School of Medicine curriculum upgrade to be implemented next school year

A comprehensive plan to update the UC Davis School of Medicine curriculum is scheduled to be implemented for the 2021-22 academic year.

The Faculty Senate and Academic Federation last month voted overwhelmingly to adopt recommendations by the curriculum design team, which proposed to dramatically improve what and how students learn in lecture halls, virtual classrooms, clinics, and hospitals during their years of study.

The academic medical center’s leaders, faculty and students agree that curricular modifications are essential in a world that has undergone major transformation since the last significant renewal 15 years ago.

“Medical knowledge changes faster than any human can learn it all,” said David A. Lubarsky chief executive officer of UC Davis Health and vice chancellor of Human Health Sciences. “This is one of the lessons we’ve learned from COVID-19, as we’ve seen best practices change multiple times within the course of a single day.”

He added that future physicians “need to be experts at using technology to access and manage all of the world’s medical knowledge, and at the same time, to reduce their workload so they can better focus on human interactions with their patients.”

The new curriculum, known as I-EXPLORE, short for Integrated Explorative Patient- and Learner-Oriented Education, is the culmination of 18 months of hard work by the design committee led by Kristin Olson, associate dean for Curriculum and Medical Education.

The core design team included 11 faculty members, two residents and two students who consulted with hundreds of community forum participants. Their recommendations were then approved by voting faculty members.

“The resounding faculty support for I-EXPLORE is deeply inspiring, and I am honored to be a part of this new era of curricular integration and collaboration,” said Olson said. “I am excited to embark upon the final stretch of this journey alongside our amazing faculty educators.”

I-EXPLORE will:

• Establish three pillars – biomedical science, clinical science and health system science – to span the entire curriculum
• Add four new “threads,” or complex themes interwoven across courses and years. These threads include diagnostic medicine, stages of life, care for vulnerable populations, and preventive medicine, and will be added to pre-existing threads in pain medicine and behavioral health
• Allow students to begin acquiring clinical experience within the first few weeks of school, as opposed to the traditional start in the third year
• Provide students with more opportunities for mentorship and customization of their education through a broader range of elective experiences
• Adjust the duration of the clinical rotations – which currently range from four weeks or eight weeks – to six weeks with fewer interruptions; these clinical rotations are further supported by case-based learning in separate intersessions
• Require clerkships in neurology and the intensive care unit
• Restructure vacation time to allow for a longer and better aligned summer break

“One of the great strengths of the proposed curriculum is its collaborative and integrated approach to medical education,” said Allison Brashear, dean of the School of Medicine. “Adopting this framework is critical to providing a world-class medical education while strengthening our commitment to promoting greater inclusivity and collaboration in the medical field.”

Community forums offered stakeholders a voice in designing the new curriculum.

For example, I-EXPLORE will expand research opportunities and include coursework on health system science so that medical students can view their role in the health care system

The redesigned curriculum is organized around the School of Medicine’s multiple missions, which emphasize collaboration, diversity, community needs, and learner-centered education resulting in patient-centered care.

Given the recent local and national attention to social justice issues, which have been a mainstay at the School of Medicine, there’s a lot of enthusiasm about how the curriculum will emphasize the importance of efforts to achieve health equity.

“The proposed curriculum redesign represents an unprecedented opportunity to meet squarely the challenge of the hour: the centuries-old legacy of racial and social inequities that have a measurable and often devastating impact on the health of ethnic minorities, especially African Americans and other disadvantaged groups,” said Andrés F Sciolla, professor of clinical psychiatry.

Sciolla, who as chair of the Faculty Executive Committee played an instrumental role in steering the curriculum toward approval, predicts I-EXPLORE will be ideal in meeting the multiple interests of students, including research, academic medicine, and the care of the underserved in urban and rural settings.

Adopting the new curriculum proposal is a “historic moment” for the school of medicine, said Mark Servis, the vice dean for medical education.

He added: “This will align our national recognition in medical education for workforce initiatives with a cutting-edge curriculum that will superbly train the next generation of physicians.”