Medical University of South Carolina (College of Medicine)

The College of Medicine, founded in 1824, was the first medical school in the southern United States. The college pioneered in clinical teaching and its faculty members wrote some of America’s first medical textbooks. For over 170 years, the College of Medicine has been dedicated to the training of physicians. Today, it is comprised of over 25 departments which independently and collectively contribute to the education of future physicians.

The College of Medicine admits 135 students each year into its four-year medical curriculum. The students are awarded a Doctor of Medicine (M.D.) degree upon their completion of the college’s academic requirements. Two years of basic science instruction and two years of clinical education are closely supervised by full- and part-time faculty members.

In addition, the College of Medicine, in conjunction with the College of Graduate Studies, offers the Medical Scientist Training Program which leads to an M.D./Ph.D. degree.

The College of Medicine, as an integral part of the Medical University of South Carolina, is dedicated to the University’s education, research and service missions. The College recognizes the imperative for decisive leadership in responding to changing concepts, resources and systems of delivery which relate to health care generally and academic medicine specifically.

The College is committed to maintaining an educational environment for all students which prepares them for a career of excellence in the practice of medicine and service to their communities. We recognize the need to engender and support life-long learning to sustain and expand competence and performance throughout the physician’s career. We acknowledge the importance of interdisciplinary education in the provision of accessible, high-quality health services.

The College is committed to the continued development and expansion of biomedical research to extend the boundaries of health care for all people. Further, we support enhancement of research directed to improving access, enhancing quality and controlling costs of health care.

The College participates in a medical center with broad capabilities and responsibility for the provision of tertiary/quaternary health services for citizens in the state. At the same time there is need to establish and nurture strong programs in primary health care to support current and future educational, research and service requirements.

The College is concerned with ensuring optimal opportunities for all constituents-students, faculty and administration, including all backgrounds and levels of diversity, to achieve full potential.

Medical education should foster in each student the following capabilities:

* Life-long, self-directed learning
* Acquisition and critical evaluation of new information related to the physician’s practice of medicine
* Interpersonal skills necessary for optimal interaction with the physician’s patients and colleagues.

All graduates of the College of Medicine should have acquired the following four fundamental competencies.

* The knowledge, skills, and attitudes necessary for continued, self-directed learning and for the critical evaluation of new scientific information as it might relate to the diagnosis, treatment, and prevention of disease.
* The fundamental knowledge necessary for understanding the scientific basis of medicine and its application.
* The knowledge, skills, and attitudes necessary for the effective diagnosis, treatment, and prevention of disease.
* The personal characteristics required for the types of interactions with patients and other health care professionals necessary to achieve the best possible medical care.

The goal of the College of Medicine is to produce caring and competent physicians who are capable of succeeding in their postgraduate career. The four-year program, which leads to an M.D. degree, is divided into two years of preclinical instruction which consists of education in the basic sciences and an introduction into clinical medicine, followed by two years of clinical science education. The curriculum, during the first two years, addresses four major objectives: provision of basic science concepts, acquisition of problem-solving strategies, development of skills which permit the performance of an adequate history and physical examination, and an introduction to the role of the physician in society. Throughout, emphasis is placed on small group instruction. The curriculum was changed in fall, 1999, to expand and improve opportunities for independent, self-directed learning. As a result, students are being exposed earlier to certain clinical skills.

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College of Medicine Medical School Location

College of Medicine Courses

YEAR 1 COURSES :

* Anatomical Basis of Medicine : Provides the student with a good understanding of the structure and function of the human body and a three dimensional concept of its parts. The clinical importance of the study of anatomy is stressed. Presentation: lectures (mostly on basic anatomy, but also on radiographic and clinical anatomy) and laboratory study (cadaver dissection and study of cross sections, prosections, skeletal material, models, and radiological images). The body is studied by regions rather than by systems.

* Doctoring Curriculum I : The course goals of DC I are t 1) prepare students for their third-year clinical clerkship with medical interviewing, oral, and written presentations, and an introduction to physical examination skills; 2) provide students early and meaningful patient contact; 3) increase students’ knowledge about behavioral sciences concepts relevant to medical practice; 4) develop and refine students’ knowledge and skills of medical informatics; 5) foster students’ acquisition of life-long, self-directed learning skills; 6) foster students’ professional development as future clinicians; 7) introduce students to issues related to the practice of community-based primary care medicine; 8) integrate clinical and basic science concepts relevant to medical practice.
The DC I course is composed of 5 coordinated segments in which learning content has been developed to increase conceptual integration across segments and learning activities have been selected to complement one another and maximize active, self-directed learning principles. These segments are:
- Longitudinal Patient Care Experience (LPCE) -
students acquire and practice medical interviewing,
oral and written presentation skills in small-groups
and visit community-based primary care physicians’
offices.
- Behavioral Sciences in Medical Practice (BSMP) -
using a problem-based learning (PBL) format,
students develop self-directed learning skills and
acquire information regarding the biological,
psychological, and sociocultural factors that
influence and explain patients’ and health-care
providers’ behavior in medical practice.
- Physical Examination - students acquire basic
physical examination skills in specific anatomical
regions (e.g., head and neck, abdomen,
musculoskeletal, male genitourinary systems).
- Basic Science Integration - students integrate
knowledge acquired in the basic science courses
with the practice of medicine.
- Medical Informatics - students develop and refine
computer skills through self-directed learning
experiences.

* Molecular Basis of Medicine : This inter-disciplinary course introduces students to fundamental concepts of cell structure and function with an emphasis on aspects relevant to clinical medicine. The major metabolic pathways and their regulation by hormonal, allosteric, and genetic mechanisms are discussed in relation to nutrition and to a variety of diseases, including heart disease, cancer, diabetes, and enzyme defects. Basic aspects of DNA chemistry, and the structure, function, and regulation of prokaryotic and eukaryotic genes are taught using clinically relevant examples. Students actively participate by performing a nutritional evaluation on themselves, by evaluating their own lipoprotein profiles, and by leading a small group discussion on a topic of their choosing. Course activities include lectures, laboratories, independent problem-solving, and small group conferences.

* Medical Histology and Embryology : This course presents the development of the human from conception to birth and the microscopic architecture of the adult human body. There are two major goals in this course: one is for the student to gain a working knowledge of developmental processes and terminology with an awareness of when and where developmental malformations occur; the other goal is to gain a level of knowledge of microscopic architecture such that the student will be able to visualize the architecture of each tissue and organ system down to the cellular and subcellular level. The knowledge of normal microscopic structure/patterns and function (histology), will prepare the student for the study of higher levels of function and regulation of function (physiology) and abnormal microscopic patterns (histopathology). Presentation of course content is by lecture and hands-on laboratories during which students use microscopes, videodisc players and computer based interactive lessons. Much of the practical work in this course can be accomplished independent of instructors. Regular laboratory times are scheduled to meet with instructors in a small group setting to refine what is learned by independent study and to assist the student to fit the course detail into major concepts and principles of structure-function design.

* Doctoring Curriculum II : The goals of DC II are to provide students with continued experience in a primary care community setting and to evolve and refine their medical interviewing and patient presentation skills (building on the skills developed in DC I). Students will be introduced to certain special topics, common in primary care, which requires a multi-system approach in interviewing. During the special topics, students have the opportunity to practice the interview techniques within a controlled environment with standardized patients. In addition, students will continue to acquire basic physical examination skills in specific anatomical regions (e.g. chest, nervous system). The clinical preceptorships, small-group discussion sessions, and special topic sessions are offered in three-week cycles. Students continue to integrate knowledge acquired in the basic science courses with the practice of medicine.

* Medical Neurosciences : An interdisciplinary course in which contemporary concepts of the structure and function of the nervous system are explored. Discussion of the function of the normal adult nervous system is coupled with consideration of both its structural and functional development, and the functional consequences of various types of pathology and injury. Lectures cover neuronal function; molecular and cellular mechanisms of interneuronal signaling; the integrated function of neuronal systems responsible for sensation, motor control, cognition, and emotion. Lectures are reinforced by laboratories, clinical correlations, and small group projects. During the course, the students will learn the basic elements of the clinical neurological examination.

* Medical Physiology : This course is a general survey of human physiology in which an emphasis is placed upon discussion of basic physiologic principles and on how cellular and organ system functions are integrated within the intact organism. Considerable attention is paid to the etiologies and clinical consequences of disturbed physiologic function. Lectures are reinforced by laboratories, clinical conferences, and small group projects. During the course, the students will learn the basic elements of the clinical examination of the cardiovascular and pulmonary systems.

YEAR 2 COURSES :

* Mechanisms of Disease I : he purpose of MOD I is to enable the student to understand the pathogenesis of disease and to further develop a medical vocabulary. MOD I provides insight into the morphologic changes in cells and tissues of the body in various disease states. These morphologic changes and their underlying pathophysiology will be applied to the understanding of diseases of nutrition, pediatrics, autoimmunity, genetics, the environment, arteriosclerosis, infectious agents, transplantation, blood, and coagulation components. Presentation: lecture/demonstrations, group laboratory exercises, small group sessions, self-instructional computer-assisted learning programs and museum observation.

* Infection & Immunity : his course introduces the basic concepts of molecular and medical microbiology and the major concepts in modern basic immunology and exemplifies the application of those concepts to the understanding of human diseases. Lectures on selected topics in clinical immunology and infectious diseases are integrated with a variety of small group activities designed to stimulate the development of clinical problem-solving and self education skills. The course emphasizes the importance of basic science information in understanding the mechanisms of disease and applying that understanding to the diagnosis and management of immunological and infectious diseases. Presentation: lectures, small group exercises, computer-based instruction, and problem-based learning. The students are also required to write an essay on a topic of their choice. Lectures given as PowerPoint presentations, general information, and useful links to other sites are available through a course Web site.

* Doctoring Curriculum III : DC III consists of Physical Diagnosis and Introduction to Clinical Ethics. Physical Diagnosis provides students with further skills in developing rapport with patients, taking a detailed medical history, performing a complete physical exam, and making verbal and written presentations of medical information. Emphasis in this semester is placed on the physical examination of the normal person and taking a medical history.
Clinical Ethics provides the student with the basis for identifying the major ethical problems involving patients that clinicians face most frequently in their training and future practices. This course helps the student to understand the history of these problems, and see them as opportunities to provide optimal care for patients and families whose lives have been disrupted by illness, pain and suffering; and to use a method of case study that a) enhances planning for the optimal care of patients and prevents disruption of care by ethical problems or helps resolve a complex or novel ethical problem; and b) helps clinicians to bring major ethical considerations and principles to bear upon these issues and problems. Presentation: small group sessions.

* Doctoring Curriculum IV : DC IV consists of Introduction to Clinical Problem Solving, Physical Diagnosis, and Psychopathology. In Introduction to Clinical Problem Solving, the student learns the deductive reasoning process which reduces the patients’ problem into a differential diagnosis. The student learns to (1) define the patient’s complaint, (2) develop a patho-physiological mechanism which explains the complaint, and (3) generate a list of probable causes for the complaint.
Analytical Medicine, which is integrated into Introduction to Clinical Problem Solving, prepares prospective physicians to use probability and statistics in the diagnosis and care of the individual patient and to interpret and apply results of clinical and epidemiological studies to patient care. Students learn to obtain and use additional patient-related information to eliminate and rank probable diagnoses. Presentation: taught in small groups with patient problems assigned for preparation for the following week.
Physical Diagnosis provides students with basic skills in developing rapport with patients, taking a detailed medical history, performing a complete physical exam, and making verbal and written presentations of medical information. Emphasis in this semester is on the practice of physical diagnosis skills on actual patients. Each patient is then presented to the instructor. Presentation: groups of two students and one preceptor.
The Psychopathology course provides students with an introduction to the phenomenology of the major categories of psychiatric diseases, including affective disorders, schizophrenia, anxiety disorders, substance abuse, organic mental disorders, somatoform disorders, personality disorders, eating disorders, and disorders of childhood and adolescence. For each diagnostic group, information is provided regarding the characteristic features, epidemiology, prognosis, and treatment of the disorder. Information introduced in the course will be expanded during the Psychiatry Clerkship. Presentation: lectures using audio-visual patient presentations.

* Pharmacology & Therapeutics : Provides a working knowledge of pharmacologic principles and their practical application in the therapeutic use of drugs. Emphasis is placed on understanding the disposition, effects, efficacy, and relative toxicity of all major drug groups in light of their biochemical and physiological mechanisms. Focuses on the application of this knowledge in the use of therapeutic agents. Presentation: an evidence-oriented approach; material is presented through a series of lectures, small group discussions, laboratory demonstrations, clinical pharmacology conferences, and self-study modules. Prerequisite: successful completion of first year courses.

* Mechanisms of Disease II : Enables the student to understand specific disease processes of individual organ systems. Provides insight into the clinical, morphologic, pathophysiologic, and laboratory changes resulting from specific disease processes of the individual organ systems (cardiovascular, respiratory, renal, neural, alimentary, genitourinary, endocrine, skin and skeletal). Clinical and pathophysiological aspects of lab medicine are also encompassed. Presentation: lecture/demonstrations, group laboratory exercises, small group sessions, and self-instructional computer-assisted learning programs and museum observation.

YEAR 3 COURSES :

* Family Medicine / Rural Clerkship : The MUSC Family Medicine and Deans’ Rural Primary Care Clerkships have merged to form the Family Medicine/Rural Clerkship. The purpose of the Family Medicine/Rural Clerkship is to foster student development of a strong understanding of the clinical issues and professional role of a primary care physician and to further broaden the focus of student learning from providing care to individual patients to improving the health of defined population health perspective. The perspective “encompasses the ability to assess the health needs of a specific population; implement and evaluate interventions to improve the health of the population; and provide care for individual patients in the context of the culture, health status, and health needs of the populations of which that patient is a member.” (Population Health Perspective Panel Report, Academic Medicine. 1999;74:138). The partnership formed between the MUSC College of Medicine and USC School of Medicine through the Deans’ Rural Primary Care Clerkship will continue through the Family Medicine/Rural Clerkship in its dedication toward improving the health of the citizens of South Carolina.

* Internal Medicine : Introduces the principles of patient diagnosis in the clinical setting. Students are expected to develop effective communication and technical skills which enable them to obtain a history and perform a physical examination on hospitalized patients, and to develop problem-solving skills which permit them to interpret the data that they have collected. Presentations emphasize student-patient encounters followed by written and verbal presentations to a resident and an attending-physician during rounds. The student will be expected to concentrate on pathophysiology of disease, requiring inte-gration of basic and clinical sciences. A series of didactic conferences and preceptorships complement the “hands-on” experience.

* Neurology : The 4 week core neurology rotation is designed to build competence and proficiency in the technique of medical/neurological history and physical examinations, especially emphasizing the integration of these skills in assessment of neurologic function. The students are assigned to either MUH in-patient service, Pediatric neurology, MUH Consultation or VA in-patient service. Instructional methods include inpatient evaluation, lectures and active participation in ambulatory clinics.

* Obstetrics & Gynecology : Introduces the basic knowledge and clinical problems as encountered in the field of obstetrics and gynecology. Students are taught to acquire and develop their clinical skills in the care of patients. Emphasis is placed on obtaining experiences in routine obstetrics delivery, outpatient gynecologic management, and common gynecologic surgery. Presentation: didactic lectures, morning conferences, and ward rounds. Under supervision, students take histories and perform physical examinations.

* Pediatrics : Introduces common and unique pediatric pathologic processes; further develops clinical skills and experience in handling and managing both healthy and ill infants, children and adolescents, and their families, and encouraging application of basic science knowledge to patient care. Approximately half of the rotation is devoted to inpatient care with experiences both in acute, undiagnosed illnesses and chronic illnesses (subspecialty care). A portion is devoted to the newborn nursery and the remainder to ambulatory care (general clinics, specialty clinics, acute care clinics, and community resources). Presentation: direct patient/parent contact with house staff and faculty supervision. Experiences are supplemented with conferences and lectures.

* Surgery : Introduces the students to the care of surgical patients. Emphasis is placed on establishing the diagnosis, learning the pathophysiology of surgical diseases, participating in the treatment of surgical patients, understanding the means to support patients before, during, and after surgery, and understanding the impact of surgical illness on the patient and family. Presentation: direct patient contact with house staff and faculty supervision. Experiences are supplemented with small group discussions.

* Psychiatry : Introduces the student to the care of psychiatric patients. Learning objectives are to increase the students’ ability to recognize psychopathology, use interview techniques, correctly diagnose psychiatric disorders, appropriately use psychopharmacological agents, establish a supportive therapeutic relationship with patients, document and present verbally a psychiatric history and mental status examination, and work with health care personnel. Presentation: direct patient responsibility with close supervision from house staff and faculty.

YEAR 4 COURSES :

During the senior year, students take a minimum of eight four-week rotations. The student is required to take a clinical externship and one month each of ambulatory surgery, psychiatry, internal medicine and, beginning with the 2004-2005 school year, emergency medical/critical care. The remaining three blocks are elective and, depending upon previous academic performance, can be taken at approved sites throughout the state or country.

* Psychiatry : This course will be an extension of the junior year clerkship and seeks to prepare medical students for future encounters with patients who have psychiatric or psychological issues. Experiences will be weighted more towards outpatient treatment, although one or two experiences continue to be inpatient-based. The third-year clerkship focuses largely on the diagnosis and treatment of severe psychiatric disorders. The fourth-year clerkship will seek to focus on more routine psychiatric issues and problems that are often seen in general practice. We want you as fourth-year students to feel comfortable with the diagnosis and management of anxiety and depression, for example.
Although less than 5% of medical students nationwide become psychiatrists, psychiatric illnesses are seen in almost all disciplines of medicine, and so it is important to expose you to these types of problems and give you the tools you need to more effectively treat your patients. We are excited about the opportunity to help you progress to more advanced skills as you return for the senior clerkship, and think this experience will be very germane to your future day-to-day practice of general medicine. It is our hope that you will find the course to be educational, interesting, exciting, and clinically practical.

* Surgery
* Internal Medicine
* Subinternship.
* Electives.

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