State University of New York at Buffalo (School of Medicine)

This School is now 154 years old and was the founding faculty of this University. Up until 1962 it was part of a private University but, in that year, the University at Buffalo became part of the much larger SUNY system. Throughout this long period, it has undergone many transformations, partly related to the changing science of medicine, education principles and methods, but in large measure reflecting our changing society and its priorities.

In 1987, the School of Medicine added to its masthead "and Biomedical Sciences", in recognition of the importance of the basic biologic science underpinning of medical knowledge, its importance to the practice of medicine and the obligation for a modern medical school to continuously contribute to that body of knowledge. Therefore, in addition to training future physicians, the School has made a commitment to train future medical scientists. The combined MD-PhD program is an important "bridge" training experience focused on developing a special cadre of academic physicians.

In addition to it commitment to biomedical science, the School has made an equally firm commitment to train practitioners of medicine. Our goal is to train an "undifferentiated" graduate, capable of entering any field of graduate medical education. That is, our graduates will be able to enter, and to excel, in virtually any field of medicine that currently exists, or are likely to develop in the future.

Unlike many other medical schools, the School of Medicine and Biomedical Sciences does not own or operate its own hospital facility or clinical practice site. Rather, it has organized a consortium of affiliated hospitals offering a wide range of clinical experiences and training opportunities. This provides a unique opportunity to provide a broad-based learning environment. Our affiliated institutions include: Kaleida Health (Buffalo General Hospital, The Children's Hospital of Buffalo, DeGraff Memorial Hospital, Millard Fillmore Gates Circle Hospital and Millard Fillmore Suburban Hospital), Erie County Medical Center, Sister's Hospital, Buffalo VA Hospital, Roswell Park Cancer Institute, Hauptman-Woodward Medical Research Institute and the Buffalo Center of Excellence in Bioinformatics Center for Computational Research.

The UB School of Medicine and Biomedical Sciences is an academic unit of the State University of New York at Buffalo. It is a publicly owned and supported medical school committed to the education of medical, graduate and other health science students to serve primarily the health care needs of the citizens of New York State. Commitment to excellence in the pursuit of scholarship, research, patient care and community service are the fundamental foundations necessary to provide excellence in education:

* To provide a center of research and scholarship that will advance and promote health-related services
* To provide well-trained physicians and other health care professionals who will attend to the health needs of citizens and
* To offer a source of continuing education to the community of health care providers.

As a public institution, the mission places particular emphasis on diversity, inclusion and the special needs of the state such as generalist education, minority recruitment and retention, and the underserved urban and rural health populations.

As UB enters its sesquicentennial year, its goals are to provide for the complex set of education, research, scholarship and public service needs of a modern health care environment. This includes the preparation of students for the Doctor of Medicine degree, Master of Science degree and the Doctor of Philosophy degree. The School is dedicated to producing physicians for the full spectrum of medical disciplines. The pursuit of lifelong learning is fostered through postdoctoral training, graduate medical education programs and continuing medical education. With the recent opening of the Biomedical Research Building a new opportunity exists for the centralization and expansion of clinical and basic science research. The long-term goals continue to be the integration of education and research in an enterprise that will provide for excellence in meeting the health care requirements of New York State and the nation.

The School's vision is to be recognized as a comprehensive medical school which contributes to the public good through the preparation of informed critical and caring physicians, and innovative and productive basic and clinical scientists. The conduct of original research in the basic and applied medical sciences is fundamental to achievement of the vision, as is the rendering of quality patient care. In addition, UB's medical school seeks to ensure the continuation of cost-effective, socially responsible health care systems in Western New York.

The Integrated Medical School curriculum was first fully experienced by the class of 2005. It replaced the traditional departmentally based, lecture intensive, coursework of the past. This new milieu reduces contact hours and didactic teacher centered education with an emphasis on integration of the basic sciences, increased clinical relevance, and self-directed learning.

Our students come from a variety of backgrounds and bring to our community a number of accomplishments and interests. Beyond their medical studies, many students participate in volunteer activities to enhance the quality of life in the Buffalo area. Many volunteer activities exist through involvement with Polity and student clubs and organizations.

A variety of opportunities are available to students who are interested in doing research while in medical school. Numerous projects are ongoing at any time in Buffalo and several opportunities exist outside Western New York. Students may want to consider undertaking a project not only for the experience it will provide, but because many competitive specialties seek this background in applicants to residency.

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School of Medicine Medical School Location

School of Medicine Courses

FIRST YEAR COURSES

* Gross Human Anatomy : This course is designed to examine the nature and organization of the major, grossly visible structural components of the dissected human body. The course emphasizes the normal functions of the above components, particularly as these functions relate to clinical management of patients. The course is composed of lectures and demonstrations, laboratories, and clinical correlations. Lectures and demonstrations are given the Gross Anatomy staff. These involve a presentation of anatomical details along with general functions and aspects of clinical relevance. In the laboratory, pairs of students, under the guidance of the faculty, dissect and present the anatomical detail and general organization of assigned regions to the other students at their dissecting table. Additional study aids, such as radiographs, CAT-scans, motion pictures, and special dissections, are also made available. The order of dissection is designed to permit progressively greater correlation with microscopic and developmental anatomy as the course proceeds. Clinical correlations are also presented throughout the course to augment the material in each region. By the end of the course, the gross anatomy of the entire human body will have been surveyed. Experience gained by dissection should permit students to relate the more advanced anatomy of their interests to that of the human body as a whole, and to the interests of their colleagues, as in consultation or in presentation of patients.

* Clinical Practice of Medicine : The Clinical Practice of Medicine is a two-year course that is designed to provide students with the fundamental knowledge and skills required in clinical practice. During the first year of this course, students learn basic skills that are essential for clinical medicine, including medical interviewing, the performance of a physical examination, and the medical write-up. Working in seminar groups and with community-based physicians, students will focus in the fall semester on developing patient-centered communication skills, and the challenges of medical interviewing. In the spring semester, continuing with seminar groups and preceptorships, the focus is primarily in developing physical examination skills. At the end of year one, there is a clinical competency examination where students demonstrate and confirm skill attainment.

* Medicine and Society : This foundation course for entering medical students begins the process of the study of medicine in an integrated curriculum. The student is exposed to issues regarding the role of the physician in society, followed by issues in the prevention of disease in a population. The student will acquire the lifelong skills to critically appraise and integrate the best evidence into clinical practice through the application of evidence-based medicine and the use of concepts underlying epidemiology and biostatistics.

* Fundamentals I: Molecules, Cells and Molecular Genetics : This required foundation module covers the fundamental structure-functional properties of proteins, cells, and genes. Basic mechanisms of signal transduction in response to neural, chemical and growth factor signals are also presented.

* Fundamentals II: Underlying principles of disease : This foundation block addresses basic issues of Biochemistry, Physiology, Pathology, Microbiology, etc. and their roles in health and disease. In conjunction with the other courses of the first semester, this course completes the underpinnings of basic science to enable students to begin an integrated system based curriculum.

* Gastrointestinal System and Metabolism: : This required system-based block integrates the basic sciences into the study of the gastrointestinal system and metabolism in both health and disease. Each of the basic science topics is incorporated into an integrated body of knowledge utilizing both didactic and self-directed learning methods, and clinical models.

* Urinary tract and Renal System : This required system based block integrates the basic sciences into a study of the urinary tract and renal system in both health and disease. Each of the basic science topics is incorporated into an integrated body of knowledge utilizing both didactic and self-directed learning methods, and clinical models.

* Musculoskeletal System and Integument : This required system based block integrates the basic sciences into a study of the musculoskeletal system and integument in both health and disease. Each of the basic science topics is incorporated into an integrated body of knowledge utilizing both didactic and self-directed learning methods, and clinical models.

* Hematology : This required course in hematology integrates the basic science knowledge of the blood and hematopoetic systems.

SECOND YEAR COURSES

* Clinical Practice of Medicine : The Clinical Practice of Medicine is a two-year course which is designed to provide you with the fundamental knowledge and skills required in clinical practice. During the first year of this course, you will learn basic skills that are essential for clinical medicine, including medical interviewing, the performance of a physical examination, and the medical write-up. Working in seminar groups and with community-based physicians, students will focus in the fall semester on developing patient-centered communication skills, and the challenges of medical interviewing. In the spring semester, continuing with seminar groups and preceptorships, the focus will be primarily on developing physical examination skills.

* Human Cardiovascular System : This course provides instruction into the mechanisms of operation of the human cardiovascular system. Emphasis is placed on the integration of relevant principles from anatomy, physiology, biochemistry, pathology, pharmacology and microbiology with respect to the behavior of the normal circulation and its responses to the stress of injury and disease. Both expert‑directed and student‑directed methodologies will be employed in this module and a select set of clinical cases will be used to guide instruction.

* Pulmonary System : This required system‑based block integrates the basic sciences into a study of the pulmonary system in both health and disease. Each of the basic science topics is incorporated into an integrated body of knowledge utilizing both didactic and self‑directed learning methods, and clinical models.

* Neuroscience and Behavior I : This required system‑based block integrates the basic sciences into a study of neuroscience and behavior in both health and disease. Each of the basic science topics is incorporated into an integrated body of knowledge covering neuroanatomy, neurophysiology, neurological correlations, neuropharmacology, neuropathology, human behavior and psychiatry, utilizing both didactic and self‑directed learning methods and clinical models.

* Endocrine and Reproductive Systems and Life Cycle : This required system‑based block integrates the basic sciences into a study of the endocrine and reproductive systems in both health and disease. Each of the basic science topics is incorporated into an integrated body of knowledge utilizing both didactic and self‑directed learning methods, and clinical models.

* USMLE – Step I – Summer between Second and Third Year : This required course integrates the basic and clinical sciences, including the foundations modules, in a review of the essentials of the organ systems in health and disease. An emphasis will be placed upon microbiology and pharmacology as they apply to each organ system. Clinical vignettes and case discussions will be an important method of approaching various diseases. There will be a focus on practical applications, problem-solving and synthesis of information across previous modules.

THIRD YEAR COURSES

* Family Medicine : The goals of this course are to teach medical students the basic knowledge, skills, and attitudes involved in the discipline of Family Medicine, primarily in the diagnosis and management of common undifferentiated problems of patients of all ages in the ambulatory setting, and to promote independent learning, critical thinking, and problem-solving skills.
The course consists of two components, a clinical preceptorship, and a small-group tutorial. Students will work in small groups and will be assigned to a variety of ambulatory settings. They will have the opportunity to see family medicine patients in various urban, suburban, and rural inpatient and outpatient settings, including home visits, nursing home visits, night call, and the coordination of patient care with community social agencies. The tutorial component consists of problem-based learning and independent study.
At an orientation of the first day of the clerkship, each student will receive detailed written course materials describing clerkship responsibilities, course curriculum, and student evaluation.

* Psychiatry : The objectives of this clerkship are to introduce medical students to clinical psychiatry and enable them to acquire knowledge and skills through clinical experiences under faculty guidance.
Students will be assigned to Psychiatric Units at one of the area hospitals. They will be given responsibility for direct patient care under the supervision of attending psychiatrists and staff. In addition, they will gain experience in emergency psychiatry through night and weekend rotations at the CPEP at Erie County Medical Center . This six-week program includes lectures, seminars, and conferences on a variety of psychiatric subjects.
On the first day of each rotation students will receive an orientation to psychiatry and written material pertinent to the course, including lists of objectives and a bibliography of required and suggested readings. At the end of the course, a multiple-choice written examination will be given.
Upon completion of the clerkship, the students should be competent to evaluate and manage patients with major mental illness, should be able to interview patients skillfully, possess basic knowledge of psychopharmacology, be familiar with common problems at the psychiatric-medical interface, and be able to assess psychiatric emergencies.

* Pediatrics : The goals of the Pediatric Clerkship are to introduce medical students to the specialty of pediatrics, and to give them the opportunity to acquire knowledge and skills in this field by means of clinical experiences under expert guidance.
Students will work in small groups and will be assigned to a variety of clinical activities at the Children's Hospital and its related facilities, as well as Mercy Hospital . Students will have the opportunity to see pediatric patients and their families in various inpatient and outpatient settings including pediatric wards, newborn nurseries, well-child clinics, and community pediatric practices. Throughout this rotation, students will be assigned patients, work them up, and present them to the teaching staff for comments and evaluation. Emphasis will be placed on having students fully involved in the comprehensive care of pediatric patients for a more thorough understanding of this specialty. Students will perform night and weekend duties during this rotation. A clinical problem-based curriculum will enable students to focus on common pediatric problems. This pediatric clerkship includes regularly scheduled seminars, discussions, and lectures, as well as teaching rounds with faculty and resident staff. Pediatric residents and attendings will arrange for talks and seminars related to case material and pertinent subjects. Audiovisual and library facilities are available for self-education.
At orientation on the firstday of the clerkship, each student will receive detailed written course materials describing clerkship objectives, responsibilities, course curriculum, and student evaluation.

* Gynecology & Obstetrics : In the third year, a six-week clinical clerkship offers each student an opportunity for personal firsthand experience in the care of both normal and abnormal pregnancy. Experience gained by working with patients is reviewed in group conferences and on ward rounds. Concepts not readily observed during the direct patient contact are emphasized in special conferences.
The student is provided with an opportunity to develop clinical skills under adequate supervision in the areas of history taking, pelvic examination, special diagnostic procedures, differential diagnosis, observation and support of patients in labor, aiding and then conducting actual delivery, and assisting at gynecologic operations. Each student has an opportunity to participate in the active care of patients both in inpatient wards and in the outpatient clinics.
Students who develop an interest in clinical or basic investigation are encouraged to pursue their interests. Four-week elective periods during the fourth year may provide either additional clerkship experience or opportunity to pursue investigative interests.

* Medicine : Clinical clerkship in Medicine is intended to enable the student to understand the clinical correlation of basic science knowledge and to acquire further medical information and clinical skills necessary for understanding and management of commonly encountered medical problems and diseases of adult patients. Six hospitals and numerous ambulatory sites participate in the clerkship program. The course is composed of both inpatient and outpatient experiences.
For the inpatient rotations, the students are arranged into groups of two or three who work as members of a medical ward team that also includes an attending physician and two or three house officers. In addition to their daily work, they take night and weekend duties. Each student is expected to perform initial evaluation and close follow-up of a limited number of patients. During the early part of the clerkship, the emphasis is placed on patient interview, physical examination, problem identification, write-ups, and case presentations. More direct involvement with patient management and decision making, as well as familiarization with common bedside and lab procedures, is progressively added to their clinical clerkship activities. With diverse roles, the attending physician and house staff actively participate in student teaching.
The ambulatory portion of the clerkship is done under the supervision of a preceptor. Students will be expected to perform directed histories and physicals and to write up and discuss the cases seen with the preceptor.
At the outset of the course, each student is provided with a course syllabus describing the objectives, expectations, student's responsibilities, and outline of the core curriculum with pagination of a most updated medical textbook and other references. Although the students will have ample learning opportunities through their participation in patient workup, daily rounds, case presentations and discussions, teaching conferences, lectures and seminars, their self-learning through reading and effective use of the medical libraries and learning resource centers will be stressed throughout the clerkship. The eventual goal is to develop the skills that will allow each student to continue independent learning and problem solving.

* Surgery : The clinical education program is carried out in six hospitals/ surgical services affiliated with the School of Medicine and Biomedical Sciences. During the Clerkship in the Surgical Sciences, the student-learner will acquire the basic surgical skills required of any physician. He/she will participate in the student-credentialing program and attend a series of conferences that are designed to emphasize the interplay of anatomic, physiologic, and pathologic factors responsible for surgical disease. On the clinical services, the learner follows individual cases and works with the resident and attending staff. The learner is assigned responsibility commensurate with his/her knowledge and experience.
The didactic experience in surgery is 12 weeks in length and the primary responsibility of students during the entire 12- week module is Surgery. The clinical experience in General Surgery is offered for eight weeks total (four weeks each at two separate sites) from the following: BGH, ECMC, VA, Millard Fillmore (Gates), the WCHOB, MF Suburban and RPCI. These are intense inpatient experience with intraoperative experience, ward assignments, ambulatory experience, required night call, student credentialing, and conference attendance. Each site may also have an ambulatory component in which the student learner will participate in the evaluation of patients in the clinic/ office setting. The remaining four weeks may be used for Surgery 800 or for an approved elective. Surgery 700 will take priority over any electives. All students will be required to participate in all mandatory surgical activities for the entire 12-week clerkship. These include orientation, skills lab, didactics, case conferences, grand rounds, the surgical conferences at the hospital to which he/she is assigned, testing sessions and the exit interview. In addition, student-learners are expected to read and master the assigned textbook.
The Department assigns a grade according to the academic status policies of the School of Medicine and Biomedical Sciences. Grades are based on completion of the basic, mandatory components including attendance and presentation at the Student Case Conferences, completion of all credentialing documents, completion of required procedures, attendance at all required conferences, clinical evaluations, and testing.

* Dilemmas in Medicine : The Dilemmas in Clinical Medicine (DCM) course is designed as a year-long experience in addressing human and ethical issues in medicine and the decision-making process. By design, it occurs within the six major clinical clerkships of the third-year curriculum, with each clerkship providing at least one 90 minute session dedicated specifically to these issues. The sessions are clinically oriented and usually based upon cases from the students' experience. The design of the course is intended to emphasize small-group independent learning and discussion. One written case report with discussion of the relevant ethical issues will be required of each student. Student grades will be based on a combination of class participation and the case report. Course evaluations will be completed by each student.

* Electives

FOURTH YEAR COURSES

* Basic Neurology : The student will work on the Inpatient Neurology Service as part of the treatment team and, under close supervision, will have the responsibility for the primary and continuing care of a reasonable number of patients.
At the end of the course, the student will be able to develop and present a neuroanatomic and differential diagnosis; to select appropriate diagnostic studies with knowledge of the risks and costs to the patient; to prepare a reasonable therapeutic plan for patients with some of the most common neurologic disorders.

* Advanced Clerkship in Medicine : Advanced Clerkship in Medicine is a four-week rotation that will give students an inpatient experience aimed at developing expertise in managing acute illness in the hospital setting. It will stress normal and abnormal physiology, management of fluid and electrolytes, and highlight some of those conditions that are commonly treated by practicing internists. The rotation will be structured around a work team consisting of resident and intern, a fourth-year clerk, and a third-year clerk. There will be daily participation in morning report and in scheduled didactic conferences. In addition, there will be a didactic portion specifically geared to the fourth year clerk.
By the end of the rotation the student should feel comfortable with responding quickly to acute medical problems and should be able to develop a reasonable pertinent differential diagnosis for presenting problem and begin to discuss appropriate management. The student will thus be prepared to handle not only acute medical problems, but complications that may result from surgery or that may be seen in patients that are commonly seen within other specialties.

* Surgical Specialties : This module in surgical subspecialties includes experience in both hospital and clinic based surgery. The clerkship is 4 weeks in length and includes 1 week of Anesthesiology, 1 week of Urology and a 2 week rotation on one of the following: Neurosurgery, Orthopedic surgery, Ophthalmology or ENT.
The goal of this experience is to prepare the learner for the practice of medicine by offering an experience in the scientific basis of surgical practice and exposure to a range of surgical specialties. In this course, the learner will increase their working knowledge of the clinical practice of surgery and surgical subspecialties. The learner will be able to apply this knowledge to the patient’s complaints and design therapeutic plan.
Direct patient contact is through participation in hospital rounds, clinical practice, office practice and participation in seminars. At the onset of the course, each student is provided with a course syllabus describing the objectives and expectations (Goals Statements). Small numbers of students are assigned to the surgical specialty services. The students are expected to attend the surgical conferences at the hospital to which they are assigned. They are expected to reach and master any assigned texts and handouts.
The Student Evaluation and Education Committee assigns the grade according to the academic status policies of the School of Medicine and Biomedical Sciences. Grades for the clerkship are based on completion of defined goals and clinical evaluations.

* Electives.

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