The USC School of Medicine and its departments offer three types of curricula leading to award of the Doctor of Medicine, joint M.D./Ph.D. degrees and graduate degrees (in conjunction with the Graduate School) in Anatomy and Cell Biology, M.S., Ph.D.; Applied Biometry and Epidemiology, M.S.; Biochemistry, M.S., Ph.D.; Biometry, M.S., Ph.D.; Epidemiology, Ph.D.; Microbiology and Immunology, M.S., Ph.D.; Pathobiology, Ph.D.; Pharmacology and Nutrition, M.S., Ph.D.; Physiology and Biophysics, M.S., Ph.D.; Preventive Medicine, M.S., Ph.D. The Department of Family Medicine also offers the Bachelor of Science in Physician Assisted Practice. In addition, departments of the school offer certificate programs in certain medical specialties.
The Educational Policy Committee is responsible for overall planning of the medical school curriculum. Separate curriculum committees plan and supervise the instructional programs for each year of medical school. Each of the committees comprises student representatives and faculty members from the departments involved in each year's teaching program.
The curriculum of medical education at USC continues to emphasize preparation of the student to give optimal patient care. Students are progressively involved in patient care beginning with their first semester. The curriculum is patient-oriented, and students are expected to assume increasing responsibility for patient care as they acquire sufficient knowledge and skills. During the clinical experiences of the Junior/Senior Continuum students eventually attain a level equivalent to that of an intern.
At the same time, the school recognizes that the explosion of knowledge and techniques brought about by the current "biotechnology revolution" is rapidly altering the practice of medicine. During the four years of medical school, students cannot be taught all that will be needed for the practice of medicine - either now or in the years ahead. To a far greater degree than in the past, the present curriculum encourages students to acquire skills and habits of self-education and self-instruction which will prepare them for lifelong learning.
The faculty of the school recognize that while most students will eventually practice medicine, some will choose an academic research career. The plan of medical education fosters the development of individuals whose careers may be directed along this path. Faculty are available to counsel and encourage research participation by students during their medical school training.
The curricula of the School of Medicine and its departments acknowledge the crucial place of basic medical science in the advance of modern clinical practice. Both basic and clinical science are taught throughout the four years of the undergraduate medical curriculum. Basic science is taught both as pure basic science and in correlation with clinical science. In addition, a number of the school's departments cooperate with the USC Graduate School to offer degree courses leading to the award of the Master of Science and Doctor of Philosophy. Most of these graduate courses may also be taken as part of the school's joint M.D./Ph.D. program.
Doctor of Medicine
The USC School of Medicine awards the Doctor of Medicine to enrolled students who have satisfactorily completed the four-year curriculum of the school. This curriculum integrates instruction in all departments of the school: Department of Anesthesiology, Department of Biochemistry and Molecular Biology, Department of Cell and Neurobiology, Department of Emergency Medicine, Department of Family Medicine, Division of Medical Education, Department of Medicine, Department of Microbiology, Department of Neurological Surgery, Department of Neurology, Department of Obstetrics and Gynecology, Department of Ophthalmology, Department of Orthopaedics, Department of Otolaryngology-Head and Neck Surgery,Department of Pathology, Department of Pediatrics, Department of Physiology and Biophysics, Department of Preventive Medicine, Department of Psychiatry and the Behavioral Sciences, Department of Radiation Oncology, Department of Radiology, Department of Surgery/Division of Surgery and Department of Surgery/Division of Urology.
The sections that follow provide a year-by-year synopsis of the emphases and organization of this curriculum; for further information consult the current University of Southern California Bulletin: School of Medicine.
Year I (38 weeks)
The first year of medical school is approximately 38 weeks in length. First-year students begin the curriculum with a 16-week introductory course, Human Biology, followed by a 22-week sequence of courses grouped under the title Organ System Review. Concurrently with these courses, which represent the largest portion of the first-year curriculum, students also take Introduction to Clinical Medicine I, Family Medicine, Introduction to Psychiatry and Preventive Medicine.Each week of the academic year is composed of approximately 32 hours of class and laboratory time and eight hours of unscheduled time. The class and laboratory time of each week is structured as follows: Human Biology/Organ System Review sequence (24-28 hours); Introduction to Clinical Medicine I (4-6 hours); Family Medicine, Introduction to Psychiatry and Preventive Medicine (two hours).
In Year I, the instructor's descriptive comments are an optional part of a satisfactory evaluation. At the close of a student's second year, the comments noted on evaluation forms during Years I and II are synthesized into a summary letter by the Associate Dean for Student Affairs.
Human Biology
This 16-week introductory course provides the student with the knowledge necessary for integrated basic and clinical science study of human organ systems. The basic science component of this course orients the student to the biochemical, functional and morphological concepts relating to the cells and major tissues of the mammalian organism. The course also includes instruction in human cardiovascular physiology.
Organ System Review
A sequence of courses presenting integrated basic and clinical science instruction on each of five major human organ systems: blood system, endocrine-reproduction system, gastrointestinal-liver system, neurobehavior system, renal-respiratory-skin system.The integrated presentations of each of these courses focus on the normal structure, function, and clinical significance of the organ system under discussion. The basic science component of the courses includes instruction in anatomy and cell biology, biochemistry, physiology, introductory psychiatry, and nutrition. Presentations in the clinical sciences demonstrate the application of basic science to disease.
Introduction to Clinical Medicine I
This course expresses the strongly patient-centered orientation of the medical school curriculum. The student is introduced to patients and is involved in patient care activities from the first day of the course. The course introduces students to the principles of patient care and management and examines what it means to be a physician and how one becomes a physician.A group of five or six students spends from four to eight hours each week with an instructor from the clinical faculty who remains with the group for the entire year. As the group deals with basic medical themes (death, pain and helplessness) and issues (patient responsibility, learning to live with ambiguity and uncertainty), instructors help students to cope with their own feelings. This format opens the door for student-faculty interaction and improvement of student-faculty communication.
The major content areas of the course include communication in the setting of illness, the unified concept of health and disease (the biopsychosocial model), basic clinical skills and the correlation of basic science with clinical medicine.
Throughout the course, instructors encourage students to discard the passivity of the lecture hall and to take advantage of the learning experiences provided by their roles as helping and therapeutic persons. Students develop their ability to communicate with patients in the setting of illness and are guided by patient concerns to enhance their own growing knowledge, skills, abilities and responsibilities. Students are expected to acquire skills and habits of self-education and self-instruction which will prepare them for lifelong learning.
The unified concept of health and disease presented in this course enables the student to comprehend the human organism in all its complexity. Using their clinical experiences as a teaching model, students are taught to consider the patient as an integrated whole and to view the patient's illness or disease as more than simply a disruption of physiologic processes or a collection of physical findings.
This course integrates instruction in a variety of basic clinical skills with other components of instruction often presented as separate courses. These include history taking and physical diagnosis, the doctor-patient relationship, growth and development, introductory geriatrics and alcoholism. In the course of clinical instruction, the student is offered opportunities to explore a variety of medical settings, role models and career possibilities.
In addition, the course is designed to help students learn and apply basic science knowledge in the clinical setting. By encouraging a thorough understanding of the direct applications of basic science research to modern clinical medicine, instructors motivate the student to learn, use and retain more of the content and concepts presented in the basic science portions of the curriculum.
The course is administered by the Department of Family Medicine and uses faculty members from the Department of Family Medicine, in addition to clinical faculty from the community. The course continues through the second year of the medical school curriculum.
Family Medicine
The Family Medicine lecture series introduces Year I students to the specialty of family practice and to primary care. The content of the Family Medicine course is closely coordinated with the Introduction to Clinical Medicine course. Family and individual life cycles are explored. Students meet in small groups with individual patients with more specific problems; geriatric patients discuss their aging, runaway adolescents discuss drug and sexual concerns, patients with AIDS discuss their disease and their encounters with physicians. This course also introduces students to ethics and medical legal issues and to the organization and financing of the U.S. health care system.
Introduction to Psychiatry
Recognizing that a large percentage of patients with physical complaints have an underlying emotional component to their illness, this course introduces students to the biopsychosocial approach to medicine. Students receive an overview of normal psychosocial development through the life cycle, as well as an introduction to behavioral and psychodynamic developmental theory. This theoretical framework is then applied to clinical situations such as dealing with stress, loss and grief, death and dying, and the physician-patient relationship. The student also receives an introduction to the principles of clinical psychiatric evaluation, the mental status examination and the biochemistry of behavior.
Preventive Medicine
This course introduces students to problems relating to public health and disease prevention. Part One focuses on principles of epidemiology and biostatistics, providing students with basic skills required to understand and critically evaluate the medical research literature. Part Two focuses on potentially preventable health hazards, for example, smoking and other substance abuse, accidents and violence, physical inactivity, high fat diets and air pollution. For each such hazard, students learn the extent of the problem, the quality of the evidence, who is at greatest risk and obstacles to prevention. Part Two also includes an introduction to occupational medicine.
Year II (37 weeks)
The major theme of the second year of medical training is the study of disease and pathology. The Year II curriculum is designed to build on the knowledge and skills acquired in the first year. In preparation for their assumption of clinical responsibilities during the third year of medical school, students are expected to integrate their understanding of basic science concepts with their knowledge of the fundamental mechanisms and personal and social aspects of disease.The second-year curriculum begins with an 17-week introductory course titled Mechanisms of Disease, which is followed by a 20-week sequence of courses grouped under the heading Organ Systems. Concurrently with these courses, students continue their clinical studies in Introduction to Clinical Medicine II.
During the second-year curriculum, faculty of the basic science and clinical departments collaborate to present lectures, seminars, group discussions and laboratories, including animal laboratories. Students are expected to gain a practical understanding of the basic sciences, especially as they apply to pathological processes. In addition, they should achieve competence in physical diagnoses, understand the basic use of the clinical laboratory, recognize the major manifestations of disease, be able to differentiate the basic mechanisms of disease, and become familiar with introductory principles of therapeutics.
By February 1 of their second year students are expected to select their academic advisors and to begin arranging for the schedule of clerkships to be taken during the Junior/Senior Continuum. By the end of fall semester, Year II, each student receives a handbook which describes the required, selective and elective clerkships; the advisement program; and a calendar of rotation dates. Students choose the area of medical practice which they are most likely to pursue, and an advisor is assigned from that discipline. The advisor counsels the student on clerkships and opportunities in graduate medical education. Students who have not chosen a career path by February 1 are assigned to an advisor in the Department of Medicine.
In Year II the instructor's descriptive comments are an optional part of a satisfactory evaluation. At the close of a student's second year, the comments noted on evaluation forms during Years I and II are synthesized into a summary letter by the Associate Dean for Student Affairs.
Mechanisms of Disease
This 17-week introductory course emphasizes instruction in basic concepts and pathophysiologic mechanisms as a foundation for the integrated basic and clinical science presentations of the second-year Organ Systems. Faculty of the basic science departments (pathology, microbiology and pharmacology) and psychiatry present core material fundamental to their own disciplines, integrating this instruction whenever possible with the presentations of faculty from the clinical departments.
Organ Systems
A sequence of courses providing integrated basic and clinical science studies of nine major human organ systems: neurobehavior system, musculoskeletal system, renal system, pulmonary system, cardiovascular system, blood system, gastrointestinal-liver system, endocrine system and reproductive system.The instruction in each of these courses focuses on the abnormal structure and function of the organ system under discussion. The integrated presentations for each organ system course are designed and taught by an interdepartmental committee which includes faculty of the appropriate clinical departments as well as the departments of pathology, microbiology, pharmacology and psychiatry.
Introduction to Clinical Medicine II
This course continues the development of clinical skills begun during the first year of the curriculum. Instruction during the second year emphasizes systematic acquisition of the clinical skills of interviewing, history taking, physical examination, elementary clinical problem solving and medical record keeping. Although the small-group format of this course continues in the second year, new groupings of students are arranged. The small groups are supplemented at intervals throughout the year with workshops on specific clinical skills.The course is administered by the Department of Family Medicine and uses community-based physicians who are members of the clinical faculty at the School of Medicine.
Junior/Senior Continuum (two calendar years) The final two years of medical school are designed as a continuum of two calendar years, beginning in June at the end of Year II. During the spring of their second year, students schedule clerkship rotations to be taken during the two years of the continuum. Each student's program is individually designed with the assistance of faculty advisors and includes 57 weeks of required clerkships, 12 weeks of selective clerkships and 15 weeks of free elective clerkships.
All degree candidates are required to take and pass Step I of the United States Medical Licensing Examination and take Step II of the USMLE as a graduation requirement.
During the continuum each student may schedule 17 weeks of vacation for personal convenience, remedial work, funded research work and other noncurricular activities, such as investigating postgraduate training programs. Although every effort is made to provide flexibility in the scheduling of each student's program, some inherent limitations are imposed by the maximum enrollment permitted for each clerkship. Students are a vital part of the university's medical team, which provides health care for patients throughout the year; vacations are therefore subject to some scheduling adjustments.
Required Clerkships Ambulatory Primary Care (6 weeks) General Surgery (6 weeks) Medicine I (6 weeks) Medicine II (6 weeks) Neurology (4 weeks) Obstetrics and Gynecology (6 weeks) Pediatrics (6 weeks) Psychiatry (6 weeks) Two clerkships must be selected from the following surgical specialties. These must be taken consecutively.
Neurosurgery (3 weeks) Ophthalmology (3 weeks) Orthopaedic Surgery (3 weeks) Otolaryngology (3 weeks) Urology (3 weeks)
Selective Clerkships
Students are required to schedule 12 weeks of selective clerkships, chosen from a list of four- or six-week clerkships approved by the Year IV curriculum committee. Selective clerkships are carried out at USC-affiliated hospitals and encompass virtually all specialty areas.
Elective Clerkships
The "free" elective period consists of 15 weeks, during which electives may be taken on campus, at USC-affiliated hospitals or at more distant medical schools or medical centers. Approved on-campus electives which are offered regularly are listed in the elective catalogue.Proposals for other on-campus and off-campus electives are reviewed individually by a committee composed of faculty members and students. All petitions must be submitted at least six weeks before the beginning of the rotation. Off-campus electives require documentation from the off-campus preceptor, endorsement of the student's medical school advisor, and prior approval and review by the Year IV Curriculum Committee. Credit is not given for electives until an evaluation has been received from the preceptor and a critique of the elective submitted by the student. Students with an academic deficiency may not schedule off-campus electives.
Orientation to Clinical Medicine
This required one-week course is scheduled during the first two weeks of the junior/senior continuum. This didactic, small group and practical skills training will expose students to the essential knowledge and skills they will need to function effectively during the clinical clerkships of the junior/senior continuum.
Basic and Clinical Science Rotation
During the spring of the junior year, the entire class takes a four-week block of basic and clinical science instruction. Each student is required to perform basic science course work, including (but not limited to) nutrition, radiation biology and biostatistics. Also incorporated is the course titled The Physician in Society. This course examines such issues as medical practice in the 21st century, the move toward a national health care system, malpractice and ways to understand its impact, and the development of a standardized national medical license. Each year issues that impact the house officer and the practicing physician will be addressed. This information is invaluable to students preparing to enter postgraduate training and future medical practice.
Fifth Year Research Option
USC offers students the opportunity to take a full year of research experience with either a USC School of Medicine faculty mentor or an approved faculty mentor at another institution. This program is open to any student in good to excellent academic standing who has completed his or her first year of medical school. Students interested in the option should identify a faculty preceptor and present a description of the proposed research program and funds available in support of the program to the associate dean for curriculum. A stipend, comparable to that received by a graduate student at the postgraduate level, is available. Application for this program is made through the Office for Curriculum (KAM 400), and will be supervised through the Office of the Associate Dean for Student Affairs (KAM 100E).Baccalaureate/M.D. Program
The Baccalaureate/M.D. Program began in September, 1993. The focus of this program, initiated in 1993, is to assure these students admission to medical school (based upon the maintenance of their GPAs and requisite MCAT scores) and to allow them the opportunity to enrich their studies with a balanced liberal arts education. It is hoped that these students will explore the diverse educational opportunities the University of Southern California has to offer and become members of the medical profession with a balance of medicine, science and the arts. The Baccalaureate/M.D. Program is not designed to advance these potential medical professionals with four years of science and medicine prior to attending medical school, but rather to allow them the necessary time to explore and develop into mature and serious students of medicine.Information and applications are available from the Office of College Academic Services, College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089-0152; (213) 740-5930, FAX: (213) 740-1338.
M.D./Ph.D. Program
Departments of the School of Medicine participate in the joint M.D./Ph.D. degree program administrated by the Graduate School and School of Medicine. This program integrates the medical school curriculum with graduate curricula in the basic sciences, to provide a unified course of study leading to both the M.D. and Ph.D. degrees.This program is especially designed to prepare highly qualified students for careers in academic medicine and medical research. Formal course work and dissertation research provide the student with in-depth scientific preparation and research experience which enhances the application of basic science information to the diagnosis, treatment and prevention of disease. Conversely, the Ph.D. education becomes more meaningful because of its disease-oriented emphasis.
The curriculum for M.D./Ph.D. students differs from that of Ph.D. graduate students in the basic sciences in that the former take medical school courses as well as selected graduate level basic science courses. The integrated training of the M.D./Ph.D. program enables students to compress their total academic effort by applying some course work toward the requirements of both degrees. On average, completion of the combined program requires a total of seven years.
The following graduate programs participate in the M.D./Ph.D. program:
Biochemistry and Molecular Biology
Cell and Neurobiology
Microbiology
Pathology
Physiology and Biophysics
Preventive Medicine
Time limits for qualifying examinations and other procedures are determined by considering M.D./Ph.D. students as medical students for the periods when they are following the medical curriculum and as full-time graduate students during their years of graduate research prior to advancement to the Junior/Senior Continuum.
During the first two years of their program, M.D./Ph.D. students follow the medical school curriculum and gain added exposure to the basic science departments through a special survey course. Students are guided by the M.D./Ph.D. Committee, which outlines the integration of their graduate program with the medical school curriculum and serves as the students' liaison until they have selected a department and graduate research advisor. The graduate programs vary widely in the extent to which they allow credit toward the Ph.D. for courses taken during the first two years of medical school. M.D./Ph.D. students are encouraged to select a graduate department by January of the second year of medical school. Students will be required to apply for admission to the Ph.D. program by the deadline on the graduate application.
Beginning with the third year of the M.D./Ph.D. program, students enter their selected department as full-time graduate students. Although the content of graduate courses required of M.D./Ph.D. students is generally identical to that required of Ph.D. students in the same graduate program, M.D./Ph.D. students are permitted greater latitude in the scheduling of their graduate courses. Three years are commonly necessary to fulfill departmental requirements for the Ph.D., including course work, qualifying examinations, independent dissertation research, and writing of the dissertation.
After completion of the graduate program, the student is advanced to the Junior/Senior Continuum and completes the final two years of clinical training required by the medical school curriculum. No portion of clinical training is deleted from the joint program.
Further information about the M.D./Ph.D. program at the USC School of Medicine may be obtained by contacting: Office of the Associate Dean for Research, USC School of Medicine, 1975 Zonal Avenue (KAM 110), Los Angeles, CA 90033; (213) 342-1607, FAX: (213) 342-1610.
Graduate Degree Programs
In conjunction with the Graduate School, the School of Medicine offers graduate curricula on the Health Sciences Campus leading to the Doctor of Philosophy with majors in anatomy and cell biology, biochemistry and molecular biology, microbiology, pathology, pharmacology and nutrition, and physiology and biophysics. The Department of Preventive Medicine also offers graduate courses leading to Master of Science degrees in biometry or applied biometry/epidemiology and to Ph.D. degrees in biometry, epidemiology or health behavior research. Graduate credit is provided for some courses included in the Years I and II curriculum of the medical school. The Department of Medical Education in collaboration with the School of Education offers courses of study directed toward the M.S.Ed., Ed.D. and Ph.D. degrees.The following sections provide an overview of the departmental graduate studies programs. The requirements listed are those of the individual departments and must be taken in conjunction with the general requirements of the Graduate School. For further information regarding graduate studies in the medical sciences, consult the specific departments or contact: Office of the Associate Dean for Research, USC School of Medicine, 1975 Zonal Avenue (KAM 110), Los Angeles, CA 90033; (213) 342-1607, FAX: (213) 342-1610.
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