Phase 1 Fundamentals

Human Dimension Details

The Human Dimension is a three-year course composed of two sequential elements (one in Phase 1 and one in Phase 2).

The Human Dimension is at the heart of the SOM curriculum. Through the service-learning experiences and integrated curriculum, students will come to understand the many Determinants of Health – this includes the Social Determinants of Health as well as the personal, economic, and environmental determinants. Determinants of Health are the factors that impact health outcomes, and fall under several broad categories: policy, social factors, health services, behavior, biology and genetics, and access.

Within the Human Dimension, pairs of students will be matched to 3 families in the community whom they follow longitudinally over the entire core curriculum, paying specific attention to three domains of health: social, behavioral, and medical. The student will develop a close relationship with the families and will become involved in all aspects of family members’ health, including the individual’s life, family, and community.

Activities in this course will include meeting with individuals and families in their communities and in various health care and community-based settings, meeting with peers and faculty mentor, and participating in small and large group teaching sessions. Students will also participate in community-immersion service activities. The student teams will be closely mentored by a faculty member who will meet regularly with the student teams in a small group and review monthly themes as well as debrief and process the students’ experiences. Student case presentations and workshops will also take place in this setting.

Core focus areas will include:

• Continuity of Care
• Transitions of Care
• Health Care Disparities
• Determinants of Health broadly
• Social Determinants of Health
• Health outcomes
• Community Systems
• Social Services
• Health Care Delivery systems
• Integrative Medicine
• Mental Health and Illness
• Substance Abuse
• Trauma
• Housing and Food Insecurity
• Professional identity

Students will talk with their families and screen them for social needs that are impacting their lives. Students will be trained in this screening, and will be given resources and access to information about resources so that they can help families access services that may be available to them.

This experiential and service learning curriculum will be integrated with the content students learn in the other components of the core curriculum. The Phase 1 curriculum will be structured using patient presentations that will serve as the framework for the content taught in each week. This integrated approach will emphasize the critical role that all these fields play in human health and disease.

Sciences/Skills/Reasoning Courses

The Sciences/Skills/Reasoning (SSR) courses are integrated block courses that students will progress through sequentially. The first two are foundational courses, the last 5 are systems-structured courses. These integrated courses will include content from the Biomedical, Behavioral, and Health Systems Sciences. Each week of Phase 1 will be framed by a weekly patient presentation. This patient presentation, begun in the first session every Monday, will form a scaffolding for all content taught during that week.

• Foundational Courses
• Systems Courses

Foundational Courses

Molecular & Cellular Principles:

An eight-week course that introduces students to fundamental concepts in genetics, molecular biology, genetics/epigenetics, immunology, pathology, and pharmacology.

Structural Principles:

An eight-week course that introduces students to fundamental concepts in anatomy, histology, and medical imaging.

Systems Courses

Immunity, Infection & Cancer:

An 11-week course that builds upon the fundamental principles of the immune system that are presented in Molecular and Cellular Principles. The essential role of the immune system in maintaining health as well as disease states resulting from its dysfunction is addressed. The focus on immunity provides a natural home for concepts in rheumatology and dermatology. Fundamental concepts in infectious disease and microbiology will also be included in this course, although many specific pathogens are addressed in other courses. The end of this course transitions into major concepts in neoplasia, spanning the implications of this suite of pathologies from the molecular to the social/systems levels. As is the case for pathogens, specific types of neoplasias are addressed in subsequent courses.

The Developing Human:

This eight-week course addresses growth and development from a cellular level to an organismal one, focusing on advanced concepts in genetics, and the reproductive, endocrine, and hematologic systems. The continuum of human development and its various stages are included in this course, incorporating concepts in pediatrics and geriatrics.

Homeostasis & Allostasis:

This 11-week course focuses on the structure and function of the cardiac, pulmonary, and renal systems in maintaining internal physiologic equilibrium in the body. The concept of allostasis, or the process of achieving homeostasis, is included in the course as recognition of the concept that internal physiology stability is achieved only through alteration in physiology in light of both predictable and unpredictable events (“stability through change”). The idea of allostasis is extended from the cellular and organ-system level up into the societal context of the patient.

Nutrition, Metabolism & Digestion:

This eight-week course focuses on the structures and processes required for metabolism, presented in the context of the digestive system. Biochemistry and normal and defective metabolic pathways (and the resulting disease states) are a major component of this course, building upon content from the Foundational Courses. Nutrition is a longitudinal curricular thread, but has a concentration within this course.

Neurosciences & Behavior:

This eight-week course addresses the structure and function of the central and peripheral nervous system, from the cellular to the societal level. In light of the emerging understanding of the biologic basis of psychiatric disease, neuroscience and psychiatry are presented in an integrated fashion.

Longitudinal Content Areas

Clinical Skills and Clinical Reasoning

Clinical Skills and Clinical Reasoning training will be integrated throughout the Phase 1 curriculum. It will include clinical skills workshops (physical examination, physical diagnosis, communication skills, etc.), Standardized Patient Sessions, Simulation (task-based and high-fidelity), longitudinal outpatient clinical placement, and other inpatient and outpatient clinical teaching.

The Clinical Reasoning curriculum will take place in a number of core elements of the Phase 1 curriculum, including the weekly patient-presentation, clinical skills small groups, and clinician-led small group Problem-based Learning sessions.

The content taught in the Human Dimension and in the SSR courses will be integrated with training in clinical skills and clinical reasoning. For example, in one week a student might be learning anatomy of the heart, cardiac physical examination, pathophysiology, and treatment of Cardiovascular Disease, and will develop a food map of their family’s neighborhood to identify the sufficiency of healthy food sources and safe exercise facilities.

Health Systems Science

This longitudinal content area directly addresses the three-part problem we are trying to address: (1) poor quality of healthcare outcomes, (2) poor value in the healthcare system, and (3) unacceptable healthcare inequities. The breadth of content within Health Systems Science includes:

• Determinants of Health; Social Determinants of Health
• Health law, health policy, and medical ethics
• Healthcare financing, delivery, and outcomes
• Health inequities
• Biostatistics and epidemiology
• Evidence-based medicine, Information Mastery, and Evidence-based practice
• Public health
• Population health
• Quality Improvement and patient safety
• Health Information Technology
• Teamwork and Interprofessional Practice
• Systems Science

Additional longitudinal content areas include:

• Professional Identity Formation
• Interprofessional Education and Practice