MD Student Clerkship Program

Curriculum – Years I and II

The primary goal of the pathology course is to initiate the medical student in the study of disease. Without a clear understanding of the etiology (cause), pathogenesis (development), pathological anatomy, and pathophysiology of disease, clinical medicine would mean little more to the student than memorization of clinical syndromes and the empirical treatments applied to them. These concepts are developed in close association with the other basic sciences and with the clinical science that is also being introduced at this time.

Pathology course is taught during both the first and second years of this medical school. The general format is to introduce a topic with a one-hour lecture to the entire class of about 168 students. Following this, the class is divided into seven laboratory groups for informal, interactive sessions in which gross specimens, kodachromes, virtual microscopic images and case discussions are utilized.

Last year, the vast majority of this teaching was done by 37 of our full-time faculty and 7 of our voluntary faculty. In addition to actual classroom teaching, the lecturer and laboratory instructors meet for one hour prior to each teaching session to review the teaching material and to discuss the details of the laboratory so that all instructors are in agreement. Following this, the laboratory instructors are asked to attend the lecture preceding the laboratory so that they are aware of the lecture content and can develop continuity between lecture and laboratory.

Evaluation of the Pathology instructors by medical students has always been positive and the pathology course is rated as the best in the basic science years. Our students consistently perform well on step 1 of the USMLE and usually score about half a standard deviation above the mean on the pathology component.

General Pathology

General pathology is taught during the second half of the first semester of Year I (Core Principles of Health and Disease) following basic gross anatomy, biochemistry, genetics, molecular biology, physiology, nutrition, pharmacology, and preventive medicine. It consists of lectures and laboratories on the effects of injury on cells and tissues, the host response to injury, abnormalities of blood supply, and disorders of development and growth as well as the associated laboratory medicine.

Organ Systems Pathology

Following the Core Principles of Health and Disease is a sequence of courses in which pathology, the other basic sciences and clinical science are integrated into the study of the major organ systems. Skin, Hematology and Clinical Immunology, Neurosciences, and Musculoskeletal systems are taught in the second semester of Year I. These are followed by the Cardiovascular, Renal, Respiratory, Endocrine, Reproduction, and Gastrointestinal-Liver systems in Year II. The instruction for each of these focuses on both the normal and abnormal structure and function of the system under discussion. The integrated presentations for each organ system are designed and taught by an interdepartmental committee, which includes representatives from the appropriate basic science and clinical departments. Pathology is an active participant in all of these and applies the principles learned earlier in the general pathology course to each of these systems.

Integrated Case Section

The Integrated Case Section is given in the last seven weeks of Year II. This section has two basic goals – to integrate the basic and clinical science presented in the preceding organ systems, and to prepare the students for the transition to the clinical years. It also helps students in their preparation for the step 1 examination of the USMLE. These goals are achieved by the use of cases which are based upon a common chief complaint. The students are asked to develop an appropriate differential diagnosis, evaluate the physical and laboratory findings, review the pathophysiology and relevant basic science, arrive at a diagnosis, and formulate a treatment plan. Pathology is included in each of these cases and takes the opportunity to compare and contrast the pathologic findings of the various entities listed in the differential diagnosis.