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. Team based learning and interactive lectures enhance the learning experience during the first two years.
Goals of the Curriculum
The Eight Domains of Competence
SUNY Downstate's domains of competence delineate the attitudes, knowledge and skills that students should possess upon graduation from this medical school. Each domain represents a distinct but interrelated component of an integrated model of physician competency. These competencies form the basis for graduation from Downstate, assuring that the physician is knowledgeable, technically skilled, socially conscious and professionally responsible. Upon graduation from SUNY Downstate, the student will have demonstrated the following:
The graduate demonstrates integrity and honesty in her/his role as a physician, respect and responsiveness to the needs of patients and society that supersedes self-interest, and high standards of moral and ethical behavior. Included in this is awareness of the ethical dimensions and broader social issues in the practice of medicine and health care policy.
2. A knowledge of basic science that forms the basis of clinical medicine
The graduate demonstrates knowledge of the basis of disease and its natural history at the molecular, cellular and system level, understanding the scientific rationale that guides therapeutic intervention. Inherent in this competency is an understanding of the scientific process and a commitment to the use of scientific knowledge in the clinical care of patients.
3. Effective communication
The graduate conducts a thorough patient-centered interview, eliciting a medical history from patients of diverse backgrounds in major clinical venues, forming a therapeutic alliance which encourages patient education, counseling and shared decision making. The graduate communicates clearly in writing and orally with members of the health care team in order to effectively teach and coordinate care.
4. Basic Clinical Skills
The graduate demonstrates skill in eliciting information from the medical history and physical examination in a compassionate and respectful manner. The graduate uses appropriate and cost-effective laboratory tests and technology, and synthesizes patient information to arrive at a reasoned diagnosis, therapeutic plan, and ongoing management.
5. An understanding of health maintenance and disease prevention
The graduate demonstrates the ability to educate patients and their families to adopt health-promoting behavior, and to work within a health care team to optimize health. Moreover, the SUNY graduate will know those practices that maintain the health of the patient and those that address the health of a population.
6. An awareness of healthcare in the context of community and society
The graduate understands the many non-biological factors that influence health, disease, disability, and access to care. Specifically, the SUNY Downstate Medical Center graduate will be aware of those issues affecting health and the resources available to care for patients within an urban, culturally diverse community.
7. Information management
The graduate must demonstrate competency in utilizing resources that support clinical decision making, including an understanding of the principles of evidence based medicine. This requires the ability to critically appraise the literature and to apply this knowledge to the care of the individual patient.
8. A commitment to life-long learning
The graduate recognizes and reflects upon personal limitations in knowledge and experience, and uses feedback to enhance her/his ability to fulfill the role of a physician. There is evidence of a clear commitment to on-going learning to maintain state-of-the-art patient care.
Second Year Curriculum Through the Class of 2016
Block 1. Immunity, Inflammation & Infection
This block deals primarily with the scientific basis of infectious disease, including fundamental aspects of medical microbiology, human immunology, pharmacology of anti-microbial drugs, pathology of inflammation, and epidemiologic and public health issues relating to communicable disease. The block forms the basis for coverage of specific infections during the organ-system blocks occurring during the rest of the second year. Also covered are the pathology and pathophysiology of rheumatic diseases, diseases of the skin and musculoskeletal system, and the fundamental principles of drug therapy and of cellular pathology, which are the foundations of the pharmacology and pathology coverage throughout the year. Special emphases include immunopathology and AIDS.
Block 2. Hematology/Neoplasia
This block addresses abnormal hematology and the pathophysiology of neoplasias.
Block 3. Gastrointestinal System
This interdisciplinary course presents the biological basis of disorders of the gastrointestinal tract, liver, biliary tree and pancreas. It includes anatomic, genetic, pathologic, microbiologic and immunologic aspects, and illustrates pathophysiologic and clinical features of digestive disease. The indications and mechanisms of action of chemotherapeutic approaches for both infectious and non-infectious conditions are highlighted.
Block 4. Cardiovascular System
This block covers both the pharmacology of the autonomic nervous system and the mechanisms of cardiovascular disease. Students are introduced to the pathology and pathophysiology underlying several cardiovascular conditions and their associated pharmacological treatments.
Block 5. Respiratory System
This block covers diseases and disorders of the respiratory system, including the lungs, chest wall, upper airways, and CNS control pathways. The content includes major/representative chest diseases, pathogenetic mechanisms, applied physiology, pathology, microbiology, diagnostic tests, pharmacology, and epidemiology. Pertinent illustrations from the fields of public health, environmental medicine, and disease prevention are presented. The block consists of lectures and practical laboratory sessions (clinical and basic science faculty), with case-based learning used to reinforce some core concepts and provide experience in clinical assessment and reasoning.
Block 6. Endocrine & Reproductive Systems
The block covers disease processes involving these organ systems. The topics are taught through a multidisciplinary approach with the participation of pathologists, clinicians and pharmacologists. The pathology, pathophysiology, clinical manifestations and pharmacologic therapy of these diseased states are discussed. Specific women's health issues as well as fetal and neonatal diseases and infections will be addressed in the Reproductive portion. The block consists of a series of lectures and laboratories with sexually transmitted diseases taught through a case-based learning approach.
Block 7. Urinary System
The goal of the second year urinary system block is to enable students to learn principles for regulation of fluid and electrolytes and principles of disease processes of the kidney and the urinary tract, so that they can better understand pathological conditions that involve this organ system and disorders of fluids and electrolytes.
Block 8. Nervous System & Psychopathology
This second year block further aims to prepare the students for the clinical rotations by means of lectures, case-based learning, laboratories and clinical preceptorships. The subjects covered in these learning sessions include introduction to clinical assessment and pathophysiology of central and peripheral nervous system disorders (including disorders relevant to neurology, psychiatry, otology, ophthalmology, and anesthesiology), which covers neuropathology, microbiology of nervous system diseases, neuro and psychopharmacology, pharmacology of anesthetics, and pain management. Additionally, forensic pathology and toxicology are taught in this section.
Essentials of Clinical Medicine II
The second year of the Essentials of Clinical Medicine is designed to help students acquire the knowledge, skills and attitudes to master seven competencies important to every physician. These competencies are:
- prevention & screening,
- medical history taking,
- physical diagnosis,
- health partnership with patients,
- the healthcare team,
- the healthcare system, and
- using the literature.
The Essentials of Clinical Medicine II is arranged in two parts:
- Part I: Comprehensive Care Case Studies, a component based on five cases each of which offers exploration of several of these clinical competencies, and
- Part II: Preparation for Clinical Medicine (PCM) Interviewing and Physical Exam, a series of sessions designed to help students develop history and physical diagnosis skills.
Second year students are required to take USMLE Step 1by June 30 and earn a passing score to continue in the third year.
Clinical Neurosciences Pathway
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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.
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.
Specific Elements of the Program
Basic Mechanisms of Clinical Neuroscience Course
This course is offered as an elective every Fall of 2nd year; for students enrolled in the Pathway, it will be a mandatory part of their curriculum. Eight sessions, 1–1.5 hr each, cover clinical topics in the neurosciences and highlight what is understood about the underlying basic mechanisms. This is a cutting-edge course in which our research faculty members have the opportunity to share with the students their research endeavors in an exam-free setting. Students benefit by (1) gaining insight into the strong clinical relevance of the basic neuroscience they learned in 1st year, (2) hearing about breakthroughs in the neurosciences before these topics make it into their textbooks, and (3) discovering the extent of basic neuroscience research taking place on this campus by our world-renowned faculty.
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.
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.
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.
History of Neuroscience/Journal Club Seminar and Discussion
In this series of lectures and discussions, students will review topical neuroscience articles (“landmark” papers) or cover aspects of the historical development of our knowledge about the nervous system and the evolution of modern neurology. These will be held in an informal social setting, allowing for an intimate casual discussion of the topic. There will be no more than 3-4 such sessions per year.
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.).
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.