1. Longitudinal Curriculum at Case Western Reserve
23 Jan 2011
Jason Chao, MD

2. Slide Header Western Reserve2 Curriculum
Year I
Year II
Year III
Year IV
Foundations of Medicine and Health
(20 months, including vacation)
Core Clinical Rotations
(48 weeks, flexible scheduling, basic science integration)
Research & Scholarship
(16 week block + electives, flexible scheduling)
Advanced Clinical and Scientific Studies
Areas of Concentration
Electives
(10 months, flexible scheduling)
Slide Header
Text, chart and/or photo here.
During the second half of year I and first half of year II, there is a longitudinal half-day per week session in an ambulatory clinic, usually primary care. Used for learning continuity, practice for interviewing and PD.
Year II was shortened, with additional basic science integrated into didactics incorporated into core rotations ½ day/wk.

3. The Core Clinical Rotations
BASIC CORE 1
Internal Medicine, Surgery
Basic Science Integration
(16 weeks at one of 3 teaching sites)
BASIC CORE 2
Pediatrics, Women’s Health (OB/GYN), Family Medicine
(16 weeks at one of 4 teaching sites)
BASIC CORE 3
Psychiatry and Neuroscience
(8 weeks at one of 3 teaching sites)
ADVANCED CORE
1) Undifferentiated Care and Emergent Care
2) Aging and Society
(Each four weeks, flexible scheduling)
Three basic core rotations may be done in any order along with 16 wk research block. Advanced core rotations to be done following basic cores.

4. Basic Science during Clerkships: IQ+ Goals
Reinforce importance of sciences basic to medicine and emerging knowledge in the practice of clinical medicine
Continue to use a team-based, learner-centered small group to enhance professional growth and development
Practice advanced skills in communication, physical exam, clinical reasoning, evidence based medicine
Students return to the Med School campus 1-5 PM on three out of four Friday afternoons in each block.
Three separate curricula matching cases to the three clinical blocks.
Making good on a promise of the Western Reserve2 curriculum transformation.

5. Hospital Systems for Block 2
UH/VA
CCF
MetroHealth
Kaiser (new 2010)
Family Medicine
4 wks ambulatory
longitudinal
Pediatrics
4 wks in-pt; 8 wks long. amb.
4 wks in-pt
OB/Gyn
4 wks in-pt & amb.
Interdisciplinary/ other
2 wks;
2 wks elective
8 wks ambulatory
ED & elective longitudinal
Each core block has goals & objectives that apply to all sites. However, each site is free to implement them as they take advantage of their unique resources.

6. Kaiser Core 2 Clerkship
A focused Longitudinal Integrated Clerkship – FM, Peds, OB-Gyn
One day/week with a faculty preceptor in each specialty, ½ day in the ER + Observation Unit, 1 day of didactics, ½ day of independent study/elective
On call for deliveries, inpatient admissions from personal or preceptor panels
Pilot with 4 students per block

7. Lessons Learned
Hard to get separate disciplines to coordinate teaching
Clinical units are not conducive to interdisciplinary teaching
Coordinated didactics are the easiest to way to provide some integration
Preceptor recruitment & retention is important

8. Unanswered Questions
Does integrating basic sciences into clerkships make a difference?
Should longitudinal integrated clerkships be available for all students?
Are they worth the extra cost in administrative effort?