University of Maryland (School of Medicine)

The School of Medicine was established in 1807. It is the first public and the fifth oldest medical school in the United States and the first to institute a residency training program. The School of Medicine was the founding school of the University of Maryland and today is an integral part of the 11-campus University System of Maryland. On the University of Maryland, Baltimore campus, the School of Medicine serves as the foundation for a large academic health center that combines medical education, biomedical research, patient care and community service. While its tradition of excellence remains constant, the School of Medicine and its reputation for academic achievement continue to grow under the leadership of its Dean, Donald E. Wilson, MD, MACP, Vice President for Medical Affairs.

The University of Maryland School of Medicine is dedicated to providing excellence in biomedical education, basic and clinical research, quality patient care and service to improve the health of the citizens of Maryland and beyond. The School is committed to the education and training of MD, MD/PhD, graduate, physical therapy & rehabilitation science, and medical research technology students. We will recruit and develop faculty to serve as exemplary role models for our students.

The University of Maryland School of Medicine will achieve international eminence as an academic institution in undergraduate, graduate, post-graduate and continuing professional education; basic and clinical research; clinical practice and service; public health and prevention; and responsiveness to its community.

The School of Medicine, in an environment with both rapid scientific and technological advances and economic changes, will be recognized for its excellence and innovation in:

* Education
* Research
* Patient care

We will accomplish this through the recruitment, development and retention of talented, culturally diverse faculty, staff, trainees and students, utilizing:

* Interdisciplinary approaches
* Interprofessional relationships
* Partnerships with our local and regional communities
* Collaboration with industry

These values will serve as the basis for the School of Medicine’s efforts to fulfill its mission and achieve its vision for the future in teaching, research, clinical practice and service.

Our students bring to the School of Medicine a richness of personal and academic accomplishments creating a vibrant environment for their learning and individual growth. They come from urban, suburban and rural areas in Maryland, as well as from many of the 49 other states. They come from a variety of undergraduate schools, including the Ivy League, small liberal arts colleges and state institutions. They are music majors and biomedical engineers. They are mothers and teachers. They are athletes and student government leaders. They are fresh out of college and changing careers after ten years. They are the first in their family to attend college and they are children of professionals.

Being bright and conscientious, our students drive themselves and each other to succeed, valuing their camaraderie and using it to work together in small groups in and out of the classroom setting. This is also an active and compassionate group with a commitment to service and community involvement. They possess strength of character and keen intellect. These attributes in combination will help them become future leaders in patient care, research and medical education.

From the first slice of the scalpel in gross anatomy lab to the Hippocratic oath at graduation, University of Maryland School of Medicine students enjoy a four-year journey of academic achievement and self-discovery. Students will explore the mysteries
of the human body, learn the language of medicine, and face a series of intellectual and emotional challenges.

Problem-based learning with fewer lectures and more small-group discussions has become one of the hallmarks of the School of Medicine. An integrated curriculum, known as the block schedule, enables students to focus more on their individual methods of studying. The early inclusion of innovative information technology as part of the training has been a natural outgrowth of the integrated approach. During the first two years of medical school the basic sciences are taught as systems, using interdisciplinary teaching with both basic and clinical science faculty. Clinical experience is the backbone of medical education at the University of Maryland School of Medicine. Students have a wealth of clinical experiences available during their tenure at Maryland, particularly with the block schedule, which allows for team learning and student research. The block schedule’s success is attributed to open communication between students and faculty
which can lead to curriculum changes that advance the learning process. The Curriculum Coordinating Committee, composed of course and clerkship leaders, key faculty educators and student body representatives, monitors and reviews the rigorous and demanding curriculum to ensure that students are successful.

Medicine is an extremely versatile, varied and multi-faceted profession. Only a part of it can be captured in formal course work, particularly during the first two years of medical school. Furthermore, medical practice places a considerable premium on communicating and relating effectively with patients and fellow health care professionals, on becoming familiar with a great variety of conditions and situations, and on exercising good judgment under adverse conditions. These are learned more by "doing" than by "studying."
Particularly during your first two years in medical school, you can really make your academic studies "come alive," and gain valuable experience by taking advantage of numerous opportunities to observe and participate in doctoring at very close range. For example, the Department of Psychiatry offers possibilities for participating in the Combined Accelerated Program in Psychiatry (CAPP) and the opportunity to learn and train and to become involved with patients and their medical problems earlier in your medical school career. The Department of Family Medicine has organized an extensive program of preceptorships which are available to students throughout the medical school years. Other departments can also arrange preceptorships which will provide valuable first-hand experience during the first years of medical school. Many interest groups provide students with opportunity to meet faculty members in various clinical departments.

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School of Medicine Medical School Location

School of Medicine Courses

FIRST AND SECOND YEARS

The freshman year begins with a nine-day introduction that includes orientation, informatics and the start of the Introduction to Clinical Medicine course. This initial time is spent getting the students comfortable in the role of medical student and beginning the process of becoming a physician. ICM as the course is known continues throughout the first two years of medical school and includes such topics as Human Sexuality, Interviewing, Physical Diagnosis, Medical Ethics and Medical Economics. The initial introductory period is followed by a nine-week block on "Structure and Development," which offers a comprehensive overview on the morphological and developmental organization of the body, including the traditional disciplines of anatomy, histology and embryology. Following this, a nine-week block, "Cell and Molecular Biology," presents the fundamentals of biochemistry, cell biology, molecular biology and human genetics and correlates them with clinical issues. Functional Systems, which includes the major principles of human physiology and the clinical correlations of these, follows for ten weeks, with six weeks of Neuroscience completing the first year. Neuroscience covers both structural and functional aspects of the nervous system.

The integrated curriculum continues in the second year when sophomore students take three blocks, including Host Defenses and Infectious Diseases (10 weeks) and Pathophysiology and Therapeutics I and II (for a total of 24 weeks). Pathophysiology and Therapeutics, organized by body systems, contains neuroscience and psychiatry, cardiovascular, gastrointestinal, reproductive, pulmonary, renal, endocrine, neoplasia, locomotive and hemopoietic sections. The sophomore year is characterized again by two hours of lecture per day, and two hours of small group or laboratory per day. Introduction to Clinical Medicine continues with a primary focus on Physical Diagnosis. Passage of Step I of the United States Medical Licensure Examination is required for proceeding to the clinical years.

COURSES :

* BLOCK I - MEDICAL INFORMATICS : Students begin their medical school training with a three day introduction to medical informatics. Students receive their laptop computers on the first day of Informatics. Curriculum includes instruction in the access of campus-wide electronic resources and those available via the Internet. Students gain essential laptop computer skills and are introduced to the use of electronic mail and Web-based curriculum resources. Learning experiences are designed to bring computer relevancy to medical research and clinical applications. Nationally recognized speakers in Medical Informatics present the latest technologies in medicine.

* BLOCK II - STRUCTURE AND DEVELOPMENT : A comprehensive overview of the morphological and developmental organization of the human body is provided. The basic concepts of structure as related to function are described in lectures and demonstrations. Study includes all levels from gross morphology to the ultrastructure of cells revealed by electron microscopy. Laboratory facilities for gross examination are provided for dissection, topographical study, osteology and radiology. Light microscopical laboratories are available for study of histological preparations of human tissue and for correlation of tissues studied at this level with electron micrographs. The course also includes instruction in living anatomy, radiology and clinical correlation. Laboratory instructors include anatomists, surgeons and radiologists. The interdependence between structure and function in the different tissues and organs of the body is emphasized.

* BLOCK III - CELL AND MOLECULAR BIOLOGY : It is clear that, as biotechnology develops, an increasing number of diseases are understood at the cellular and molecular level. Thus, an understanding of biological molecules and their interactions underlies modern medicine and the treatment of diseases. The goal of this course is to present fundamentals of biochemistry, cell biology, molecular biology and human genetics from an integrated multi-disciplinary perspective. Further, these molecular principles are correlated with clinical issues throughout the course so that the importance of cell biology in the illumination of the causes of, as well as the strategies for the treatment of many diseases, is clearly revealed.
This comprehensive course presents a concise view of many topics including the basic structure and function of mammalian cells, structure and function of proteins and enzymes, cellular energetics and metabolism, biochemical nutrition, cellular receptors and intracellular signaling. Fundamental principals of modern molecular biology are presented, including DNA structure and function, protein synthesis and the regulation of gene expression. The principles of modern molecular biology are integrated with clinical human genetics so that fundamentals of cytogenetics and population genetics are examined.
The goals of this course are accomplished through a series of focused lectures complemented by clinical correlation sessions presented by the clinical faculty. In addition, this course includes a major commitment to teaching fundamentals through multiple small group sessions where students learn through problem solving, clinical case studies and through discussion and presentation of the medical literature.

* BLOCK IV - FUNCTIONAL SYSTEMS BLOCK : An introduction to the study of cellular function. The course begins with the study of general membrane and cellular physiological principles, including diffusion and membrane permeability, osmotic pressure and cell volume changes, electrochemical equilibrium including the Nernst equation and Donnan equilibrium, the origin of resting membrane potentials, active and passive transport processes and epithelial transport. Study then focuses on action potential generation and propagation in excitable tissue like neurons and muscle cells, the structural and functional properties of skeletal muscle including its mechanical properties and excitation-contraction coupling and the pathophysiology of nerve and muscle.
This block covers the functional aspects of the major organ systems. It provides students with a basic understanding of mammalian and, in particular, human physiology, and lays the foundation for the study of clinical medicine. The subject matter is organized into sections that cover cellular, cardiovascular, renal, respiratory, gastrointestinal, endocrine and integrative physiology. Each section ties together aspects of structure with function and includes discussion of relevant pathophysiological and clinical applications. Conference periods are used for clinical correlations, small group discussions, laboratory exercises and computer-assisted simulations. The curriculum includes problem-solving and problem-based, self-learning sessions.

* BLOCK V - NEUROSCIENCES : The Neurosciences course provides a unified approach to the study of the central nervous system, i.e., fundamental concepts of neuroanatomy, neurochemistry, neurophysiology and clinical neurology are considered in an integrated sequence. The course begins with structural, biochemical and developmental aspects of the brain and spinal cord. Studies of the major sensory and motor systems and consideration of higher neural functions subsequently form the core of the course. Clinical presentations highlight the importance of major neurobiological principles in the hospital and office setting. Methods used include lecture, laboratory and small group discussions, along with self-teaching and self-evaluation units. The course faculty includes members of the departments of anatomy and neurobiology, biochemistry and molecular biology, physiology and neurology.

* BLOCK VI – INTRODUCTION TO CLINICAL MEDICINE : Introduction to Clinical Medicine is a course created in 2004 o teach aspects of ethics, human behavior, sexuality, nutrition, interviewing and diagnosis issues, and the doctor – patient relationship. Professionalism will also be emphasized. The course will be conducted in small group format one afternoon a week throughout the year. Each individual group of seven to eight students will be led by one preceptor or group of preceptors. Evaluation will include attendance, small group participation, an exam, and the successful completion of three standardized patient interviews.

* BLOCK VIII - HOST DEFENSES AND INFECTIOUS DISEASES : Host Defenses and Infectious Diseases is the first course of the second year and is approximately eleven weeks in duration. The course is divided into three sections: (1) immunology, (2) bacteriology, (3) virology/parasitology/mycology. This integrated course focuses on topics including the general principles of immunology and to introduce infectious diseases caused by bacteria, viruses, fungi and parasites. The format will consist of lectures, small group discussions (coordinated by the Microbiology and Immunology basic science faculty), clinical small group conferences (coordinated through the Department of Medicine), PBL sessions, computer-based sessions, as well as demonstrations and self-instructional material. In this year's course, particularly the immunology section, there will be increased participation of faculty from the Departments of Pathology and Pharmacology and Experimental Therapeutics with the aim of achieving a more integrated coverage of major topics.

* BLOCK IX - PATHOPHYSIOLOGY AND THERAPEUTICS : This course begins with basic and clinical neuroscience (including neuropharmacology, neuropathology, and psychiatry), followed by biostatistics and epidemiology, oncology and the pulmonary system. The six-week neuroscience unit first examines the various receptors systems that affect both nerve, cardiac, smooth and skeletal muscle, placing the material within a clinical perspective. The material is later examined along with nonpharmacologic treatment within the central nervous system and psychopathology portion of the unit. The mechanism and actions of centrally acting drugs are considered from a therapeutic viewpoint as well as in the context of drug abuse. The pathological processes that underlie the more prominent central and peripheral diseases are presented in lecture and case studies using histopathologic and radiologic approaches. The biostatistics-epidemiology unit emphasizes epidemiologic principles on the basis of a statistical examination of lung cancer and leads directly into a general study of neoplastic development. Finally, the subject area of pulmonary begins with discussions of pulmonary neoplasia and then other disease entities affecting the pulmonary system (asthma, hypertension, infections). Students are also exposed to complementary and alternative medicine and the potential use of herbal agents in treating various disease processes.

* BLOCK X - PATHOPHYSIOLOGY AND THERAPEUTICS : Pathophysiology and Therapeutics II begins with a four-week unit of cardiovascular disease and hypertension. This unit examines the common cardiovascular diseases, their pathophysiology and therapy and is integrated with cardiac physical diagnosis. This is followed by 1-to-2 week sections on the pathophysiology of renal, hematologic, gastrointestinal, endocrine, reproductive, dermatologic and musculo-skeletal diseases. In the various systems, principles of pathology, pharmacology, epidemiology, radiology and clinical medicine are emphasized in lecture and reinforced by small group clinical case studies. Concepts and principles taught in Pathophysiology and Therapeutics I serve as building blocks for Pathophysiology and Therapeutics II.

* BLOCK XI - INTRODUCTION TO CLINICAL MEDICINE : Introduction to Clinical Medicine includes Physical Diagnosis and sessions on ethics and medical economics. Physical Diagnosis specifically assists the medical student in making the transition from graduate student to physician and is part of the foundation upon which the clinical experience of the physician begins to take form. Students lean to master fundamental clinical skills and begin to synthesize the principles learned in the basis sciences with the information derived at the patient’s bedside. With careful guidance and instruction, students acquire the skills to perform a thorough history and comprehensive physical examination.

THIRD AND FOURTH YEARS

The two clinical years are viewed as a single unit with the student assuming progressive responsibility for patient care. The clinical experience consists of the following clerkships: Medicine (12 weeks), Surgery (12 weeks), Family Medicine (4 weeks), Obstetrics, Gynecology and Reproductive Sciences (6 weeks), Pediatrics (6 weeks), Psychiatry (4 weeks), Neurology (4 weeks). As noted, students take all of these rotations according to individual schedules. The sum of these experiences provides a 48-week introduction to clinical science. Students are evaluated based on clinical performance and end-of-clerkship examinations. Approximately one third of the third year is spent in ambulatory care settings.

The 32-week fourth year that follows includes four four-week electives. The student may take a maximum of eight weeks of electives off-campus. Eight weeks must be spent in student sub-internships in one of four clinical fields: medicine, surgery, pediatrics or family practice. Here the student has an opportunity for direct, primary patient care responsibility over a prolonged period of time. These rotations are offered at the University of Maryland Medical System and in approved affiliated hospitals. The third component of the fourth year is a consecutive eight-week experience in an ambulatory setting. The ambulatory rotation is designed to be completed in a rural or underserved area supplemented by teaching in preventive medicine.

The 80-week combined clinical years program provides a strong grounding in clinical science with a progressive opportunity for primary patient care responsibility. The curriculum is designed to prepare the medical student for the increasing responsibility demanded by the specialty residency programs throughout the country.

The Curriculum Coordinating Committee, composed of course and clerkship leaders, key faculty educators and student body representatives, has the responsibility of regularly monitoring and reviewing the curriculum and recommending changes deemed appropriate.

COURSES :

* Junior Year: Students are assigned by lottery to the sequence of their schedules. Junior blocks include: twelve weeks of Internal Medicine (at University of Maryland Hospital, Veterans Administration Hospital, Mercy Hospital); twelve weeks of Surgery at different sites; six weeks of Pediatrics and Obstetrics and Gynecology; four weeks of Psychiatry, Neurology and Family Medicine. Preventive Medicine is a part of the Longitudinal Ambulatory experience.

Courses:
- Family Medicine
- Medicine
- Surgery
- Pediatrics
- Psychiatry
- Neurology
- Obstetrics & Gynecology

* Senior Year: Three mandatory rotations are included in the Senior year. These include two student sub-internships of four weeks each spent functioning at the intern level on an inpatient unit, primarily in one of four electively selected rotations (Internal Medicine, Pediatrics, Surgery, Family Medicine); the second is the eight-week Senior Ambulatory rotation at a Maryland based Area Health Education Center (AHEC) in Eastern or Western Maryland in the fields of Internal Medicine, Pediatrics or Family Medicine. Dermatology and Epidemiology and Preventive Medicine are part of the Ambulatory experience.
Four rotations are elective with the potential to spend two of these rotations at an approved site away from campus. OSA staff are available to juniors selecting the senior schedule to assist the student in programming a balanced, useful senior-year curriculum that fulfills the student's needs and also provides a thorough and varied medical education experience. A student may do 2 of the 4 electives in their chosen field of residency. Also, up to 2 months of electives may be done outside the UMB system. Additional off-campus courses in the senior year may be granted on request by the Clinical Years Committee. Lotteries are used to determine priority numbers for course selection. Most students are able to obtain what for them is their "ideal" senior schedule. Time is possible for scheduling residency interviewing during the planning of the senior schedule.

Courses:
- Senior Ambulatory
- Sub-Internship
- Electives

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