East Tennessee State University (Quillen College of Medicine)

The James H. Quillen College of Medicine is part of the ETSU Division of Health Sciences, which includes the College of Nursing and College of Public and Allied Health.

The primary mission of the Quillen College of Medicine is to educate future physicians, especially those with an interest in primary care, to practice in underserved rural communities. In addition, the College is committed to excellence in biomedical research and is dedicated to the improvement of health care in Northeast Tennessee and the surrounding Appalachian Region.

The Quillen College of Medicine endeavors to meet community and regional health needs by identification, creation, and execution of the necessary programs through utilization of its diverse resources. The college is a major health care provider for East Tennessee. In view of this responsibility, the college emphasizes primary care as the focus of medical practice and training programs. The primary care physician is defined as the physician of first and continuing contact,
coordinating the entire care of the patient. Primary medical care is a function rather than a discipline. This care is provided by family physicians, general internists, general pediatricians, and obstetricians/gynecologists. In addition to meeting the clinical and service responsibilities, the college also supports a significant research endeavor.

The Quillen College of Medicine has an experienced and qualified faculty in the biological, behavioral, and clinical sciences. In addition to the full-time faculty,
a number of practicing physicians in the community participate in the educational process as both part-time and volunteer faculty.

Goals :

1. Education: Continue to strengthen the "student centered learning environment" that focuses on the overall professional development of students and residents.
2. Research: Continue to strengthen research productivity, especially clinical research.
3. Clinical and Community Service: Firmly integrate our academic values into the planning and implementation of clinical activities as we focus on meeting the needs of our patients and the communities we serve.
4. Faculty and Staff Development: Further strengthen the College's committment to the success of our faculty and staff by investing in their professional development.
5. Diversity: Strengthen our recruitment and retention of a diverse complement of faculty, staff, and students so as to enrich our cultural environment, to strengthen our cultural competence, and to improve the care of our patients.

Quillen College of Medicine enjoys an expansive array of modern, state-of-the-art, teaching facilities.
Most academic coursework is provided in Stanton-Gerber Hall on the Veterans Administration campus.
First occupied in 2002, this joint venture of the VA and the State of Tennessee provides over 180,000 square feet of teaching, laboratory and office space. Classrooms provide a pleasant learning environment
and are equipped with every modern teaching tool and convenience. The Internet is a major teaching tool of
the faculty and all teaching facilities are fully connected. Every classroom seat in these facilities is Internet-ready through high-speed Internet connections. Labs are modern and provide equipment appropriate to the teaching/research enterprise. Small group and other academic experiences are provided in numerous other buildings and clinics on the grounds.
Clinical instruction is provided through the hospitals and clinics associated with Quillen. These include a number of modern hospitals throughout the Tri-Cities (listed below) and in our rural teaching locations. In addition, on the VA campus is the Mountain Home VA Hospital and directly across from Johnson City Medical Center on State of Franklin Road is the P.L. Robinson Clinical Education Building. These modern facilities provide a broad patient base with exposure and training in every area of primary and tertiary care medicine. Specialized units include two level-one trauma centers, complete cardiac care, women's health units, neonatal and pediatric intensive care, cancer treatment and children's hospitals (within hospitals).
Nearly every area of modern medicine is practiced through our affiliated hospitals and additional experience is available at hospitals/health centers in our rural training locations. Always expanding, the Quillen College of Medicine currently enjoys a hospital patient base of over 3,000 teaching beds and school clinical facilities averaging over 275 patient visits per year.

The Medical Library provides access to information, which meets the educational, research, and patient
care needs of the students, residents, faculty and staff of the College of Medicine (COM). The library also serves as a resource for other university departments as well as the health care community of the region. To
fulfill the goal of satisfying the information needs of its clients, the library utilizes online databases, such as
PubMed, MD Consult, Embase: Psychiatry, Up-To-Date, InfoRetriever; offers classes on using information
resources; provides personalized information services; and provides interlibrary loans for items not owned
by the library. Other services include access to numerous electronic journals, document delivery,
photocopying, library orientation tours and lectures on historical aspects of medicine, and reference searches. The library's online public catalog, VOYAGER, contains monograph, journal, audiovisual and computer software and microfilm holdings. The online catalog provides easy access to all of the university’s library collection via author, title, subject and keyword searching.

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Quillen College of Medicine Medical School Location

Quillen College of Medicine Courses

YEAR 1 COURSES :

* The Human Body : Required of all first-year medical students. Deals with the structure of the human body and relates this structure to function. The course presents a three-dimensional analysis of the human body and includes several clinical experiences and a correlated study of radiological anatomy.

* Cell and Tissue Biology : Required of all first-year medical students. The structure-function relationships of human cells, tissues, and organ systems are described with an emphasis on the modern cell biological,
biochemical and ultrastructural methods used to understand these close relationships. The material
is presented in an integrated sequence of cell biology, basic tissue histology, organology, and endocrinology-reproductive systems. The unique modifications of the cell membrane, the cytoskeleton, the various subcellular organelles, and the characteristic molecular content of these structures as they relate to specialized tissue functions are noted throughout the course. (lecture, lab, and demonstrations) For the sake of continuity, the topics for this course are closely aligned with those in the physiology course and include some integration sessions related to specific disease process.

* Medical Biochemistry : Required of all first-year medical students. This course is an introduction to basic biochemical concepts and principles and includes a description of the structure, function and metabolism of the molecules of life. Clinical case conferences on diseases involving biochemical abnormalities serve
to enrich the lecture material. An undergraduate course in biochemistry is strongly recommended as a preparation for this course.

* Medical Physiology : Required of all first-year medical students. Systematic study of the function of human organ systems emphasizing regulatory and compensatory mechanisms (lecture, case conferences and problem solving sessions).

* Communication Skills for Health Professional : Required of all first-year medical students. This interdisciplinary course addresses basic communication skills that are used by health professionals. The course focuses on data gathering skills, development of rapport, listening skills, and empathic and facilitative responses. Principles
of interpersonal, family, group and interdisciplinary communication strategies are addressed.
Students begin to address ways to reconcile differences in expectations between patients and
health care providers.

* Human Developmental Biology and Genetics : Required of all first-year medical students. An interdisciplinary assessment of gene structure and function utilizing current emphases and concepts that are common to the disciplines of Developmental Biology, Biochemistry and Medical Genetics and provide a scientific basis for
understanding the genetic basis for disease. The course will consist of lectures, clinical conferences and student presentations.

* Biostatistics and Epidemiology : Required of all first-year medical students. Course content: medical and epidemiological study designs, statistical data analysis and interpretation, concepts of diagnostic testing, introduction to epidemiology, public health and vital statistics. Course presentations provide a foundation that allows students to better assimilate medical literature reports and research inquires.

* Behavioral Sciences and Lifespan Development : Required for all first-year medical students. Course covers the basic behavioral science principles that underlie and pertain to medical practice. The biopsychosocial model serves as an organizing principle for the course. Specific content includes life span development, behavioral medicine, cultural issues in health care, social issues relevant to medical practice and theories of human behavior. A combined lecture and experiential learning format is used in the course.

* Introduction to the Physical Examination : Required of all first-year medical students. Course teaches students the basic physical examination skills required to enter the clinical years of medical school and to provide a knowledge base and skill set for the learning of more complex clinical skills required in the more advanced stages of medical training as well as their medical careers. Didactic sessions, trained standardized patients, and clinical correlation sessions with physicians and their patients are used to teach physical
examination skills. Students are expected to approach this course in a self-directed learning format with active participation expected.

* Clinical Preceptorship I : Required of all first-semester freshman medical students. Program exposes students to a full week of the role of the provider in the office, hospital, and community. Students are expected to spend each day of the provider's workweek from the beginning to the end of their workday in the office,
on hospital rounds and /or any community activities the provider participates in. This program not only continues to reinforce the student's clinical use of knowledge but also exposes them to the overall role of a provider in the community. This week-long program can be spent with a primary care provider (Family Practice, Internal Medicine, Pediatrics) in the immediate area or away from the College of Medicine.

* Rural Case-Oriented Learning and Preceptorship I :
Students develop an understanding of their personal lifelong education process by addressing learning issues identified from encounters with rural patients. Students will explore issues of health and disease in context of their patients’ lives, families and communities. Emphasis is placed on the case-oriented learning process using real patients in rural communities. The course is comprised of team-building and clinical experiences, complemented with group discussion,
review of clinical encounters and self-directed information acquisition. Topics correlate closely with material from the basic medical sciences curriculum.

* Rural Case-Oriented Learning and Preceptorship II :
A continuation of Rural Case-Oriented Learning and Preceptorship I, this course continues to emphasize personal life-long education by addressing learning issues identified from rural community and clinical patient encounters. Students explore issues of health promotion and disease prevention. Emphasis is placed on the case-oriented learning process as well as disease
management in rural communities. The course includes clinical experiences coupled with indepth evaluation of rural patients with common diseases. Clinical experiences are reviewed with peers and faculty through group discussion and self-directed information acquisition. Topics complement material covered in the basic medical sciences curriculum.

YEAR 2 COURSES :

* Immunology : Required of all second-year medical students. Introduction to the cellular and molecular bases of the immune responses, including the molecular basis of specificity, the molecular basis for induction of immune responses, the cellular distinctions between humoral and cell-mediated immunity, and the contribution of each of these to the immunology of allergy, organ transplantation, microbial infection and to autoimmune and immunodeficiency diseases (lecture).

* Medical Microbiology : Required of all second-year medical students. Deals with the study of microbial organisms including structure, genetics, metabolism, and physiology; also a study of related information including antibiotic action and resistance, immunology, principles of infectious disease, bacteriology, virology, mycology and parasitology (lecture, lab).

* Clinical Neuroscience : Required of all second-year medical students. An extensive analysis of the morphological, physiological, and behavioral aspects of the human nervous system. Clinical conferences will be
used to illustrate normal and abnormal mechanisms of neural function and structure. (lecture, lab)

* Medical Pathology : Required of all second-year medical students, others by permission. Introduction to the basic concepts of etiology and pathogenesis of disease, and their application to organ systems. (lecture,
computer-assisted instruction)

* Medical Pharmacology : Required of all second-year medical students. This course deals with the study of drugs commonly used in medical practice including their classifications, pharmacokinetic and pharmacodynamic properties, therapeutic usages, sites and mechanisms of action, common side effects, contraindications and toxicities (lectures, computer simulation laboratory, videotapes, small group discussions, clinical conferences, drug fair, optional computer-assisted web-based instruction). In addition, certain aspects of toxins and poisons that may be encountered in medical practice or in bioterrorism are discussed.

* Introduction to Clinical Psychiatry : Required for all second-year medical students. Course provides an introduction to clinical psychiatry. Students learn the basic principles and practices of psychiatric assessment, diagnosis and treatment. The course includes lectures, videotaped vignettes of patients and supervised small groups for interviewing patients. The students learn fundamental psychiatric interviewing and
diagnostic skills as well as the basics of treatment options.

* Clinical Preceptorship II : Required of all second-year medical students. Course further enhances the understanding of the role of the provider in the office, hospital, and community while continuing to reinforce their comprehension and application of skills they have learned in their courses, labs, and previous preceptorship experiences. This week-long course can be spent with an expanded list of providers that can provide a clinical environment for the student either in the immediate area or away from the College of Medicine.

* The Practice of Rural Medicine : The Practice of Medicine I is a concentrated experience occurring both at a selected rural site and on campus which familiarizes students with the community and provides a foundation for later coursework and clinical experience. The main objective is the integration, review, and application of basic science pathophysiology through an introduction to clinical medicine with attention to the
rural community. This occurs within the context of rural clinical and community experiences as well as case-oriented learning encounters. Students use their knowledge base to build differential diagnoses and learn advanced interviewing and physical exam skills. Additionally, students are introduced to evidence-based medicine and how to use the resources available to them. Basic interpretation of electrocardiograms, lab data, and diagnostic imaging studies is also presented.
Rural community patients, standardized patients, small group attending physician sessions, and simulation lab workshops are used to facilitate the course. Students are expected to approach this course in a self-directed learning format with active participation expected.

* The Practice of Rural Medicine II : A continuation of The Practice of Medicine I, this course is part of the Rural Primary Care track. A concentrated experience occurring both at a selected rural site and on campus familiarizes students with the community and provides a foundation for later coursework and clinical experience. The main objective is the integration, review, and application of basic science pathophysiology through an introduction to clinical medicine with attention to the rural
community. Focusing on real-world experiences in rural communities, students use their knowledge base to build differential diagnoses and learn advanced interviewing and physical exam skills. Additionally, students are introduced to evidence-based medicine and how to use the resources available to them. Basic interpretation of electrocardiograms, lab data, and diagnostic imaging studies is also presented. Rural community patients, standardized patients, small group attending physician sessions, and simulation lab workshops are used to facilitate the course. Students are expected to approach this course in a self-directed learning format with active
participation expected. This course allows medical students to conduct focused community-based participatory health projects that they plan while partnering with a rural community. Building on prior experiences in the Rural Health Research and Practice course as well as the Rural Community-Based Health Projects I course, students work on a project of their own design.

YEAR 3 COURSES :

* Internal Medicine Clerkship : Required of all third-year medical students as an eight-week rotation designed to develop skills in history-taking, patient examination and patient care. Students will spend four weeks each in two of the three following hospitals: Veteran's Administration Medical Complex, Holston Valley Medical Center or Johnson City Medical Center. The student will develop advanced clinical skills in history taking and physical exam; understand sensitivity and specificity of laboratory and imaging studies; learn to order diagnostic tests using a logical, cost effective approach; learn to
present patients in a precise comprehensive manner; record a detailed history and physical exam, formulation of problem, assessment and plan--including diagnostic, therapeutic and education components; and to complete a written evaluation in a timely fashion. Each student's final grade is based on a composite evaluation of performance by preceptors, resident and ward attending, a clinical skills exam, and the student s performance on the NBME internal medicine subject
examination.

* Surgery Clerkship : Eight-week rotation required of all third-year medical students. A series of lectures provides a framework for learning general surgery and guidance for independent reading. Quizzes on lectures
and assigned text reading are given three times throughout the course. Students are assigned ward
teams for active participation in surgical patient care with the surgical residents and faculty. This includes preoperative work-up, intraoperative assistance and post-operative care. Students spend six weeks on general surgery services divided between the Veterans Affairs Medical Center and Johnson City Medical Center. During the six weeks of general surgery, call will be required. A two-week subspecialty elective is available during the clerkship in anesthesiology, cardiac surgery, ENT, neurosurgery, ophthalmology, orthopedic surgery, pediatric surgery, plastic surgery, trauma surgery, urology and vascular surgery. Attendance at selected rounds, conferences and clinics is required. Course evaluations are based on ward evaluations from faculty and residents, as well as performance on departmental quizzes and end of course SHELF scores. There is an individual midterm performance review with the clerkship director.

* Family Medicine Clerkship : Required of all third-year medical students as an eight-week rotation. Students will be assigned to one of the three family practice programs located in Bristol, Johnson City, or Kingsport. The clerkship involves the student in the comprehensive practice of medicine unrestricted by age, sex, disease, organ system, or treatment modality. The goals are to encourage the development of the student's knowledge and skills in family medicine. The student will be involved in the diagnosis and management of undifferentiated problems both in the ambulatory and hospital setting.
Students will become acquainted with the role of the family physician in prevention and treatment of disease. They will understand the importance of the family and the community in relation to the disease process. The student will develop further history-taking and physical examination skills and communication skills. Students will see patients in a family practice ambulatory care center,
follow patients in hospital, attend rounds, and make case presentations.
Students will be expected to attend a block of didactic sessions, make a home visit and collaborate on a student presentation that will be presented to the residents and faculty. They will also spend a week with a local or rural family physician, and will participate in a rural health fair in the region.
Students will be evaluated by faculty and community preceptors on the referenced projects. Students will take a written exam, OSCE (objective structure clinical exam) and an advanced interviewing, standardized patient exam.

* Obstetrics/Gynecology Clerkship : Required of all generalist track third-year medical students as an eight-week rotation. Students will be assigned time in both obstetric and gynecological services. They will work with patients in the prenatal outpatient department, examining women at various stages of pregnancy. Students will participate in a busy high-risk service. Many of these patients remain in the hospital for prolonged periods of time as their fetus' mature. Students will learn the fundamentals of labor and delivery by being assigned patients who enter the hospital for delivery. They will examine patients during
labor and assist in their delivery under direct supervision. On the gynecological service, the student will be responsible for examination of both inpatients and outpatients. The student will take a history and must demonstrate competence in examination of the breasts, abdomen, and the performance of a pelvic examination. Assistance will be required in operations and with
postoperative care. This clerkship is designed to permit each student to become familiar with women's health, including endocrine, reproductive, neoplastic and preventive care issues. In hospital, night call is mandatory, as are ward rounds.

* Pediatrics Clerkship : Required of all third-year traditional track medical students as an eight-week rotation. Students are assigned to the inpatient ward (3 weeks and nursery (2 weeks) at Johnson City Medical Center and the ambulatory care services (3 weeks) at ETSU Physicians & Associates. In the clerkship role,
the students will be responsible for complete studies of patients assigned to them, including histories, physical exams, laboratory studies and progress notes. Activities include daily teaching rounds, small group discussions, clinical conferences, lectures, and grand rounds.

* Psychiatry Clerkship : Required of all generalist track third-year medical students as an eight-week rotation, where the students will be provided with a balanced exposure to two of the following: Inpatient Psychiatry,
Consultation/Liaison Services at the Veterans Affairs Medical Center, and the psychiatry pavilion at Indian Path Hospital. In addition the faculty will provide the students with outpatient experience in child psychiatry services at the Psychiatry Clinic. During the rotation the students will be responsible for the evaluation of patients with psychiatric disorders under the supervision of residents and faculty and will actively participate in treatment planning under the concept of a multidisciplinary treatment team approach. The faculty will provide didactic exercises as well as serving as proctors to the students in weekly scheduled meetings.

YEAR 4 COURSES :

* Keystone: Transition to Residency Course : Required of all fourth-year medical students. Course designed to bridge the gap between undergraduate and graduate medical education and ease the transition of the graduating medical student into residency training. The course is run on a continuing medical education (CME)
model and includes lectures and workshops on topics not previously addressed in the four years of medical education (such as medical jurisprudence), reinforces training already received (ex: hands-on workshops on orthopedic casting techniques), and introduces issues that will face the new resident physician.

* Electives

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