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Curricular Evolution: Geisel School of Medicine Embarks on a New Integrated Curriculum

Keeping pace with evolving changes in healthcare and healthcare education, Geisel’s new integrated curriculum recently designed by direction of the school’s Medical Education Committee (MEC) and approved by the Faculty Council, creates a cohesive pedagogical approach throughout all four years, building on the medical school’s strong foundation in biomedical sciences and clinical competence. It also creates expanded clinical opportunities in the fourth year.

Implementation begins in August 2019 with the entering Geisel class of 2023.

“We had input from all parts of our community in developing this new approach to medical education. It captures all the excellent features of our current curriculum and enhances them in ways that I believe will be very impactful for our students,” says Geisel School of Medicine Dean Duane Compton, PhD.

For the past year, an MEC curriculum sub-committee—co-chaired by Gregory Ogrinc, MD, MS,senior associate dean for medical education and a professor of medicine and of The Dartmouth Institute, and Rand Swenson, MD, PhD, chair of the Department of Medical Education and a professor of medical education and neurology—has worked with course directors, pre-clinical administrators, and students to create the revised curriculum model, which has been presented and discussed at multiple departmental meetings. Discussions with other stakeholders include the Geisel Board of Advisors, the Alumni Council, and student organizations.

According to Ogrinc, building a highly integrated curriculum across all four years delivers on Geisel’s goal of graduating the complete physician.

“We know that Geisel’s curriculum has served our students well for decades, but we are very excited to be moving to a more fully integrated curriculum,” he says. “The new curriculum will have better coordinated topics within and across the academic years, better connections between the basic, clinical, and healthcare delivery sciences, and better opportunities for our students to prepare for residency.”

One of the biggest changes will be the creation of preclinical organ system-based courses that will enable the preclinical curriculum to be covered in 20 months, affording students greater opportunities to participate in sub-internships and electives later in their academic program. The new courses will largely be comprised from current course content while some may be shifted to later in the curriculum. The Medical Education Committee and course directors will oversee the integration of existing content to enhance reinforcement of material while minimizing unintended redundancy. On Doctoring, Geisel’s highly-regarded introduction to clinical medicine, and Patients and Populations, an introduction to healthcare delivery science, both remain as core components of the preclinical experience.

According to Swenson, the trend of earlier transition to required clerkships has been a clear and accelerating trend in medical education over the past five years or so. “We are carefully planning the new courses to preserve the essential features of our strong biomedical curriculum. The economies that we will need to find in the preclinical curriculum will come from much tighter integration between the basic science and clinical pathophysiology than was possible in our prior curriculum. This will also result in fewer, more highly integrated, multidisciplinary courses.”

He adds, “The earlier completion of our required clerkship sequence will afford our students much more flexibility in career exploration and in activities that strengthen their residency application. The expansion of what has been traditionally year four will have additional advantages. Most importantly, it will permit incorporation of additional required experiences that reinforce and enhance the appreciation of fundamental pathophysiology in our students at a stage when they are differentiating themselves and preparing for transition to residency.”