University of Cincinnati (College of Medicine)

The University of Cincinnati is one of the leading academic health centers in the nation. Because of its excellence in education, patient care, and research, students, researchers, physicians and patients travel from all over the world to take advantage of the many unique opportunities. The College is committed to providing a curriculum which offers diverse learning opportunities. Students develop a broad range of knowledge, skills and attitudes necessary to practice medicine. The curriculum has been carefully structured to balance subject-specific courses, integrated content blocks and clinical experiences.

The primary educational mission at the University of Cincinnati College of Medicine (UCCOM) is to provide a stimulating learning environment intended to create the undifferentiated MD who is ready to excel in his or her chosen residency and who will provide excellent patient care.

Using an integrated curricular approach and a variety of teaching modalities such as lab, small group discussion, team-based learning, and lectures, the first two years provide students with the scientific and humanistic principles of medicine including the application of those principles to medical practice.

The College of Medicine is one of the leading academic health centers in the nation. The college is housed in the Medical Sciences Building (MSB). The Medical Sciences Building serves as the center of many of the activities within the Medical Center at large. Admissions, Student Services, The Office of Research and Graduate Education, Academic Information Technology & Libraries are all housed within MSB.

The Vontz Center for Molecular Studies, was designed by renowned architect Frank Gehry and was built to be the most advanced facility for the study of cancer and neuroscience. The Vontz Center consists of three stories with walkable, six-foot interstitial space per floor with a total of 150,000 gross square feet of open lab space, core support areas (such as refrigeration units and darkrooms), office suites, a lobby and lecture hall. The open lab areas, modular work spaces, office clusters, common areas and adaptable utilities readily accessible through the interstitial space are designed to encourage interaction among researchers and provide a environment responsive to changing research needs.

Holmes is affiliated with the University Hospital and provides many health services for the students, faculty, and staff at the Medical Center. Some of the areas within Holmes include: the Infectious Diseases Control Center, the Pain Control Center, University Orthopaedics & Sports Medicine Center, Same Day Surgery Facility, Holmes on Eden (hotel facilities primarily for patients who will be using same day surgery), Infertility Clinic, University Fitness Center, University Health Services and the Women's Health Initiative.

The Cardiovascular Center houses laboratories, conference rooms, and faculty offices where scientists and physicians search for causes and cures for heart disease. The seven-story building is connected at most floors to the Medical Sciences Building, where the College of Medicine is located.

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College of Medicine Medical School Location

College of Medicine Courses

YEAR 1

Year 1 focuses on the normal structure, function,
and development of the human body.

COURSES :

* Biochemistry : Is a course designed for medical students having their first exposure to biochemistry, although it is assumed that everyone has a working knowledge of organic chemistry. Upon completion of this course the student should have an excellent grasp of the metabolic basis of disease. In order to understand the altered state, it is first necessary to study the normal pathways of metabolism, such as the biosynthesis of large molecules, the metabolism of small molecules involved in the generation and storage of energy, and the use of molecular genetics in diagnosis and treatment of disease. Once the normal pathways are understood, defective steps causing diseases will be introduced. By teaching biochemistry via a disease oriented approach the student should have a greater appreciation for the role of biochemistry in disease and the role of modern biochemistry in clinical treatments. There are three major course objectives. For each pathway and disease discussed in class, a separate list of specific objectives will be provided.

* Brain and Behavior 1 : The goal of Brain and Behavior 1 is to provide varied learning opportunities to assist the first-year medical student in developing a strong structural, functional, and clinically-oriented knowledge base in the neurosciences. This course is part of the 4-year longitudinal neuroscience curriculum. It lays a solid foundation on which the second year Brain and Behavior 2 course, third year psychiatry clerkship, and the fourth year neuroscience selective can build.

* Gross Anatomy : Is a course that serves as an introduction to the the structural organization of the human body and an appreciation for how the structural organization relates to function. This course takes a regional approach rather than a systematic approach to the anatomy, and is organized into five content blocks.

* Clinical Foundations of Medical Practice 1 : Is designed to teach students clinical skills and clinical reasoning that will serve as the foundation for their clinical work in years 3 and 4. CFMP1 is presented in two specific components: small group case studies on Tuesday afternoons and clinical skills on Thursday mornings. The small group case studies help the student integrate basic science concepts with clinical science concepts into a specific case or specific patient problem and help the student develop clinical reasoning skills. Clinical concepts that will be discussed in each case include medical ethics, clinical nutrition, human sexuality, cultural competency, grieving and loss, health payment systems, chronic illness care, evidence based medicine and public health. The clinical skills component includes medical interviewing (obtaining a medical history from a patient), introduction to the normal physical exam, and opportunities in actual clinical practice.

* Physiology : Is the integrative study of molecular, cellular, and organ systems and their homeostatic control mechanisms that function to maintain life. Thus, physiology represents one of the major foundations of clinical medicine and a firm grasp of the essentials of physiology is a mandatory component in the practice of medicine. The physiology course at the University of Cincinnati College of Medicine is divided into four units containing a total of twelve sections. Unit 1 is focused on cellular and muscle physiology, Unit 2 on cardiac physiology, circulatory physiology, and the physiology of hemostasis, Unit 3 on renal, respiration, acid-base, and temperature regulation, and Unit 4 on gastrointestinal, endocrine, and reproductive physiology (neurophysiology is taught in the Brain and Behavior courses).

* Microscopic Anatomy : Is a lecture and laboratory course that provides students with knowledge of the structure of the human body at the levels of cells, tissues and organs as studied by light and electron microscopy. An important theme of the course is the consideration of function as it relates to structure.

YEAR 2

Year 2 emphasizes the basis and mechanisms
of human disease.

COURSES :

* Microbiology and Immunology : Introduces the student both to immunologic concepts and their relationship to medicine and to medical microbiology and infectious diseases. The Immunology section provides an overview of the adaptive immune response and of the host’s response to infection. The emphasis in the Microbiology section is on the biology of the pathogenic microorganisms and their mechanisms of pathogenesis. In addition, the course covers epidemiology, clinical manifestations, general principles of diagnosis, and means to prevent common infectious diseases. Information is presented in lectures, laboratory and case-based discussions.

* Pharmacology : Presents an introduction to all important major drug classes using exemplar drugs for each class to illustrate the mechanisms of drug action, modes of action, anticipated desired effects, common adverse effects, serious but rare adverse effects, important drug-drug interactions, and contraindications of drug use. Orientation to important principles of drug absorption, distribution, metabolism and elimination as well as pharmacokinetics and pharmacodynamics are integrated with genetic variability, age, sex, and racial factors important for understanding drug use and drug effects. The material is presented in a context of relevant clinical disease without emphasis on clinical therapeutics or clinical decision-making using lectures, workshops, and case-based small group tutorials.

* Brain and Behavior 2 : Is an integrated neuroscience course incorporating the disciplines of neurology, neuropharmacology, neuropathology, and psychiatry. This course provides experiences that reinforce the concepts and principles presented in the Brain and Behavior 1 course, and enable the student to understand the pathologic characteristics, signs, symptoms, and treatment modalities for common neurologic and psychiatric disorders.

* Pathology : provides an overview of human diseases by studying general disease processes and those associated with specific organ systems. The course uses lectures and related small group sessions. For the small group sessions, 3-4 students are assigned a case for presentation to their classmates. The students receive clinical information, laboratory data, and images (gross and microscopic). Guided by a set of learning objectives, students prepare and give an electronic presentation using the computers and projection equipment in the teaching laboratories. Emphasis is placed on understanding etiology, pathophysiology, structural and functional manifestations of disease, clinicopathologic correlations, and developing a vocabulary to communicate this knowledge.

* Clinical Foundations of Medical Practice 2 : Is a multidiscipline course that presents a clinical view of disease and advances medical history and physical diagnosis skills. The course employs lectures, case discussions, supervised patient workups, specialty rotations with Neurology, Urology, Obstetrics, Gynecology, Otolaryngology, and Ophthalmology. It provides opportunity for clinical exposure through Family Care, Homeless Health Care and through Saturday rounds with medical in-patient teams. Students are also given an overview of Universal Precaution procedures as well as an orientation to how to read the medical literature, in part, with a review of epidemiology and biostatistics.

YEAR 3

The third year consists mostly of core and selective clerkships. Each clerkship combines clinical service work with classroom work.

COURSES :

* Family Medicine : Family Medicine has been a required clerkship at the University of Cincinnati College of Medicine since 1994. The clerkship is four weeks. Student ratings of this clerkship are consistently very high.
Assigned to a community family doctor, students spend the majority of the month-long rotation seeing patients and participating in hands-on patient care as a member of the healthcare team in their individual preceptor’s office. The community preceptors range from solo practices to small group practices to residency programs. The sites may be urban, suburban or rural. Students are encouraged to take advantage of all learning opportunities during the month; for example, participate in hospital rounds, visit nursing home patients, accompany their preceptor on home visits and become familiar with the business side of running a medical practice.
Students spend four days a week with their community preceptors, one day a week at the medical school for didactics. The didactics are interactive, adult-learning sessions with an emphasis on common outpatient problems, communication skills, and the thought process involved in evaluating patients.
The grade for the Family Medicine clerkship is a combination of three components: the preceptor evaluation (60%); the end-of-rotation exam (20%); and an in-depth family study paper (20%).
The uniqueness of Family Medicine may be a bit difficult to define. However, as we poll students, they report there is something different and special about this rotation. What is most often mentioned is the time spent at one site with a small group of preceptors, which allows students to enjoy the camaraderie of a medical practice as well as to develop close relationships with the doctors and office staff.
Family Medicine emphasizes the benefit of longitudinal care. Our community preceptors have cared for their patients for many years. That long-term relationship gives the doctor great insight into a patient’s physical, mental and emotional health.
Family Medicine also stresses the importance of caring for the patient in context, not just dealing with the disease process. For example, to care for a patient with diabetes the doctor must know the pathophysiology, the medicines, and the recommended care guidelines. The doctor must also know what that disease means to the patient, what’s going on in their lives and what issues will impede or help the patient gain control of their sugars.
The Family Medicine Clerkship is designed to help students hone their clinical and communication skills. Our goal for students is that, after the four week rotation, they understand the role of a family physician, the care techniques unique to family practice and the contribution family doctors make to the healthcare team.

* Internal Medicine : The Internal Medicine third-year clerkship is an eight-week rotation consisting of four weeks on an inpatient ward service and four weeks in ambulatory care.
On the inpatient service, students are assigned to General Internal Medicine ward teams and given patient care responsibility commensurate for their level of training under the supervision of interns, senior residents and attending physicians. The educational emphasis is on history and physical examination skills and problem definition. The third-year students are given the opportunity to complete a detailed history and physical examination, written and oral presentation and discussion of their assigned patients several times during the month. The students are encouraged to participate in all aspects of patient care including medical procedures.
In the ambulatory setting, students are given significant patient-care responsibility. In the Student Clinic, patients are scheduled specifically for the student-physician who is responsible for the patients’ entire outpatient care under the guidance and supervision of a faculty physician. To complement their student clinic experience, students work with a preceptor based in the community and in an Internal Medicine subspecialty clinic.
Also during the ambulatory block, the IM rotation provides opportunities for self-study with computer-based teaching modules in EKG interpretation, Dermatology and Nutrition. Once per month, students attend a clinical skills session in the clinical skills lab where, under the direction of a faculty member, students practice techniques of venipuncture, intravenous catheter insertion, arterial blood gas sampling and nasogastric tube placement.
The Internal Medicine clerkship includes a weekly lecture series given by full-time faculty in Internal Medicine on 24 core Internal Medicine topics which are the basis for the Professors’ Rounds examination. Third-year students participate in all academic conferences within the Department of Medicine. Students are given direct feedback by faculty physicians and standardized patients on their history, physical examination, and communication skills through structured clinical exercises. Students get written feedback on their history and physical examination write-ups by the course director.

* Ob/Gyn : The Obstetrics and Gynecology clerkship, in the third-year, is an eight-week rotation that consists of six weeks of inpatient care and two weeks of ambulatory care. The inpatient service is equally divided between obstetrics and gynecology at one of five hospitals in the Tri-State area: University Hospital, The Christ Hospital, Good Samaritan Hospital, St. Elizabeth’s Hospital, or St. Lukes Hospital. The obstetrics portion may consist of normal labor and delivery, high-risk obstetrics (maternal fetal medicine), or routine prenatal care. Gynecology may include benign gynecology, gynecologic oncology, or reproductive endocrinology and infertility.
During the two-week ambulatory preceptorship, the student is paired with a physician in the outpatient setting for direct one-on-one instruction. The goal of the preceptorship is to expose the student to the practice of ob/gyn in the ambulatory setting rather than the hospital environment. The focus is on the common problems encountered in the ambulatory setting. The student will have the opportunity to see patients and present them to the preceptor.
The curriculum has been revamped to reflect learner-based teaching. All but the basic lectures have been replaced with small group sessions. In these sessions, the student will cover a majority of the Association of Professors of Gynecology and Obstetrics (APGO) learning objectives. The learning is problem based with a faculty leading the students through the workup of a case. Each case has a list of learning objectives and discussion questions. The goal of the small group session is to allow the students to apply knowledge learned in the reading assignments to clinical scenarios with the help of faculty with clinical experience.
Finally, students are required to bring one case from their clinical experience as a case to present to the class. The clerkship director leads the class through the case by working on skills in taking a focused history, formulating a problem list, creating a differential, making a diagnosis and formulating a plan of therapy.

* Pediatrics : Pediatrics is a specialty of medicine dealing with the physical, mental, and psychosocial health of infants, children, and adolescents. The third year clerkship is an eight week program designed to present the fundamentals of pediatrics which should be mastered by any physician, as well as to provide a sound foundation for those choosing to enter the specialty.
The faculty of the Department of Pediatrics is committed to an educational experience designed for adult learners. The focus of this experience is the curriculum. This curriculum, adapted by our faculty from one developed by the Council on Medical Student Education in Pediatrics, includes a series of competencies. The primary expectation of this clerkship is achievement of these competencies. During the course of the next two months, we expect you to refer frequently to these competencies, documenting which ones you achieve with the specific patient encounter. We are offering you, as adult learners, a variety of ways to achieve these expectations.

* Psychiatry : During this six-week rotation, each student is actively involved in patient care on two inpatient units, an outpatient clinic, a substance abuse service, and the Psychiatric Emergency Room. Our faculty lead weekly interactive clinical case conferences, which cover the major psychiatric diagnoses. At the conclusion of the Clerkship, students are able to elicit a psychiatric history, mental status examination and formulate a comprehensive treatment plan that incorporates the biologic, psychotherapeutic, and social needs of their patients.

* Surgery : The surgical clerkship is an eight week rotation. Upon completion, the clerk will be expected to understand the basis of surgical disease processes, as well as the decision-making used to manage surgical patients. The clerk will be an integral part of the surgical team, be responsible for patient care, and will participate in surgical procedures. The trials and tribulations of surgeons in general surgery and the surgical subspecialties will be experienced first hand, in both inpatient and outpatient settings. The clerk will learn basic surgical techniques and the management of minor wounds of violence.
The clerkship is divided into three sections. The first week may be considered introductory, and consists of eight hours of suture practice and minor wound management, and twelve hours devoted to anatomic review, surgical procedures, laboratory value interpretation, order writing and hemodynamic monitoring. In addition, there are five hours of didactic lecture and twelve hours of interactive teaching, when the student is expected to complete assigned reading the night before in order to participate in discussion of the topic. There is a test Saturday morning at the end of the first week, followed by a meeting with the chief residents who will explain expectations on the clinical services. The purpose of the first week is to cover a large portion of the didactic material before the long hours begin and also to prepare the student in order to get the most out of the operating room experience.
The next six weeks are devoted to two three-week clinical rotations. During each rotation there are nine more interactive teaching sessions (total eighteen) concluded with a quiz (total two). Students are expected to attend the resident teaching sessions, Surgical Grand Rounds, Morbidity & Mortality Conference, and Professor's Hour. One day is devoted to Nurse-for-a-Day. The student shadows a nurse (medications, intravenous, dressings, orders, discharge summaries). All students must complete at least one general surgery rotation. Once these rotations are filled, a lottery system is used to fill the remainder of the available general surgery rotations, the balance of students will then be assigned subspecialty rotations, based on student preference. Subspecialty rotations are often selected by students particularly interested in these fields, but also by students not particularly interested in surgery. Subspecialty rotations include vascular, cardiac, burns, plastics, pediatric, transplant, urology, neurosurgery, otolaryngology and orthopaedics. Clinical performance evaluations are based on clinical expertise, fund of knowledge, work ethic and professionalism. The student may expect feedback from the chief resident and the clerkship director at the conclusion of each clinical rotation.
The final week of the surgical clerkship is devoted to operative procedures of interest and not yet observed, additional lectures (subspecialties, geriatrics, end-of-life, ethics), and study for the standardized, national surgery examination. We also include a pass/fail oral examination, primarily for the students' enlightenment.
Final grades are determined as follows: sixty percent of the grade is determined by tests (test 1 = 15%, quiz 1 = 7.5%, quiz 2 = 7.5%, final = 30%). Forty percent of the grade is determined by clinical effort (20% each rotation). A student must score at least the mean on the final exam to be eligible for a high pass or honors for the clerkship. Students are ranked in numerical order. Approximately 60% of students may expect a pass, and the remainder high pass or honors. The number of high pass and honors allotted is determined by distribution of grades, and may vary slightly from one rotation to another. Student grades are not negotiable.

YEAR 4

In Year 4, students’ clinical skills are honed during their Acting Internship and required Neuroscience selective. Students also choose from over 100 elective offerings, some of which are clinical, while others expose the student to the ways in which medicine fits into society.

COURSES :

* Acting Internship in Internal Medicine : The College of Medicine requires that every fourth-year medical student complete two months of Acting Internship (AI) in Internal Medicine. The Acting Intern is given primary patient care responsibility on an inpatient service under the direction of first-year residents, senior residents and an attending physician. The students lottery for Acting Internship rotations on the General Internal Medicine wards at the University Hospital or VA Medical Center, Medical Intensive Care Unit, Cardiac Care Unit, VA Cardiovascular team, Infectious Diseases team, Hematology/Oncology team or community hospitals. Students consistently rate the Acting Internship in Internal Medicine as the highlight of their clinical years.

* Neuroscience Selective : The required four-week Clinical Neuroscience Selective has a didactic segment followed by a specialty rotation. The specialty selection is made during the first week of enrollment from the following: adult neurology; pediatric neurology; neurosurgery; and physical medicine and rehabilitation.

* Electives

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