Orientation

Orientation will be your introduction to the Vanderbilt University School of Medicine. You will spend two days in discussions about professionalism, diversity, and the relationship between culture and medicine. The goal of orientation is to make the transition to a new system/city/school as smooth as possible. Traditionally, the first day includes a welcome from the deans and an introduction to everyone in the class. Attire for this day is dressy; men should wear a tie and slacks, and women should wear a dress, skirt, or nice pants. Other events include a luncheon with your faculty advisors and photographs for the class composite, student directory, and your VUMC ID badge. In addition, at some point in the week you will break up into small groups to discuss a book that you should have received via mail this summer. There will be a Student Organization fair, where you will learn about student organizations, resources at Vanderbilt, and a variety of electives that are being offered.

Informational sessions about the first-year courses will be administered by the course directors. Fear not, notes will not be passed out on the first day! However, be prepared to be inundated by a great deal of information regarding classes, course material, and how to prepare to be a medical student. Just remember that the professors at Vanderbilt are always there to help you; this will become evident starting from day one. Other activities planned for the week include an informational session about the Student Health Center and a trip to Student Health if you didn’t mail in your health information or are not up-to-date on immunizations.

In your free time during orientation and the first few days of classes, be sure to run your errands (set up a bank account, call the utility companies, etc) and take care of parking registration if you plan to park on campus.

First-Year Academics

With help from Dean Bonnie Miller, Dr. Tyler Reimschisel, Dr. Chrissy Marasco, Dr. William Cutrer, Aidan Hoyal, Regina Russel, and Martha Hutchinson

Curriculum 2.0

Congratulations, Class of 2019, and welcome to Vanderbilt! As you know, Vanderbilt’s curriculum has been changing over the past couple of years. By the time you begin classes, Curriculum 2.0 will have been completed by two classes ahead of you and has been tried and tested for years before this when previous classes transitioned into a 1.5 year preclinical curriculum prior to the full change. There will be great mentorship available from the two classes above you and the curriculum is being optimized constantly through continuous student feedback to provide the best learning experience possible. The new curriculum is rigorous, but the Classes of 2018 and 2019 are thriving and your acceptance here means that with hard work you will be able to do the same! Also, the first-year interactive, student-centered curriculum will be to your benefit when you enter the clerkships because it will provide you with a much better foundation in clinical medicine than your predecessors had.

See below for a brief description of each of the blocks in the first phase of the new curriculum as well as a section with common questions.

An enlarged version of this schematic of Curriculum 2.0 can be found here.

Foundations of the Profession

Course Director: Dean Bonnie Miller

“Foundations” is your very first course in medical school. It begins immediately after Orientation and runs for one week. During this time, you will discuss various components of what it means to be a modern physician, including the ethics, business, and history of the profession of medicine. The course gives you time to reflect on why you are in medical school prior to jumping into the “hard science” courses. It encourages you to understand the humanity behind medicine instead of just the facts and data. Use this week wisely to explore your motivations for going into medicine and how you envision your career unfolding. Also, strive to get know your classmates and get settled in Nashville during this time.

Foundations of Medical Knowledge

The first phase of the curriculum, Foundations of Medical Knowledge, will last thirteen months and will provide a solid, broad foundation of knowledge and skills. Multiple learning methodologies, including teamwork around structured cases (called “case-based learning”), will be utilized to promote integration and application of new information. Subsequent years of training will deliberately build upon this foundation, with escalating level of detail as the learner advances. The intent is to focus on conceptual understanding, thus promoting better retention of information.

Foundations of Clinical Care

Progressing through the curriculum, the student will have graduated responsibilities. The Foundations of Clinical Care (during the second year) provides education in multiple medical disciplines via clerkships in medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, and neurology. There are elective opportunities as well.

VC3, a symptom-based framework of core clinical problems, is coupled with a portfolio system that automatically tracks individual student-patient encounters. These programs promote integration of learning across disciplines. A unifying longitudinal course (Diagnostics and Therapeutics) explicitly addresses the strengths and limitations of various diagnostic/therapeutic approaches and elucidates clinical reasoning; this will encourage informed, effective and efficient care.

Immersions

The Immersion phase (during years 3 and 4) is a highly individualized period which will build upon the foundational knowledge acquired earlier, in a context that is most relevant each student’s individual interests. Immersion courses will incorporate explicit teaching of the scientific, ethical, legal and social dimensions of medicine, frequently in the context of delivering clinical care. Students will select from a broad menu of courses to complete core requirements and pursue individual interests. The intent is to encourage learners to “dive deeper” as they become more sophisticated. Within this period, each student will complete a research requirement (Emphasis). Students will avail themselves of Vanderbilt University’s tremendous research enterprise and can choose from many areas of academic focus, such as Biomedical Informatics, Community Health Initiatives and Health Outreach, Global Health, Healthcare and Public Health Research and Management, Laboratory-Based Biomedical Research, Medical Education, Medical Humanities, Ethics and Policy, Patient-Oriented Research.

Longitudinal Courses

The Learning Communities

Course Leadership: Bill Cutrer, Keith Meador, Larry Churchill, Quentin Eichbaum, Lynn Webb, John Graves, and the College Mentors

The Learning Communities course was originally launched with the Class of 2015, as the College Colloquium, representing a big step in the transition to Curriculum 2.0. The College Colloquium expanded the College system to include a stronger academic focus, since this course was taught within the individual Colleges. The 25 students of each College met in separate rooms, along with their two College Mentors. The College Colloquium was developed by Quentin Eichbaum, who oversaw its development and implementation. The Learning Communities course represents the continued evolution of the academic focus of the Colleges and now includes the College Colloquium as well as separate blocks addressing Ethics, Leadership and Policy.

The Learning Communities course is a unique experience for both students and Mentors. Its curricular content is comprised of many different issues that are important to medicine, yet not traditionally found within the science-laden curriculum of the pre-clinical years. The course will critically train and mentor students in understanding the principles of medical ethics, addressing medical controversies and issues in professionalism, and reflecting upon the clinical patient-physician relationship. The course then continues with a strong focus in meta/neurocognition (“thinking about thinking” – including topics on how we learn, critical thinking, how we make decisions, human/cognitive error, medical error, language and communication, mindfulness, the nature of empathy, etc). Understanding how uniquely each person is cognitively “wired” is considered the basis for empathy and tolerance as well as for respectful professional interaction and debate. Neuroscience has immensely enhanced our understanding of human cognition in recent years, making this an exceptionally rich field where the humanities and sciences now meet and find exciting common ground. The Learning Communities also includes topics in “narrative medicine” and students will be expected to write three personal reflections each semester. Reflective writing is envisioned as another approach towards fostering and nurturing, in a sustainable manner, students’ innate empathic capacities.

Learning communities sessions have three main components: 1) Pre-reading preparation, 2) Context talk, and 3) College group discussion. Mentors will help to facilitate each session, with the goal of generating interactive, engaged discussions. Accordingly, the Learning Communities are envisioned as the center of the College community, since the course will provide a special opportunity for the students and Mentors to come to know, appreciate, and understand one another.

Research

Course Directors: Tina Hartert, MD, MPH and Chrissy Marasco, PhD; Course Coordinator: Lynne Caples

The research curriculum is a four-year thread. During Foundations of Medical Knowledge in your first year, students will have an Introduction to Research and Evidence-Based Medicine course. During the second year, students will take a Research Processes course, in which they will learn about the entire process of research, from asking an initial question to communicating the results. This course includes a "boot camp" on preparing for the research clerkship (selecting a mentor, developing a project plan, etc.) During the third year, students will have a research project (previously called "Emphasis"), where they will complete a minimum of three months of research, with the option of doing up to six months. The required three months would be done in the third year, and the additional months could be contiguous or spread out (so that students can do what makes the most sense for their schedule). There will also be an option to do research electives or additional research blocks on a project not pertaining to the research clerkship (although this could limit the length of the research clerkship). Students can avail themselves of Vanderbilt University's tremendous research enterprise and can choose from many areas of academic focus, such as Biomedical Informatics, Community Health Initiatives and Health Outreach, Global Health, Healthcare and Public Health Research and Management, Laboratory-Based Biomedical Research, Medical Education, Medical Humanities, Ethics and Policy, or Patient-Oriented Research.

For more information, click here.

Electives

One strong feature of the Vanderbilt curriculum is that, in addition to the required courses, VMS provides you with a mechanism to tailor your education to your specific interests. This is accomplished through electives. Electives are changing with the curriculum: stay tuned for more information!

Grades

The 2015-16 school year will be the twelfth year for the pass/fail grading system. The change was motivated by the desire to shift performance evaluation to include not only your ability to master the course material, but also your professional development and values. This system was also put in place to compensate for the diverse backgrounds that incoming students have. The pass/fail system is designed to level the playing field and create a collegial environment in which those students with a stronger background can help others who are struggling. In addition to receiving the grade “pass” in a course, students receive written evaluations from their professors. Both grades and written comments are available online. You can also view them by checking your academic file in the Office of Student Affairs. In the first year, final grades for courses will be Pass (P) or Fail (F). A grade of P will be given to students whose work is satisfactory in all aspects of course work, and the cut off will be set by the course directors. A marginal pass, P* (colloquially referred to as “P star”), will be given to students who have certain deficiencies in some aspects of course work. If a student receives a P*, the Promotions Committee may recommend that the student undertake remedial activities. Upon review, the Promotions Committee may accept the grade of P* for academic credit, at which point the grade will be recorded on the official transcript as a P. After review a P* may also be downgraded to an F, which is given for unsatisfactory work. Any student who receives an F will receive special review by the Promotions Committee and will be required to undertake remedial activities or be subject to dismissal. An F grade will remain in the student’s official transcript in addition to the grade achieved in remediation; however P* is only an internal consideration and does not remain in the permanent student record if the Promotion Committee’s conditions of remediation are met.

Q&A about the new curriculum

Why was the curriculum changed?

The old curriculum included largely passive learning. Basic sciences, social sciences, and clinical information were more separated. The new curriculum features more active learning, and basic sciences, social sciences, and clinical information are more integrated. For example, when you learn about the anatomy of the heart, you will be exposed to the diseases of the heart at the same time. The goal of Curriculum 2.0 is to create a responsive, agile system of lifelong learning that 1. embraces innovation and improvement; 2. fully integrates learning with patient care; 3. rapidly translates discovery into practice; 4. supports the professional growth of teachers and learners; and 5. creates physician leaders.


What was the curriculum like before and why is the new curriculum different?

You might be interested to know what Vandy’s curriculum was like before your class. The Class of 2015 (current VMS IVs) was the last class to spend 2 years in the classroom and 2 years in the clinics (“Curriculum 1.0”). The courses that they had were as follows:

MFM – Molecular Foundations of Medicine

SFD – Structure, Function, and Development

M&I – Microbiology and Immunology

DDT – Disease, Diagnosis, and Therapeutics

The Class of 2016, the “hybrid class” (current VMS IIIs), will have spent 1.5 years in the classroom by the time they take the USMLE Step 1 in March (“Curriculum 1.5”). They had the same courses as the students before them, but were on a faster timeline. In addition, the class of 2016 had more problem-based and team-based instruction than the students before them. These new learning formats will feature prominently in your curriculum. The VMS IIs also were the first students to experience the Continuity Clinic.


How will exams work?

In the Foundations of Medical Knowledge course, all components will be P=Pass, P*, or Fail (see the section on grades below). This relieves a lot of the pressure and makes the focus on learning the material for learning’s sake. There will be weekly formative assessments including essays and multiple-choice questions to help you verify that you are learning at the appropriate level. At the end of each block, there will be a summative assessment that will last two to three days, depending on the length of each block.


I’m worried because it sounds like our curriculum is just a sped-up version of the previous curriculum. How are we supposed to learn so much information in only one year?

Instead of the curriculum just being compressed, details that aren’t really necessary for your learning in the first year have been moved to the Immersion courses or omitted altogether. Also, information that you learned during the first phase will be reviewed in a clinical context during the Foundations of Clinical Care phase. So the curriculum has not been compressed so much as it has been restructured.


What if I have a problem with the way our curriculum is going? If I think something is not working well, or I am really having trouble with the way material is being presented, is there anything I can do?

Since you will be exposed to many new and unfamiliar learning formats, the professors anticipate that it will take a little bit of time for you to become comfortable with these different formats. Remember that our professors have many years of experience teaching and the design of the new curriculum is informed by extensive evidence on the best way to learn in medical education. The various learning formats will be discussed during Orientation and throughout your first course, Human Blueprint and Architecture. You can always talk with course directors about any concerns you have. It may simply be helpful for them to explain the rationale for the design again. We are lucky that our course directors at Vandy are very open and always willing to listen to student comments or concerns, and they always stand up for us. Also, you will have an elected curriculum committee next year, which will work with the curriculum committees from the second, third, and fourth years to ensure that when students are dissatisfied with the curriculum, concerns are relayed quickly and efficiently to the administrators so that any appropriate changes can be made. You can choose to run for a position on the curriculum committee, or you can just speak with or email one of your elected committee members. You can also always speak with one of the Deans about a concern you have.