The Practice of Medicine Course

The School of Medicine curriculum contains a unique course titled, "The Practice of Medicine (POM)." This revolutionary course, spanning all four years, allows students to begin clinical training during the first two years while studying the basic sciences. Students then revisit these basic sciences during their final two years of clinical experience. The POM course is the largest course running throughout Years 1 and 2.

In Years 1 and 2, POM consists of three segments. In the Doctor, Patient and Society (DPS) segment, students are assigned to eight-member "mentor groups," which are led by two faculty mentors (one of whom is medical faculty, the other psychiatric faculty) and a 4th-year student. In this segment, students learn about the doctor-patient relationship, essential communication skills, basic clinical assessment skills of interviewing and physical examination, professionalism, ethics, and many issues of the medicine-society interface. The Clinical Skills Center in the new hospital will be the setting for much of this experience.

In the Clinical Apprenticeship Program (CAP), students are paired in one-on-one relationships with primary care physicians for a longitudinal two-year apprenticeship in which they can practice their newly learned skills and participate in clinical medicine from the first two weeks of their studies.

Finally, students participate in a Problem-Based Learning (PBL) segment that challenges them with clinical cases that integrate biomedicine, psychosocial issues, and the art and science of clinical problem solving and decision making.

In the third year, POM includes one day every two months of didactic instruction and technical skill instruction that reinforces psychosocial behavior and ethical objectives within the context of real life experiences. Basic science concepts within the clinical setting are also reintroduced in Year 3.

In addition, students are exposed to evidence-based medicine practice and statistical and epidemiological principles in clinical practice. The DPS mentor groups also continue once every eight weeks during POM 3. This offers students continuity with their "home group" of familiar peer students and faculty to help process the many new experiences of life and learning that occur during the third-year clinical clerkships.

As a bridge from POM 3 to POM 4, students are required to work with a faculty member over a year-long period on a scholarly project that will result in a written report that is suitable for submission for publication. In the past, students have researched a wide range of topics and a substantial percentage of their papers are published each year.

The 4th year POM course includes an intensive two-week experience involving the refinement of many ward and ambulatory technical skills and didactic lectures to reinforce the clinical competencies in the areas necessary to prepare students for life as a physician in residency training.

As a senior elective, students may participate in the POM IV Elective, a unique medical education course called "Teaching Senior Students to be Educators." This two-week experience is actually composed of six workshops and an instructional practicum that occurs throughout the senior year.

Students receive instruction on general adult learning theory, how to teach skills, how to give feedback, and how to serve as a standardized patient (SP). They are then teamed with a DPS mentor group and given the opportunity to co-teach, with a medical faculty member, physical examination skills.

These students also serve as a SP-examiner during the Performance-based Examination at the end of each semester in Years 1 and 2 of the POM course. In these exams, the seniors assume the role of a patient, evaluate their junior peers' performances, and give them real-time feedback. Between 40 and 60 students participate in this teaching elective each year, and they have continually rated it as extremely valuable. It serves as an excellent preparation both for the teaching roles graduates immediately assume as residents and for their teaching roles with their future patients.