Wake Forest University (School of Medicine)

Wake Forest University Baptist Medical Center, one of the nation's preeminent academic medical centers, is an integrated health care system that operates 1,298 acute care, rehabilitation and long-term care beds, outpatient services, and community health and information centers.

The Medical Center has 20 subsidiary or affiliate hospitals and conducts 87 satellite clinics throughout the region. It provides a continuum of care that includes primary care centers, outpatient rehabilitation, dialysis centers, home health care, and long-term nursing centers.

Although its primary service area is a 26-county region in northwestern North Carolina and southwest Virginia, the Medical Center in the past year has served patients from 91 North Carolina counties, 39 additional states and several foreign countries.

The Medical Center's component institutions carry out a joint mission of patient care, education, research and community service. The partnership includes three major members: Wake Forest University Health Sciences, North Carolina Baptist Hospital, and Wake Forest University Physicians.

The medical school is the centerpiece of Wake Forest University Health Sciences. We are a $100-million research community, with much of our funding coming from the National Institutes of Health. We maintain nationally recognized research centers in cancer, drug abuse, human genomics, hypertension and vascular disease, investigative neuroscience, stroke, ultrasound, women’s health, and many other disciplines including our newest, the Maya Angelou Research Center on Minority Health. Our joint venture with Virginia Tech to open a School of Biomedical Engineering and Sciences, and the dramatic expansion of our urban research park are two major initiatives that will carry us into the future.

The School of Medicine recently celebrated its centennial, and for 62 of our 100 years we have been affiliated with North Carolina Baptist Hospital. Today, the school and the hospital together make up the Wake Forest University Baptist Medical Center, an 830-bed tertiary-care center with a Level I Trauma Center, the Brenner Children’s Hospital, the J. Paul Sticht Center on Aging, and the Comprehensive Outpatient Rehabilitation Center.

This stimulating environment provides an ideal situation for the study of medicine, anchored by what we believe is the best medical curriculum available anywhere. Our curriculum has earned national accolades as a model for medical education reform. This problem-based program makes excellent use of personalized, small-group learning, while emphasizing high-technology resources that have placed us among America’s “most-wired” campuses.

Our medical school carefully selects applicants who demonstrate the intellectual ability, personal attributes, and motivation to be successful—in medical school, in postgraduate training, and throughout their professional careers. We also recognize and appreciate a genuine desire on the part of our students to improve the lives of others by preventing, treating, and when possible, curing disease. Our students enjoy an atmosphere of camaraderie and collegiality with each other and with our highly qualified faculty and administrators, who provide a superb education as well as personal support. Beyond the academic experiences offered at our medical school, we encourage the development of our students as caring physicians dedicated to providing the very best care, professionally and personally, to all patients.

The curriculum, Prescription for Excellence:
A Physician's Pathway of Lifelong Learning, is organized to meet the seven goals of the undergraduate medical education program: the development of proficiency in self-directed learning and lifelong learning skills, and in the acquisition of appropriate core biomedical science knowledge, clinical skills, problem solving/clinical reasoning skills, interviewing and communication skills, information management skills, and professional attitudes and behavior.

Students study the basic and clinical sciences in an integrated fashion across the five phases of the four-year curriculum, utilizing a variety of educational methods including small-group, problem-based learning. Community-based clinical experiences in the first-year, as well as a focus on general population health, are hallmarks of the curriculum. Humanistic and professionalism issues are addressed longitudinally across the curriculum in formats designed to provide students with a clear understanding of the role and responsibilities of physicians within society. Information technology has been integrated into the curriculum and all incoming students are provided with an IBM ThinkPad laptop computer.

Wake Forest University School of Medicine recognizes the education of students as one of its primary missions. The fundamental goal of the school is to graduate students with the knowledge, clinical skills, and desire to excel in their chosen areas of medicine. In conjunction with appropriate societal and professional bodies, the School of Medicine endeavors to guide students to choose among various areas of interest — generalist or clinical specialty, academic practice, and basic research — to satisfy society’s needs.

The School of Medicine strives to provide its graduates with the skills to be lifelong learners. For the student, this aim requires a broad knowledge of basic clinical science and the ability to analyze and incorporate new knowledge. In addition to being a scholar, the student must possess attitudes and values that include a respect for life and a desire to serve the suffering. The School of Medicine endeavors to produce graduates with the attitude, integrity, and compassion they need to be caring health professionals.

The work of the School of Medicine is divided among 29 academic departments. Each department includes an appropriate number of professors, associate and assistant professors, instructors, associates, and assistants. Clinical departments also utilize the services of volunteer faculty, drawn from North Carolina’s privately practicing physicians and surgeons.
Wake Forest University School of Medicine is governed by the Board of Trustees of Wake Forest University through its Health Affairs Committee. Administrative responsibility for the school is delegated, by the University President, to the President of Wake Forest University Health Sciences. Health Sciences also has a separate subsidiary board. Responsibility for management of the educational/academic mission is delegated to the Dean of the School of Medicine.

The Center for Human Genomics is a multidisciplinary research center at Wake Forest funded by public and private grants. The Missions of the Center for Human Genomics include the following: facilitate the identification of genes that contribute to common human disease; determine how these genes interact with environmental risk factors; define the context under which interventions can be devised to prevent disease; and promote the development of novel therapeutic regimes. Within the Center are three general subdivisions: Clinical, Molecular and Analytical/Informatics. These three divisions work closely together to examine common complex diseases with a genetic component such as Aging-related Disorders, Cardiovascular Disease, Diabetes, Cancer with specific emphasis on prostate cancer, and Respiratory Diseases (Allergy, Asthma, Chronic Obstructive Pulmonary Disease, and Sleep Disorders).

The Clinical Laboratory collects individual and population information from patients and families for genetic and pharmacogenetic studies. The DNA samples are obtained from samples collected by scientists at Wake Forest University School of Medicine and from collaborators from all over the world to identify genetic components of common diseases. The Center possesses the talent and the technology necessary to identify genetic regions of interest through genome wide screens, study specific polymorphisms in genes, and sequence DNA to determine the specific genetic cause of a disease. The Analytical/Informatics Laboratory is a critical component combining the information collected in the Clinical Laboratory and Molecular Laboratory. With the information from both laboratories, the Analytical Laboratory can identify disease susceptibility genes and determine which polymorphisms affect specific disease characteristics through statistical and linkage studies. In addition, the Analytical group commonly uses informatics approaches as well as modeling of the epidemiological patterns of diseases within families to further understand the basis of common diseases. The overall approaches in the Center include identifying genes that affect disease susceptibility and expression (severity) in order to investigate pathophysiologic mechanisms in common diseases, explore gene-environment interactions, and develop novel therapeutic approaches and new methods for early disease identification and prevention.

The Center for Investigative Neuroscience is a multidisciplinary center dedicated to research in fundamental issues of neural organization and function and to the treatment of diseases in the central nervous system. One of the missions of the Center is to provide a mechanism by which the extensive clinical and basic science expertise at the University can be maximized to help understand the biological bases of central nervous system function/dysfunction and develop strategies for the amelioration of these national health problems. The Center’s key role is to facilitate collaborative research arrangements among the more than 100 neuroscientists at the University.

Among the current areas of research interest which have coalesced are Developmental Neurobiology, Substance Abuse, Stroke and Cerebrovascular Diseases, Sensory and Intersensory Function, the Neural Bases of Behavior, Learning and Memory, Brain Plasticity, Neuroimaging, Epilepsy, Aging, Biological Psychiatry, and Computational Neuroscience.

The aim of the curriculum is to create self-directed learners who will continue to develop as caring physicians during graduate training and practice. This aim is accomplished by providing students with the environment and incentive to acquire knowledge, skills, and attitudes basic to all fields of medicine. The curriculum fosters a knowledge of (a) normal states of health and disorders of structure and function that result from disease, injury, or defect; (b) the manner in
which physical, chemical, biological, psychological, and social factors affect health and disease; (c) skills and resources within the community that relate to the prevention or cure of disease, limitation of disability, and promotion of health; and (d) social, ethical, and historical traditions associated with medicine.

Central to the medical curriculum is the study of the human body and the structure, function, and coordination of its major systems. Lectures, conferences, and small-group tutorials are a
required part of the student’s course of study.
The faculty encourages and assists the student in (a) developing a better understanding of patients and their problems; (b) establishing essential habits of continuing self-education; and (c) becoming thorough and accurate in perception, recording, and interpretation of information.
The student is taught the usefulness and limitation of basic diagnostic and therapeutic skills. The student learns through personal experience with patients that the health professional can cure sometimes, relieve often, prevent frequently, and comfort always.

The main teaching hospital of the School of Medicine is North Carolina Baptist Hospital, which contains 781 licensed beds. The facilities include a 75-bed intensive care unit; a 20-bed intermediate care unit; a 22-bed coronary care unit; a 125-bed Brenner Children’s Hospital including a 37-bed intensive care nursery; 83 cancer beds; a 12-bed bone marrow transplant unit;
44 psychiatry beds; a 39-bed rehabilitation unit; an eight-bed burn unit, a 40-room operating suite, and adjoining postanesthesia units consisting of 83 beds. Patients come from all parts of North Carolina and many other states.

The School of Medicine and hospital buildings join to form a single unit, resulting in close correlation of clinical and basic medical science teaching programs.

More than 33,000 patient admissions, with nearly 220,000 total patient days of care annually and more than 415,000 outpatient patient visits, allow medical students and house officers the opportunity to observe a broad range of unusual medical problems as well as the more common diseases.
Performed each year are more than 25,300 surgical procedures, 318,600 radiologic procedures, 2,200,000 laboratory tests, 64,700 medical ultrasound diagnostic tests, and 3,800 cardiac catheterizations.

The programs are enriched through the integration of Forsyth Medical Center, Moses Cone Hospital (Greensboro), Forsyth County Health Clinic, the Downtown Health Plaza of Baptist Hospital, Umstead Hospital (Butner), and other clinic sites as cooperating institutions.
In addition, through the North Carolina Area Health Education Center (AHEC) Program, Wake Forest University School of Medicine provides formal education and training opportunities for residents, medical students, and physician assistants with the Catawba Memorial Hospital (Hickory), Rowan Memorial Hospital (Salisbury), and Watauga County Hospital (Boone).

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School of Medicine Medical School Location

School of Medicine Courses

PHASE I : FIRST YEAR COURSES * Human Structure and Development : This 12-week course is an introduction to human structure and development and includes the topics of gross anatomy, embryology, radiographic anatomy, histology, and neuroanatomy. Basic medical terminology, morphology of the human body, and sectional anatomy are introduced in a correlated fashion with the weekly clinical case and the other topics within the course. Lectures, clinical case presentations, and laboratory sessions are utilized to promote achievement of course objectives. Examinations include written and laboratory practical examinations. * Cellular and Subcellular Processes : This 12-week course is an introduction to cellular and subcellular function and includes the topics of biochemistry, molecular biology, immunology, introductory pathology, and genetics. Basic medical terminology, the basic processes of the cell and its subcellular components, and introductory concepts in immunology, pathology, and genetics are introduced in a correlated fashion with the weekly clinical case. Lectures and laboratory sessions are utilized to promote achievement of course objectives, which are assessed by written examination. * Basic/Clinical Science Problems I : This course extends across the entirety of Phase I. Students meet twice per week in small groups of six to seven students and two faculty facilitators to promote development of clinical reasoning skills and acquisition of basic and clinical science knowledge. The case topic serves as the anchor for each week of instruction in correlation with the material presented in the other Phase I courses. The course also promotes development of cooperative and self-directed learning skills, interpersonal skills, and professional behavior. Faculty assessments of student performance are made at the midpoint and the end of Phase IA and Phase IB. Each end-of-phase assessment (IA and IB) contributes to the final course grade given at the end of Phase IB. * Medicine As A Profession : This phase-long course focuses on various aspects of medical culture (defined as the interacting set of concepts, practices, institutions, and traditions that shape healthcare interaction and meaning) and medicine as a professional practice with its own history and culture. Course segments include physician socialization and professional development, ethical decisions in medicine, medical humanities, legal aspects of medical practice, and compassionate, respectful treatment of patients. Sessions alternate between large-group presentations and small-group discussions. Evaluation includes attendance and participation in large- and small-group sessions, examinations, and completion of self-directed learning activities. * Foundations of Clinical Medicine I : This course extends across Phase I and facilitates the development of physical examination skills as well as the interviewing skills and interpersonal skills essential for establishing effective professional relationships with patients. Students alternate on a weekly basis between the doctorpatient (interviewing and interpersonal skills) and physical examination components of the course. Interviews of hospitalized patients are employed to enhance development of students’ interpersonal and interviewing skills. Evaluation is performance-based and includes a standardized patient examination. * Population Health/Epidemiology : Because we are in an era of rapid generation of new knowledge, special skills are needed to access, critically review, and efficiently use good evidence from the medical literature in the care of patients and populations. This course extends across Phase I and facilitates students’ understanding of medical epidemiology and provides an introduction to evidence-based medicine. Included are an understanding of basic epidemiologic principles, strengths and weaknesses of various study designs, use and interpretation of basic statistics, use and interpretation of diagnostic tests, techniques of efficient literature searching, and framing a precise patient (or population) care question in the areas of diagnosis, prognosis, harm, and therapy. The material will be presented in alternating lecture and small-group formats. Student evaluation includes small-group participation, problem sets, and computer-based examinations at the end of Phase IA and Phase IB. * Community Practice Experience : The Community Practice Experience (CPE) extends across Phase I and Phase II. Students spend eight weeks with a community-based primary care practitioner; 4 weeks are completed during the summer session between the first and second academic years. The goals of the CPE include identification of the resources within a community that relate to health promotion, disease prevention, health maintenance, and recovery from illness or disability; development of professional attitudes and behaviors that are adaptable to different healthcare practice environments; and refinement of skills in interviewing, physical examination, and communication with patients, families, and other health professionals. Students complete a community health project and study learning issues related to patients seen with their preceptor. PHASE II : SECOND YEAR * Systems Pathophysiology A, B, and C: : This course is intended as an introduction to clinical medicine, bridging the Phase I course work with the clinical rotations. Instruction that will integrate basic science (e.g., physiology, pharmacology, pathology, microanatomy) with clinical material is built around nine organbased topics: Phase IIA (9 weeks) – infectious disease/microbiology, hematology/lymph, endocrinology/reproduction; Phase IIB (9 weeks) – cardiovascular, pulmonary, renal; Phase IIC (13 weeks) nervous system, digestive diseases/nutrition, integument, musculoskeletal. The broad course objectives are to define the basic vocabulary and principles of normal and abnormal function; identify normal and pathologic structure by gross, microscopic, and radiologic methods, as appropriate; correlate structure with normal physiology and pathology and be able to explain the mechanism of action, important side effects, and pertinent interactions of pharmacologic agents used for therapeutic intervention; identify causes, symptoms, and treatments of selected diseases of each organ system; and develop and use clinical reasoning skills and professional interactions in standardized patient cases, with the goal of applying fundamental knowledge to patient care. Course material is delivered through didactic lectures, labs, clinical experiences, and self-directed learning. Examinations include weekly quizzes and periodic summative written examinations. * Basic and Clinical Science Problems II :This course is a continuation of Basic and Clinical Science Problems I. In this small-group course that spans the length of Phase II, a group of six to seven students work to resolve basicscience and clinical issues related to a patient scenario that has been written by faculty of the corresponding weekly topic in Systems athophysiology. In Phases IIA and IIB, a faculty facilitator works with each group in a traditional problem-based learning format. In Phase IIC, students work in their small groups together with other small groups in a large conference room, led by roving faculty, in a process known as Team Learning. The major goals of Basic and Clinical Science Poblems II are to use the cases to develop skills in clinical reasoning, group and individual problem-solving, and cooperative as well as self-directed learning, as well as to promote professional behavior and interpersonal skills. Faculty assessments of student performance are made midway through and at the end of Phases IIA and IIB. Performance is measured through student self-assessments and quiz scores midway through and at the end of Phase IIC. Each endof- phase assessment contributes to the final course grade given at the end of Phase IIC. * Foundations of Clinical Medicine II : This course is an extension of the course from Phase I, focusing on doctor-patient relations and development of history-taking, physical examination, and communication skills. Opportunities to perform complete histories and examinations on real patients and to teach clinical skills to Phase I students occur during this phase. * Medicine As A Profession II : The MAAP course in Phase II is an extension of the course in Phase I and supports medical student professional development through curriculum segments on the social impact of medicine as a profession in American society; physician socialization and professional development; ethical decision making; issues of access to and control of medical care; research involving human subjects; medical humanities and the physician/patient relationship; legal aspects of medical practice; and compassionate, respectful treatment of patients. Student performance is assessed through attendance and participation in large- and small-group sessions, examinations, short essays, and completion of self-directed learning activities. PHASE III : THIRD YEAR COURSES * Inpatient Internal Medicine : During this 8-week clerkship, students are assigned to patient care teams and are responsible for the day-to-day care of identified patients. Student responsibilities include obtaining histories and physical examinations, generating differential diagnoses and treatment plans, assessing patients at the bedside, writing daily progress notes to demonstrate level of understanding, presenting patient information to house staff and faculty, and participating actively on rounds by responding to questions of faculty and house staff regarding disease processes and patient care issues. Students are expected to demonstrate evidence of individual reading and use of learning resources to help them fulfill these responsibilities. Differential diagnosis and presentation of clinical data are emphasized throughout the rotation. * Ambulatory Internal Medicine : During this 4-week clerkship, students learn about the scope of outpatient internal medicine through assignments with generalists and subspecialists in a variety of clinics. Experiences with palliative care and Hospice are included in this clerkship. Use of computer-based technology to round out the students’ exposure to essential topics is featured, as are case-based conferences. * Surgery : A list of educational goals and objectives for the surgery clerkship is provided to students on the first day of the rotation. Students serve as junior members of the surgical team and are expected to prepare for surgeries they observe by reading about the case and reviewing relevant anatomy. Case conferences, ward rounds, and grand rounds are employed to help students learn about differential diagnoses, diagnosis, and treatment. Students are required to document acquisition of various motor skills/tasks, including establishment of an IV and placement of a nasogastric tube. * Obstetrics/Gynecology/Women’s Health : This 6-week experience provides students with exposure to common topics in women’s health in both the inpatient and ambulatory settings. Inpatient activities include exposure to peripartum problems, operative obstetrics, operative gynecology, and common Ob/Gyn diagnostic and therapeutic modalities. In addition, as part of the high-risk obstetrics team, students are responsible for following patients from admission to discharge, participating in all aspects of care from the initial physical examination to the formulation of a management plan. The ambulatory component focuses on issues relevant to outpatient women’s care. * Pediatrics : This 8-week experience is a blend of outpatient and inpatient clinical activities in pediatric health care. The goal of the rotation is to facilitate the development of communication skills and competency in the physical examination of infants, children, and adolescents; an understanding of the influence of family, community, and society on the child in health and disease; the enhancement of clinical problem-solving skills; and the acquisition of knowledge necessary for the diagnosis and initial management of common acute and chronic illnesses in the pediatric population. Clerkship objectives are met via participation as a member of the inpatient ward team and discussion of case vignettes in a small-group setting. The ambulatory component utilizes outpatient clinical settings to enhance students’ skills in synthesis of clinical information, interpretation of physical examination findings, generation of a differential diagnosis, selection of diagnostic tests, and development of a treatment plan. * Psychiatry : This 4-week clerkship facilitates student attainment of knowledge, attitude, and skill objectives including the conduct of a psychiatric interview and the formulation of an initial differential diagnosis for common psychiatric presentations. Students are routinely expected to evaluate patients, read about the diagnostic possibilities raised by the case, synthesize information and present the patient on rounds, pursue further diagnostic testing, participate in planned therapeutic activities, and report and record patients’ progress. While on the clerkship rotation, students are expected to read material relevant to their patients’ conditions. They are also expected to utilize standard textbooks and review materials to familiarize themselves with clerkship objectives not addressed by their clinical exposure. * Neurology/Rehabilitation : This 4-week clerkship assists students in addressing the primary clerkship objectives relating to the identification of common neurologic diseases, the recognition of emergency neurologic situations, the management of common neurologic problems, and communication with patients and families of patients with motor, sensory, and cognitive deficits. The process of daily rounds and clinic (ambulatory) conferences, as well as weekly grand rounds, provides students with relevant examples of integrated clinical thinking. Students are expected to pursue independent reading on cases encountered on the wards and in clinics. * Family Medicine : The 4-week family medicine clerkship focuses on care in the outpatient clinical setting. The rotation incorporates outpatient clinical experience, small-group case discussion promoting the development of higher-order thinking skills and problem-solving skills, standardized patient educators in a smoking cessation activity, and a videotaped patient interview. Clerkship objectives include comprehensive, coordinated continuous care, psychosocial aspects of patient care, and group communication and presentation skills. * Anesthesiology : The primary objective of the anesthesiology experience is to expose students to the practice of clinical anesthesiology with special emphasis on the clinical application of anatomy, physiology, and pharmacology as students gain familiarity with procedural aspects of anesthesiology, including intravenous access, airway management, and regional anesthetic techniques. Students gain experience in anesthesia management of clinical cases utilizing the patient simulator. * Radiology : The radiology clerkship includes large-group sessions. Topics for self-instructional modules are selected for direct relevance to curricular goals of the medical school. Core biomedical science education is reinforced by the correlations drawn between diagnostic images, development and structure of the human body, pathologic anatomy, and pathophysiology. Clinical skills are emphasized in the modules that introduce and refine image analysis and image interpretation skills. Problem-solving and clinical-reasoning skills are learned in the process of developing imaging-based diagnoses, selecting diagnostic imaging tests, and correlating the results of those tests with other clinical information at hand. PHASE IV : FOURTH YEAR COURSES * Advanced Inpatient Management : Students complete two AIM rotations, each selected from one of the following separate disciplines: surgery, psychiatry, family medicine, obstetrics and gynecology, internal medicine, neurology, and pediatrics. The primary goal of this clerkship experience is the development of students’ abilities in complete patient management. Students are actively involved in all aspects of patient care, including primary work-up, development of differential diagnoses, in-hospital patient management, and post-hospital care planning. Goals and objectives for each approved AIM are listed in the Phase IV Program Guide and online. * Emergency Medicine : This 4-week clerkship provides students with experience in the diagnosis and initial management of patients presenting to the emergency department. Students complete eighteen 8- hour shifts during the clerkship and participate in interactive case-study presentations with emergency medicine faculty. EMS (ambulance) experience is available on an elective basis. * Intensive Care : The primary objective of this clerkship is to expose students to patient care in the intensive care setting, with emphasis on patient management issues, such as differential diagnosis, rational laboratory and radiologic testing, and acute and chronic management of patients with multiple medical and surgical problems. Student participate as an integral part of the intensive care team, in the Medical Intensive Care Unit (MICU), Coronary Care Unit (CCU), Neurosurgical Intensive Care Unit (NSU), Cardiothoracic Surgery Intensive Care Unit (CTSU), Pediatric Intensive Care Unit (PICU), Neonatal Intensive Care Unit (NICU), or the Trauma Surgery Unit. Students assume supervised responsibility for patient admission, evaluation, diagnostic testing, and initiation and evaluation of therapy and are exposed to patient-care issues such as end-of-life decisions, patient disposition, and family healthcare dynamics. Students also spend time in the Patient Simulation Laboratory (PSL), where they have the opportunity to learn and practice management skills relating to acute cardiovascular, pulmonary, renal, and neurologic intensive care.

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