Meharry Medical College (School of Medicine)

Meharry Medical College exists to improve the health
and health care of minority and underserved
communities by offering excellent education and
training programs in the health sciences; placing
special emphasis on providing opportunities to people
of color and individuals from disadvantaged backgrounds, regardless of race or ethnicity; delivering high quality health services; and conducting research that fosters the elimination of health disparities.

Meharry Medical College exists to improve the health and health care of minority and underserved communities by offering excellent education and training programs in the health sciences; placing special emphasis on providing opportunities to people of color and individuals from disadvantaged backgrounds, regardless of race or ethnicity; delivering high quality health services; and conducting research that foster the elimination of health disparities.

To achieve national recognition as a community-focused quality-driven academic health center noted for its:

* Uniquely nurturing, highly effective educational programs
* Preeminence in health disparities research
* Culturally sensitive, evidence-based health services
* Significant contribution to the diversity of the nation's health professions work force

Meharry has 202 full-time faculty members, many of whom are the nation's most eminent in health-science education and in clinical and basic research. Meharry has 20 buildings on 26 acres of land. The outdoors Amphitheater seats over 1,000.

Meharry Medical College is fully accredited by the Southern Association of Colleges and Schools (SACS). SACS is the college's primary accrediting agency and may be contacted at the following address, telephone number, or Website to inquire about Meharry's accreditation status: Southern Association of Colleges and Schools.

Meharry offers students a diverse array of educational, cultural and recreational programs. Many Greek-letter fraternities and sororities are represented on Meharry's campus, as well as various student organizations and honor societies.

The School of Medicine is the oldest and largest of the four schools at Meharry. It admits 90 medical students and some 30 residents annually. Its residents train in Family Practice, Internal Medicine, Occupational Medicine, Preventive Medicine, OB/GYN or Psychiatry.

In addition to offering the M.D. degree to its medical students, the School trains graduate students for the Master of Science in Public Health degree offered through Meharry's School of Graduate Studies and Research. Similarly, the School trains graduate students for the Doctor of Philosophy degree in Biochemistry, Microbiology, Pharmacology or Physiology. Finally, the school provides significant training to students from Meharry's Schools of Dentistry and Allied Health Professions.

The School is nationally recognized for its community-based and academic programs. National centers and programs have been established to address sickle cell anemia, hypertension, HIV/AIDS, environmental health, teen pregnancy, cancer, kidney failure, aging and more. The School's faculty, staff and students actively serve the community in many ways: mentoring for high school and college students; Health Careers Opportunity Programs for elementary, high school and college students; speakers on health topics and more. The School has a program to assist college graduates in preparing to enter health professions schools.

Meharry's primary affiliated clinical training sites also include the Veterans Affairs Medical Centers, located in Nashville and Murfreesboro, Tennessee; the Middle Tennessee Mental Health Institute; and the Blanchfield Army Community Hospital at Fort Campbell, Kentucky. Other affiliated clinical facilities include the United Neighborhood Health Services Medical Clinic, the Matthew Walker Comprehensive Health Center, the Centennial Medical Center, and the Baptist Medical Center.

Meharry's student body reflects the diversity of the nation, with representation from the African American, Caucasian, Hispanic, Asian, and Native American communities. The majority of Meharry's graduates keep the commitment of the founding fathers by practicing in underserved urban and rural communities. More than 60 percent of Meharry's School of Medicine graduates have selected generalist fields of family medicine, internal medicine, pediatrics, and obstetrics and gynecology as areas of specialization. Since 1970, Meharry has conferred more than 10 percent of the Ph.D. degrees awarded nationally to African Americans in all of the biomedical sciences. Meharry continues to be proud of its leadership role in helping to ensure diversity in the nation's health professions work force.

The School of Medicine is organized into 11 departments that administer the instructional, research and clinical activities of the School. The clinical departments include Internal Medicine, Pediatrics, Obstetrics and Gynecology, Surgery, Family and Community Medicine,
Radiology, Psychiatry, Medical Education and Pathology. The basic sciences are organized under one Department of Biomedical Sciences with five divisions: Professional Education, Cancer Biology, Microbial Pathogenesis and Immune Response, Neurobiology and Neurotoxicology and Cardiovascular Biology.

The four-year curriculum of the School of Medicine is divided into two phases. Phase I consists of the first
two years generally referred to as the basic sciences years. The sequencing of course content provides
students with a basic, systematic pre-clinical curriculum. Daily class schedules are arranged to foster effective teaching and learning. Phase II consists of the last two years, generally referred to as the clinical years. The clinical clerkships begin in the junior year which is 48 weeks in length. Students are randomly assigned to the six clinical rotations-internal medicine, obstetrics and gynecology, pediatrics, surgery, psychiatry and family medicine.

The senior clinical rotations are divided into required clerkships and electives. Thirty six weeks, divided
into eight clinical rotations and the USMLE Steo 2 Review (four weeks each) are required to complete the senior year. The four required senior clerkships are internal medicine, radiology, senior family medicine, and psychiatry/neurology; additional electives include four units (16 weeks).
Junior and senior clinical clerkships are taken at the Alvin C. York VA Medical Center in Murfreesboro,
Nashville VA Medical Center, Nashville General Hospital at Meharry, Vanderbilt Children’s Hospital, Blanchfield Army Community Hospital (BACH), Middle Tennessee Medical Center, University Medical Center, Middle Tennessee Mental Health Center, Elam Mental Health Center, Parthenon Pavilion, Centennial Medical Center and/or other affiliated sites approved by the department.

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School of Medicine Medical School Location

School of Medicine Courses

FIRST YEAR COURSES :

* Gross Anatomy and Embryology : Gross anatomy and embryology is offered in the Fall semester of the first year of the curriculum and is a course that teaches the gross structure and developmental sequences of the human body. Students working in small groups dissect a human cadaver. Didactic and clinically oriented lectures are supplemented by prosections, radiological
presentations and surface anatomy. Clinical orientations are made through periodic demonstrations and/or didactic lectures by clinicians.

* Principles of Immunology and Host Defense : This course is offered in the Spring semester of the first year of the curriculum. The goal of this course is to help students achieve an integrated and correlated understanding of the immune system and its role in host response and human disease. The course encompasses a presentation of the basic immune response and the principal mechanisms involved in disease with an in-depth presentation of the pathology associated with immunologic diseases. The course has two components. The basic immunology component focuses on the processes in the innate humoral and cellular immune systems and the lymphoid tissues involved in those responses. The clinical immunology component focuses on how the immune system is involved in many areas of clinical medicine including allergy and hypersensitivity, tumor resistance, transplantation, autoimmune diseases, primary and secondary immunodeficiencies, blood transfusions, infectious diseases and immune modulation. The information is presented in a combination of didactic lectures, laboratory exercises, small-group sessions, patient-oriented problem solving exercises, on-line clinical case evaluations and clinical correlations.

* Foundations in Human Disease and Treatment : This course is offered to freshman medical students during the Spring semester and includes modules in microbiology, pathology and pharmacology. The goal of this course is to provide students with a foundation for understanding the cellular basis of the physiologic and biologic manifestations of disease. A focus on fundamental principles related to disease mechanisms and treatment sets the stage for coverage of specific disease processes presented in the organ system modules. Moreover, the microbiology component of the course provides students with the fundamental principles of microbial structure and function, physiology, genetics and molecular biology and understanding of the significance of microbes as disease causing agents.

* Principles of Infectious Diseases : This course is offered in the Spring semester of the first year of the medical school curriculum. The goal of this course is to help students achieve an integrated and correlated understanding of the principles of infectious diseases involving bacterial, fungal, parasitic and viral pathogens including current knowledge regarding the epidemiology, virulence mechanisms, clinical symptoms and pathology, diagnosis, treatment and prevention of specific infectious agents. This course is divided into two sections: bacterial and fungal pathogens, and parasitic and viral agents of human disease. The approach is to present the pathogens as a survey of infectious agents but within the context of the major organ systems/tissues affected. This approach should facilitate the student’s study in the organ-based courses. Information in the course is presented in a combination of didactic lectures, laboratories, small-group sessions, patient-oriented problem solving exercises and clinical correlations.

* Foundations in Clinical Medicine : This short introductory course is designed to acquaint students with the very basic information and skills they will need to negotiate the medical curriculum.
Lecture and /or small group discussion sessions address professionalism, medicine as a profession,
patient confidentiality, CPR training, evidence-based medicine, bioinformatics and 360o evaluations.
Students participate in a number of assessment activities designed to identify strengths and weaknesses in academic areas, as well as proficiency in computer skills, searching the medical literature and critical analysis of Web-based information.

* Principles and Practices of Medicine : This course, offered in the fall of the freshman year, concentrates on appreciation of the patient-physician encounter (styles of communication, cultural competency, patient confidentiality); development of scientific reasoning and critical thinking skills including the interpretation of biostatistics and epidemiological findings, understanding of health policy and the organization of health care systems and clinical research in the United States; and an introduction to clinical ethics and end-of-life issues. A particular highlight of the course is opportunities for all students to shadow physicians in clinical settings. Approximately half of all scheduled sessions utilize
a small group format. Additional interactive sessions address medicine and societal issues relating to
basic science coursework occurring parallel to the PPM course. Students are required to submit journals
describing their clinical experiences and to prepare a number of papers and reports demonstrating the
development of their scientific reasoning skills.

SECOND YEAR COURSES :

* Musculoskeletal, Skin & Related Connective Tissues : This course is offered in the Fall semester of the second year and builds on the knowledge obtained from the freshman year in understanding the normal musculoskeletal, skin and related structure in health and in disease states. The course will help the students in understanding the physiological processes, the pathological changes and effects of both pharmacological and other clinical interventions to restore tissues and the organ at the molecular, cellular and macroscopic levels to their optimum functional conditions. In addition, the course will assist students in understanding the associated behavioral changes in normal and disease states as it affects the musculoskeletal, skin and related connective tissues and the body as a whole. The course presents the detailed microscopic and macroscopic structures of the musculoskeletal, skin and related connective tissue in health, disease, and the result of pharmacological and other clinical interventions as they relate to the musculoskeletal, skin and related connective tissues.

* Cardiovascular System : This course is offered to sophomore medical students during the Fall semester and begins to explore how alterations in structure (anatomy) and function (physiology) of the cardiovascular system disrupt the human body functions. It provides the foundation by which the
students begin to understand the cellular basis for the physiologic and biologic manifestations of diseases
of the cardiovascular system and the adaptations that the body makes to the changes produced by the
disease process. Integral in this course is the understanding of how the basic anatomy and physiology of the cardiovascular system relates to the adaptation and the pathogenesis of cardiovascular diseases.
Topics related to blood vessels, pericardium, myocardium and endocardium serve as the basis for the
course. A variety of instructional modalities including laboratory exercises, small group discussion, team
learning exercises and individual assignments using clinical cases and problem sets are utilized to
emphasize and integrate conceptual information.

* Pulmonary System : This course is offered to sophomore medical students during the Fall semester and is designed to assist the students in building on the foundation of knowledge of structure and functions of organs and tissues of the human body learned in the freshman year. The course will give more detailed microscopic and macroscopic structures of the pulmonary system in health, disease, and the result of pharmacological and other clinical interventions. Comprehensive and coherent didactic information presented in lecture format, small group discussions, case presentations and self-learning assignments in the pulmonary system will be utilized to emphasize and integrate conceptual information.

* Gastrointestinal and Hepatobiliary Function : This course is offered in the Fall semester of the second year and examines the physiology, pathology and pharmacological treatment of gastrointestinal and hepatobiliary function. Clinical presentations and small group discussion of patientbased cases assist the student in the correlation of basic and clinical information. The goal of this course is to assist students in understanding the structure and function of the gastrointestinal and hepatobiliary systems in health and disease. The course covers the normal and abnormal processes of the gastrointestinal system, the principles of therapeutics in the gastrointestinal system, and the gender, ethnic, and behavioral considerations affecting disease treatment and prevention, including psychosocial, cultural, occupational, and environmental factors.

* The Endocrine System : This course is offered to sophomore medical students during the Spring semester and examines the physiology, microanatomy, pathology, microbiology, and pharmacology of endocrine function and dysfunction. Clinical team learning presentations and small group discussions of patient-based cases assist the students in correlating basic and clinical information. The goal of this course is to assist students in understanding the structure and function of the various components of the endocrine system in health and disease. The course covers the normal and abnormal processes associated with the endocrine system, the principles of therapeutics associated with endocrine function and dysfunction and the gender, ethnic, and behavioral considerations affecting disease
treatment and prevention, including psychosocial, cultural, occupational, and environmental factors
associated with endocrine function and dysfunction.

* The Reproductive System : This course is offered in the Spring semester of the second year and examines the physiology, microanatomy, pathology, microbiology, and pharmacology of reproductive function and dysfunction. Clinical team learning presentations and small group discussions of patient-based cases assist the students in correlating basic and clinical information. The goal of this course is to assist students in understanding the structure and function of the various components of the reproductive system in health and disease. The course covers the normal and abnormal processes in relationship to reproductive function, the principles of therapeutics associated with reproductive function and dysfunction and the gender, ethnic, and behavioral considerations affecting disease treatment and prevention, including psychosocial, cultural, occupational, and environmental factors associated with
reproductive function and dysfunction (e.g., STDs).

* Renal/Urinary System : This course is offered in the Fall semester of the second year and is designed to assist the students in understanding the physiological processes, the pathological changes and effects of both pharmacological and other clinical interventions to restore tissues and the organ at the molecular, cellular and macroscopic levels to their optimum functional conditions. The course will allow the students to build on the knowledge obtained from the freshman year in understanding the normal immune system, structures and the response to infectious diseases of the renal/urinary system.
Behavioral changes in normal and disease states as it affects the renal/urinary system and the body as a
whole are an integral component of this course.

* Integrated Neuroscience : The Integrated Neuroscience course will help students achieve an integrated and correlated understanding of nervous system structure, function, dysfunction and therapeutics. The course will be taught in the following blocks: (1) excitable cells and synapses, including muscle and the autonomic nervous system; (2) anatomy of the nervous system, meninges and vasculature; (3) sensory systems; (4) motor system; and (5) higher function. Each block will be composed of instruction in biochemistry, neurology, pathology, anatomy and cell biology, pharmacology, physiology, psychiatry and behavioral sciences.

THIRD YEAR COURSES :

* Family Medicine Clerkship : A one-on-one preceptor experience at one of the many approved and affiliated community hospitals, office practices and health centers located in Tennessee. This clerkship focuses on ambulatory services in a comprehensive, continuing health care program, preferably utilizing a family health care team. Students are under the supervision of a physician preceptor as part of a family health care team. They are expected to share in decision-making and in planning for patients, their families and communities.

* Internal Medicine Clerkship : This is a 12-week core clerkship during which third-year medical students spend four weeks at various clinical sites affiliated with the Department of Internal Medicine. The students spend four weeks on each of the following services: general internal medicine service of the Nashville General Hospital, in-patient service at the Murfreesboro VA Medical Center and at one of numerous rural or urban ambulatory sites. A balanced program of clinical work is designed for students, with emphasis placed upon perfecting the techniques of history taking, physical examination, case presentation and the functional utilization and correlation of basic laboratory and clinical findings.
Students participate in rounds regularly with residents and attending physicians. In these settings the student assumes a role as an accepted and valuable member of the health team and thus plays a major role in the daily evaluation and treatment of patients. Students take night call with their team and attend weekly medical grand rounds, journal club and morbidity/mortality conferences. Daily lectures and conferences in selected subspecialty areas are given to supplement the educational program.

* Psychiatry/Neurology Clerkship : This required senior clerkship is a shared four-week rotation with the Department of Psychiatry and Behavioral Sciences allowing the student neurology and psychiatry clinical experiences throughout the Nashville community. The goal of the neurology component is to teach the principles and skills underlying the recognition and management of the neurologic diseases a general medical practitioner is most likely to encounter in practice. Additional neurology exposure will occur on the consultative neurology service and diagnostic testing at Nashville General Hospital and surrounding hospitals in the Nashville/Murfreesboro region.

* Clerkship in Obstetrics and Gynecology : This course is designed to help medical students become familiar with many of the usual and unusual gynecological and obstetrical problems that will confront them, especially during their postgraduate training periods and to encourage them to cultivate the initiative and sober judgment necessary in the mastery of these problems. To achieve this objective, students are assigned to smaller groups, which rotate alternately on the obstetrical or gynecological service while gaining specific exposure to various aspects of the field. Students are required to attend weekly grand rounds, daily bedside rounds, weekly clinical pathology conferences and perinatal mortality conferences. Emphasis is placed on history-taking, physical examination, case presentation, diagnosis, clinical management, testing and laboratory. Audiovisuals, student-controlled seminars, lectures and clinical demonstrations are used liberally.

* Pediatric Clerkship : During a period of eight weeks, students are assigned to clinical duties in the inpatient and outpatient settings. Students obtain patients on rotation as they are admitted to the Nashville General Hospital or Vanderbilt Children's Hospital. They also see patients in the Meharry Pediatric Clinic, Matthew Walker Comprehensive Health Center and private office settings. Students have the opportunity to perform Clinical Laboratory Improvement Amendments (CLIA) waivered laboratory tests in the work-up of their cases. To ensure greater depth and more insight into the clinical problems presented by their cases, students are required to engage in certain unique supplementary diagnosis and therapeutic exercises in completing the study of the problems that the patient presents. Apart from formal lectures by the faculty on common pediatric problems, small group conferences, preferably at the
bedside, are held and at that time the student's work and understanding of the patient's disease processes are discussed and evaluated. Demonstrations of the techniques of examining infants and children are given and supervised practice opportunities are provided so that each student achieves some degree of proficiency. In addition, students are given computerized cases to complete weekly. A simulated skills lab is available and allows for procedural techniques to be perfected. Attendance is required at ward rounds, ambulatory clinics and the weekly pediatric grand rounds, pediatric x-ray conference, case (morbidity and mortality) conferences and Clinical Pathology Conference (CPC).

* Surgery Clerkship : The junior surgical clerkship is served in a twelve-week block in the third year of medical school. During this time students are exposed to general surgery, the surgical specialties and the emergency medicine division at Nashville General Hospital, the Alvin C. York Veterans Administration Medical Center and the Blanchfield Community Army Hospital. Principles of acute trauma life support are incorporated into the rotation. Students are exposed on a rotating basis to evening call and the emergency room. In this role, they serve as a part of the health care team with active participation in the patient's care, under adequate supervision of staff and full- and part-time surgical specialists.

FOURTH YEAR COURSES :

* Principles and Practice of Medicine IIA and IIB : This
course is presented in an interdisciplinary format correlated with the organ system presentations of each
of the second-year disciplines. The purpose of this course is to assist students in integrating the basic
and clinical sciences and to provide a framework for students to learn the interviewing and physical
examination skills necessary for competent patient care. This two-semester course also serves as an
introduction to the concepts involved in clinical problem solving and consists of physical diagnosis, casebased
teaching and clinical correlations.

* Psychiatry Clerkship : This senior clerkship period is a shared four-week rotation with the Department of Neurology allowing the student two weeks of outpatient psychiatry and neurology clinic experiences throughout the Nashville community. Didactic classroom activities are held in the Elam Mental Health Center. The facilities include the VA Medical Center - Murfreesboro, Middle Tennessee Mental Health Institute, Tennessee Christian Medical Center and Parthenon Pavilion.

* Senior Radiology Clerkship : This is a four-week rotation that is offered four times a year.
The format includes lectures and presentations that are held in the Learning Resources Center four hours
each morning. An organ system approach is utilized and incorporates all imaging modalities. Students are
also encouraged to attend interdisciplinary conferences that are held jointly with other clinical departments. Emphasis is given to the evaluation of the various imaging modalities and the formulation of a differential diagnosis by the clinic delivering primary or specialty care to the patient. The emphasis of the course is the development of a series of basic concepts on how to use imaging studies for the improvement of patient care, particularly in the managed care environment.

* Electives.

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