To assist students in successfully achieving the
Einstein Educational Competencies, the 18-month pre-clerkship phase deliver
a curriculum consisting of formal and informal programs that nurture students’
human values. Einstein believes that medical education should try to simulate
the real world of medicine by fostering an atmosphere of collegiality and
cooperation. We try to remove competition by grading all courses on a pass/fail
basis.
The pre-clerkship education at Einstein provides
students with the opportunity to acquire appropriate knowledge bases in
biological and behavioral sciences, population sciences, and the mechanisms of
disease. The program allows students to achieve competence in clinical examination
and effective communication skills. Students learn how to apply knowledge and
skills to diagnose, treat, and prevent human disease; to understand the
importance of non-biological factors that influence health in diverse
populations; and to advocate for patients.
As inter-disciplinary and inter-professional
medicine gains a foothold in the world today, Einstein is implementing a
longitudinal theme program that incorporates into its courses current events
and changes in the medical delivery system.
The pre-clerkship curriculum structure consists
of interdisciplinary courses that reflect major unifying themes and concepts of
modern biology, linkages between different biomedical science disciplines, and
applications of basic knowledge to diagnosis, prevention, and treatment of
human disease as well as a rich exploration of health system science, health
equity, and community service. For example, Molecular and Cellular Foundations
of Medicine integrates concepts in cell biology, biochemistry, immunology,
genetics, general physiology, and pharmacology. And Nervous System and Human
Behavior brings together topics in neuroscience, neuropathology,
psychopathology, and pharmacology of the central nervous system. Organ system
courses integrate relevant organ system physiology, anatomic pathology,
pathophysiology, pharmacology, radiology, and epidemiology. The Infectious
Diseases course provides an integrated view of microbial biology and disease
together with an understanding of pharmacologic interventions; anatomic
pathology correlates of certain infectious diseases have also been incorporated
into the course. Foundations for Epidemiology and Biostatistics introduces
students to concepts and problems in population health, epidemiology, and clinical
epidemiology, as well as offering a bootcamp in Biostatics. The Health Systems
Sciences and Health Equity course provides students with the skills to
understand the communities they work in and the medical training
they will receive in the context of broader social, environmental, and
institutional lenses. Service learning within our communities will further
foster students’ knowledge of the structural determinants adversely affecting
the wellness and access to care by the diverse individuals in the Bronx.
The pre-clerkship curriculum process focuses on
case-based conferences, with group sizes ranging from 10 to 25, in almost all
courses. Although conducted in different ways ranging from the problem-based to
team-based learning to case method approach, all case conferences require
students to prepare, collaborate, and participate. The aim is for students to
work cooperatively toward the solution of clinical problems of varying
complexity, with assistance from faculty facilitators, when necessary, and in
so doing acquire and hone skills needed for lifelong self-directed learning.
About half of the pre-clerkship curriculum
consists of case conferences, clinical encounters, and other interactive
educational strategies. The mix of lecture- and student-centered strategies is
a reasonably balanced one, providing individual students the opportunity to
express their own learning style and achieve course objectives through the
utilization of different learning approaches.
Although all our pre-clerkship courses expose
students to clinical issues and problems in varying degrees, it is in the
Introduction to Clinical Medicine (ICM) program where students specifically
focus on acquiring the knowledge and skills needed for effective interaction
with the patient and the health care system. Hallmarks of course are the
clinical experiences and small-group discussions that enable students to
develop an integrated approach to history-taking, interviewing skills, and the
clinical examination. In addition to teaching knowledge and skills, the ICM
program aims to nurture attitudes needed for respectful and compassionate
interaction with patients and their families, help students to understand and
appreciate the sociocultural context of illness and disease, and teach students
the principles and concepts needed to deal effectively with issues and dilemmas
in medical ethics.