Chobanian & Avedisian SOM Curriculum

The BU Chobanian & Avedisian School of Medicine Curriculum is guided by the principle of integration of foundational science, clinical medicine, and health equity.

Highlights

Principles Integrating Science, Clinical Medicine, and Equity (PISCEs)

PISCEs is a longitudinal integrated course during the preclerkship phase of the curriculum that prepares students with the medical knowledge needed to care for patients. It integrates foundational science, pathophysiology, and disease management. The course is broken into three foundational modules followed by eight systems-based (e.g., cardiovascular, neuro/psych) modules. Woven into each of these modules are longitudinal threads that include oncology, infectious disease, anatomy, microbiology, pharmacology, and pathology, as well as the school’s health equity curricular themes. The last 10 weeks of the preclerkship curriculum, called the Advanced Integration Weeks, focus on integrated cases based on the Core patient presentations organized by clinical areas and disciplines. Students will revisit prior foundational, clinical, and social science content in patient cases to help students consolidate and integrate the material. In these final 10 weeks of the preclerkship phase, students are immersed each week in patient cases that begin with a patient presentation to a clinic or ER and then evolve over a week where students navigate patient signs, symptoms, labs, and imaging to again connect foundational science to patient data they will see in clerkships. These cases also have a goal of introducing students to patient cases that are representative of our patient population at Boston Medical Center, our primary teaching hospital. All cases are based on real patient cases and integrate teaching about our unique populations highlighting knowledge and skills needed to address our curricular key themes and populations. Finally, students collaborate in small groups to solve clinical problems, simulating the “clinical team” in medical practice, and review and prepare for the USMLE Step 1 exam. The PISCEs curriculum uses multiple instructional design strategies to support active learning, peer learning, and team development.

Learn, Experience, Advocate, Discover, and Serve (LEADS)

LEADS is a two-year course intended to provide our students with time in the formal curriculum to immerse themselves in learning, experience, and discovery in health equity so that they can develop skills in designing scholarly innovations now and in their future careers.

The LEADS health equity curriculum begins with an overview of health equity and the inequities in health that exist due to factors at the personal, social, political, and other structural levels. The course has students consider the role physicians have in recognizing and addressing adverse social determinants of health and the inequities and injustices that contribute to health disparities. The health equity areas of focus in this course include: LGBTQIA+ Health, Global and Refugee Health, Community Health, Homeless Health, Structural Determinants of Health, Racism in Medicine, and Addiction and Health. All areas of focus have one or more faculty leads who are content experts, deliver core knowledge in the course, provide mentorship, and work with students to develop individualized goals.

The curriculum also engages students in experiential opportunities to advance their understanding of inequities and allow them to further witness the challenges marginalized patients face. Students are introduced to BMC faculty and staff and community leaders who will share solutions and interventions that have led to improved health outcomes. Longitudinally, students engage in regular journal clubs highlighting evidence-based interventions related to health equity and are taught scholarly methods to make change, including research methods, educational methods, health systems science, and community-based and advocacy interventions.

Finally, students learn ways to disseminate their ideas, including through narratives, curricula, and other formats. Students are responsible for designing a scholarly project focused on a potential intervention of change in their health equity focus area by the completion of the course.

As part of this course, students can join a Longitudinal Research Track as part of the Medical Student Research Program and will be mentored in a three- to four-year experience designed for students who want to immerse themselves in research. Students in this track participate in additional required extracurricular hours with their research team outside of the LEADS curriculum.

LEADS weeks also include PISCEs Integrated Cases. During the LEADS weeks, in addition to the LEADS-focused work, students are presented with several patient cases that emphasize foundational science concepts presented in prior weeks to help students reintegrate content from multiple systems previously presented. The cases: 1) present student with signs and symptoms that demonstrate how physiologic and anatomic processes lead to patient presentation, 2) present diseases that are multisystem and highlight multiple processes at once, 3) integrate clinical schema to emphasize the approach to developing a differential diagnosis based on patient presentation, and 4) introduce students to the Core Presentations, which are the 44 chief complaints and 15 health prevention/chronic diseases/other conditions we expect students to be able to clinically reason through before they graduate.

The curriculum described below applies to the four-year program.

First Year

The first-year curriculum includes:

• Principles Integration Science, Clinical Medicine, and Equity (PISCEs)
  • Foundations 1
  • Foundations 2
  • Foundations 3: Pharmacology, Immunology, Microbiology/ID, Genomic Medicine, Oncology
  • Cardiovascular
  • Pulmonary
  • Renal
  • Reproduction and Endocrinology
  • Hematology
• Learn, Experience, Advocate, Discover, and Serve (LEADS)
• Doctoring

Second Year

• Principles Integrating Science, Clinical Medicine, and Equity (PISCEs)
  • Neurology
  • Psychiatry
  • GI
  • Dermatology/Rheumatology/Musculoskeletal
  • Advanced Integration Weeks
• LEADS
• Doctoring
• Consolidation and Preparation for Clerkships (CPC) Course

Third Year

This is the core clerkship year. Students complete their initial clinical rotations, participating in active ambulatory and inpatient practices on major teaching services:

• Medicine—8 Weeks
• Surgery—8 Weeks
• Family Medicine—6 Weeks
• Obstetrics/Gynecology—6 Weeks
• Pediatrics—6 Weeks
• Psychiatry—6 Weeks
• Neurology—4 Weeks
• Third-Year Selective (Radiology, Emergency Medicine, Research)—4 Weeks

Students work with residents and attending physicians in the care of a broad range of patients and clinical conditions through a series of required and elective clinical blocks.

Fourth Year

In the fourth year, students complete advanced clinical rotations in geriatrics and a sub-internship in the specialty of their choice, a back-to-the-classroom course where foundational science concepts are revisited through a clinical lens, and a minimum of 28 weeks of elective time with opportunities to pursue clinical and basic science research, teaching, as well as independent study programs.

Study Abroad and Research

Many students choose to spend some of this time at other institutions, either in the US or abroad in Chobanian & Avedisian School of Medicine’s very active International Health program.

Chobanian & Avedisian SOM is a major research institution and students may return to research interests they have pursued in the past or try out research projects for the first time. Stipends are available for those rising second-year students who wish to undertake a summer research fellowship.

Elective Research Year

Students may choose to take an elective research year between the second and third years or third and fourth years of the curriculum.