New York University (Mount Sinai School of Medicine)

Commitment to excellence in research, education, and patient care form the foundation that makes Mount Sinai School of Medicine (MSSM) in Manhattan one of the world’s foremost centers for medical and scientific training.

Mount Sinai’s educational philosophy reflects the ever-changing face of contemporary science—the most important thing a medical or science student can learn is how to continue learning.

Medical education at MSSM is designed to help each student reach his or her maximum potential as a well-rounded human-being through a truly exceptional educational experience that leads to graduates who are not only highly skilled but also compassionate caregivers. An innovative curriculum that is one of the most progressive in the country, stresses the humanistic and ethical aspects of medical practice as well as problem-solving strategies. Students learn clinical care working side-by-side with world-renowned doctors and gain experience in the laboratory from scientists answering fundamental questions about human diseases. Recognition that successful and empathetic communication is critical to effective patient/doctor relationships led to the establishment of programs, such as The Morchand Center for Clinical Competence, to help students and physicians develop superb communication skills.

Mount Sinai School of Medicine, Graduate School of Biological Sciences trains students to elucidate the underlying mechanisms that cause disease and discover the knowledge necessary to develop new life-saving treatments. The Graduate School confers degrees of Ph.D., M.D./Ph.D., and M.Sc. Contemporary science involves multidisciplinary efforts, development of whole new fields and application of fundamental knowledge to important biomedical problems. To prepare students for this new era in research, the Graduate School offers each student a wealth of options for developing the rigorous program in scientific research to meet his/her individual goals.

Exceptional patient care is a hallmark of The Mount Sinai Hospital and one of the keystones of medical education at the School. A seamless connection between the School and the Hospital sets Mount Sinai apart from most centers of scientific inquiry, by facilitating the rapid transfer of research developments to patient care and clinical insights back to the laboratory for further investigation.

As a regional leader in numerous areas, including geriatrics, cardiology, organ transplantation, Alzheimer’s disease, cancer, gene therapy, AIDS, spinal cord and traumatic brain injury, hemophilia, high-risk pregnancy, neonatal specialty care, and pediatric respiratory disease, the Hospital and the School work together to remain at the cutting-edge of modern medicine. For example, Mount Sinai was the first U.S. medical school to establish an academic Department of Geriatrics, as well as departments of environmental and occupational medicine. Mount Sinai is also one of the few schools of medicine in the United States to have a Department of Health Policy, which focuses on outcome measures.

For 40 years, Mount Sinai School of Medicine has fostered a cooperative environment that facilitates the development of the two most important skills a future physician can acquire: the capacity to critically evaluate new information and the flexibility to synthesize the information into adaptations in practice. We focus on treating the whole patient. Medical ethics, the social aspects of disease and cultural diversity are essential elements of study.

Students learn clinical care working side-by-side with world-renowned doctors and gain experience in the laboratory from scientists answering fundamental questions about human diseases. Recognition that successful and empathetic provision of care requires more than the acquisition of scientific knowledge led to the establishment of innovative programs, such as The Morchand Center for Clinical Competence and the Humanities and Medicine Program. Community service, social and cultural enrichment, and working with a wide diversity of patients from numerous racial, ethnic and socioeconomic backgrounds in urban and suburban settings cultivates the skills needed to become a superb, compassionate care giver.

As demanding as medical school is, students are usually pleasantly surprised to discover there is ample time for other pursuits. New York City affords extraordinary opportunities for exploring your interests, whatever they may be. Together the Student Council and the Recreation Office work to help students make the most of these opportunities, including obtaining discount tickets to shows, concerts, movies and other events.

Contrary to the image many have of medical school, interests and hobbies do not need to be discarded. Mount Sinai students pursue sports, art, and other interests. Each year SinaiArts stages a theatrical production and an art show at which students display their own art work, everything from photography to poetry to ceramics.

Community service is viewed as an integral component of medical education at Mount Sinai. Through helping to improve the health and education of our neighbors students have the chance to exercise their developing skills, particularly essential communication skills. Numerous programs already exist and the Community Service Committee of the Student Council is available to assist students in developing new programs when needs are identified.

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Mount Sinai School of Medicine Medical School Location

Mount Sinai School of Medicine Courses

FIRST YEAR

The first year begins the transformation from layperson to physician. Courses taught by basic scientists and clinicians utilize innovative teaching techniques and advanced technology to convey the fundamental principles of science and application of this knowledge to the care of the patient.

Learning about the body's structure and function at the cellular, tissue and organ system level is but one element. Parallel with the acquisition of this knowledge, students begin to work with patients, learning to communicate and explore the world of medicine from the patient's perspective. In the first year, students also begin to acquire the fundamental skills of taking a patient's history and conducting a normal physical examination. The year ends with Bench to Bedside, a three-week block that illustrates the intimate relationship between the basic sciences and clinical care.

COURSES :

* Introduction to Emergency Medicine : Students are introduced to emergency care, and develop an understanding of the initial approach and management of acute medical problems. Students also become certified in Basic Life Support techniques.

* Embryology : This course provides an introduction to the study of basic development of the human embryo. This course also provides insight into human malformations and a meaningful framework for the subsequent study of anatomy.

* The Art and Science of Medicine I : The Art and Science of Medicine (ASM) Course (I & II) provides first- and second-year medical students with the core knowledge, clinical skills, and professional attitudes essential for them to make a seamless transition into the clinical years. In ASM I students establish a strong foundation in communication skills and professionalism. The course provides students with the tools they need to efficiently and expertly gather information within a patient-centered context. History taking is presented in a variety of settings, including small group interactive sessions, hospital rounds, and individual student and patient experiences. Woven into this experience is exposure to various health care delivery systems, cultural and community awareness, patient education, interdisciplinary teamwork, and medical ethics. In addition, ASM provides medical students with strong clinical role models and mentors.

* Molecules and Cells : This course focuses on understanding the mechanisms by which cells receive and process extracellular signals, regulate gene expression, control organelle biogenesis, and divide or differentiate. It also explores the fundamentals of cellular metabolism. The relationship of these processes to human disease is emphasized as an underlying theme throughout the course.

* Gross Anatomy : Gross Anatomy introduces first-year students to the structure of the entire human body through both sequential dissection and the use of imaging modalities. Surgeons and physicians participate side by side with anatomy faculty in laboratories, affording students the opportunity to learn the clinical and functional correlates of structure first hand. In lectures and demonstrations, the latest diagnostic and procedural imaging technologies such as CT, MRI, ultrasound, and use of minimally invasive laparoscopic approaches are introduced. The Anatomy course also provides unique peer-teaching opportunities for senior students to return as Teaching Assistants to share their knowledge and experiences.

* Histology : Histology teaches the structure and function of specialized cells, tissues and organs, and their organization into organ systems. The course also provides students with unique peer-teaching opportunities. An interdisciplinary approach underlies the close coordination with Physiology and the Art of Science and Medicine courses. Histology also provides the setting for reinforcing concepts students have learned in Molecules and Cells, and importantly, sets the groundwork for understanding the pathology of disease.

* Physiology : Physiology is the study of the physical and chemical processes that control the performance of body functions in living organisms. It is taught from an organ system approach, with considerable focus and emphasis on the integration of these systems to maintain normal body function. The goal is to provide students with a framework that facilitates the understanding of normal physiology and a foundation for the future study of pathophysiologic mechanisms of disease.

* Pathology : General Pathology, the main focus of this course, examines basic and common responses of cells and tissue to various stimuli, including cellular injury, adaptation and death, inflammation and repair, hemodynamic disorders, immunologic disorders, and neoplasia. These general patterns will provide a framework for understanding pathophysiology of specific organ systems in the second year.

* Pathogenesis and Mechanisms of Host Defense : This course uses lectures and small group discussions to introduce medical students to bacteria, fungi, parasites, and viruses. An emphasis is placed on structural and molecular characteristics of the organisms important for the understanding of pathogenicity and successful treatment. Information about the microbes is presented in the context of the host response and includes discussions of vaccines, antimicrobial drugs, and microbial resistance. There is also a laboratory component where students are taught basic techniques which they use to identify a microbial unknown given with a case history.

* Immunology : The immune system is responsible for protecting the body from infection. This course introduces the student to the organization of the immune system, how the ability to fight infections develops, and problems that result when immunity fails or when inappropriate responses are made against healthy cells and tissues.

* Epidemiology and Preventive Medicine : This course is designed to sharpen students’ ability to read the literature in a critical way. Students are introduced to epidemiology and biostatistics – the tools of research. Small group exercises reinforce key concepts through case studies in preventive medicine and critical appraisal of published research. The course emphasizes the logic of inquiry and concepts relevant to the decision-making process in clinical medicine.

* Bench to Bedside : Bench to bedside concludes the first year with a two-week clinical selective that focuses on translation of findings in basic science to the care of patients. Students select among options including, Cardiology, Sexual and Reproductive Health, HIV, Transplant Surgery, Geriatrics, Alzheimer’s Disease, Autism, Pediatric Leukemias, Kidney Function, Liver Disease, and so on.

SECOND YEAR

The second year of medical school has three purposes. The first is to present to students the underlying pathogenesis that explains abnormality in the structure and function of the human body. The second is to introduce basic principles of pharmacologic therapeutics that attempt to redress abnormality. The third is to continue to master principles of communication and data collection through the medical interview and the physical examination of hospitalized and ambulatory patients.

The basic physiology of organs and major systems is explored along with the continued development of skills and development of a greater understanding of issues of critical importance to the practice of medicine today. At year's end, both epidemiology and a comprehensive exercise link the basic preparation of years one and two to the tasks of the next two years.

COURSES :

* The Art and Science of Medicine II : The Art and Science of Medicine (ASM) Course (I & II) provides first and second year medical students with the core knowledge, clinical skills, and professional attitudes essential for them to make a seamless transition into the clinical years. ASM II students learn to gather clinical information accurately from history, physical examination, and chart review that includes all relevant factors; communicate information accurately both orally and in writing; interact with patients using consistent clinical skills; and reliably conduct basic physical exams. They also develop the knowledge base and skills needed to differentiate normal findings from abnormal ones and identify new clinical problems.

* Pharmacology : This course presents an overview of the general principles governing the actions of drugs on the human body and on invading organisms, as well as the way drugs enter, are distributed in, and eliminated from the body. The therapeutic and adverse actions of major classes of clinically used drugs are discussed. The course goal is not to teach therapeutics per se, but the pharmacological basis for rational drug prescribing.

* Brain and Behavior/ Psychopathology : This course addresses structural, functional, and biochemical aspects of the nervous system, and introduces students to neurologic illnesses commonly encountered in clinical practice. Through patient-based small group discussions students gain insight into the scientific basis for evaluation and treatment of clinical phenomena such as pain, weakness, depression, coma, sleep disorders, and stroke. The goal is to enable each student to reach a basic understanding through which normal and abnormal nervous system functioning can be interpreted.

* Human Genetics : Medical genetics is one of the most rapidly advancing fields of medicine, and understanding of its principles is now integral to all aspects of biomedical science. This course introduces basic concepts and some major topics in human genetic medicine including cytogenetics, molecular genetics, biochemical genetics, pharmacogenetics, genetic testing and screening, developmental genetics, and dysmorphology.

* Musculoskeletal Pathophysiology : The Musculoskeletal Pathophysiology Course introduces students to a series of diseases that overlap the disciplines of Pathology, Radiology, Orthopaedics, and Rheumatology. It is the first "transitional" course of the second year because it bridges the gap between basic science and clinical applications for the diagnosis and treatment of connective tissue diseases. By the end of the course, students will have developed a rational, clinical approach to the patient with musculoskeletal complaints.

* Cardiovascular Pathophysiology : This course provides students with a comprehensive review of anatomy, hemodynamic function, and electrophysiology of the normal cardiovascular system, and in-depth study of the pathophysiology of cardiovascular diseases including cardiomyopathies, valvular heart disease, ischemic heart disease, vascular diseases, and congenital heart disease.

* Gastrointestinal-Liver Pathophysiology : This course provides an overview of diseases affecting all components of the digestive system. Emphasis is placed on understanding the mechanistic basis of digestive diseases, with a strong underpinning in pathology. This fosters skills in developing appropriate differential diagnoses and gaining an appreciation of the diagnostic evaluation of patients. Students will learn how diseases of the gastrointestinal tract and liver interface with other systemic conditions. Approaches to treatment are discussed mainly to reinforce pathophysiologic principles.

* Blood (Hematology) Pathophysiology : This course provides an overview of the normal physiologic production and regulation of red blood cells, white blood cells, and platelets and about the normal system of blood coagulation. Students learn about the pathophysiologic events leading to disruption of the normal blood system, resulting in hematologic diseases. Through lectures, case-based small group sessions, “virtual” and “actual” morphology sessions students are taught to recognize the presence of hematologic abnormalities, understand the pathophysiology of the clinical manifestations, formulate a differential diagnosis, and develop a strategy for investigating these diagnoses.

* OB-Gyn Pathophysiology : This course is an introduction to obstetrical and gynecological patho-physiology by means of a case-based tour of the female genital tract. Patient-centered cases include symptoms, work-up and procedures, pathology findings, and outlook. Students are exposed to viewpoints of: obstetricians, gynecologists, specialty pathologists, gynecologic surgeons, and patients. Labs and small groups sessions help to integrate major themes and introduce concepts of patient management.

* Endocrine Pathophysiology : The course reviews general endocrine physiology and explains the pathophysiology of endocrine diseases such as diabetes mellitus, osteoporosis, thyroid diseases, and other disorders of hypo- and hyper- function of various endocrine tissues. Students become familiar with the signs and symptoms of endocrine diseases and learn to formulate a differential diagnosis and a diagnostic workup to rule in or rule out endocrine disorders in patients.

* Dermatology Pathophysiology : This course introduces students to the basic pathophysiology and the myriad expressions of skin disorders. The key topics addressed are skin structure and function, how to describe skin lesions, and dermatology-related pharmacology. Students then take a pictorial journey through skin related infectious, immunologic, and neoplastic diseases.

* Pulmonary Pathophysiology : Given its placement at the end of the second-year curriculum, respiratory pathophysiology is intended to bridge the basic sciences with that of clinical care of the patient. Although the main focus of the course is geared toward an understanding of basic respiratory pathophysiology and its application to patient care, students are introduced to the concepts at distinct clinical entry points (e.g. dyspnea, cough, fever). Teaching modalities include standard lectures, which form a foundation for clinical case-based seminars, pathology lab sessions, and patient presentations. The course culminates in a combined clinico-pathologic conference where students participate in panel discussions under the guidance of faculty from both the respiratory and renal courses.

* Compass I Comprehensive Clinical Skills Assessment :
By the end of the second year students have begun to develop the critical thinking and problem-solving skills required to diagnose and manage patients. This two-day long, end-of-year, comprehensive clinical assessment is designed to assess students’ abilities to:
- Integrate and apply pathophysiologic information from
the first two years, and to focus data gathering and
interpretation skills
- Recognize ethical issues, identify professional
responsibilities, and apply ethical principles in
communication with and care of patients
- Identify learning issues (what students need to
know in order to care for a patient)
- Take a history, perform a physical exam, and
communicate with patients in a patient-centered,
culturally competent manner

THIRD YEAR

The third year marks the beginning of the transformation into a caregiver. The third-year curriculum is designed to assist students with applying the principles learned in the first two years to the diagnosis and treatment of patients in both inpatient and outpatient settings. Equally important is the honing of the attributes of an exemplary professional, applying ethical principles to patient management, respecting the value of team interactions, and developing and refining communication skills.

At Mount Sinai, the third year is made up of four 12-week clinical clerkship modules. Within each module, the disciplines are arranged to increase opportunities for students to appreciate the interdisciplinary nature of patient care. The extensive facilities of The Mount Sinai Hospital and the other institutions affiliated with the School are used for clinical teaching. In addition to the required clerkships, third-year students have the opportunity to explore individual interests through electives. Over the course of the year there are also one-week periods in which the entire class comes together to explore interdisciplinary themes. Between the second and third clerkship modules students have a two-week vacation.

COURSES :

* Pediatrics : This clerkship addresses issues unique to the newborn period, childhood, and adolescence by focusing on growth and development, and by emphasizing the impact of family, community, and society on child health and well-being. Additionally, the clerkship focuses on principles of health promotion, disease prevention, and the recognition of common health problems in this age group.

* Internal Medicine and Geriatrics : Internal Medicine and Geriatrics share a three-month module. During this clerkship, students learn to develop a high level of proficiency in caring for adult and geriatric patients in both the inpatient and outpatient setting. Focus is placed on communication skills, the ability to generate a differential diagnosis, order and interpret laboratory investigations, and develop a framework for understanding professionalism as it relates to the practice of medicine.

* Obstetrics and Gynecology :The six-week Obstetrics and Gynecology Clerkship gives students an opportunity to learn about women’s health issues by exposing students to both inpatient and outpatient Obstetrics and Gynecology. Experiences include active participation on the Labor and Delivery and Surgical services as well as in the outpatient practices.

* Anesthesiology : The week-long anesthesiology mixes practical time in the operating room, didactic sessions and interactive sessions with the Human Patient Simulator.

* Neurology : This four-week rotation prepares students to perform a competent screening neurological examination, understand the components of a comprehensive neurological examination and recognize both normal and abnormal neurological and mental examination findings.

* Family Medicine : During this four-week ambulatory rotation, students learn to provide comprehensive health care for individuals and families. Issues related to disease prevention and health/wellness promotion are also a main focus of this clerkship.

* Psychiatry : During this four-week clerkship students learn to effectively and empathically listen to patients with psychiatric illness, to understand the wider context in which their symptoms are occurring and the implications to their lives. The students’ primary clinical assignment is to the inpatient psychiatry service, but they also have exposure to one or more of the following: Consultation-Liaison Psychiatry, Child Psychiatry, Psychiatric Emergency Room, Geriatric Psychiatry, Substance Abuse Programs, and/ or Outpatient Psychiatry.

* Surgery : The goal for the surgery clerkship is to enable students to experience the excitement and satisfaction of a surgeon; that is, the ability to work up a patient’s problem, make a diagnosis and provide immediate treatment that solves the problem. Students will spend six weeks assigned to surgical teams at Mount Sinai and Elmhurst Hospital and participate in the pre, post and intra-operative care of patients. For the remaining two weeks of the clerkship, students are assigned a selective experience that may include exposure to specialized surgical services, the surgical ICU, or to community hospital practice.

* Compass II - Comprehensive Clinical Skills Assessment
This is a two-day exercise to assess student’s abilities in focused history taking and physical examination, and student’s interpersonal, oral, and written communication skills.

FOURTH YEAR

The fourth-year student begins to finalize career choices. To assist in this process, the curriculum for this year allows for extended elective time to explore various aspects of medicine while increasing degrees of patient care and responsibility continue to facilitate professional development. The year is divided into 10 blocks: nine 4-week blocks for rotations and one 7-week block during which students concentrate on interviews for residency programs. Throughout the year students meet with course directors, chairs, and specialty advisors to tailor a fourth-year curriculum that permits exploration of each individuals interests.

COURSES :

* Emergency Medicine : This four-week opportunity helps students to polish evaluation and presentation skills, and practice medical decision-making prior to internship, under the supervision of Emergency Medicine faculty. This sub-internship allows students to manage undifferentiated patients of all ages with acute, urgent and critical complaints, permits opportunities for advancement of procedural skills and use of evidence based medicine to refine diagnostic work up and therapeutics. Cultural as well as clinical competency is stressed in this fast-paced environment. Recommended readings and Cyber School contribute to the educational experience; a comprehensive exam and most memorable case with teaching points provide additional breadth and depth. Feedback is provided after each clinical shift.

* Critical Care : In this clerkship experience students have the unique opportunity to participate in the direct care of the critically ill patient and learn to become an effective member of the critical care team. Students will function as sub-interns while on a four-week rotation in medical, surgical, or pediatric ICUs. They will help admit patients to the unit, manage their care, and assist in a number of procedures under the direct supervision of the medical resident, fellow and attending. Students also train on a human patient simulator to learn how to assess the acute critically ill patient, provide basic resuscitation skills and initiate mechanical ventilation.

* Anatomic Radiology : Anatomic Radiology is a two-week clerkship experience that gives students the opportunity to revisit the structure of the body through imaging modalities, to learn the strengths and weaknesses of these differing modalities, and to be introduced to advances in visualization technologies. Material is presented via interactive presentations, anatomy workshops, direct participation in Radiology read-out sessions, and by student case presentations.

* Sub-Internship in Medicine : The goals of the Medicine Sub-Internship are for students to assume increasing responsibility for patient care, and to function as a fully integrated member of a medical team on the inpatient floors. The experience will hone the skills of data gathering and interpretation, and further the student’s knowledge of the illnesses that effect adult patients, and the basic management of these illnesses. Students who select to do the sub-internship in Medicine render direct patient care and assume all the responsibilities of an intern with a reduced load. The sub-intern works directly under the ward chief resident and will be responsible for discussing all patient care issues with that resident on a daily basis. The sub-intern also works closely with the interns on the team and the ward attending.

* Sub-Internship in Pediatrics : The goal of the sub-internship in Pediatrics is to foster competence in the fundamentals of diagnosis and management of common Pediatric problems through active participation on the Pediatric inpatient service. The sub-intern, under the supervision of house staff and faculty, will participate actively in a wide range of diagnostic evaluations, patient management, and pediatric procedures.

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