University of New Mexico (School of Medicine)

Established in 1994, the University of New Mexico Health Sciences Center is the largest academic health complex in the state. Located on the University of New Mexico campus in Albuquerque, New Mexico, the HSC combines its four missions areas - education, research, patient care and partnership - to provide New Mexicans with the highest level of health care.

The University of New Mexico School of Medicine was established in 1961 and admitted its first class in 1964. Currently 75 students are admitted yearly to the first year class including 3 MD/PhD students. The medical school is located on the north campus of The University of New Mexico which allows students and faculty easy access to the educational, recreational, and cultural offerings of the university.

The UNM Health Sciences Center has recently completed a Strategic Plan for the Clinical Enterprise calling for significant changes in the manner in which the clinical organization operates. The “Clinical Enterprise” refers to the combined patient care programs of UNM Hospitals and the physician faculty members of the School of Medicine.

The purpose of the strategic plan is to guide the development of the Clinical Enterprise as it repositions the HSC in the health care marketplace: continuing to serve as a valued safety net for the underserved and a primary care provider, while moving toward a specialty referral, tertiary care provider role for the state and region.

The Clinical Enterprise will create a stable financial environment that will support planned growth, such as the expansion of UNM Hospital and will also allow the School of Medicine to grow and develop its programs to support the expanded clinical capacity, while simultaneously enhancing its strengths in education and research to enable higher levels of patient care and doctor and hospital staff satisfaction.


The School of Medicine has gained national and international recognition for its constantly evolving curricular innovations which are aimed at adapting adult learning theory to medical education. Educational emphasis has shifted from the learning of facts to teaching students the skills they will need to be effective lifelong learners. Current educational initiatives are aimed at improving the integration of the basic sciences and clinical medicine, shifting teaching and learning to ambulatory and community settings, integrating problem-based learning throughout the curriculum, and emphasizing computer literacy and information management skills.

The current four-year curriculum, implemented in the fall of 1993, incorporates the successful aspects of the school's prior educational innovations and experiments found in the Conventional Curriculum and Primary Care Curriculum tracks (see center fold). These aspects include problem-based and student-centered learning; early clinical skills learning coupled with sustained, community-based learning; the incorporation of a population and behavioral perspective into the clinical years; peer teaching; computer-assisted instruction; and biweekly seminars on professional responsibility. The new curriculum also addresses the historically unmet as well as changing health care needs of our population and changing learning needs of future physicians.

The UNM School of Medicine is committed to improving health and health care in New Mexico by providing the best medical education, research and clinical care. This is made possible by the generosity of alumni and friends who believe in the school’s mission and have invested in its future. As state appropriations decrease, private support is becoming even more critical in achieving the school’s mission of providing cutting-edge research, innovative education and superior patient care to the people of this state.

In order to encourage more physicians to practice in rural areas, the school has launched a combined BA/MD degree program. A collaboration with the UNM College of Arts and Sciences, the program will reach out to talented high school seniors committed to practicing medicine in New Mexico and will reserve for them a space in the medical school.

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School of Medicine Medical School Location

School of Medicine Courses

FIRST AND SECOND YEARS

Phase I of the curriculum lasts approximately 20 months and employs learning methods which feature a variety of approaches including small group, problem-based tutorials, lectures, seminars, and laboratories (see center fold). The curriculum is organized around organ systems, each incorporating three perspectives - biologic, behavioral, and population. Hands-on medical skills are gained through weekly clinical skills and laboratory sessions. Students have the opportunity to apply these skills in a weekly continuity clinic. About half of each week’s time is unprogrammed so that students can utilize learning resources appropriate for their individual needs. Some of these resources include use of the library, faculty consultation, computer-assisted instruction, self-assessment exercises, and community visits.

At the end of the first academic year, students participate in a 9 week, in-depth Practical Immersion Experience (PIE) in a professional setting in either a rural or urban community. A portion of the time may also be spent in a research laboratory or working on a community project. Students apply and continue to learn basic and clinical sciences in these settings.

COURSES :

* Introductory Biochemistry : The emphasis in this survey course is on a chemical understanding of the mechanisms by which cells integrate and control intermediary metabolism. Also included in the course of study are quantitative problems in pH control, enzyme kinetics, genomics and bioenergetics. For many students this is a first, and sometime only, upper division science course. As an upper division course, integrates materials you have studied in your previous general chemistry, organic chemistry and biology courses within the context of human physiology.

* Intensive Biochemistry : An introduction into the physical and chemical properties of proteins and enzymes; enzymic catalysis; structure, synthesis and processing of nucleic acids and proteins. {Three lectures and one small group discussion each week}

* Cell Biology & Physiology : Cell Biology and Physiology research at UNM is a discipline that encompasses research ranging from molecular studies of intracellular function to animal-based studies of organ system function. The unifying feature of the group is the study of integrated systems that encompass more than one enzyme, cell type or organ system. Faculty members come from many academic backgrounds including molecular, cellular and developmental biology, anatomy, biophysics, biochemistry and physiology.

* Molecular Genetics & Genomics : Changes in signaling pathways and transcriptional regulation are the basis for all important cellular and disease processes including apoptosis, differentiation, proliferation, senescence and development. The faculty in this Research Area study these processes at the cellular and molecular levels and strive to understand how changes in the interactions between proteins or between proteins and nucleic acids are translated into biological differences such as changes in the cell cycle, differences in gene expression, altered immune response or increased resistance to chemotherapeutic agents. These studies touch on all aspects of biomedical sciences, from the mechanisms of disease to the molecular basis of neural cell function to the identification of novel therapeutics for the treatment of cancer, diabetes, genetic diseases or infections.

* Neurosciences : Neuroscience research at UNM-HSC is comprised of laboratory investigations in the fundamental areas of neuroscience, as well as clinical and translational research among the Departments of Neurosciences, Neurology, Psychiatry and Psychology. Molecular genetics, neurophysiology and cell biology approaches are applied to research questions concerning Learning and Memory, Addiction, Brain Injury and Repair, and Psychiatric disorders. In addition, new efforts to coordinate basic and clinical neuroscience research have emerged in association with state-of-the-art functional brain imaging facilities of the MIND (Mental Illness and Neuroscience Discovery) Imaging Center and the BRaIN (Biomedical Research and Integrative Neuroscience) Institute.

* Toxicology & Pharmacology : Toxicology and Pharmacology are two closely related disciplines. Pharmacology focuses on the study of the effects of chemicals (including drugs) on living systems, but primarily the beneficial or therapeutic effects. Toxicology focuses on the study of the adverse effects of chemicals, drugs and other environmental insults on living systems. Many of the faculty working in this area investigate various mechanisms of Molecular and Environmental Disease and are members of the the NIEHS-funded UNM Center for Environmental Health and/or COBRE: Center of Biomedical Research Excellence: Integrative Program in CNS Pathophysiology Research. Research interests of the faculty working in this area utilize exciting multidisciplinary approaches and state-of-the-art molecular, cellular, and physiological techniques to study problems of environmental toxicology, chemical carcinogenesis, signal transduction pathways, radical- mediated cell damage, immunotoxicology, neurotoxicology, metabolism and bioactivation of chemical toxicants, pharmacogenomics and new approaches to drug discovery, drug design and drug delivery.

THIRD YEAR

Phase II is the next year and a half of the curriculum and includes problem-based tutorial learning in both inpatient and ambulatory care settings. Continued reinforcement of basic and clinical science integration and development of basic science learning resources for use on clinical services are additional features of this phase of the curriculum.

Students are introduced to Phase II with the last block in Phase I, the Transition Block. This Block examines cases that are more complex than previously experienced and will prepare students for the transition into the clinical years. Students will be expected to rise to the next level of problem solving through the practice of skills in questioning, generating hypotheses, thinking ahead, and in-depth interpretation and analysis of clinical data. In addition, in preparation for Phase II, there will be presentations that include writing notes, reading a chart, introduction to the hospital laboratories, ordering tests, procedures training, computer system (PowerChart) training, common emergency training, and introduction to rounds. In Phase II, students will spend half of their time in an ambulatory setting where they will confront a mix of patients with and without prior diagnoses and with acute and chronic conditions. An equivalent amount of time will be spent on various inpatient services (pediatrics, family medicine, general surgery, internal medicine, neurology, obstetrics/gynecology, and psychiatry). Here students will continue to work in small group tutorials focusing on problems presented by patients seen on these services.

COURSES :

* Rotation in Anesthesiology : This is a mandatory one-week rotation in anesthesia for third year students. The course is designed to introduce the student to basic concepts in applied pharmacology, pharmacokinetics, IV placement and airway management. These skills are crucial not only for the anesthesiologist but also for physicians in other specialties and family practice.

* OB / GYN :Our residents continue to assume active roles in supervising and teaching medical students and junior residents. The third year residents' curriculum consists of six two-month blocks of the following rotations:
* Labor & Delivery
* Night Float
* Maternal-Fetal Medicine
* Genetics/Pathology
* Lovelace/Sandia Healthcare-gynecology
* Gynecology

* Surgery : This Surgery Rotation program has been designed to help the student understand the goals, objectives, and structure of the clerkship, the evaluation process, and administrative requirements for the rotation. The student curriculum guide outlines the attitudes, skills and knowledge that students need to learn during the clerkship. Students should use this material to help focus their learning efforts. An orientation session for all students will be held during the first week of their surgical rotation.

* Psychiatry : For the resident entering the program at the PGY-2 level, the rotation plan will differ. Since the same basic experiences in psychiatry, including 12 months of inpatient work, are required for all residents, those entering in PGY-2 have only 6 months of individually planned time remaining in the final year of training. Those who have not satisfied the Board requirement for 2 months of neurology will need to use a part of these 6 months for that purpose.

* Neurology : The program has nine residency positions, three in each level of training for adult neurology. In depth training in diagnosis, patient care, and treatment of adult neurological disease is supplemented by rotations in pediatric neurology, electroencephalography (EEG), electromyography (EMG), neuroradiology and psychiatry. Special opportunities are provided for research and/or extended training in epilepsy, multiple sclerosis, dementia, neuro-ophthalmology, neuromuscular disease, and stroke.

* Pediatrics : Housestaff spend one month in each of their first-and third-years in the pediatric emergency department. We have five full-time Pediatric Emergency Medicine boarded faculty who staff the Pediatric ED 12 hours per day (Other hours, patients are cared for in Pediatric Urgent Care or the Main ED. We will have 24-hour dedicated Pediatric ED services when the new hospital opens in April 2007.) We have the only Level 1 trauma center in the state, and residents are involved in everything from stabilization of a child's life threatening injuries, to severe infections, to colds.

* Internal Medicine : Interns in ambulatory care are expected to have the skills to obtain a focused history and physical exam, formulate a problem list, develop appropriate diagnostic and therapeutic plans, and present them succinctly to the attending.

* Family Medicine

FOURTH YEAR

Phase III of the curriculum, lasting approximately 13 months, features more hospital-based clinical experiences in which the student will have progressive responsibility for patient care under house staff and faculty supervision. Students will also be able to select clinical experiences that will assist them in making future specialty decisions. One month will be spent in a community preceptorship. This experience involves a working relationship with a practicing physician who has chosen primary care as his/her life's work, and who can serve as a role model.

* Subinternship in Anesthesiology : Fourth year medical students who are interested in anesthesiology have the opportunity to do a sub-internship with the Department of Anesthesiology. The rotation is one month long and consists of a) didactic discussions about preoperative, intraoperative, and postoperative management, b) an opportunity to function as a member of the anesthesia team on a daily basis, c) sessions in the high fidelity human simulator, and d) participation in all departmental educational conferences.

* Subinternship in Pain Management : Fourth year medical students interested in a career in anesthesiology or pain management may elect to study acute and chronic pain management for a one month rotation under the tutelage of Dr. Robert Zuniga, the rotation director, and his pain fellows. The student is exposed to the whole spectrum of pain management from acute interventional inpatient care to chronic outpatient pain management.

* Diagnostic Radiology : Observe performance of special, interventional, GI, and GU procedures. Attend
clinical film reading sessions.

* Radiation Oncology : Basic introduction to radiation oncology, physics and biology; and involvement in patient care.

* Clinical Dermatology : Emphasis placed on the diagnosis and treatment of the most common skin diseases and on cutaneous manifestations of systemic diseases.

* Emergency Medical Services : Enhance appreciation for the clinical care provided by EMS, including the limitations and challenges of the prehospital and interhospital environments. Understand the education and training of EMTs and paramedics.

* Geriatric Medicine : Student participates in a multidisciplinary approach to comprehensive geriatric assessment with a team of health care professionals (physicians, nurse practitioners, social workers, pharmacists, psychologists, etc.) Team members together evaluate and manage multiple complex medical, functional, psychosocial and care giver problems faced by the rapidly expanding population of frail, elderly patients.

* Medicine Intensive Care : Introduction to intensive care medicine; experiences offered in pulmonary, cardiology, gastrointestinal, infectious disease and multiple organ dysfunction. A concentrated experience and acquisition of invasive skills achieved under close supervision.

* Subinternship in Cardiology : Provide students with increased experience in Cardiology and Internal Medicine, providing an increasing degree of responsibility for patient care.

* Neurosurgery : To learn the neurological exam, management of head and spinal cord injuries, management of low back pain, and interpretation of neuro-imaging studies.

* Gynecologic Oncology : This rotation will provide its student the unique opportunity of comprehensive care for the Gynecologic Cancer patient. This student will actively participate in techniques of diagnosis and cancer treatment, including surgical management, radiation therapy, chemo therapy and palliative care. In addition, the student will learn techniques in delivering bad news and end of life transitioning. Also, risk assessment and cancer prevention strategies will be taught.

* General Orthopaedic Surgery : To participate as an active member of the surgical team, delivering care to patients with musculoskeletal problems, especially trauma.

* Clinical Pathology Clerkship : To expose the student to laboratory diagnosis of disease on an intense level. The student may rotate through different sections of the pathology laboratory in blocks specifically tailored to individual career goals.

* Subinternship in Pediatrics : Direct responsibility for diagnosis and treatment of hospitalized pediatric patients (under supervision of residents and faculty attending physicians).

* Subinternship in Surgery : Expose student to surgery in an applied, direct patient care setting at the responsibility level of a surgery intern.

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