University of Virginia (School of Medicine)

The University of Virginia School of Medicine has a long tradition of excellence in a highly collaborative atmosphere within the School, the Health System, across the grounds, and throughout the Commonwealth and beyond. We at the UVa School of Medicine are serving as a national model for excellence through innovation and collaboration.

We find innovative ways to improve health by building on the firmest of foundations: the pyramid of education, research, patient care, and service to the community.
The structure is so strong because each part of the pyramid contributes to the other: we teach students in the health professions at all levels, including our colleagues, and at the same time learn from all of them, making patient care better.

We advance knowledge through research at the fundamental level and translate that research for the benefit of our patients. We treat each of our patients with compassion and respect, and we not only make the community healthier, we also serve as volunteers and advisers to the Commonwealth and the nation.

We are creating models in a number of areas such as translational research, superior patient service access and care, distributed networks serving patients at a distance, use of electronic data for the most effective and efficient care, optimal education based upon what the learner needs to know and how best to teach, as well as models for policy.In the words of Thomas Jefferson about the University he founded: "A blessing to my state, and not unuseful to some others."

Research forms the foundation for all medicine whether developing new treatments and cures for patients or teaching the latest and best approaches to aspiring physicians. At UVa, we tackle research using a collaborative approach built around multidisciplinary teams of basic and clinical scientists who organize their efforts around a disease- or organ-based framework.

This approach builds upon the strength of our basic science departments, three of which rank among the top 15 in the nation in National Institutes of Health (NIH) funding. Discoveries being made in these laboratories fuel an expansive translational research effort aimed at bridging the gap between bench and bedside and translating promising laboratory findings rapidly into clinical applications for patients. The success of these efforts so far has been unprecedented. In the last five years, NIH support for medical research at the School of Medicine grew by 76 percent.

When students come to UVa to study medicine, they learn in a vital and progressive academic community. Our faculty rank among the top in the nation, lead professional medical societies, and participate in forums that inform the national agenda. Likewise, our students are eager and gifted, with a variety of backgrounds and strengths. The result is a medical school that ranks among the best in the nation. Each year, we continue to develop our curriculum, offer new opportunities to our students, and expand our understanding of both the science and the art of medicine.

How do we best prepare medical students to enter the world of health care? Medicine today is far too complicated and requires far too many diverse skills for a medical school to be able to teach its students everything. Instead, the measure of a good medical education is one that presents the topics most pertinent to 21st century medical practice, blends clinical experience and basic science, demands mastery of new information technologies, and provides students with skills to become independent, lifelong learners. Using these new dictates, we asked not only what students should be taught, but also how they should be taught. Ultimately, we opted for a teaching mix that balances large lecture classes with smaller, problem-based courses. We also increased the use of information technologies in teaching to familiarize students with these tools.

n 2000, UVa first-year students traded in some of their lecture time to begin learning to work with patients. The students see "standardized patients," individuals who have been trained to mimic symptoms that are characteristic of certain illnesses. Students first learn to take medical histories on these "patients," and later practice physical exams. The idea is to make students more comfortable with, and attentive to, patients. The standardized patients are trained to give feedback by noting things students did that put them at ease or that made them uncomfortable. Students are also expected to learn more when the material presented in their textbooks is linked to the actual practice of medicine.

"Faculty members were worried that the students weren't making the connections they could be making," says Donald Innes, M.D., Associate Dean for Curriculum. So now, when they see a standardized patient who complains of symptoms such as numbness in his feet and frequent urination, students fit the two clues together and link to the pathophysiology of a disorder, in this case diabetes. At the same time they learn to consider the social impact of the disease on the patient.

Curriculum changes for first-years also include the introduction of Practice of Medicine, a first-year course that combines lecture and small-group sessions. Students are taught fundamental knowledge, attitudes, and skills in an environment that stresses one-to-one interaction with medical faculty. First-year basic science courses have also been reorganized so that concepts presented (such as how to dissect a shoulder) parallel the concepts presented in Practice of Medicine (such as how to examine a shoulder).

While no one can teach future physicians everything they will ever need to know, we can teach them where to go for the information they will need. At UVa, our Health Sciences Library provides state-of-the-art information technology for faculty and students alike. Faculty frequently use these resources in their teaching and make assignments that require students to master the use of medical databases.

This emphasis on information mastery by students and faculty is also supported by UVa's Department of Health Evaluation Sciences. The department was the first of its kind among American medical schools to use clinical epidemiology, biostatistics, and informatics to link diagnosis and treatment to clinical outcomes. Findings made through this department are critical to how physicians (and students) relate to clinical challenges.

Curriculum changes continue to be felt across the School of Medicine. Faculty have been surprised by some of the various spinoff benefits. By working in small groups, for example, students are learning to put aside individual goals and work together for the patient. Likewise, students appear to retain more of the basic science they are taught in the context of relevant clinical applications.

For the School of Medicine, the new curriculum changes are just the beginning. Possibilities for the future include an elective "exploratory" program in the first and second years, more simulated learning opportunities, and joint projects with the University of Virginia's School of Nursing and School of Law. The only thing for certain is that the school will constantly be seeking out the best methods to prepare students and faculty for what promises to be a future full of change.

Few doubt the importance of new scientific discovery to the future practice of medicine. As we learn more about the intricate cellular workings of the human body, we stand to develop increasingly sophisticated ways to treat disease. At UVa, a select group of students trains to develop the full potential of this revolution. They are part of the Medical Student Training Program (MSTP), a six- to seven-year curriculum that combines a medical and scientific doctoral degree (M.D./Ph.D.). Supported by a NIH Medical Scientist Training Grant, the program trains physician-scientists to become leaders in discovering the foundation of human disease and in developing innovative new treatments.

Admission to the program, one of only 39 of its kind in the nation, is highly competitive and attracts students from across the country. Each year, some 150 students compete for the six or so program slots available. Once admitted, students receive highly individualized instruction with tailored assignments and a faculty mentor, while simultaneously completing coursework for their medical and doctoral degrees. They also establish active research programs and, upon completion of the program, pursue additional residency and research training before assuming positions in academic medicine.

Ultimately, every discovery we make, every student we teach, and each step we take in the School of Medicine has the same goal providing better care for patients. With our full cadre of physicians, scientists, and teachers, we offer exceptional patient care informed by up-to-the-minute research. We are innovators in offering new treatments to our patients, bringing research to bear on care, harnessing new technologies to reach out to underserved populations, and restructuring our clinics to meet our patients needs. Such diligence has made the UVa Medical Center a leader ranked among the top 100 hospitals in the nation for the 7th year in a row. In 2005, 7 of our medical specialties ranked among the nation's top 50. The "Best Doctors in America" list includes 125 UVA physicians, 51 of our physicians are listed in the 2005 edition of "America's Top Doctors," and 15 UVA doctors are listed in a new volume published in 2005, "America's Top Doctors for Cancer." Never content with yesterday's advances, we strive daily to find new and better ways to transform research into care.

Student activities at the School of Medicine are centered around the Mulholland Society Mulholland Society--the student government organization that includes all medical students and which promotes the interests and concerns of the student body. The Mulholland Society also educates and informs students of national and regional events in the medical field and serves as an outlet for the academic, social, and athletic interests of medical students. Members of the Mulholland Society are elected to represent the School of Medicine on University-wide committees such as the Honor and Judiciary Committees and the Student Council.

The School also encourages students to participate in community activities such as Service, Humanity, Action, Responsibility, Education (SHARE), which initiates projects involving AIDS, and drug abuse education as well as other service-oriented activities.

Medical students form two singing groups called the Spinal Chords and the Arrhythmics, which perform for patients and charitable organizations. In addition, the Student American Medical Association, the Student National Medical Association, and the American Medical Women's Association are actively represented in the School of Medicine. Students may also become involved in the Family Practice Club, the Internal Medicine Club, the Pediatrics Club, the Surgery Club, or they may participate in the Mulholland Society's social committee, which is responsible for several social events throughout the year. In addition, School of Medicine students have access to all University facilities and athletic events.

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School of Medicine Medical School Location

School of Medicine Courses

FIRST YEAR : FOUNDATIONS

In the first year, students develop an understanding of normal human biology and its relationship to the practice of medicine. Instruction in physiology, histology, genetics, biochemistry, anatomy, and neuroscience present the scientific core of the physician's knowledge base. At the same time, the students' advancing scientific knowledge is integrated with clinical applications in the Practice of Medicine-1 course. The course is taught in small groups of six students with two faculty members. Students interview patients in hospitals and in other health care settings and learn to take patients' histories and conduct physical examinations.
During the first or second semester, students are placed for 30 hours of service learning with a community organization as part of the Social Issues in Medicine course. Students learn about the social, economic and cultural context of the practice of medicine and identify and understand the interrelationships between the socio-cultural environment and the occurrence, prevention and treatment of disease. Students also identify and begin to nurture the values that characterize a humanistic practice of medicine and an ethic of service.
First year students are also involved in the Patient Clinician Encounter Program where they work individually with clinicians and patients in clinics and the hospital.
In the new Cells to Society Curriculum, the Foundations Program ends in April, and there is a May Term which begins the Core Systems Program. After the May Term there is a summer break. Many students participate in a research project during the summer period.

COURSES :

* Cells to Society
* Practice of Medicine I
* Anatomy
* Cell and Tissue Structure / Physiology
* Biochemistry
* Medical & Molecular Genetics
* Neuroscience
* Human Behavior
* Clinical Preceptorship
* Social Issues In Medicine

SECOND YEAR : CORE SYSTEMS

The coordinating theme of the Core Systems Program is provided by the problem-based course, Practice of Medicine-2. This course consists of clinical case studies which students solve in weekly small group tutorials of six students led by physicians. During the year, students also work on a one-to-one basis with physicians to develop their skills in taking medical histories and conducting physical exams. Other courses such as pathology and pharmacology are coordinated with the Practice of Medicine-2 to emphasize the clinical correlations between medical science and medical practice. The organization of this course is by organ systems, i.e., pulmonary, gastrointestinal, cardiovascular, renal, neurological, infectious disease, endocrinology.

COURSES

* Practice of Medicine II
* Pharmacology
* Pathology
* Microbiology
* Intro to Psychiatric Medicine
* Clinical Epidemiology

THIRD YEAR : CORE CLERKSHIPS

The third year is devoted to clinical training. Students take 40 weeks of core clerkships in medicine, ambulatory internal medicine, surgery, pediatrics, family medicine, psychiatry, neurology, and obstetrics and gynecology. There is extensive direct contact with patients, and students work with a well-balanced patient population, which includes primary, secondary, and tertiary care. Teaching is related to the patient on rounds and in small tutorial seminars, lectures and group discussions. Emphasis is given to the principles of prevention, diagnosis, treatment, and the continuing integration of clinical medicine with medical sciences and the psychological factors which influence health.
Students work in small groups and rotate among many clinical services, gaining practical experience under supervision in the wards and outpatient clinics of the University of Virginia hospital, the Roanoke Memorial Hospital, the Veterans Administration Medical Center in Salem, Virginia, Western States Hospital, and Fairfax Hospital in Northern Virginia. The teaching programs at the affiliated hospitals allow students to observe the practice of medicine in multiple settings and gain exposure to a somewhat different spectrum of illnesses than that seen at the University of Virginia
Two months of clerkships are devoted to ambulatory and family medicine and students work individually in physicians offices in medical practices throughout Virginia. In addition, students return to the university during their clerkship month to participate in workshops taught by UVA faculty such as Information Mastery, Motivational Interviewing, Point-of-care Clinical Problem-Solving and EKG reading.

COURSES :

* Internal Medicine
* Ambulatory Internal Medicine
* Surgery
* Pediatrics
* Family Medicine
* Psychiatry
* Obstetrics/Gynecology
* Neurology

FOURTH YEAR : SELECTIVES AND ELECTIVES

The selectives and electives program in the fourth year allows students to pursue their own interests. Under the guidance of a faculty advisor, students choose clinical rotations, basic science and humanities courses, and research activities. Clinical rotations are available at sites in Salem, Roanoke, Lynchburg, Fairfax, and Charlottesville. Programs are tailored to meet individual interests and needs, including a selection of programs in other domestic and foreign settings, in appropriate community medicine programs, or in other activities of suitable educational merit.
In the new Cells to Society Curriculum, there is additional time for students to explore career opportunities to help them decide on specialties and residencies. Two courses, Basic Science for Careers and U.S. Health Care System are provided in the Selective and Electives program and are required for all 4th year students.

COURSES :

* Selectives in Subspecialties:
- Internal Medicine
- Surgery
- Psychiatry
- Obstetrics/Gynecology
* Advanced Clinical Elective (ACE)
* Electives
* U.S. Healthcare System
* Basic Science for Careers

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