2 Foundations Phase Overview: Core Components and Academic Year Schedules

M.D. Curriculum overview

The M.D. curriculum is taught in three phases over 4 years. You will be teaching in the first phase, Foundations, which constitutes the first 18 months of medical school. At the end of this phase, students must pass the NBME Step I exam. Students then enter the Patient Care phase (a.k.a. clerkships/second phase) which consists of 12 months of required and elective training. Students conclude their medical school career with the Explore and Focus phase (third phase) which is 15 months of required advanced patient care, emergency medicine, neurology and elective clinical training. For more information on the full UWSOM 4 year curriculum: Description of 4 year curriculum

For a graphic display of the 4 year M.D. curriculum (including block schedules for the first 18 months) click here: 4 year curriculum map

Foundations

As block faculty, your teaching is focused on the initial 18 month (3 Terms) Foundations curriculum. This phase consists of 2 components taught concurrently. Organ system based courses (Blocks)  and the Foundations of Clinical Medicine (FCM) course. Course material is integrated between the 2 components. Each component is discussed below:

Blocks

Blocks are organ system based modules designed to bring together basic, clinical, and social sciences. They range in duration from 1 to 7 weeks. To maximize uniformity, all WWAMI sites employ the same teaching materials, course packs, and examinations (assessments), across each block. This ensures the curriculum is educationally equivalent across all sites.

The content is compiled and created by Block Directors. Regional block leads are responsible for delivering the content at regional sites. Block Directors also rely on regional block leads for input on the design and delivery of block content. Although all teaching materials are the same at all sites, regional block leaders are free to modify content delivered in class as long as all learning objectives are met and content is delivered within the same week. Note that the lectures delivered in Seattle are recorded and available to all students by 5pm pacific time on the day of the lecture. Students are expected to spend no more than 1-1.5 hours on out-of-class preparation for each hour in class, including reading assignments, pre-class videos, and other required activities. The role of Block Directors and Regional Block Leads is covered in more detail in Chapter 9. 

Here is a summary of Spokane Regional Block Leads:

Block course material is taught through large group lectures, small group sessions and anatomy labs at each site:

Large group – Traditional didactic lectures delivered by the regional block lead or guest speaker using slide sets compiled and edited by the block director. Large group attendance is optional. Lectures are limited to 2 hours per day (usually).

Small group – Student led case based small group discussions made up of 10 to 12 students. Each group is facilitated by a member of the Spokane block faculty. Small group sessions emphasize student collaboration, discussion, and problem-solving. Small group attendance is mandatory in Spokane. Small groups are 1 to 2 hours long.

Anatomy lab – Anatomy and Embryology (A&E) is taught through both large group lecture and traditional anatomy lab (dissection) sessions. This content is taught concurrently with the relevant organ system. A&E is one of 3 “Threads” (more on that below).

Scheduled classroom time for block teaching is limited to four hours per day, four days per week.

Although common teaching materials are provided to all students and provide everything a student needs to succeed, many students also pay for outside resources. Examples include Boards and Beyond, Pathoma, and Anki. Spokane students seem to spend between $300-$500 on outside resources (estimate based on informal conversations). Some students may pay for up to 6 outside resources. This can cost $1800-$2000.  Students share information about outside resources on Slack, by word of mouth, and through their Big Doc’s (upper-class mentors).

Threads

Anatomy & Embryology, Pharmacology, and Histology & Pathology are integrated into each block. Each of these disciplines is referred to as a thread. Teaching the material from these disciplines together with the corresponding organ system promotes a more cohesive and comprehensive understanding, and creates opportunities to emphasize clinical relevance.  Students must master the content in each of the three thread areas to meet graduation requirements. During the regular block exams, they are evaluated on specific questions tagged for each thread. These questions not only contribute to the overall block grade but also to the cumulative thread grade for the term. To pass, students need to score at least 70% in each thread area by the end of the term.  For the purposes of evaluating thread mastery, the Foundations Phase terms are defined as follows:

• Term 1 includes the Fundamentals of Medical Science & Research (FMR), Infections & Immunity (I&I), and Cancer Hormones, & Blood (CHB) blocks.    
• Term 2 includes the Muscles, Joints, Bones, & Skin (MJBS), Cardiovascular Systems (CVS), Respiration & Regulation (R&R), and Head, Neck, & Gut (HNG) blocks.
• Term 3 includes the Mind, Brain, & Behavior (MBB) and Reproduction & Development (R&D) blocks.

Testing Services sends students an estimate of the total number of thread questions on each exam at the beginning of each block. If a student finishes a term with a thread grade below the 70% bar for mastery, they may need to complete a remediation course. For more information, see “Remediation” under Trouble Shooting chapter (this book) or the Foundations Phase Remediation page.

There are two additional components taught during the Foundations Phase of the curriculum that are distinct from the organ-based blocks:

Themes – Medicine, Health, and Society (MHS) I & II

Theme sessions and MHS courses emphasize core concepts needed for clinical practice in the changing healthcare environment. Students explore areas related to humanism in medicine including the themes of equity and inclusion, diversity, ethics, social determinants of health, global population and public health, climate health, and health systems science.  Much of this content is embedded within each block. It is also delivered as two short standalone courses called Medicine, Health, and Society (MHS) I & II.  MHS sessions may include large group, small group, and asynchronous learning. Students are assessed through written assignments such as reflections and case analysis and attendance. Attendance is mandatory.

Integration

The 18 month block curriculum includes three Integration weeks. They occur once per term and are designed to build clinical reasoning skills and cultivate a commitment to lifelong learning. Students are asked to apply concepts learned during block teaching to solve clinical problems. In addition, there is time set aside for students to reflect on their professional identity.

The AY (academic year) schedule

The daily Foundations curriculum is displayed on the AY schedule. This is an Excel spreadsheet maintained by your site admin. For large group lectures, the schedule is organized by date, time, topic, and lecturer. Small group sessions are organized by room, time, topic, and facilitator. We use the AY schedule to sign up to facilitate small groups:

AY Schedule Spokane

Student and Faculty Expectations

Student and faculty expectations for the first 18 months of block teaching are summarized here: Foundations 2022 Rules of the Road Final.docx

Foundations of Clinical Medicine (FCM)

The Foundations of Clinical Medicine (FCM) course runs concurrently with block teaching. The course teaches proficiency in fundamental clinical skills including history taking, physical examination, diagnosis, clinical reasoning, and the utilization of informatics. FCM is a longitudinal course that spans from Term I through Term III. FCM topics are usually taught concurrently with the related block material. FCM is covered in more detail in Chapter 4.

Independent Investigative Inquiry (III) – Triple I

Successful completion of an Independent Investigative Inquiry (Triple I) is required in order to graduate. Students typically investigate an area of interest over the summer between first and second year. This scholarship can take many forms. For some, it is hypothesis-driven research in fields such as basic science, clinical research, or health services. For others, it is work that synthesizes and gives meaning to a body of prior knowledge through a literature review. And for others, it is promoting the uptake of interventions that have proven effective in routine practice with the aim of improving population health. These investigations are conducted under the guidance of a faculty mentor. Students report their findings during the fall of their second year. The program provides a unique opportunity for students to choose both the content and form of their scholarship and to pursue an interest not found elsewhere in the curriculum.

A full description of the Independent Investigative Inquiry can be found here: Description of Triple I