Curriculum Overview: Educational Mission, Key Features & Phases
The mission of the UC Davis School of Medicine is to transform lives by improving health through the combined power of education, research, clinical care, and community.
Competency-based medical education emphasizes the achievement of knowledge, skills, abilities, and attitudes through a variety of experiences that span the curriculum. Competencies are assessed through a variety of methods that include both formative and summative events. Competency-based education is designed in a collaborative and integrative manner that allows students to grow and evolve throughout their educational experience.
The competencies that the curriculum is derived from are available here.
I-EXPLORE: Integrated EXplorative Patient and Learner Oriented Education
The new I-EXPLORE curriculum was developed by the Curriculum Design Team (CDT) under the leadership of associate dean of curriculum and medical education Kristin Olson. The CDT was composed of faculty educators, residents, medical students, and staff with expertise in medical education. In crafting the new curricular plans, CDT reviewed a broad range of data from numerous sources (including but not limited to the 2016 internal and external curricular reviews, multiple years of course and block evaluations, AAMC Graduation Questionnaire reports, LCME documents and white papers, the medical education literature, and recommendations from department chairs, general faculty, residency program directors, students, the patient advocate office, and community partners). CDT met regularly throughout 2019 with periodic solicitation of input on key decisions from all faculty, resident physicians, medical students, and staff through town halls, surveys, and an online suggestion box, culminating in the creation of two curricular plans (the “Blue plan” and the “Gold plan”) for review by Committee on Educational Policy. CEP selected and approved the “Blue plan” as the new I-EXPLORE curriculum in March 2020, and the faculty voiced their strong support for the plan at the ballot box in July 2020.
Three pillars of biomedical science, clinical science, and health systems science are horizontally and vertically integrated throughout the curriculum, and each course is led by three co-course directors, one from each pillar.
- Biomedical Science – Those science disciplines whose primary focus is the biology of human health and disease.
- Clinical Science – The application of the biomedical and health system science to care for patients and their diseases.
- Health Systems Science – A foundational platform and framework for the study and understanding of how care is delivered, how health professionals work together to deliver that care, and how the health system can improve patient care and health care delivery.
Customization of the medical education experience is a central component of the I-EXPLORE curriculum. We have a range of offerings that allow students to explore to the depth of their ambition; whether that’s a half-day workshop in the intersessions or a dedicated pathway spanning the whole of medical school.
- Community Health Scholar programs train medical student leaders to identify, understand, and serve the unique health needs of California's rural, urban, and valley communities. There are four programs: Accelerated Competency-based Education in Primary Care (ACE-PC), Rural Program in Medical Education (Rural-PRIME), Reimagining Education to Advance central California Health (REACH), and Transforming Education and Community Health for Medical Students (TEACH-MS). To learn more about these programs, click here.
- Student-run clinics are free community clinics overseen by UC Davis medical students and physicians. These 12 clinics are designed to make significant contributions to the health of underserved populations in the Sacramento area by training students in delivering primary care services while simultaneously improving access to care in underserved communities. The programs have been recognized nationally as an exemplary partnership between an academic medical center and the community.
- Areas of scholarly concentration (ASCs) allow students to join a thematic learning community that spans the curriculum. ASCs include asynchronous module content, experiential learning during the intersessions and beyond, and a capstone project. Current ASC themes are clinical or translational research, global health, health care policy and advocacy, medical education, and quality improvement and patient safety.
- Intersessions occur in the pre-clerkship and clerkship phases. The I-RESTORE pre-clerkship intersession promotes the development of a team mindset, professional identity formation, and master adaptive learning skills, while fostering wellness and personal growth. Students engage in learning passport activities in the categories of interprofessional experience, clinical experiences/procedural workshops, personal development, career exploration, lifelong learning, and leadership development. The clerkship intersessions focus on case-based learning with incorporation of the six threads and UCD 43, objective structured clinical examinations (OSCEs), and professional identity formation work with coaches.
- The 6-week Selective Block is a component of the Clerkship phase. The menu of options includes 2-, 4- or 6-week clinical selectives, research, advanced clinical clerkships, and clinical didactics. These offerings include both in-person and asynchronous formats.
- More than 180 elective courses, spanning all clinical UC Davis Health Departments, are offered in the post-clerkship phase. These experiences provide students an opportunity to further round out their education in preparation for residency.
- Continuing Medical Education (CME) offerings are plentiful and widely advertised, and welcome medical students to participate.
- Advocating for and meeting the workforce needs of our communities through training more primary care physicians, specialists, and researchers that directly contribute to serving these communities.
- Prioritizing understanding of the diseases and health care issues of greatest concern for our local communities.
- Incorporating new patient-centered threads: diagnostic medicine (including point of care ultrasound), stages of life with fictional families whose health care issues evolve over time (including content relating to pediatrics, geriatrics, sex/gender differences, chronic illness and disability, death and dying), care for vulnerable populations (including social determinants of health), and preventive medicine (including nutrition, obesity, exercise, sleep, wellness, alcohol, tobacco, and cancer prevention); these will join the already established pain medicine and behavioral sciences threads.
- Emphasizing the UCD 43, a set of common chief concerns, for which patients seek medical care. Students will be exposed to each of these 43 concerns at least once during team-based learning sessions in the pre-clerkship and clerkship phases. Through the UCD 43, students will practice their clinical reasoning skills and differential diagnosis development using diagnostic schema and illness scripts, and will continually refine their differential diagnosis through an iterative process that incorporates the history, physical examination, laboratory test results, and imaging findings.
- Experiencing the “whole patient” perspective – patient signs, symptoms, goals, values, and need for functionality, as well as the family caregiver view.
- Providing more patient panels, standardized patient sessions, and simulation experiences to better prepare students for clinical setting.
- Adding neurology and the intensive care unit as required clinical experiences.
- Increasing emphasis on Step 1-relevant content and assessment methods, such as peer instruction, weekly formative quizzes, and exams in the NBME format.
- Creating efficiency in learning through better content integration, minimization of extraneous cognitive load, and schedule standardization.
- Emphasizing clinical reasoning throughout the phases.
- Increasing time for self-directed learning and student wellbeing.
- Expanding e-Learning opportunities to maximize flexibility (through asynchronous content in the pre-clerkship phase and online coursework for the selectives and post-clerkship phase).
- Maximizing preparedness for residency programs through increased career advising, direct mentorship, and optimization of the Transition to Residency course.
Students take ownership of their education through these active learning pedagogies that occur in the standardized weekly schedule of the I-EXPLORE curriculum.
Team INQUIRE/Problem-based learning (PBL): a form of self-directed, small group learning in which students identify learning objectives for a patient case and then independently research them during self-directed learning time. The groups are facilitated by a faculty member who is a process expert rather than a content expert. Students receive a Team INQUIRE student manual with full details on the PBL process. No advance preparation is needed before the case; assessment occurs through course exams and facilitator evaluations. This teaching method is particularly strong in life-long learning, self-directed learning, critical thinking, and teamwork skills.
Team-based learning (TBL): a form of small group learning in which students work through open-ended questions for an integrated patient case. These cases often have more complexity and ambiguity, and frequently include questions that incorporate elements from the three pillars of I-EXPLORE: biomedical science, clinical science, and health systems science. This teaching format is facilitated by faculty who function as content experts. A subset of TBLs are dedicated to the UCD 43, a set of 43 chief concerns patients relay at time of presentation. The UCD 43 TBLs emphasize the development, refinement, and prioritization of the differential diagnosis. Advance preparation is needed before all TBLs in the form of lecture viewing or reading assigned materials and completion of an individual readiness assessment test (IRAT) before the TBL begins. Assessment occurs through course exams. This teaching method is particularly strong in clinical reasoning, critical thinking, and teamwork skills.
Peer teaching/peer instruction: an interactive quiz session that emphasizes answering multiple choice questions (MCQs) to prepare for higher-stakes course exams. The MCQs are typically formatted in a style consistent with that used by the National Board of Medical Examiners (NBME), which offers standardized exams students complete over the course of their undergraduate medical career (USMLE Step 1, USMLE Step 2 CK, and USMLE Step 3). Questions that are more challenging for the whole class will have a round in which students consult with their peers about the correct answer. Advance preparation is needed in the form of lecture viewing or reading assigned materials. This teaching method is particularly strong in critical thinking, test-taking skills, and teamwork skills.
Patient panels: opportunities to meet patients and caregivers to learn about their lived experiences with a clinical condition or the health care system. This teaching method is particularly strong in reflection, professional identity formation, and understanding the patient and caregiver experience.
Journal clubs: an opportunity to review, analyze, and critique an original journal article in small groups using principles of scientific inquiry and evidence-based medicine. This is an important skill that students continue to use for the entirety of their career as a physician, as most treatment methods, surveillance guidelines, and diagnostic criteria are based on the published literature. This teaching method is particularly strong in critical thinking, lifelong learning, and teamwork skills.
Lectures: delivered through a pre-recorded or audience-response system format, lectures are designed to prepare students for associated active learning sessions. All lectures contain learning objectives, and all assessment questions (whether in peer teaching, quizzes, or midterm or final exams) are linked to learning objectives. This provides faculty and students with a shared framework for learning.
Clinical skills: a small group experience affiliated with the student’s academic coach in which students learn clinical skills directly relevant to patient care. Learning objectives may be assessed through multiple formats. This teaching method is particularly strong in patient care, clinical reasoning, professional identity formation, and teamwork skills.
Longitudinal clinical experience (LCE): a hands-on continuity experience in an ambulatory clinic that allows the practice and application of classroom and clinical skills learning, with frequent feedback from the preceptor. The LCE occurs approximately every other week in the pre-clerkship curriculum beginning with the MCM course. Students receive a LCE handbook with full details about the experience, including discussion of required advance preparation, goals of the experience, and assessment. This teaching method emphasizes patient care, professional identity formation, and learning to navigate our health care system.
The guiding principles for this curricular phase include content integration; inclusivity of all SOM departments; earlier clinical experience; weekly schedule standardization with incorporated self-directed learning time; customization of experience through intersessions; strengthened Step 1 preparation; and promotion of student well-being.
The clerkship phase includes the clerkship intersession course, six required core clerkships, and a selective block.
The Post-Clerkship Phase ensures students demonstrate an understanding of neurology, emergency medicine, the intensive care unit, and the role of the acting intern, while also promoting flexibility and individualization. The early start to the fourth year in May allows students to pursue electives for early exposure to clinical specialties or to complete clerkships or selectives that may have been deferred from the clerkship phase.
To view the legacy curriculum overview, please click here.