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College of Medicine: Integrated Pathways Curriculum

  • Students in class

    The primary goal of the College of Medicine is to graduate excellent physicians. Whether the student's ultimate goal is general or specialty practice, research, medical administration or academic medicine, the College provides a comprehensive educational experience for all students.

    The educational objectives of the curriculum are intended to provide students with the basics that they will need to embark upon graduate medical education in the field of their choice, and ultimately to become competent and compassionate physicians. To achieve these objectives, the College has set standards of knowledge and develops the skills and attitudes necessary to enable students to reach their goals.

    The Integrated Pathways Curriculum emphasizes learning across disciplines with an emphasis on understanding core principles. It is a competency-based curriculum designed to prepare our graduates to enter any field of medicine and will include attaining the knowledge, attitudes, and skills contained within the six Domains of Competence. These Domains of Competence, are modeled after the six competencies, which are followed by residency programs. Our curriculum will provide a form of continuity for our graduates into residency, and better prepare them for the next level in their careers.

    Integrated Pathways Curriculum

    Curricular Map

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    Four Year Curricular Map

    Curricular Map

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  • Goals of the Integrated Pathways Curriculum


    SUNY Downstate Medical School’s competencies state what skills, attitudes, and knowledge our graduates need to demonstrate to go on to residency training and to becoming independent physicians. This document:

    • Defines key terms associated with the competencies
    • Introduces the six domains of competence
    • Outlines the curricular goals associated with each domain of competence

    Key Terms and Definitions

    The Competencies are defined in five increasing levels of detail:

    Domains of Competence:

    These are six broadly defined groups of knowledge, skills, and attitudes required of all graduates at the end of 4 years as depicted in the following graphic. They are also referred to as the competencies.

    The Six Competencies

    Curricular Goals:

    Curricular goals are summary statements within each competency domain that represent the knowledge, skills and attitudes required of students at the end of the 4 year curriculum.

    Unit, Clerkship, and Rotation Goals:

    Unit, clerkship, and rotation goals are the measurable knowledge, skills, and observable behaviors that each student should be able to demonstrate as a result of successfully completing the curricular component.

    Learning Objectives:

    Learning objectives are what a student is required to know or do at the end of a learning activity. These are stated in terms of observable behaviors.


    Content is the term used for facts, pieces of a skill set, or other small pieces of data which are related to learning objectives.


    Benchmarks are used to evaluate progress in each of the competencies when determining promotion to the next portion of the curriculum. They are defined at four gateway points in the curriculum: end of first year, after the Foundations of Medicine portion, after Core Clerkship portion, and mid-way through the Advanced Clinical portion.

    Domain and Curricular Goals

    Each domain of competence is defined below. In addition, curricular goals associated with the domain of competencies are listed below the definition. Note that the domains are NOT presented in order of importance or priority. Each domain is equally as important as the other.

    1. Domain of Patient Care

    Graduates must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

    1.1 Gather accurate complete and focused histories in a prioritized and organized fashion, appropriate to the clinical situation and the patient’s ability to communicate. (Medical History Taking)

    1.2 Conduct relevant, complete and focused physical examinations in patients of all age groups. (Physical Exam)

    1.3 Select and interpret common diagnostic and screening tests based on patient information and patient preferences, using evidence-based and cost-effective principles. (Clinical Testing)

    1.4 Demonstrate clinical reasoning in gathering focused information, formulating and prioritizing a differential diagnosis and integrating patient data to formulate an assessment. (Clinical Reasoning)

    1.5 Develop and carry out a management plan with preventive, therapeutic, and palliative interventions based on patient information and preferences, up-to-date scientific evidence, and clinical reasoning skills. (Management Plan)

    1.6 Formulate a prognosis and make shared decisions with patients. (Prognosis and Shared Decision Making)

    1.7 Assess the indications and necessity for medical and invasive procedures utilized in patient care. Perform general basic procedures of a physician. (Clinical Procedures)

    1.8 Document encounters and present patient information efficiently, accurately and concisely. (Clinical Information Management)

    2. Domain of Medical Knowledge

    Graduates must demonstrate knowledge of established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

    2.1 Demonstrate an understanding of molecular, cellular, organ and system processes, fundamental biologic principles, and structure-function relationships in normal and disease states. (Biologic Structures, Processes, and Principles)

    2.2 Explain the underlying mechanisms and causes of disease and disability, and analyze how these processes contribute to clinical presentation. (Causes of Disease and Disability)

    2.3 Apply the principles of diagnosis to identify system-specific and cross-system diseases and disorders. (Principles of Diagnosis)

    2.4 Apply the principles of pharmacology and therapeutics in therapeutic decision-making and disease management. (Pharmacology, Therapeutics, and Decision Making)

    2.5 Demonstrate an integrated knowledge of the cognitive, social, and physical aspects of human development in assessing clinical presentation and in formulating treatment plans for patients at all stages of the life cycle. (Human Development and Lifespan)

    2.6 Assess the impact of genetic, nutritional, occupational, environmental, epidemiologic, and social-behavioral factors on health maintenance and wellness, and on disease prevention. (Health Maintenance)

    2.7 Explain how scientific investigation advances biomedical knowledge, assess the limits of current knowledge, and evaluate the impact of emerging data on disease diagnosis and therapy. (Scientific Investigation)

    3. Domain of Practice-Based Learning and Improvement

    Graduates must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.

    3.1 Use patient care experience to continually improve ability to care for patients through ongoing self-directed learning and self-reflection. (Life-long Learning)

    3.2 Use information technology to manage information and access on-line medical information to support one's own education and provide the best care for patients. (Critical Appraisal and Informatics)

    3.3 Make informed decisions about diagnostic and therapeutic interventions based on best evidence; critically appraise the biomedical literature. (Evidence Based Medicine)

    4. Domain of Interpersonal and Communication Skills

    Graduates must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, patients' families, and professional associates.

    4.1 Create and sustain a therapeutic and ethically sound relationship with patients of all ages. (Doctor-Patient Relationship)

    4.2 Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families. (Patient-Centered Communication)

    4.3 Use effective verbal communication with colleagues to exchange information for patient care. (Communicating with Colleagues)

    4.4 Work effectively with others as a member or leader of a health care team or other professional group. (Team Skills)

    5. Domain of Professionalism

    Graduates must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Graduates must also assess personal values and priorities in order to maintain an appropriate balance of personal and professional commitments.

    5.1 Demonstrate commitment to excellence in personal/professional development; respect, compassion, integrity and altruism; demonstrate accountability to patients, society, and the profession. (Professional Development)

    5.2 Demonstrate a commitment to ethical principles pertaining to all aspects of medical practice. (Medical Ethics)

    5.3 Demonstrate sensitivity and responsiveness to patients' culture, age, gender, socioeconomic status, education level, sexual orientation and disabilities, among other elements of diversity. (Cultural Competence)

    6. Domain of Systems-Based Practice

    Graduates must demonstrate an awareness of the relationship between themselves and the patient, community, and healthcare system as well as recognize the impact on optimizing patient care.

    6.1 Recognize the impact of financial, organizational, linguistic, and other social factors on the ability of patients to participate in their health care. (Patient Participation in Health Care)

    6.2 Explain the appropriate behaviors of a physician for the regulatory and financial environment of hospitals and other practice settings. (Health Care Delivery Systems)

    6.3 Incorporate fundamental principles of patient safety into clinical care across healthcare systems and settings of care. (Patient Safety)

    6.4 Describe the biological, social and environmental determinants of prevalent health conditions and health inequities locally and globally. (Determinants of Health)


    Both clinical medicine and foundational basic science will be taught over the entire four years in a three phased curriculum

    Foundations of Medicine 18 months
    Core Clinical Medicine (Clerkships) 12 months
    Advanced Clinical Medicine 14 months
  • Foundations of Medicine — 18 Months

    There are six major interdisciplinary units in the Foundations of Medicine that promote learning in all six competencies and integrate learning normal and abnormal structure and function. Students will begin practicing clinical skills from the beginning of the curriculum allowing them to develop their mastery of basic techniques over an 18-month period prior to entry into Core Clerkships.

    Foundations of Medicine: Year 1

    The Foundations of Medicine uses a multidisciplinary, systems-based approach to teach the normal structure and function of the body while introducing students to basic clinical skills and abnormal structure and function. The disciplines (i.e., Gross Anatomy, Biochemistry, etc.) are integrated and organized into Units based either on foundational concepts (Units 1–3) or on organ systems (Units 4–6).

    Each Unit incorporates multiple teaching modalities including lectures, case-based learning, team-based learning, Problem Oriented Patient Sessions (POPS), laboratories, and patient skill laboratories. Students are expected to take responsibility for ensuring that they obtain a conceptual understanding of subject matter in addition to knowledge of factual information. Weekly formative assessments, similar to those used at the end of unit summative assessments, will help students track their progress.

    Unit 1. Systems Overview & Musculoskeletal System

    The first Unit begins with an overview of major organ systems that allows students to begin learning and practicing clinical skills such as listening to heart and lung sounds, palpation of major organs and measuring pulse and respiration rates. Students will also begin to learn the structure of the human body by examining prosections and then performing dissections intended to demonstrate the musculoskeletal systems and consequences of injury to these systems. This learning will be supplemented by the use of medical imaging such as radiographs and ultrasound.

    Unit 2. Molecules to Cells

    In Unit 2 students will develop an understanding of the biochemical, molecular and cellular biological and genetic basis for disease. Progressing from a visual understanding of the musculoskeletal system they explore cell and tissue structure and function based on diseases with both genetic and environmental origins. At the same time they continue to practice and develop clinical skills introducing elements related to the diseases under study and begin to work with physician preceptors in ambulatory offices. Among topics to be covered will be the expression of genetic information, differences in structure and function of differentiated cells, protein and enzyme structure and function, energy generation by metabolism of basic foodstuffs and the role of nutrition in health and disease, early embryonic development, the cellular basis of neoplasia and the life cycle and function of red blood cells.

    Unit 3. Infection & Host Immunity

    Unit 3 introduces students to infectious diseases, the biology of the causative agents and the defense systems that protect against them both as defenders of the human body and as causes of disease when regulatory systems fail. Students will first extend their knowledge of blood cells by studying white blood cells and their role in defense against pathogens. They will study the role of lymphocytes and antigen-presenting cells in humoral and cell-mediated immune responses along with understanding the body-wide distribution of lymphoid tissues and organs. Principles of neoplasia learned in Unit 2 will be extended by studying cancers of the lymphoid system, leukemias and lymphomas, and their treatment . To understand the anatomical distribution of defense mechanisms and the sensitivity of respiratory passages to infectious agents students will explore the anatomy of the head and neck and the susceptibility of these structures to infections by respiratory viruses. Diseases caused by disorders of the immune system such as allergies, inflammation, HIV infection, and auto-immunity will be examined in relation to specific diseases. The role the immune system plays in diseases of skin, muscles, bones and joints will also be a focus of this Unit. Concepts developed during this Unit will also be applied to further development of clinical skills.

    Unit 4. Gastrointestinal and Reproductive Systems

    Unit 4 is the first of three units focused on defined organ systems. Fundamental knowledge acquired in Units 1 to 3 will be applied to disorders and diseases that affect the gastrointestinal and reproductive systems. Initially students will explore the structure of the gastrointestinal tract and the physiology and pathophysiology underlying its normal function and disorders that arise. Imaging techniques will help students relate the anatomy of the organs to their microscopic structure and the mechanisms underlying functionality. Inter-relationships between organs (e.g. bowel and liver) will be explored to understand digestion and uptake of nutrients and the role of nutrition in normal health or disease. Later, students will examine the structure and function of male and female reproductive systems and the control mechanisms that regulate their functioning. In an integrated fashion students will become familiar with diseases and disorders that affect these systems including breast and uterine cancer and dysfunctions of the endocrine systems that regulate such organs. Students continue to practice taking histories, doing physical exams and applying the information they gather to making diagnoses.

    Foundations of Medicine Year 2

    Unit 5. Cardiovascular, Renal, Respiratory & Endocrine Systems

    After the summer, this Unit begins the second year of Foundations. Students will learn about the structure and function of the cardiovascular system and the effect of various diseases affecting it such as valvular disease and myocardial infarction. At the same time the effect of disorders of the endocrine system will be explored in relation to their contribution to cardiovascular and other diseases such as diabetes and atherosclerosis. Later, students will explore the functioning of the lungs and kidneys and their roles in maintaining homeostasis together with the consequences of diseases affecting these organs and their treatment. Since these organs act together to regulate normal conditions within the body, students will learn how their functions are integrated and what happens when this normal state is disrupted. Throughout the Unit students will apply their clinical skills and incorporate new information related to examination of the patient including EKG data interpretation and imaging techniques. In this unit, students begin to interview and examine patients in the hospital setting to refine their clinical skills and to practice the fundamentals of clinical reasoning.

    Unit 6. Brain, Mind & Behavior

    Unit 6 is the last component of the Foundations of Medicine and is focused on understanding the central nervous system and its disorders. Initially students will examine the gross and microscopic structures of the various regions of the human brain using dissections, imaging and virtual microscopy. These studies will be combined with recognizing the effects of tumors and infections on the brain. Students will then learn to apply concepts of central neural pathways to the neurological aspect of the physical examination together with the effect of disorders such as epilepsy and stroke and demyelinating diseases. Finally students will explore how the brain determines aspects of human behavior and consciousness and the consequences of defects that lead to abnormal function and behavior (dementia, delirium, psychosis and anxiety or depression). Students continue to practice their clinical skills in order to prepare them for their Core Clinical, or clerkship year.

    Following the assessment week for Unit 6, students will have an interval to study for and pass the Step 1, United States Medical Licensing Exam (USMLE), one of the three exams required for licensure and also required for promotion to our next level of Core Clinical Medicine.

  • Clinical Medicine

    Core Clinical Medicine (Clerkships) — 12 months

    Paired clerkships during the Core Clinical Medicine year to enhance interdisciplinary teaching across clerkships and support integration of relevant basic science knowledge

    Advanced Clinical Medicine — 14 months

    Advanced Clinical Medicine year requires students to take four weeks of integrated biomedical science selectives, a Diagnostic Imaging rotation, a Critical Care rotation, an expanded Emergency Medicine rotation, four weeks of Geriatrics and Palliative Care, and a Sub-Internship. Students will have four months of elective time and four months for vacation, Step 2 studying, and residency interviews.

    Third and Fourth Year Curriculum

    The requirements for graduation are as follows:

    Core (3rd-year) Clerkships Number of Weeks in Rotation
    Transition to Clerkship 1
    Internal Medicine 8
    Surgery 8
    Anesthesiology 2
    Pediatrics 6
    Women's Health 6
    Psychiatry 6
    Neurology 4
    Primary Care/Family Medicine * 4

    * The Primary Care/Family Medicine clerkship extends one half-day per week for 24 weeks, through the Medicine and Perioperative Care clerkships, to allow students a longitudinal ambulatory care experience.

    The third year includes 4 weeks of elective time that can also be used as flexible time or vacation as long as the total clinical time requirements are met by graduation. In the spring of the third year students are required to successfully pass a mandatory standardized patient experience, which is designed to be preparation for the Clinical Skills, United States Medical Licensing Exam (Step 2CS, USMLE).

    Advanced Year (4th-year) Rotations Number of Weeks in Rotation
    Emergency Medicine 4
    Geriatrics/Palliative Care 4
    Critical Care 2
    Subinternship (Medicine or Pediatrics) 4
    Diagnostic Imaging 4
    Biomedical science rotation 4
    Clinical electives 16
    Total Clinical Requirement 85
    Number of “Unscheduled” Weeks 22

    In addition to the clinical requirements listed above, students are required to take the USMLE Step 2CK and USMLE Step 2CS examinations no later than October 31 of their fourth year and to pass them prior to graduation. .

    Clinical Affiliates

  • Learning Methods

    The new curriculum emphasizes methods that will prepare students for the type of learning they will need to engage in as physicians. Teaching methods have been selected which promote student centered, active learning and promote problem solving and clinical reasoning, rather than memorization.

    The curriculum supports active learning through a variety of learning methods described below that promote learning in groups and are linked to frequent feedback via formative assessments allowing both students and faculty members to monitor progress. These methods are chosen to promote learning at an application level with long-term retention.

    Faculty-directed, student-centered learning supports the development of students as life-long learners by using a range of active learning methods to promote higher order cognitive understanding and retention.

    Watch an example video: Radiology Rotating Exhibit

    Students will continually receive feedback on their progress in the six competencies so that they and faculty members can ensure that they become the finest physicians possible

    Interactive Lecture

    Lectures are used to ensure conceptual understanding of difficult material, emphasize key concepts and principles and provide an organizational structure on which to build new learning. Many lectures will be interactive—that is, they will involve students in problem solving, demonstrations, or discussion.

    Laboratory-Based Exercises

    These exercises require students to learn directly from biological materials, such as dissecting cadavers or growing microbial cultures. In addition to the acquisition of medical knowledge, students in laboratory-based exercises learn to work in teams and can practice communication skills by presenting results of their work to other students and to faculty.

    Virtual Microscopy Exercises

    These exercises require students to learn about the normal structure of human tissues and the pathologies affecting them using state of the art technology both in groups and by students on their own.

    Facilitated Small Group Case-Centered Learning

    Students work in groups of 9 or 10 with a facilitator on a patient case. Cases might begin with students gathering case information from a standardized patient to practice patient interviewing skills. Students will derive learning issues from the case by group discussion. After researching the learning issues, groups will meet again to present their findings. This mode lends itself to integrating learning of medical knowledge with clinical skills and mirrors the “discovery learning” skills needed by physicians for a lifetime of learning.

    Facilitated Small Group Clinical Skills Training

    Students work in small groups with a faculty member to learn basic clinical skills. They will develop their command of these skills by practicing on each other, on patients in clinics or doctors’ offices or by working with mechanical simulators or standardized patient actors or teaching associates.

    Patient Care Centered

    Students will work with patients during all four years but learning from patients is most intense in the Core and Advanced Clinical Medicine years. Students will learn medicine in the office and at the bedside during clerkships, other clinical rotations and electives. Standardized patients will be used during the Core Clinical Year to help students refine their clinical skills and to prepare them for the Step 2 Clinical Skills exam.

    Both clinical medicine and foundational basic science will be taught over the entire four years in the three phased curriculum.

  • Assessment (Grading)

    Foundations of Medicine is a Pass/Fail grading system. The Core Clinical Medicine and the Advanced Clinical Medicine is a five (5) tier grading system (Honors, High Pass, Pass, Conditional, Fail).

    Formative assessments will be designed to prepare students for summative assessments at the end of units or clerkships. Assessment, like learning, will be integrated: a standardized patient case might include assessments of several competencies. The use of assessment methods other than multiple choice tests will include essays, objective structured clinical examinations (OSCEs), and other interactive methods.

    All six competencies will be represented in the learning objectives and assessment outcomes for each unit and clerkship. Students will not be allowed to progress to the next phase of the curriculum without satisfying the requirements for each competency.

  • Clinical Neurosciences Pathway

    Read student comments

    Startling breakthroughs in molecular biology and basic neuroscience have defined the cause of many diseases of the nervous system and are transforming the practice of neurology, neurosurgery and psychiatry. Basic research is giving new information on how the brain works and how brain injury occurs-and how it can be prevented or improved. A large number of our faculty are actively involved in and have been contributing significantly to these groundbreaking discoveries. Recognizing the exciting opportunities now available to better understand nervous system function and to design new treatments for neurological diseases, we've developed an interdepartmental program, The Clinical Neurosciences Pathway, to provide an enhanced exposure to the neurosciences while pursuing the Doctor of Medicine degree.

    Program Goal

    The Clinical Neurosciences Pathway provides medical students with an enriched experience in the neurosciences throughout their four years in medical school. This program will provide students interested in the clinical neurosciences (e.g., Neurology, Neurosurgery, Ophthalmology, Neuropathology, Neuroradiology, Psychiatry, Neurorehabilitation, Neuroanesthesia) with access to a number of stimulating clinical and research activities. In addition, students will have the opportunity to participate in activities specifically designed for medical students in the program. Pathway students will be eligible for special summer research and year-out opportunities for clinical and basic neuroscience study.

    Some Specific Elements of the Program

    Special Conferences and Seminars

    Students will receive invitations to departmental programs such as Grand Rounds, Journal Club, and Visiting Professor and other special seminars. Opportunities will be provided for the students to meet with outstanding scientists from within and outside our institution.

    Summer Research Experiences

    The program will provide opportunities for research in laboratories of basic and clinical neuroscientists. Students may apply for funding for this work.

    Clinical Activities

    In conjunction with activities sponsored by the Student Interest Group in Neurology (SIGN), the Downstate Psychiatry Society, and the Alumni Association, students have numerous opportunities to gain clinical exposure, even in their early years of training. Students in the program have the opportunity to shadow faculty and/or residents in relevant clinical areas if desired. Students can also arrange for tours of our specialized facilities (epilepsy monitoring unit, stroke unit, sleep lab). Other clinically-relevant activities typically include panel discussions on career opportunities and residency training in neuroscience-relevant fields as well as case presentations and clinical conferences by residents and/or faculty from the relevant departments. Finally, the Mystery Case of the Month provides the opportunity to work on advanced clinical cases in the neurosciences (see below for more information) and is accessible to all students in all years of training.

    Mentoring Program

    In conjunction with the Alumni Association mentoring program, each student enrolled in the Clinical Neurosciences Pathway will be paired with a clinical or basic neuroscientist as a faculty mentor. This mentor will meet with the student on a regular basis to discuss topics ranging from research issues and new approaches to treating neurological disease to career opportunities. Mentors will help students select summer or year-out research experiences and help develop opportunities for in-depth study.

    Mystery Case of the Month Web-Based Competition

    Each month (September through May), a new mystery case will be posted on PRIME, and students will be invited to submit their answers to the Director of the Pathway. This competition will be open to all students, but members of the Pathway will be expected to submit answers at least every other month in their 3rd and 4th years. This will allow participation in the program even when clinical rotations take our students off campus, making it difficult for them to attend meetings and seminars on site.

    Partnering with Junior Students of the Neurosciences

    Students in the program will be able to participate in Brain Awareness Week activities at local elementary and high schools by giving presentations on common nervous system disorders (dizziness; seizures; effects of drug use; autism; et al.).

    Year-Out Fellowships

    Students will have the opportunity to compete for support for a full year off to gain laboratory or clinical research experience in a number of areas (see graduate school website for details of opportunities on our campus). Molecular neuroscience, cellular neuroscience, experimental therapeutics and other exciting programs may be available.

    Admission to the Program

    The Clinical Neurosciences Pathway is open to all medical students who have a strong interest in pursuing a career in the clinical neurosciences. While students with previous experience in neuroscience are welcome, this is not a prerequisite. Students may participate as much or as little as they like, but those who have participated in all required academic components throughout their MS2 through MS4 years will be acknowledged on Awards Day as graduates of the CNS Pathway. Students who have enrolled may drop out at any time without penalty. One may enroll by simply e-mailing the Program Director any time during the MS1 year.

    Medical Educator Pathway


    The Medical Educator Pathway (MEP) is a longitudinal experience that allows College of Medicine students to combine the Integrated Pathway Curriculum (IPC) with teaching experiences, educational scholarship, and independent coursework. SUNY Downstate has a long history of producing outstanding medical educators and can prepare its students for careers in medical education through the Medical Educator Pathway.

    Students engaged in the pathway will be afforded the opportunity to build a foundation in educational techniques and experiences prior to the start of residency. This opportunity is congruent with the Accreditation Council for Graduate Medical Education's (ACGME) emphasis on residents as teachers, and therefore may aid in enhancing the appeal of Downstate College of Medicine graduates to residency programs and directors.

    Mission of the Medical Educator Pathway (MEP)

    The purpose of the MEP is to prepare medical students with the knowledge, skills and attitudes to be future leaders in medical education, both in the formal realm of academic medicine and the informal realm of patient and community education. Medical Educator Pathway goals include promoting and celebrating excellence in teaching and to support innovation, scholarship and research in medical education.

    Medical Educator Pathway Components

    Core Requirement — MEP Introductory Course

    Through this mini course, students will acquire a basic understanding of educational principles and theory relevant to medical education, as well as basic teaching methodology. Topics to be covered in the mini-course include the following:

    • Instructional methods: pre-clerkship, clinical, patient, community
    • Curriculum development and evaluation
    • Adult learning theory
    • Evaluation and assessment
    • Medical education research and literature
    • Leadership and organizational development


    Students will be paired with a mentor who will guide them through their scholarly projects as well as be a resource throughout medical school.

    With each subsequent MEP cohort, new MEP students will be added to the mentor-MEP student team to create an MS1-MS4 Mentor team. In this way students will also serve as mentors to other junior MEP students. Other examples of mentorship opportunities include serving as mentors to non-MEP medical students, grade school, or high school students.

    Committee Service

    Students in the MEP will be encouraged to serve on at least one committee during medical school that focuses on some aspect of medical education, including, but not limited to, Admissions, Curriculum and Educational Policy, Student Liaison Committee, or Dean's Council.


    Students are expected to teach during medical school and/or complete related educational activities. Activities include, but are not limited to:

    • Developing and delivering lectures
    • Tutoring
    • Creating and/or facilitating a PBL or other small group sessions
    • Teaching clinical skills physical exam sessions
    • Serving as a simulated patient
    • Developing formative and summative assessment materials
    • Developing new materials or methods for teaching
    • Curriculum development

    All activities should be supervised and evaluated by an MEP faculty member or an MEP peer mentor.

    Research and/or Medical Education Conferences

    It is expected that students will present or attend at least one regional or national education conference while enrolled in the pathway.


    Students will assemble a portfolio to document their MEP experience. Examples of what could be included in the portfolio include:

    • Personal teaching philosophy
    • Curriculum products
    • Reflection regarding goals as an educator
    • Feedback/evaluation received from students/faculty
    • Other products related to teaching, i.e., study sheets for tutoring, lectures
    • Documentation from presentations at conferences

    Criteria for Successful Completion of Medical Educator Pathway

    • Completion of at least 1 Educational/Teaching experience per year over 4 years
    • Attendance to 4 lectures per year over 4 years
    • Attendance/Presentation to at least one Medical Education Conference in 4 years
    • Completion of Portfolio, Mentoring and Committee Service criteria

    Admission Criteria and Prerequisites

    The pathway is open to all students in good academic standing who consistently demonstrate professional behavior in medical school.

    In the middle of the first semester of medical school, the entire first year class will be sent an email which describes how interested students may enroll in MEP. A student may enroll in the MEP program during Foundations 1 or 2. Special exceptions to enroll during later years will be judged on a case-by-case basis. Students who have enrolled may withdraw at any time without penalty.

    Upon completion of the MEP, students receive an award and are to be acknowledged on Awards Day as a graduate of the Medical Educator Pathway. Their participation in the MEP is to be noted in their Medical Student Performance Evaluation (MSPE/Dean's Letter for residency application).

    Ethics Pathway


    To encourage medical students to utilize personalized, professional reflection and exercises in order to develop an individualized approach for working out real-life ethical situations in clinical settings. This pathway will supplement the existing clinical ethics exposure and training by educating students on a wide array of principles and methodologies for bioethical analysis and fostering the skills necessary to engage in rational and thoughtful bioethical discourse.


    The pathway will consist of a one semester case-based class to be completed in the first two years of medical school, with a capstone project. There will be periodic lectures during the duration of the student's time in the pathway, and the ability to facilitate and participate in classes in the following years. The course will focus on a different theme each year, beginning with neuroethics with a focus on brain death (proposed future topics include end of life decision making and advance care planning; maternal, fetal, and perinatal ethics; health disparities; public health ethics; and genetics and genomics). The overall content will emphasize analytical skills and collaborative discussion, and familiarize students with the place of bioethics in the context of medicine, history, philosophy, law, and policy.


    Attendance will be taken at all sessions, as well as all eligible ethics events that students may participate in for duration of their program. Students and participating faculty will be asked to evaluate the course yearly.


    The course will begin in Fall 2016, with sessions twice per month, totaling 8 sessions.

    Session Example of Topics
    1 Introduction to Ethical Principles, Methodologies and Analysis
    2 Foundation for Ethical Considerations in Brain Death.
    3 Ethical Principles Over Time — Collaborative discussion and project work time.
    4 Ethical Principles Over Time — Collaborative discussion and project work time.
    5 Ethical Principles Over Time — Collaborative discussion and project work time.
    6 Narrative Medicine.
    7 Preparation of Pathway Project.
    8 Share Projects with pathway participants.
    Final Students may submit their projects for presentation at conferences or for publication.

    Global Health Pathway Curriculum

    The goal of the Global Health pathway at SUNY Downstate’s College of Medicine is to provide a longitudinal curricular pathway for medical students interested in Global Health to identify, engage in and advance innovative and sustainable solutions in health care worldwide. The pathway will achieve that mission through integrating collaborative, inter-professional approaches to education, researchand servicefor GH populations and individuals into the four-year medical school curriculum.

    The GH Pathway specific goals are

    • To create awareness, understanding and a vibrant dialogue around global health issues within Downstate and our larger communities.
    • To specifically integrate knowledge of global health issues in the context of historical, geo-political, economic, environmental, and social factors into the practice of Medicine at home and abroad.
    • To develop and advance scientific research and learning concerning global health problems.
    • To develop and promote student leaders as champions for solutions to global health problems in collaboration with international partners through service learning opportunities.
    • To tap SUNY faculty leaders as supporters for direct engagement with international partners to find interdisciplinary solutions to global health problems.

    Pathway Curriculum

    MS year Activity Detail / Requirement

    MS I

    Global Health Lecture Series

    • Attend 8 of 10 scheduled GH Lectures

    MS II

    Seminar Series

    • September through January
    • Small group seminars on specific case studies (5 cases total)
    • Based on Case Studies in GH by Ruth Levine


    MS III

    Online Clinical Case Studies

    • Global Health clinical case studies

    MS IV

    Supervised Culminating Experience

    • Global health service experience
    • Local GH experience
    • International experience
    • Research project
    • GH competition

    Detailed Pathway Outline

    MS I

    Topics in Global Health Course

    The purpose of this course is to introduce future healthcare providers to a selection of issues affecting the health of populations in developing countries. The focus is on major contributions to the burden of disease in the developing world. However rather than attempting to cover every area with the purview of global health, we seek to expose students to topics in research and practice that will provoke discussion and insight into this diverse and growing field. For students who are interested in conducting work or research abroad, this course may aid in gaining knowledge for future career options as well as improve critical thinking on the role of the clinicians in global health. Additionally, students who attend and participate actively in the course should gain insight into global health issues affecting patients in increasingly diverse domestic communities.

    The course consists of 10 evening classes

    Course Objectives:

    At the completion of this course students should be able to:

    • Describe the major stakeholders involved in implementation of global health initiatives
    • Identify communicable & non-communicable illnesses that contribute to the global burden of disease
    • Identify mechanisms of which physicians can contribute to sustainable global health solutions
    • Identify barriers in providing primary care and long-term care in the global community.
    Course Structure:

    Part I: Defining Global Health and Discussion of Key Issues

    1. Overview of Global Health: Why is the third world the third world?
    2. Health Systems and Management

    Part II: Role of Physicians in contributing to Global Health Solutions

    1. Infectious Disease
    2. Disaster Management and Emergency Medicine
    3. Maternal Health
    4. Reproductive Health
    5. Mental Health
    6. Surgery
    7. Humanitarian response
    8. Careers in Global Health
    Course Requirements:
    • Attendance (8/10 sessions)
    • Active participation

    MS II

    Global Health Seminar Series

    The seminar series will provide case-based learning focused on logistical and ethical concerns within the global health arena. This five-case series will take place during the 2nd year of medical school from September until January. Monthly meetings will allow for a review and study of five cases from Case Studies in Global Health: Millions Savedby Ruth Levine. Each case will culminate in an assignment (approximately 2 pages) designed to provide written analysis and address lessons learned.

    • Provide case-based learning that illustrates real-life examples of global public health.
    • Provide a foundation in social and global awareness through ethical engagement.
    • Identify some of the strategies used in successful community health interventions to prevent or treat disease.
    • Understand the major benefits and limitations of various global health intervention strategies.
    Course Structure:
    • Case #1: Preventing HIV/AIDS and Sexually Transmitted Infections in Thailand
    • Case #2: Eliminating Polio in Latin America and the Caribbean
    • Case #3: Improving the Health of the Poor in Mexico
    • Case #4: Reducing Guinea Worm in Asia and Sub-Saharan Africa
    • Case #5: Preventing Neural-Tube Defects in Chile
    Course Requirements:
    • Attendance at 4/5 seminar sessions
    • Completion of 3/5 course assignments
    • Active participation

    MS III

    Reasoning Without Resources: Clinical Case Series

    This case-based clinical series from the district hospital of Kisoro, Uganda, provides clinical education around common diseases encountered in rural Uganda while modeling an approach grounded in clinical reasoning, practical epidemiology, and physical diagnosis skills. This series will take place during the 3rdyear of medical school and is designed to be held as a group learning session with a facilitator but can also be done as a group online activity. Each session will have 2 to 4 cases and will be organized in themes that can be completed every month.

    • Introduce students to commonly encountered diseases and disease patterns from rural Uganda with an emphasis on clinical manifestations and its relation to disease severity
    • Provide practical approaches to diagnosis in resource-limited settings
    • Learning to apply clinical prediction rules to improve diagnostic suspicion of diseases as well as disease states
    • Applying critical analysis of physical exam findings and maneuvers
    • Understanding the intersection of disease prevalence, disease severity and geo-social factors
    Course Structure:
    • Session 1: Fevers (Malaria, Dengue, Typhoid)
    • Session 2: Fevers II (Borrelia, Leptospirosis, post-viral CAP)
    • Session 3: Fevers III (Brucella, TB/HIV)
    • Session 4: CNS Syndromes (Cerebral Malaria, Bacterial Meningitis, Sleeping Sickness, TB Meningitis)
    • Session 6: Abdominal Pain (HCC, Hepatic Abscess, TB peritoneum, Amoebic Abscess)
    • Session 7: Cardiac (EMF, Mitral Stenosis/Pregnancy, Purulent Pericarditis, RHD)
    • Session 8: Renal Vignettes
    Course Requirements:
    • Attendance and participation in group sessions or online sessions
    • Submission of answers for feedback (not graded)

    MS IV

    Supervised Culminating /Practical experience

    The final year will give student the opportunity to apply the acquired knowledge in the context of an actual Global health experience. Due to differing financial and logistical circumstances these experiences may vary considerably in their make-up and execution. However, 4thyear students are required to write a well-researched proposal for their experience, seek out personal mentorship, make the necessary preparations and finally engage in the specific activity.

    • Apply GH knowledge in a real-world environment by selecting from one of the following:
    • International experience
      • National or Local experience with a GH organization
      • GH research project
      • GH case competition at Emory University
    • Be able to outline goals and objectives as well as define outcome measures
    • Understand the inherent structures and barriers in the implementation of GH projects
    • Observe, analyze and learn
    • Critically evaluate GH interventions
    Course structure:

    Students in conjunction with the course directors will identify a GH project that fits their circumstances. Several opportunities have been already identified by the course directors internationally or locally. Students may wish to undertake a research project with one of the course directors. Finally, if selected through the application process, students can participate in a national GH competition at Emory University as their chosen activity to meet their fourth-year pathway requirement.

    Either way, students will write a proposal outlining the need, the planned intervention, and the expected outcome parameters. Following their practical experience, the student will write a comprehensive and critical analysis of their project and submit to the course directors.

    Course Requirements:

    Completion of a pre-approved project, including the project proposal and the outcome evaluation.;

    Admission to the Global Health Pathway

    The GH pathway is open to all students with strong interest in GH regardless of previous GH experience. However, admission to the pathway is limited to 20 students who will write a formal application, outlining their interest, expectation, experience, and reason for wanting to choose that pathway


    Students will be assigned to GH mentors with whom they will communicate on a regular basis and who will work on specific projects. This becomes particularly important in the Fourth Year.


    The Pathway directors will record attendance and fulfillment of required tasks. Minimal criteria for completion will be distributed to the students prior to signing up for this pathway.

    Minimal Passing Criteria:

    • MS I: Attendance of 8 of 10 lectures
    • MS II: Attendance and participation in 4 of 5 seminars
    • MS III: Well researched answers to 8 of 10 case study questions
    • MS IV: Successful completion of research project or local GH service experience or International GH service experience or other

    Participation in this program and its activities is not mandatory and students may drop out at any time, however students should be aware of the additional time commitment before applying to this pathway.


    • Dr. Jack DeHovitz
    • Dr. Stephan Rinnert
    • Dr. Christina Bloem
    • Dr. Rikki Morris
    • Dr. Noriyuki Murakami
    • Dr. Cameron Page


    Global Health Pathway Examples