University of Tennessee (College of Medicine)

The University of Tennessee College of Medicine traces its origin to 1851 as the Medical Department of the University of Nashville. In 1909, the Medical Department of the University of Tennessee and the Medical Department of the University of Nashville were consolidated as The University of Tennessee Department of Medicine. The Department continued in the Nashville location for two years. In 1911, The University of Tennessee Department of Medicine moved to Memphis and merged with the College of Physicians and Surgeons, founded in 1906, and with the Memphis Hospital Medical College, founded in 1876, to become The University of Tennessee College of Medicine. Later that same year, the name of the campus was changed to The University of Tennessee Medical Units, and the Colleges of Medicine, Pharmacy, and Dentistry were established. In the early 1970’s, the College moved toward a statewide system of medical education with the development of clinical education centers external to the Memphis campus. Since the opening of the Clinical Education Center in Knoxville in 1973, additional centers have been established in Chattanooga, Jackson, and Nashville. These centers have enabled the College to provide quality health care, education, and research throughout the State of Tennessee. The designation of the campus as The University of Tennessee, Memphis -The Health Science Center was adopted in 1985 by The University of Tennessee Board of Trustees and was changed to The University of Tennessee Health Science Center in 1999. The College has an enrollment of 150 students per class currently.

The University of Tennessee College of Medicine is part of the University of Tennessee Health Science Center (UTHSC). The College of Medicine offers programs leading to the Doctor of Medicine (M.D.) degree. The College of Medicine also participates in the Doctor of Medicine (M.D.)/Doctor of Philosophy (Ph.D.) combined degree program. Three fully integrated campuses (Memphis, Knoxville, and Chattanooga) constitute the University of Tennessee College of Medicine. There are twenty-three departments on our Memphis Campus, nine departments on our Knoxville campus, and ten departments on our Chattanooga campus. Medical Students from the College of Medicine rotate on all three Campuses as well as other training areas throughout the State. Postgraduate Medical Education Programs and active research programs are present on all three College of Medicine Campuses.

The College of Medicine is a member of the Association of American Medical Colleges (AAMC) and is accredited by the Liaison Committee on Medical Education (LCME), which represents the Council on Medical Education of the American Medical Association and the Association of American Medical Colleges.

The College has well over 11,000 alumni and we continue to provide excellent medical training in one of the nation's largest medical centers. The College combines an outstanding educational experience and top quality research with an exciting and comprehensive exposure to health care delivery. At the UT College of Medicine, we are providing our students with the tools to cope with issues of the 21st century. Our commitment is to continue the strong tradition of the College which has prepared outstanding clinicians, investigators, educators, and physician managers. The enthusiasm and dedication of our faculty, administration, staff and students allows us to do this in a supportive environment.

The University of Tennessee Health Science Center College of Medicine actively encourages applicants from members of minority groups underrepresented in medicine. The Committee on Admissions evaluates nonacademic, as well as, academic factors in the selection process, with consideration being given to the unique backgrounds and challenges of these applicants. Among American medical schools, The University of Tennessee Health Science Center College of Medicine is a national leader in the admission, matriculation and graduation of these students from groups underrepresented in medicine.

Graduates of the University of Tennessee College of Medicine complete a medical education program sufficiently broad to prepare them for entry into a variety of advanced, differentiated physician training programs. To enable graduates to attain this long-term objective, the medical education program facilitates the development of the requisite knowledge, skills, attitudes and beliefs, and graduating students will be expected to demonstrate competency.

The mission of the faculty is to prepare students for the comprehensive practice of medicine. The Committee on Admissions and the College of Medicine, in accordance with Section 504 of the 1973 Vocational Rehabilitation Act and the Americans with Disabilities Act (ADA) {Public Law 101 -3367}, has established the aforementioned essential functions of medical students and physicians. The Committee on Admissions will consider applicants for admission who demonstrate the ability to perform or to learn to perform the essential skills listed in this document. The College must ensure that patients are not placed in jeopardy by students or physicians with substantially impaired intellectual, physical, or emotional functions. Students will be judged not only on their scholastic accomplishments, but also on their physical and emotional capacities to meet the full requirements of the school’s curriculum and to graduate as skilled and effective practitioners of medicine.

The Research Program offers opportunities for medical students who have a serious interest in biomedical investigation to conduct research projects under the supervision of research faculty. A grant from the National Institutes of Health provides 24 fellowships per year including stipends for a maximum appointment of three months. Fellowship grants are available on a competitive basis to all College of Medicine students in good academic standing. A number of other research training programs are available in the Clinical Research Center, the University of Tennessee College of Medicine, St. Jude Children’s Research Center, the Graduate School of Medicine at the University of Tennessee Medical Center, Knoxville, and through various private foundations. For further information on research training opportunities, please contact the Office of the Associate Dean for Research.

The M.D./Ph.D. Program provides highly motivated and unusually qualified students with an integrated clinical and basic biomedical training program leading to both an

M.D. and Ph.D. degree. The program’s goal is to prepare graduates with the skills needed to function independently in both clinical and basic research environments. The first and last two-year periods of the program contain the medical curriculum. The intervening two or three years are devoted to graduate study in a selected program of the College of Graduate Health Sciences. Students must be accepted to the College of Medicine to be considered for admission to the M.D./Ph.D. Program.

A number of activities with clinical, educational or research components require active collaboration of a variety of disciplines. In order to facilitate development of programs with multi-department and multi-college participation, several programs have been designated as interdisciplinary programs. Interdisciplinary programs imply more than close cooperation on campus; they also involve coordination of all private and public efforts in a particular field. Thus, interdisciplinary programs fit the description of being organized scientific activities “without walls.”

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College of Medicine Medical School Location

College of Medicine Courses

FIRST YEAR

The biomedical sciences portion of the curriculum is approximately 72 weeks in duration. The first year curriculum runs from August through March and is devoted to the courses of Prevention, Community and Culture; Doctoring: Recognizing Signs and Symptoms; Gross Anatomy; Molecular Basis of Disease; and Physiology.

COURSES :

* Doctoring: Recognizing Signs and Symptoms : This introductory course in the art and science of patient care is presented in five block-weeks throughout the fall and spring semesters. DRS is a hands-on course that introduces skills such as patient communication, medical history-taking, physical examination, case presentation, and chart documentation. Also presented are basic skills in recognition and interpretation of signs and symptoms of health and disease. Learning activities include interactive small group sessions with upper class students and clinical faculty, and a community preceptor experience with a practicing physician in the Memphis area. Assessment of clinical skills is by participation in learning activities, written assignments modeling patient charting, and ratings on observed standardized patient encounters at the end of the spring semester.

* Prevention, Community, and Culture : This curriculum introduces patient care through cases structured along a preventive medicine theme. The course also includes human behavior issues, ethics, professionalism, alternative and complementary medicine, nutrition, and epidemiology. The case discussions occur in small groups facilitated by clinicians and require self-directed learning, synthesis of information, and presentation skills. In addition, a community (service learning) project is required in which the student will learn the challenges of community organizations in providing services for clients. The course is taught in five week-long blocks spanning the first year.

* Human Gross Anatomy : A study of the gross anatomical structure of the human body by means of complete dissection supplemented by lectures and the study of cross sections. Human embryology is included in the program.

* Molecular Basis of Disease : MBOD is an integrated course covering the principles of biochemistry, cell biology, genetics, and molecular biology, with an emphasis on clinical applications. The course focuses on the basic interdisciplinary concepts underlying modern biomedical science. The principles of medical genetics are woven throughout the course giving the student a basic and practical fund of knowledge that can be used in the clinical clerkships. The course is a blend of lectures, clinical correlations (some involving patients), small group problem-solving sessions, and large group conferences.

* Medical Physiology : Integrated histology and general organology with the functioning of the human body is considered, ranging from cellular to higher organ-system levels. Lectures are supplemented with weekly or biweekly conference meetings of small groups of students with individual faculty for demonstrations, special clinical correlations, and problem-solving exercises.

* Medical Microbiology : A course that presents the concepts of immunology and immunity, the basic aspects of microbial morphology, growth metabolism and genetics, the actions of anti-microbial agents, and the role of microorganisms in infectious diseases. Laboratory experiences complement and expand the didactic material. Grades are assigned in the spring semester of the second year.

* Neurosciences : This is a lecture/laboratory course dealing with the anatomy and function of the central nervous system (CNS). The course includes the anatomy of the brain and spinal cord, location of nuclei and their interconnections, and the origin and termination of major fiber pathways in the CNS. Localizing neurology, disorders of cognitive function and the major classes of neurologic disease are discussed. Problem-solving sessions related to clinical application are emphasized. The course allows the student to achieve an understanding of a clinical approach to neurologic disease.

* Pathology : The course develops the principles of the discipline of pathology. Normal organologyand integrated histology are part of the course which presents disease by organ systems. The methods of instruction include lecture, laboratory experiences, demonstrations, and group discussions. Grades are assigned in the spring semester of the second year.

* Medical Pharmacology : The medical student is introduced to the pharmacologic concepts of the action of drugs and other xenobiotics. The classification, mechanisms of action, and toxic effects of pharmacologic agents are stressed. Discussion of representative examples of major drug classes are emphasized, and treatment modalities, whenever appropriate, are presented. This basic course uses lectures, clinical correlative discussions, and independent study to assist the student in understanding pharmacologic therapy in the clinical phase of his/her medical education. Grades are assigned in the spring semester of the second year.

SECOND YEAR

Although some concepts in the courses of Microbiology, Neurosciences, Pathology, and Pharmacology are presented in the months of April and May, the sophomore year begins in August and includes these courses and Pathophysiology. Students also participate in a series of Clinical Pathology Conferences (CPC), which are integrated small group case discussions focusing around related content from Pathology, Pathophysiology and Pharmacology. PCC and DRS continue in the second year in five week-long blocks.

COURSES :

* Pathophysiology : Based on the concept that pathophysiology is the study of alterations in or derangements of normal bodily function that rseult from disease processes, this multidisciplinary course is designed to bridge the gap between the basic sciences and the clinical disciplines. The main goal is to correlate the anatomic, biochemical, physiologic, and pathologic mechanisms that underlie commonly encountered clinical problems. The course is particularly important in creating an awareness in the medical student that basic science is highly relevant to clinical medicine, and that knowledge of the underlying pathophysiology of a disease process facilitates the understanding of its etiology, clinical presentations, and therapeutic alternatives. In addition to traditional lectures, emphasis is placed on non-lecture formats, such as laboratory sessions, small group integrative seminars, and related clinical correlation conferences. Grades are assigned in the spring semester of the second year.

* Doctoring: Recognizing Signs and Symptoms : Continuation of the course in the art and science of patient care presented in five week-long blocks throughout the fall and spring semesters.

* Prevention, Community, and Culture : This course continues the discussion of patient care through case discussions in small groups requiring self-directed learning, synthesis of information, and presentation skills. Community projects continue through the second year.
The Biomedical Science component of the curriculum is completed in March. Students then sit for the USMLE Step 1 Exam prior to beginning clerkships at the end of April.

THIRD YEAR

Students proceed directly into the Third Year Clinical Clerkships upon 1) successful completion of the Biomedical Sciences, and 2) obtaining a passing score on the United States Medical Licensing Examination (USMLE), Step 1. Occasionally, students may elect to delay entry into the clerkship program in order to pursue graduate studies.

Students begin the third year with a week-long DRS/PCC block which focuses on providing clinical skills essential to success in the clerkships. During the clerkships, students focus their attention and efforts on patient problem-solving and experience an increasing level of responsibility throughout the rotations. Student workload in the third year is controlled by the director of each clerkship. The total amount of time allotted for third-year clerkships is 48 weeks, which is taken over a 64-week period. After completion of a minimum of three core clerkships, students may choose one or more electives to enhance their skills and understanding in a specific discipline before completing all seven required clerkships.

These clerkships provide a breadth of clinical experiences in the major care areas. Students become an integral part of the health-care team in an academic setting involving both house staff and faculty as well as ancillary services of the teaching hospitals. Programs are available in facilities in Memphis, Knoxville, Chattanooga and Nashville.

COURSES :

* Prevention, Community, and Culture : The M3 DRS/PCC course consists of a week of "Preparing for Clerkships" and periodic workshops. The content of the introductory week includes charting skills, ECG and radiology workshops, "what to do in a code," suturing and knot tying sessions, venipuncture, and TB mask fitting. Clinical reasoning and differential diagnosis of common complaints, such as abdominal pain and headache, are reviewed. Workshops include interdisciplinary topics such as HIV/AIDS, hospital nutrition, end-of-life care, smoking cessation, complementary and alternative medicine, and medical disabilities.

* Core Clerkship in Family Medicine : The Family Medicine Clerkship is an eight-week clinical experience during which students participate in a unique breadth of patient care in the context of family and community.
Students experience traditional office-based practice under the supervision of a community-based family physician preceptor. With the office practice as a base, the family physician serves all aspects of patient care involving both inpatient and outpatient settings, ranging from the hospital to the nursing home. Students are placed with family physicians who practice the full breadth of the discipline, including obstetrical care, whenever feasible.
The department maintains a wide array of approved clinical training sites throughout the state of Tennessee and works closely with students to identify mutually agreeable clinical assignments. Student hardships will be considered in making the final assignment.
The clerkship is a full-time learning experience, typically mirroring the family physician preceptor and including both weekend responsibilities and night call. Students have several written assignments to complete as well as assigned readings during the eight weeks. This clerkship is also offered in Knoxville (FME2–3001/F) and Chattanooga (FME3-3001/F).

* Core Clerkship in Medicine : The clinical clerkship in medicine is designed to provide the medical student with an opportunity to learn by experience in patient care and by the examples set by the faculty and house staff. The student is a participating member of the clinical team responsible for patient care which includes residents and the attending physician. A student is expected to: 1) acquire skill and efficiency in history taking and physical examinations, in technical procedures, in the assembly and interpretation of laboratory data, and in patient diagnosis and management; 2) apply to clinical problems the knowledge and facts acquired in the biomedical sciences; and 3) read current medical journals as well as textbooks. Each student is assigned to the University Medical Services at the Veterans Affairs Medical Center, the Regional Medical Center or Methodist University Hospital for the eight-week rotation. At the mid-point of the clerkship, each student will switch from one hospital assignment to another. Alternatively, students may rotate through Baptist Hospital in Nashville for four weeks of their rotation (Nashville MED4-3001/F). This clerkship also is offered in Knoxville (MED2-3001/F) and Chattanooga (MED3-3001/F).

* Core Clerkship in Neurology : This four-week experience is offered in an eight-week rotation in concert with the Psychiatry Clerkship. The clinical sites for the clerkship are at Baptist Memorial Hospital, Methodist University Hospital, and the Veterans Affairs Medical Center. The major emphasis is on developing skills in neurological history taking and in the performance and interpretation of the neurologic examination. The clinical correlations of neurostructure and function taught in Neurosciences are expanded upon in the clinical setting. An exposure to the various categories of neurologic disorders and their pathophysiology is provided. The diagnostic approach to the patient stresses both anatomic and etiologic considerations. Neurology is a focal point for the dynamic advances in our understanding of the pathogenesis of disease and related new therapies. Currently, this clerkship is offered only in Memphis.

* Core Clerkship in Obstetrics and Gynecology : This required eight-week clerkship is designed to familiarize the student with female pelvic anatomy and the normal menstrual cycle. In addition, obstetric and gynecologic history taking and pelvic examination are taught, along with the normal physiology of pregnancy and care of the normal pregnant woman through the antepartum, intrapartum, and postpartum course. Basic complications of pregnancy are covered, as well as specific diseases as related to pregnancy outcome. The gynecologic portion of the clerkship focuses on basic diseases which occur in the female pelvis, including infection, endometriosis, and cancer. This clerkship also is offered in Knoxville (OBG2-3001/F) and Chattanooga (OBG3-3001/F).

* Core Clerkship in Pediatrics : Four weeks of this eight-week required clerkship experience are in an ambulatory setting that includes: general outpatient care, subspecialty clinic experience and primary care in a private office setting. The other four weeks are spent on inpatient service, providing direct "hands-on" patient management. An eight-week lecture series covers the most relevant topics in pediatric care. Regular rounds with faculty and house staff provide opportunities for interaction with all members of the health care team in managing the pediatric patient. This clerkship also is offered in Chattanooga (PED3-3001/F).

* Core Clerkship in Psychiatry : This four-week clerkship is offered in an eight-week block in concert with the Neurology Clerkship. Students are assigned to a general inpatient service as their home base, gaining familiarity with diagnosis and treatment of severely disturbed patients. Additional time is organized around psychiatric services in a general medical setting (Consultation-Liaison or Emergency Room at the Regional Medical Center) or the Alcohol and Drug Rehabilitation Services at the Veterans Affairs Medical Center. Lectures, readings, case conferences, and outpatient clinic assignments round out the experience. The student is expected to gain a basic knowledge of psychiatric diagnosis, applied psychopharmacology, and non-pharmacologic treatment options. Emphasis is on information useful to students regardless of their future specialty choice. Currently, this clerkship is offered only in Memphis.

* Core Clerkship in Surgery : This eight-week clerkship encompasses general, vascular, and trauma surgery. The objective of this clerkship is to familiarize the student with the basic pathophysiologic, diagnostic and therapeutic modalities involved in the art and science of surgery. The fundamentals taught in this rotation will be of benefit to individuals even if they do not choose a field of surgery as a career. The clinical rotations are four weeks each in two different facilities. These facilities include the Veterans Affairs Medical Center, the Regional Medical Center, Baptist East, St. Francis, and the Methodist University Hospital. In addition to this clinical involvement, each student is involved in small group conferences and an afternoon didactic lecture series delivered by members of the faculty. The student also participates in a skills laboratory, videotape presentations, grand round sessions, and generous outpatient experiences. This clerkship also is offered in Knoxville (SUR2-3001/F) and Chattanooga (SUR3-3001/F).

FOURTH YEAR

The fourth year is composed of six 4-week clerkships, one week of DRS/PCC, and four 4-week electives. These clerkships allow for increased responsibility in patient care as well as the opportunity to pursue areas of individual interest. The electives provide students with the opportunity to select the clinical or basic science experiences to best meet their particular career goals.

COURSES :

* Senior Clerkship in Medicine : The Senior Clerkship in Medicine places the student in a more direct role in patient care similar to an internship, but closely supervised and directed. The senior clerkship student will record the principal database (with resident or faculty review and counter signature), develop an evaluation and treatment plan, and write orders on patients (to be reviewed, altered if necessary, and signed by the resident or faculty prior to implementation). The student is introduced to responsibility for inpatient care in a setting in which the student is the initial evaluator of the patient's problems as outlined in the general instructions. The student develops conceptual and manual skills for evaluation and care of internal medicine patients and becomes more familiar in dealing directly with hospital and other paramedical personnel with an appreciation for the team approach to patient care. The student participates in two-hour rounds at least four days per week with the attending physician assigned to the service and consults daily with the resident house staff on each assigned patient. This clerkship also is offered in Knoxville (MED2-3002/F), Chattanooga (MED3-3002/F), and Nashville (MED4-3002/F).

* Ambulatory Care : The objectives of the ambulatory clerkship are to provide: 1) an in-depth orientation to the evaluation, management and long-term clinical course of common medical problems which are handled by internists; 2) guidelines for recognizing common clinical problems which may be cared for in an ambulatory setting versus those which require hospitalization and/or referral for specialty or subspecialty care; 3) instruction in the unique principles of successfully providing medical care in the ambulatory setting; and, 4) instruction in health maintenance, disease prevention, and relevant clinical epidemiology.
The student will work in a variety of clinical areas including general medicine clinics at the Regional Medical Center and Veterans Affairs Medical Center . There are also opportunities to participate in the Adult Special Care Clinic, Sickle Cell Clinic, Hypertension Clinic, and many of the subspecialty clinics such as Cardiology and Endocrinology. The student may spend some time with an internist in private practice. This clerkship also is offered in Knoxville (MED2-3003/F), and Chattanooga (MED3-3003/F).

* Surgery Specialties : This clerkship exposes the student to the Surgery Specialties of Orthopaedics, Ophthalmology, Otolaryngology and Urology. The clerkship is available in Knoxville (SUR2-3002F), and it is anticipated that the clerkship will be available in Chattanooga in 2005.

* Patient Safety, Quality Improvement Clerkship : Students will strengthen their concern for the patient’s need to receive quality health care in a safe environment, develop strategies and tools to identify medical errors in patient care and weaknesses in the health care system, and apply those methods to address medical errors and system errors in the health care delivery system. Most students will elect to participate in a structured, longitudinal curriculum while performing stepwise work on a Patient Safety/Quality Improvement Project (PS/QI Project) under the tutelage of a quality improvement coach. Those students who do not participate in a longitudinal PS/QI Project and complete a project report will be required to participate in a 4-week block curriculum in February/March (Block 03) of their senior year. The clerkship is graded Pass/Fail.

* Specialty Clerkship : This clerkship is offered in each block throughout the calendar year. Students will have a week each in Anesthesiology, Radiology, ICU and Palliative Care during the four-week clerkship. The clerkship will be graded “Pass/Fail.” This clerkship is available in Knoxville (SPE2-3002/F) and Chattanooga (SPE3-3002/F).

* Electives : Sixteen weeks of two-week (half-time) or four-week (full-time) elective work are required and normally taken during the senior year. Both basic science and clinical electives of varying lengths are offered in a variety of settings with maximal learning opportunities. During this time, each student has the opportunity to: 1) select experiences that meet individual career goals, 2) study in depth in a clinical or basic science area, and 3) have increased responsibility in patient care under the direct supervision of the faculty. Electives are offered by the University of Tennessee, UT-affiliated hospitals, and (with approval) at other accredited medical schools.

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