Pathways Course Info

Course Objectives

• CAREERS IN MEDICINE: Learn how your interests, strengths and weaknesses are suited to different fields.
• COMMUNICATION I: Present patient information concisely, accurately, and in timely fashion to members of a health care team in a variety of settings and formats including verbally and in writing.
• COMMUNICATION II: Keep patient and family involved and informed.
• CULTURAL COMPETENCE: Utilize understanding of cultural, socioeconomic, gender, and age are related issues in patient interactions and clinical decision-making.
• DATA ANALYSIS: Interpret data from laboratories and radiology demonstrating knowledge of pathophysiology and evidence from the literature.
• DIAGNOSIS I: Articulate a cogent, prioritized differential diagnosis based on initial history and exam.
• DIAGNOSIS II: Design a diagnostic strategy to narrow an initial differential diagnosis demonstrating knowledge of pathophysiology and evidence from the literature.
• MANAGEMENT: Design a management strategy for life-threatening, acute, and chronic conditions demonstrating knowledge of pathophysiology and evidence from the literature.
• MODELS OF HEALTH CARE DELIVERY: Understand various models of organizing, financing, and delivering health care.
• PATIENT CENTERED CARE: Understand illness in the context of a patient’s life circumstances, and understand how to ensure patient engagement in care to extent possible.
• PHYSICAL EXAM: Perform and interpret findings of a focused and thorough physical exam guided by clinical reasoning.
• PROCEDURES: Perform routine technical procedures.
• PROFESSIONALISM I: Be selfless, reliable, honest, and respectful of patients, colleagues and staff.
• PROFESSIONALISM II: Take initiative and responsibility for learning, achieving personal growth and improvement, and supporting the learning objectives of others.
• PROFESSIONALISM III: Demonstrate knowledge and affirmation of ethical standards.

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

Course Objectives

• COMMUNICATION I: Present patient information concisely, accurately, and in timely fashion to members of a health care team in a variety of settings and formats including verbally and in writing.
• COMMUNICATION II: Keep patient and family involved and informed.
• CULTURAL COMPETENCE: Utilize understanding of cultural, socioeconomic, gender, and age-related issues in patient interactions and clinical decision-making.
• DATA ANALYSIS: Interpret data from laboratories and radiology demonstrating knowledge of pathophysiology and evidence from the literature.
• DIAGNOSIS I: Articulate a cogent, prioritized differential diagnosis based on initial history and exam.
• DIAGNOSIS II: Design a diagnostic strategy to narrow an initial differential diagnosis demonstrating knowledge of pathophysiology and evidence from the literature.
• MANAGEMENT: Design a management strategy for life-threatening, acute, and chronic conditions demonstrating knowledge of pathophysiology and evidence from the literature.
• MODELS OF HEALTH CARE DELIVERY: Understand various models of organizing, financing, and delivering health care.
• PHYSICAL EXAM: Perform and interpret findings of a complete and neurological exam guided by clinical reasoning.
• PROFESSIONALISM I: Be selfless, reliable, honest, and respectful of patients, colleagues and staff.
• PROFESSIONALISM II: Take initiative and responsibility for learning, achieving personal growth and improvement, and supporting the learning objectives of others.
• PROFESSIONALISM III: Demonstrate knowledge and affirmation of ethical standards.

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

Course Objectives

• CAREERS IN MEDICINE: Learn how your interests, strengths and weaknesses are suited to different fields.
• COMMUNICATION I: Present patient information concisely, accurately, and in timely fashion to members of a health care team in a variety of settings and formats including verbally and in writing. Obtain an accurate, efficient, appropriate, and thorough history. Specifically: obtain the chief complaint, present illness, menstrual history, obstetric history, gynecologic history, contraceptive history, sexual history, family history, and social history."
• COMMUNICATION II: Keep patient and family involved and informed.
• CULTURAL COMPETENCE: Utilize understanding of cultural, socioeconomic, gender, and age-related issues in patient interactions and clinical decision-making. Perform a complete ob/gyn medical history and a focused physical exam, while demonstrating empathetic and culturally sensitive care, and formulate an assessment and plan and communicate in a well-organized presentation.
• DATA ANALYSIS: Interpret data from laboratories and radiology demonstrating knowledge of pathophysiology and evidence from the literature.
• DIAGNOSIS I: Articulate a cogent, prioritized differential diagnosis based on initial history and exam.
• DIAGNOSIS II: Design a diagnostic strategy to narrow an initial differential diagnosis demonstrating knowledge of pathophysiology and evidence from the literature.
• MANAGEMENT: Design a management strategy for life-threatening, acute, and chronic conditions demonstrating knowledge of pathophysiology and evidence from the literature.
• MODELS OF HEALTH CARE DELIVERY: Understand various models of organizing, financing, and delivering health care.
• PATIENT CENTERED CARE: Understand illness in the context of a patient's life circumstances, and understand how to ensure patient engagement in care to extent possible.
• PHYSICAL EXAM: Perform and interpret findings of a complete and organ-specific exam. Specifically: perform a comfortable ob/gyn examination as part of a general medical examination, including: breast exam, abdominal exam, pelvic exam, recto-vaginal exam.
• PROCEDURES: Perform routine technical procedures. Specifically: sterile technique, suturing and foley catheter insertion.
• PROFESSIONALISM I: Be selfless, reliable, honest, and respectful of patients, colleagues and staff.
• PROFESSIONALISM II: Take initiative and responsibility for learning, achieving personal growth and improvement, and supporting the learning objectives of others.
• PROFESSIONALISM III: Demonstrate knowledge and affirmation of ethical standards.

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

Course Objectives

• Articulate a management plan based upon the patient's presentation, being mindful of chronic conditions and the larger care team.
• Demonstrate intellectual curiosity, initiative, responsibility, reliability, and ethical behavior in patient care and self-directed learning.
• Effectively and professionally communicate information about the patient, history and physical, diagnosis, and treatment plan to other caregivers and to the patient/family.
• Formulate differential diagnoses and management plans; this process will include critical evaluation of the primary and secondary literature.
• Perform an age-appropriate, focused pediatric physical exam tailored to the patient. Recognize common pediatric conditions.
• Understand different models of delivering health care in a variety of settings, including the importance of the pediatric medical home.
• Use an understanding of cultural, socioeconomic, gender, age and developmental related issues in patient and family interactions and clinical decision making.

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

Course Objectives

• CAREERS IN MEDICINE: Learn how your interests, strengths and weaknesses are suited to different fields.
  • The PCC offers the opportunity to broaden student perspectives in making career decisions by providing a deeper understanding of the organization, delivery and economics of health care in general, and primary care specifically. Students have the unique opportunity to develop longitudinal relationships with patients, providing insight into this important aspect of clinical care. In addition, students spend 8 months working directly with an experienced faculty clinician, who can serve as a role model and mentor in considering how specific career paths unfold beyond residency training. Students are also able to observe how other specialties and consultants interact with primary care clinicians, gaining a broader view of the various career choices available.
• COMMUNICATION I: Present patient information concisely, accurately, and in timely fashion to members of a health care team in a variety of settings and formats including verbally and in writing.
  • This clerkship will emphasize concise and focused verbal and written presentation of relevant data in the context of primary care office practice. Students will present each patient to their preceptor, with particular attention to differential diagnosis and the formulation of the assessment and plan. Students will learn to write concise, timely and accurate outpatient office visit notes, including subjective and objective data, as well as an assessment and plan. Students will have the opportunity to communicate with a variety of health care providers, including members of the staff within the primary care office in the course of day-to-day coordination of patient care. Students may also have the opportunity to communicate with consultants and adjunctive providers outside the primary care office with regard to the shared management of patients.
• COMMUNICATION II: Keep patient and family involved and informed.
  • This clerkship will emphasize the development of advanced skills in communication with patients and families, with particular attention to counseling and shared decision-making. Students will learn to educate patients and families about potential diagnoses, planned evaluation, treatment plans and side effects, test results, and the proper use of medications, while demonstrating empathy, compassion, and respect for patient values. Students will be expected to assess patient understanding of evaluation and treatment recommendations, while taking into account educational background, language, health literacy, mental or physical impairments, and economic means.
• CULTURAL COMPETENCE: Utilize understanding of cultural, socioeconomic, gender, and age related issues in patient interactions and clinical decision making. This clerkship will emphasize the importance of understanding the cultural context in which patients experience both illness and health. Students will interview patients while demonstrating sensitivity to the cultural, socioeconomic, gender and age issues that affect each patient’s perspective of his/her health. Students will learn to design management plans through a process of shared decision-making with each patient, incorporating the patient’s perspective into therapeutic plans. Students will learn to critically analyze relevant research, with attention to both research design and limitations of generalizability resulting from the scope of populations studied. Students will be encouraged to understand documented disparities in health care related to specific diseases and to consider ways to avoid perpetuating this disparity.
• DATA ANALYSIS: Interpret data from laboratories and radiology demonstrating knowledge of pathophysiology and evidence from the literature. This clerkship will emphasize the interpretation of common tests performed in the primary care setting, including blood tests, growth charts, and radiologic studies. Students will become familiar with the sensitivity, specificity, and predictive value of common tests used in primary care. Students will understand the difference between a screening test and a diagnostic test, and will learn to use pre-test probability in deciding on the utility of a specific test in a given clinical context. Students will also become familiar with the costs of tests and procedures, and with the management of abnormal results and incidental findings.
• DIAGNOSIS I: Articulate a cogent, prioritized differential diagnosis based on initial history and exam.
• DIAGNOSIS II: Design a diagnostic strategy to narrow an initial differential diagnosis, demonstrating knowledge of pathophysiology and evidence from the literature.
  • This clerkship focuses on skills in the initial evaluation of symptoms and chronic illnesses that commonly present in the primary care setting. Students will learn to use the initial history and physical exam to articulate a cogent, prioritized differential diagnosis that provides the framework for appropriate and selective diagnostic testing. Students will also be expected to design a rational diagnostic strategy, based on knowledge of pathophysiology, as well as evidence from the literature, to narrow an initial differential diagnosis. The longitudinal nature of the PCC additionally affords students the opportunity to follow through on the stepwise evaluation and management of a presenting symptom or chronic illness in the stable ambulatory patient.
• HISTORY TAKING: Obtain accurate, efficient, appropriate, and thorough history.
  • This clerkship will focus on development of skills in eliciting an appropriately focused history in the office setting and performing a physical exam tailored to each patients presenting concerns. Students will learn to use the history to guide their physical exam, and to focus their approach in order to address the specific acute or chronic conditions encountered with each patient. Students will also learn to incorporate history and physical exam components that are recommended for screening and prevention in patients of various ages.
• MANAGEMENT: Design a management strategy for life-threatening, acute, and chronic conditions demonstrating knowledge of pathophysiology and evidence from the literature.
  • The PCC will focus on the development of management skills for common acute and chronic illnesses seen in the primary care setting. Students will learn to apply knowledge of relevant pathophysiology and evidence-based data in the design of a management plan for common acute illnesses and chronic conditions. Students will also learn to consider risks, costs, and efficacy in treatment options, and will become familiar with determining when a medical problem requires hospitalization for safe management. Students will learn to recognize causes of treatment failure, including non-adherence and adverse effects of medications. Students will learn to counsel patients about their illness and treatment and to include patients in the decision-making process.
• MODELS OF HEALTH CARE DELIVERY: Understand various models of organizing, financing, and delivering health care.
  • This clerkship provides students the opportunity to work longitudinally with a primary care physician to recognize the influence of insurance status and health care system complexity on the ability of patients to obtain recommended care. Students also have the opportunity over the 8-month clerkship to become part of the health care team within a primary care office, thereby developing a better understanding of how multiple providers within and beyond the primary care office interact to provide comprehensive care for each patient.
• PHYSICAL EXAM: Perform and interpret findings of a complete and organ-specific exam.
  • This clerkship will focus on refinement of physical exam skills in the outpatient setting, with particular emphasis on tailoring the physical exam to specific presenting problems. This clerkship will also emphasize the development of more advanced skills in specific components of the physical exam that may be more readily learned in the outpatient setting, including thyroid exam, breast exam, musculoskeletal exam, and genitourinary exam. Students will also learn to perform an age-appropriate screening physical exam.
• PREVENTION: Plan a strategy for reducing incidence, prevalence, and impact of disease demonstrating knowledge of pathophysiology, clinical epidemiology, and evidence from the literature.
  • This clerkship will emphasize prevention of illness and promotion of health in patients presenting in the primary care setting. Students will learn to counsel patients regarding appropriate preventive care recommendations, based on the patient’s age, gender, and family history, with particular attention to immunizations and age-appropriate screening for cancer, cardiovascular risk, and safety.
• PROCEDURES: Perform routine technical procedures. When relevant to the care of a patient seen in the office, students will learn to perform primary care office-based procedures, such as throat culture, Pap smear, STD cultures and microscopic examination, immunizations, suture removal, joint injection/aspiration.
• PROFESSIONALISM I: Be selfless, reliable, honest, and respectful of patients, colleagues and staff.
  • This clerkship is unique among HMS clinical courses in offering the student direct observation and instruction by an individual faculty member weekly over an eight or nine month period. This allows the time for observation, reflection and growth to occur within the student, nurturing professionalism in a non-threatening environment. Students will be expected to demonstrate the humanistic values of honesty, integrity, compassion, altruism, and respect for oneself and others, including patients and coworkers. Students will demonstrate the required attendance, punctuality and skills of time management and will be well-groomed and appropriately attired. Students will be sensitive to patient needs, including being non-judgmental and respecting patient confidentiality.
• PROFESSIONALISM II: Take initiative and responsibility for learning, achieving personal growth and improvement, and supporting the learning objectives of others.
  • This clerkship will emphasize self-directed learning and the evidence-based practice of medicine. Students will be expected to exhibit a commitment to ongoing self-education and to seek opportunities to deepen their clinical and factual knowledge. Students will be encouraged to read about their patients and will be expected to analyze the medical literature to guide decision-making in the course of patient care. Students should seek regular feedback from their preceptor and demonstrate personal openness to change.
• PROFESSIONALISM III: Demonstrate knowledge and affirmation of ethical standards.
  • Students will be expected to demonstrate high ethical and moral standards, including sensitivity to the needs of patients and staff within the practice. Students will be expected to respect patient confidentiality, to counsel patients regarding treatment recommendations using language patients can understand, to include patients in the decision-making process, and to advocate for patients with limited resources or limited ability to advocate for themselves.

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

Course Objectives

• Appreciate the epidemiology and course of the major psychiatric disorders.
• Appreciate the personal, family and public health impact of psychiatric disorders alone and when comorbid with other medical conditions.
• Appreciate the role of a focused physical exam, particularly in emergency department and inpatient settings and for outpatient consultation, as part of comprehensive assessment of psychiatric presentations for which underlying neurological or other non-psychiatric disorders may be responsible (e.g., mass lesions, endocrinopathies, CNS infection).
• Appreciate the role of psychiatrists and psychiatric treatment in the health care system.
• Be able to develop relationships with patients that are empathic and well-bounded, informed by knowledge of a patient's illness and experiences, and guided by the best interests of the patient.
• Be attuned to the impact of cultural background on psychiatric symptom presentation and on treatment adherence.
• Be aware of major hypotheses concerning pathophysiology of and risk factors for mood and anxiety disorders, psychosis and addictions.
• Be aware of obstacles to access to mental health treatment.
• Be aware of the empirical bases for the major psychotherapeutic treatments used in psychiatry.
• Be familiar with putative mechanisms of action and empirical basis for use of the major psychopharmacological treatments.
• Be familiar with the role of different levels and systems of care relevant to psychiatric disorders including outpatient, inpatient, partial hospital, and residential treatment programs, community mental health centers, and self-help/support groups.
• Conduct a systematic and focused psychiatric diagnostic interview including a recent and past psychiatric history and general medical history (including a substance abuse history), family history of psychiatric and general medical illness, as well as a social and developmental history (cultural factors, educational and occupational background, social and intimate relationships and supports, and legal problems).
• Demonstrate directed commitment to self-learning and team-learning through reading, active participation in didactic sessions and case conferences, seeking out informative clinical encounters, and soliciting and utilizing feedback for self-improvement.
• Demonstrate integrity, reliability, responsibility and collegiality in psychiatric care settings. Identify and evaluate personal beliefs and attitudes toward patients with psychiatric disorders.
• Interact with patients with psychiatric disorders, family members, and members of multidisciplinary teams respectfully, empathically and effectively.
• Perform a comprehensive mental status exam including assessment of appearance, behavior, motor activity, speech, mood, affect, thought processes, thought content (including paranoia, suicidality, homicidality), perceptions (including hallucinations), cognitive exam (orientation, fund of knowledge, attention, memory, abstraction), insight and judgment.
• Present a psychiatric case concisely with an emphasis on pertinent positives and negatives needed for a comprehensive differential diagnosis, risk assessment and treatment plan.
• Understand the problem of stigma associated with mental illness and its impact in health care settings and in the community.
• Write up a thorough psychiatric evaluation including all aspects of the diagnostic interview and mental status exam as well as a differential diagnosis with supporting evidence as well as a provisional DSM-IV 5 Axis diagnosis, biopsychosocial formulation and treatment plan.

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

Course Objectives

• MEDICAL KNOWLEDGE: Reinforce the understanding of the pathophysiology of inflammation, infection, ischemia, bleeding, oncogenesis and homeostasis.
• MEDICAL KNOWLEDGE: Reinforce how the above contribute to the broad categories of problems that surgeons often treat:
  • Response to injury, including elective surgery and trauma, perioperative fluid shifts, pain management, hemostasis, nutrition, prophylaxis and management of perioperative complications.
  • Acute abdominal inflammation, including appendicitis, cholecystitis, diverticulitis, and pancreatitis.
  • Chronic gastrointestinal inflammation, including inflammatory bowel disease.
  • Solid tumors, including colorectal, biliary, pancreatic, breast, melanoma, sarcoma, and lung cancer.
  • Mechanical abdominal wall and diaphragmatic defects, including hernias, such as reducible, incarcerated, strangulated hernias, as well as gastroesophageal reflux disease (GERD).
  • Endocrine diseases, including hyperparathyroidism, diseases of the thyroid and adrenal glands.
  • Vascular disease, including acute and chronic ischemia, as well as arterial embolism, thrombosis, and aneurysms.
• CLINICAL SKILLS: Perform history and physical examination. Compile relevant data from diagnostic and imaging studies.
• CLINICAL SKILLS: Formulate an assessment and plan for the surgical patient with attention to:
  • Formulating a diagnosis
  • Recognizing indications for surgical treatment
  • Recognizing options among surgical treatments
  • Assessing the risk of the patient for surgical treatment
  • Assessing the urgency of the clinical condition
• CLINICAL SKILLS: Demonstrate familiarity with technical skills including:
  • Aseptic technique
  • Wound dressing
  • Skin closure, including suturing and stapling
  • Venipuncture
  • Intravenous access
  • Foley catheter placement
  • Nasogastric tube placement
  • Airway management and intubation
  • Administration of local anesthesia, including dosage calculation
• COMMUNICATION SKILLS: Continue to develop skills to communicate effectively with patients, families and colleagues, in both verbal and written formats, including:
  • Written admission and consult notes
  • Written daily progress notes
  • Written pre-op, operative and post-operative notes
  • Oral presentations
  • Verbal request for colleague consultation
  • Surgical and procedure consent forms
• PROFESSIONALISM: Continue to develop professionalism
• INDEPENDENT LEARNING SKILLS: Continued development of independent learning skills
• UNDERSTANDING OF ASPECTS OF A SURGICAL CAREER:
  • Academic career pathways
  • Surgical training programs
  • Career-life balance and wellness

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

Course Objectives

• CAREERS IN MEDICINE: Consider a career in radiology in as much as it applies to your interests, strengths and weaknesses.
• COMMUNICATION: Communicate the relevant clinical presentation as it pertains to the request for and interpretation of radiological examinations.
• CRITICAL THINKING I: For a clinical scenario, recognize the radiological examinations available, know relative appropriateness criteria (cost, radiation, sedation, time, complication(s), consent, limitations, and reimbursement where applicable), and devise a logical course of action to solve the clinical question.
• CRITICAL THINKING II: Given a clinical scenario and radiological findings, generate an appropriate ordered differential diagnosis and a plan for management of the patient (next exam, treatment, consultation of a specialist).
• CULTURAL COMPETENCE: Recognize aspects of patient autonomy in decision-making, communication, and cultural difference.
• INTERPERSONAL: Become familiar with what it is that radiologists and radiological subspecialists do and how to interact with them as a clinical colleague.
• MEDICAL KNOWLEDGE I: Review relevant anatomy, pathophysiology, technology and performance of examinations as it relates to the daily practice of radiology.
• MEDICAL KNOWLEDGE II: Learn very basic plain film and CT interpretation and become familiar with sonography and MR.
• MODELS OF HEALTH CARE DELIVERY: Become familiar with and begin to manage the digital aspects of modern radiology (PACS, PowerPoint, Internet, CD-ROMs, etc.), radiology terminology, and radiology interpretation and use in digital presentation/consultation of case material.
• PATIENT CARE: Recognize the relevant clinical presentation as it pertains to the request for and interpretation of radiological examinations.
• PATIENT CENTERED CARE: Understand illness in the context of a patient’s life circumstances, and understand how to ensure patient engagement in care to extent possible.
• PROFESSIONALISM I: Exhibit professionalism in dealing with radiological staff and patients.
• PROFESSIONALISM II: Recognize and reduce areas of potential error.
• PROFESSIONALISM III: Recognize limitations in knowledge and understanding of radiological interpretation.

Requirement Checklist

AP (active participation) = The student participated in components of the history/physical exam, engaged in clinical reasoning, or performed/assisted in performance of a specific skill

OB (observation) = The student observed other team members engaged in patient care around a clinical issue or performance of a specific skill.

*INTENTIONALLY DOES NOT HAVE AN ITEM FOR OBSERVED H&P

Course Directors: Meredith Atkins, Kate Treadway
Course Manager: 

Capstone Description COMING SOON!

Course Listings

Essentials of the Profession II

Course Director: Jennifer Kasper
Course Manager: Rob McCabe 

Scholarly Project

Scholarly Project Faculty Director: Jeffrey Katz
Scholarly Project Program Manager: Kari Hannibal

Project Description

The scholarly project is designed to provide students with an opportunity to pursue a mentored scholarly experience analyzing a health-related question, issue, or problem in depth. The student can approach the problem through any of a wide range of disciplines in the biomedical sciences, clinical sciences, humanities, arts, or other fields. For more info for students and faculty mentors click here.

Visit the Course Catalog for more information on post-clerkship elective courses and contact information.