Although the curriculum at the CUSOM has undergone continuous improvements since the last major overhaul about ten years ago, and graduates continue to perform well in their residency matches and their careers, the CUSOM has an ideal opportunity following its recent LCME accreditation visit to more fully examine and improve the curriculum based on emerging best educational practices and a more clearly defined vision of what our graduates will look like.
The fields of healthcare, science, and medicine are rapidly changing and major changes in technology, population health, data analytics, and healthcare delivery require practicing physicians to be nimble leaders who can collaborate and thrive in transdisciplinary teams. Current curricular elements incompletely address these future requirements of the physician leaders we aim to train.
The three pillars are attributes of physicians that we believe are necessary to produce physicians who can maximally improve the health of patients and the community today and tomorrow in a personally sustainable and satisfying manner. The new curriculum at CUSOM aims to produce graduates who can effectively lead within healthcare teams, within healthcare systems, and as change agents in the world by helping them to develop leadership skills, an ever- curious mindset, and a sustained commitment to addressing unmet health needs of others.
Leadership (created with input from curriculum reform kickoff, October 2017)
Curiosity (created with input from curriculum reform kickoff, October 2017)
Commitment (created with input from curriculum reform kickoff, October 2017)
We have assigned subcommittees to fully define the pillars of leadership, curiosity and commitment and to recommend curricular structures and content that will directly address these definitions. Further, our assessment strategies and program evaluation will be designed in the next phase to measure outcomes in each of these areas.
In addition to having the traditional broad foundational science knowledge and clinical skills to be prepared to enter competitive residencies and eventual practice, our new graduates will have a more fully developed vision for how they might personally transform health, be better equipped to utilize skills as leaders, advocates, and innovators to realize that vision, and be able to maximize their impact through sustained success as humanistic, resilient, and committed change agents. CUSOM graduates will be recognized in a variety of settings (clinical, community, legislative, scientific) for their ability to solve critical societal challenges around the health of our populations and the explosion of scientific knowledge.
To produce successful graduates who can transform health through leadership, advocacy, and innovation, our curriculum must be designed with the following principles in mind:
1. The outcomes of our current curriculum have not been measured effectively, therefore, we aim for our new curriculum to be Competency Based: Our curriculum content, structure, and instructional strategies should support the type of physicians we want to produce.
2. New research in medical education and strategies for improved adult learning aim to inform curricular approaches, therefore we aim for our new curriculum to be Evidence Based: Our curriculum content, structure, and instructional strategies should be evidence-based when possible.
3. Current structures in clinical care and in teaching lead to fragmentation of relationships between students, teachers and patients; we aim for our new curriculum to focus on Longitudinal Relationships: Many of the desired attributes we hope students develop are learned by example. The program must bring students into contact with strong, positive role models who are clinicians, investigators, and advocates. To know role models and to be known and guided by mentors, students need opportunities for longitudinal relationships.
4. The science of medicine is evolving at a rapid pace necessitating integration of relevant scientific concepts throughout medical training and into practice, therefore we aim to improve Deliveryof foundational and more complex scientific concepts: The scientific knowledge and principles relevant to clinical medicine need to be ‘integrated and sequenced optimally’ across all years of medical school. Advanced sciences should be delivered later in the curriculum, in the context of patient care experiences.
5. Physician leaders of tomorrow are called to be well-rounded and also have opportunities to develop areas of expertise, therefore our new curriculum will focus on Individualization: Students need opportunities for choice in their learning and the time to pursue an area(s) of interest in depth, and to individualize their learning, especially as they advance toward graduation competencies and choose careers.
6. In some cases, the complexity of the clinical care environment and pressures for efficient care have sidelined our learners further from the bedside, therefore we aim for our new curriculum to emphasize Early Hands-on Learning in the clinical and community environments: The environment needs to provide opportunities for students to demonstrate their ability to act with regard for others (e.g., involvement with patients or community, service experiences) and demonstrate progressive competency in these interactions.
7. Social sciences, bioethics, humanities and health systems science have gained recognition and importance in the approach to medicine and health and we therefore aim to incorporate these into our future curriculum, as well, giving the broad social sciences and bioethics emphasis in our curricular design, including recognition of the importance of equity, diversity and inclusion in our process and curriculum design.
Student input into all aspects of curriculum reform is instrumental and students have integrated into all elements of the process. Students from all classes actively participated on all of the curriculum reform subcommittees and are key members of each Implementation Team. In addition, students provide input into the process through an all-student advisory committee, called Students of Curriculum Reform (SOCR). Student leaders participate in the weekly Implementation Team Captain huddle and provide input through the Medical Student Council and current curriculum and student life committee, where they hold membership. Students who are interested in participating in curriculum reform should contact Implementation Team Captains, or Medical Student Council representatives.
Through enhanced integration of scientific concepts through the whole curriculum, we aim to enhance our students’ ability to think about complex problems and apply new knowledge. The artificial silos between “basic science” and “clinical” curricula will be broken and radically transformed. An understanding of scientific principles and their application to the betterment of patients has never been more important. The pace of scientific discovery requires that we better prepare our students to be curious, lifelong learners. We will do this by increasing exposure to discovery and application of evidence throughout the medical school experience, especially within and around the context of patient experiences, such that graduates will be better able to continually learn and apply these principles and concepts for the remainder of their careers. In fact, the total curricular hours dedicated to “basic medical science” concepts is similar in the current and proposed new curriculum; however, many of these concepts are taught later in the curriculum and these concepts will be taught with even more interactive pedagogical approaches.
The SOM is committed to investing in and supporting the new curriculum and funding the bridge that is required to transition the school from the legacy to the new curriculum.