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C.O.A.S.T. CURRICULUM

OVERVIEW OF THE NEW CURRICULUM

As the new C.O.A.S.T. Curriculum rolls out, there is much to be excited about! While entering into a new system can be nerve-wracking, we hope to provide as much information as possible to help inform your medical school decision! You all will be groundbreakers–ushering in a brand-new UCSD, learning to advocate for your classes' interests, and being the leaders for all the years that follow you!

 

UCSD faculty and students built the new curriculum from a holistic, philosophical base, emphasing patient care as one of the main pillars of medical education. UCSD wants to celebrate you, its students, as their unique original person by amplifying your individual skills and abilities. The new curriculum is designed to share your superb attributes as a physician with your future residency program by collecting data about the various elements of your performance. UCSD also hopes to emphasize a culture of wellness by helping students be successful, happy and healthy!

CORE COMPETENCIES

UCSD upholds its medical education standards detailed in our 8 core competencies:

  • Medical Knowledge and Scholarship

  • Compassionate Patient Care

  • Communication and Interpersonal Skills

  • Practice-Based Learning and Improvement

  • Health Equity

  • Health Systems Science Informed Practice

  • Professionalism

  • Wellness

PASS/FAIL PRE-CLINICAL YEARS

The pre-clinical years at UCSD are Pass/Fail. There is no internal ranking system or AOA, and the collaborative efforts that arise out of this are truly heartwarming. Each day our own class Slack is overwhelmed with our classmates sharing flashcard Anki decks, study guides, and YouTube resources (amongst a fair share of memes and medical puns).

SYSTEMS BASED APPROACH

UCSD SOM teaches medicine in the pre-clinical years by using the organ-systems based approach. Every 2-5 weeks, students will be learning about a particular organ system and every aspect of the curriculum (histology, anatomy, case-studies) will revolve around that organ system. In the first year, students learn about the physiology--what is normal,  and in the second year, students learn the pathophysiology of diseases--what is abnormal.

The basic format of the pre-clinical curriculum can be divided into 4 basic categories: Lecture, Small Groups, Practice of Medicine, and Lab as well as individual student electives. The time we devote to each specific division varies somewhat depending  on the organ system. 

C.O.A.S.T. CURRICULUM

LECTURE

Presenter Format

This form of lecture is perhaps the format you are most familiar with from your undergraduate studies. Lecturers, experts within their respective organ-system, will give 1-2 hour long powerpoint presentations with a 10 minute break in between. Questions are encouraged during and after lectures. All lectures are podcasted with corresponding slides. In-class attendance is optional for most lectures, but some patient panels and case sessions required mandatory attendance depending on the block.

Team Based Learning

Perhaps you are familiar with "Clicker Questions" from your undergraduate studies. This particular lecture format is part guided lecture and part group problem set.  Each student is assigned to a particular group and location within the lecture hall to work on guided questions "Live." This form of learning is particularly useful in more calculation heavy blocks such as cardiovascular, renal and hematology. Attendance can be optional or required depending on the block, but most students find this format engaging and worthwhile. Many of the specific application of lecture topics occur during these sessions. 

SMALL GROUPS

Equity in Systems Science (ESS)

Arguably the most unique teaching modality in medical school, ESS teaches students to approach medical and ethical problems from a design mindset. Each week, student groups are presented with a case that has numerous layers of ethical considerations and medical issues that physicians face in their practice. Each case will be presented over three days, with the second day consisting of a panel of professionals relevant to the case at hand. These panels help medical students to learn the intersections of our role as future physicians with social workers, politicians, lawyers, and many other professionals. With the guidance of a faculty member, student groups explore the case with the ultimate goal of constructing a final project in the form of an OpEd, Memorandum, Lesson Plan, research design, or other numerous topical assignments. Attendance is required.

Clinical Case Studies

These sessions provide an opportunity for students to apply concepts learned in lecture to a problem set. Led by a faculty member that is an expert in the topic, small-group conferences present clinical problems that are relevant to the current block. Typically 1-2 hours, students work together to solve the problems during the first hour, and present to the group during the second. Attendance is required.

PRACTICE OF MEDICINE

Practice of Medicine (POM) is truly foundational to your future career as a physician. POM focuses on teaching you the clinical and interpersonal skills required to interact with patients from a variety of backgrounds.

Lecture

POM lectures focus on a variety of different topics. Some lectures demonstrate aspects of various physical examinations, while others focus on the social determinants of health or professional development. All lectures are recorded and posted with corresponding slides. During the first quarter, there are weekly/bi-weekly quizzes that can be used to replace the POM final. In class attendance is optional for most POM lectures, except patient panels and some more sensitive content. 

Small Group

POM small groups are formed from academic communities during the first year and stay together through second year. Jointly led by a practicing physician and a psychologist, POM groups provide an opportunity for students to discuss both the personal and the professional, in addition to practicing patient encounters. Groups become quite close, and a high level of trust is often built. Attendance is required. 

GOSCE/OSCE

Ah, GOSCEs–graded observed structured clinical examinations. Designed to prepare us for Step 2 and beyond, in these sessions students practice interacting with patients with a variety of temperaments and clinical conditions by taking histories and practicing clinical exam skills. Students receive feedback from both faculty members (who watch via video recording) and fellow students (who are present in the room while you are completing your GOSCE). While these can sound intimidating, they are the BEST place to practice clinical skills in a low/no stakes environment. There are two OSCEs (one at the end of MS1 and one at the end of MS2) which you must pass, while GOSCEs are completion only. Attendance is required. 

C.A.R.E. is a new course in the C.O.A.S.T. curriculum that includes 3-4 hours per week of instruction and activities focusing on compassion and community engagement. The course will be evenly distributed between the study of compassion (including self-compassion, wellness, processing, and micro-aggression management), meaningful interactions with participants in the healthcare system, and real community engagement and service in a variety of settings. Students will enter into a C.A.R.E. environment of their choice with a local physician. This environment can last one or multiple quarters, depending on the student's wishes! With the guide of their preceptor, students practice navigating patient visits, forming their professional identity, and processing the emotional aspects of being a physician. 

LAB

Humanistic Anatomy

Anatomy lab is for some the most memorable part of first year. Groups of four students are assigned to a body donor–their first patient. Each class begins with a meditation and reflection about the awesome privilege of performing the dissection on someone who chose to have their body help further medicine. The humanistic anatomy approach works to preserve the donor's integrity by giving students the space to reflect on their relationships with those in their group and their donor. Students complete dissections corresponding to the current organ system, while simultaneously learning and practicing surgical techniques (frequency depends on the block). Surgeons, anatomists, and 4th year medical students are available as resources while in lab, and students have access to the lab outside of class. Attendance is required. 

Histology and Pathology

Visually engaging and self-directed, histology labs are quite different from lecture. In labs students review tissue slides with an emphasis during the first year of recognizing what is "normal." During the second year, students focus on tissue pathology. Not to mention, the course director is a riot. Attendance is required. 

CLINICAL CURRICULUM

For more information on the curriculum for your clinical years (3rd and 4th year), please refer to UCSD SOM's website: 

COMPASSIONATE ACTION AND REAL ENGAGEMENT (C.A.R.E.)

Diagnostics

Ultrasound and radiology are incredible skills to develop during your medical education. Every other week during MS1 and MS2, there will be facilitated small groups and large group lectures as a collaborative effort between Radiology, Histology, and Pathology. These sessions will be coordinated with Organ blocks and have a strong focus on clinical correlation. Attendance is required. 

CLINICAL DECISION MAKING

During MS2, there will be a weekly course focusing on clinical decision making by understanding the diagnosis thought process, disease scripts, and value-based care. Students will experience a simulation of the wards and clinical cases of third year with practiced and role-modeled presentations. This course is developed by clinicians with experience in early clinical learning and is informed by evidence based clinical decision-making data.

Through your clerkships, you will take a deep dive immersion into the pillars of medicine.

  • Pediatrics

  • Neurology

  • Internal Medicine

  • Surgery

Your clerkships will allow you to explore diverse patient populations and care environments by rotating through UCSD Jacobs Medical Center, UCSD Hillcrest Medical Center, San Diego VA Medical Center, Rady Children's Hospital, Naval Medical Center, and over 100 ambulatory sites including UCSD Student Run Free Clinic, SD Department of Health, Donovan State Prison, and Lincoln High School.

  • Primary Care

  • Psychiatry

  • Obstetrics and Gynecology

  • Opportunities for Electives

CLERKSHIPS

Clerkship Master Clinician Program

The Master Clinician Program will provide formative one-on-one coaching during your clerkship years, continuing the compassion training you developed during your pre-clerkship years. This program will also emphasize personal wellness development as you move closer towards residency and beyond!

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