liver and lung transplantation, and pioneer the application of the increased understanding of the immune system to
improve transplantation efficiency, becoming a world center for immunobiology and transplantation research and organ and tissue transplant.

Medical and graduate student education is a top priority for the Keck School of Medicine.
We have the critically important responsibility of preparing future physicians and biomedical researchers. A medical school can achieve recognition for its research breakthroughs and advances in clinical care. However, it is most often measured by the excellence of its graduates. Our training programs must be designed to help our graduates meet the challenges that will confront them in the future. We are especially committed to enhancing the M.D./Ph.D. program with Caltech. Graduates of this program will be leaders of biomedical research in the 21st Century.
Medical education within a research university also offers opportunities to students that are not available at other academic institutions. Integrating research activities at the Keck School with educational opportunities elsewhere at USC provides a distinctive model of education.

The Keck School of Medicine of the University of Southern California is located on the 45-acre Health Sciences Campus, three miles northeast of downtown Los Angeles and seven miles from the USC University Park Campus.

The Health Sciences Campus (HSC) is a focal point for students, patients and scientists from around the world. The many clinical, classroom and laboratory resources of the campus combine to form a dynamic, interactive environment for learning, collaboration and scientific discovery.

The Health Sciences Campus lies adjacent to the Los Angeles County+University of Southern California (LAC+USC) Medical Center, a primary affiliate of the Keck School of Medicine and one of the nation’s largest teaching hospitals. HSC also houses state-of-the-art health care facilities, among them the USC University Hospital, the USC/Norris Comprehensive Cancer Center and Hospital, the Doheny Eye Institute. USC is also partners with the nearby Childrens Hospital Los Angeles.

Creating more opportunities for Keck School faculty and students to work at the forefront of biomedicine while continuing to provide outstanding patient care are among the Keck School’s highest priorities. New initiatives at the Keck School and greater HSC include building some 585,000 square feet of new research space, as well as expanding and modernizing patient care facilities.

The Health Sciences Campus is also home to the School of Pharmacy and the Independent Health Professions programs.

Degrees & Programs
A new technology anticipates which type of chemotherapy drug is most likely to be effective against a patient's specific cancer before the treatment begins. Scientists invent new ways to deliver the next generation of gene therapies and study the genetics underlying heart disease, osteoporosis, cancer, depression and many other diseases. Studies of stem cells and neurotransmitters offer hope to people suffering from neurological diseases, such as Parkinson’s, as part of Keck School research program in the neurosciences. Keck School faculty pioneer transplantation medicine, performing the first double lobar living-related lung transplant and the first transfusion-free liver transplant, among many others. A computer-based metabolic test allows physicians to accurately predict who will develop diabetes, while other clinicians and researchers focus on advancing women’s and children’s health.

Innovations, inventions and discoveries like these come from the stand-out faculty physicians and scientists of the Keck School of Medicine of the University of Southern California and are helping to push the school into the top ranks of research-based medical schools in the nation.

The medical and graduate educational programs of the Keck School offer students opportunities to learn alongside medical innovators, scientific inventors and biological discoverers. Graduate and professional education at the Keck School of Medicine prepares students for leadership in research, teaching, the application of knowledge and professional practice. The programs are built upon the close interaction of faculty members and students. The values that characterize these interactions include dedication to excellence, mutual respect, fairness, collegiality, honesty and integrity.

In pace with the changing face of medicine, the Keck School has stepped toward the forefront of medical education with the adoption of an integrated, modern curriculum.

Already recognized for being among the first medical schools to adopt the Introduction to Clinical Medicine courses for the first-year students which provides critical real-world experience in patient care from the start of medical school, the Keck School faculty led the movement towards the use of the "standardized patient" for medical training, an idea which has taken root at schools across the nation. The Keck School's new curriculum promises to improve the medical training at the Keck School even more, as it better reflects the current state of medicine and practice.

The Keck School offers innovative training programs for physicians interested in scientific research, including two M.D./Ph.D. programs, a fifth-year research option and master's programs to train physicians in biomedical research methods, study design and analysis. Many medical students take advantage of opportunities to work closely with leading medical faculty during their training at the Keck School. Programs to enhance the careers of future physicians in business administration and public health are also offered.

Supervised by Keck School faculty, medical students also play a key role in patient care in more than a dozen affiliated hospitals, including the adjacent LAC+USC Medical Center, one of the largest teaching hospitals in the nation.

The mission of a general medical education at the Keck School of Medicine is to enable students to acquire the scientific knowledge, clinical reasoning skills, humanistic skills and values required to make decisions concerning the diagnosis, care and management of patients within their family and community; to lay the foundation for graduate medical education while providing sufficient flexibility for students to pursue individual interests in research and specific clinical areas.

The teaching faculty recognizes that in four years of medical school, the student cannot be taught all the knowledge and skills that will be adequate for the practice of medicine, either now or in the years ahead. Therefore, the student is expected to acquire a basic core of concepts, skills and patterns of behavior that will lead to the acquisition of knowledge continually throughout the student's medical career. To a far greater degree than in the past, the student must be an active participant in the educational process.

In the curriculum, both basic and clinical sciences are taught throughout the four years of undergraduate medical education. Basic sciences are taught both as pure science and in correlation with the clinical sciences. Close interaction between individual faculty and students is emphasized.

The student is involved progressively in direct patient care, beginning with patient contact during the first semester of the first year. The student's assumption of responsibility increases as knowledge and skills are acquired. In the fourth year, the student is assigned responsibility equivalent to that of a first year graduate resident.

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Keck School of Medicine Medical School Location

Keck School of Medicine Courses

YEAR I-II
The first year of the Year I-II continuum begins with 19 weeks of Core Principles of Health and Disease, followed by 49 weeks of organ system review, ending with a nine-week Integrated Case Study section. There is an eight-week summer break between the first and second years. Students also take Introduction to Clinical Medicine and the Patient.

Each week of the academic year is composed of approximately 20 hours of lecture and small groups sessions with an additional 20 hours of independent directed study or Introduction to Clinical Medicine and the Patient. Examinations in all systems throughout the first two years are graded Pass/Fail. Dean's recognition is awarded on the basis of year-end comprehensive examinations and special projects.

COURSES :

* Core Principles of Health and Disease : This 19-week introductory system provides the student with the fundamental knowledge necessary for the integrated study of the basic and clinical sciences in the ten human organ systems which follow. Included in this section are the following major themes: cell structure and function; the human organism; disease and the body's responses; prevention and treatment of disease, including evidenced-based medicine; and introduction to clinical medicine and the patient. This section is taught in an integrated fashion and includes the use of clinical case studies.

* Gross Anatomy : Cadaver dissection remains a unique teaching tool by which the three dimensional organization of the human body is studied. Gross anatomy will begin in the Core Principles of Health and Disease system continuing in the Hematology/Clinical Immunology system with the dissection of the body wall and major body cavities followed by head and neck dissection in the Neurosciences system and ending with limbs dissection during the Musculoskeletal system. Continued study of gross anatomy by use of prosected anatomical specimens as well as computer programs, selected review lectures, etc., continues throughout the integrated organ systems.

* Introduction to Clinical Medicine and the Patient (ICM):
ICM expresses the strongly patient-centered orientation of the medical school curriculum. The student is introduced to patients and is involved in patient care activities from day one. Students are introduced to the principles of patient care and management and examine what it means to be a physician and how one becomes a physician.
The major content areas of the course include communication in the setting of illness, the unified concept of health and disease (the biopsychosocial model), basic clinical skills and the correlation of basic science with clinical medicine.
ICM emphasizes the systematic acquisition of the clinical skills of interviewing, history taking, physical examination, elementary clinical problem solving, and medical record keeping. Throughout the Year I-II continuum, the ICM clinical skills curriculum is integrated with basic science instruction. Students can therefore learn and apply basic science knowledge in the clinical setting. By encouraging a thorough understanding of the direct applications of basic science research to modern clinical medicine, instructors motivate the student to learn, use and retain more of the content and concepts presented in the basic science portions of the curriculum.
A group of five or six students spends from four to eight hours each week with an instructor from the clinical faculty who remains with the group for one to two years. As the group deals with basic medical themes (death, pain and helplessness) and issues (patient responsibility, learning to live with ambiguity and uncertainty), instructors help students to cope with their own feelings. This format opens the door for student-faculty interaction and improvement of student-faculty communication.
Instructors encourage students to take advantage of the learning experiences provided by their roles as helping and therapeutic persons. Students develop their ability to communicate with patients in the setting of illness and are guided by patient concerns to enhance their own growing knowledge, skills, abilities and responsibilities. Students are expected to acquire skills and habits of self-education and self-instruction which will prepare them for lifelong learning.
The unified concept of health and disease presented in this course enables the student to comprehend the human organism in all its complexity. Using their clinical experiences as a teaching model, students are taught to consider the patient as an integrated whole and to view the patient's illness or disease as more than simply a disruption of physiologic processes or a collection of physical findings.
Additional learning experiences occur through workshops and focus experiences. ICM workshops provide standardized instruction in history taking and physical examination, as well as integrated instruction in areas which cross disciplines. These include physician well being, substance abuse, domestic violence, and ethics. Through focus experiences, students are encouraged to explore a variety of practice environments as well as community based health and social services. For example, students may visit outpatient clinical settings, a geriatrics long term care facility, a hospice care facility, or homeless services organizations.

* Organ System Review : A sequence of study presenting integrated basic and clinical science instruction involving ten human organ systems, Hematology/Clinical Immunology, Neurosciences, Musculoskeletal, Cardiovascular, Renal, Respiratory, Endocrine/Metabolism, Reproduction, Gastrointestinal/Liver, Skin follows Core Principles of Health and Disease.

* Integrated Case Study : This section completes the second year of the Year I-II continuum and will emphasize patient-centered problems, which integrate the basic and clinical science presented in the preceding organ systems. Students will explore the multi-organ effects of disease processes and reinforce diagnostic reasoning skills. In addition, concepts of pathophysiology, evaluation, and management that can be applied to any organ system will be included. This section will also reinforce the appropriate use of medical information resources, effective self-directed learning skills, and interpersonal and group communication skills.
Separate review sessions of the important basic science and clinical concepts covered during the previous two years also occur during this seven-week section. These sessions will assist students in preparing to take the United States Medical Licensing Examination (USMLE) Step 1 examination.
By early spring of the second year of the Year I-II continuum, students are expected to select their academic clinical advisors and to begin arranging for the schedule of clerkships to be taken during the Junior/Senior continuum. By the end of the fall semester, Year II, each student receives information which describes the curriculum requirements of the Junior/Senior continuum. Students choose the area of medical practice which they are most likely to pursue and an advisor is assigned from that discipline. The advisor counsels the student on clerkships and opportunities in graduate medical education.

YEAR III-IV Continuum (two calendar years)
The final two years of medical school are designed as a continuum of two calendar years, beginning in July at the end of Year II. During the spring of their second year, students schedule clerkship rotations to be taken during the two years of the continuum. Each student's program is individually designed with the assistance of faculty advisors and includes 50 weeks of required clerkships, 16 weeks of selective clerkships and 16 weeks of elective clerkships.
All degree candidates are required to take and pass Step I of the United States Medical Licensing Examination and prior to entering the junior/senior continuum and take Step II of the USMLE as a graduation requirement.
During the continuum each student may schedule 16 weeks of vacation for personal convenience, remedial work, funded research work and other non-curricular activities, such as investigating postgraduate training programs. Although every effort is made to provide flexibility in the scheduling of each student's program, some inherent limitations are imposed by the maximum enrollment permitted for each clerkship. Students are a vital part of the university's medical team, which provides health care for patients throughout the year, vacations are therefore subject to some scheduling adjustments.

REQUIRED CLERKSHIPS :

- Family Medicine (6 weeks)
- General Surgery/Specialty Surgery (12 weeks)
- Medicine 1 (6 weeks)
- Medicine 11 (4 weeks)
- Neurology (4 weeks)
- Obstetrics and Gynecology (6 weeks)
- Pediatrics (6 weeks)
- Psychiatry (6 weeks)

SELECTIVE CLERKSHIPS
Students are required to schedule 16 weeks of selective clerkships, chosen from a list of four or six week clerkships approved by the Clinical Curriculum Committee. Selective clerkships are carried out at USC affiliated hospitals and encompass virtually all specialty areas.

ELECTIVE CLERKSHIP
The elective period consists of 16 weeks, during which electives may be taken on campus, at USC affiliated hospitals or at more distant medical schools or medical centers. Approved on campus electives which are offered regularly are listed in the elective catalogue.

Proposals for other on campus and off campus electives are reviewed individually by a committee composed of faculty members and students. All petitions must be submitted at least six weeks before the beginning of the rotation. Off campus electives require documentation from the off campus preceptor, endorsement of the student's medical school advisor, and prior approval and review by the Clinical Curriculum Committee. Credit is not given for electives until an evaluation has been received from the preceptor and a critique of the elective submitted by the student. Students with an academic deficiency may not schedule off campus electives.

º Fifth Year Research Option:
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 to excellent academic standing who has completed his or her first year of medical school. Students interested in the option should identify a faculty preceptor and present a description of the proposed research program and funds available in support of the program to the associate dean for curriculum. A stipend, comparable to that received by a graduate student at the postgraduate level, is available. Application for this program is made through the Office for Curriculum (KAM 314) and will be supervised through the Office of the Associate Dean for Student Affairs (KAM 100E).

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