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Dartmouth College (Dartmouth Medical School)




Dartmouth Medical School is a beacon of discovery and learning, stimulating inquiry and harnessing ingenuity for new solutions and better health. Building on a legacy of excellence and collaboration, DMS, the nation's fourth-oldest medical school, cultivates leaders of vision and virtuosity who are transcending boundaries to transform medicine and science. It draws on the world-class resources of Dartmouth College and Dartmouth-Hitchcock Medical Center for broad interdisciplinary programs in biomedical research, education, patient care and service.

Dartmouth Medical School educates outstanding leaders prepared to transform medicine and science. The school aspires to be the best in the world at expanding knowledge and using it wisely to improve health, all done in the context of the tradition of collegiality of Dartmouth and the values its community honors. We are committed to the challenges of discovery and innovation and to their application to health care that meets the needs and wants of patients and society.

Dartmouth faculty members are renowned not only for their leadership in diverse facets of medicine, but also for their personal approach to teaching. They serve as your instructors, role models, mentors, and team-members in the clinic and in the lab. They are vested in your success at school and beyond and demonstrate their commitment in many ways, whether it's organizing a weekend review session or inviting
you to their home for Thanksgiving dinner. As one student says,"The professors don't just have office hours from one to three on a Friday afternoon. Their doors are open all the time."

Research at DMS is diverse and well funded. In fact, DMS is in the top 10 percent of the nation's medical schools in basic science research funding on a per faculty member basis. Equally important, Dartmouth is a national leader in collaborative, interdisciplinary research projects, as evidenced by programs such as its Immunotherapy Center, Center for Shared Decision Making, and the Spine Center. The result is an intellectually stimulating environment where scientists, clinicians, researchers, and students join forces on nationally recognized projects that are changing lives.

As a student at DMS, you will be part of northern New England's most extensive clinical teaching network—a network that, along with the off-campus clerkship opportunities, exposes you to a breadth of patients, delivery systems, and management models that is unusual in American health education.

The primary teaching site for DMS students is Dartmouth-Hitchcock Medical Center (DHMC), one of two rural academic medical centers in the country. A Level 1 Trauma Center, DHMC serves a patient population of 1.6 million, drawn from across Northern New England. DHMC is home to the Norris Cotton Cancer Center, one of only 39 National Cancer Institute designated comprehensive cancer care centers in the country.

Other important centers at DHMC include the Children's Hospital at Dartmouth and the Center for Shared Decision Making. Supporting these centers are two additional major research sites, the Borwell and Rubin Research Buildings. DMS receives more than $131 million annually in sponsored research. The near future will see the opening of three added centers, an Advanced Imaging Center, the Translational Research Building, and a new home for the Center for the Evaluative Clinical Sciences.

While some students prefer to do their required Year Three clerkships and Year Four electives close to home, many others spend up to eight months of the year working in a great variety of Dartmouth programs, rural and urban, close to campus or half a world away. This breadth of clerkship and elective opportunities makes DMS a particularly compelling choice for students interested in travel.

A partnership between the Dartmouth International Health Group (DIHG) and the John Sloan Dickey Center for International Understanding at Dartmouth College supports students in their efforts to gain international health-care experience. From smoking cessation programs in Russia to studies that assess the health needs of communities in Nepal, DMS students have remarkable opportunities to touch lives around the world.

Eighty-one percent of first and second- year DMS students who responded to a recent survey said they had joined in at least one community-service project. Here, it's easy to get involved, thanks in part to the student-run Community Service Committee, which sponsors about 15 community education and service programs. Whether you are interested in volunteering at a clinic for underserved populations, becoming buddies with a child with special needs, or singing at hospitals and nursing homes, you will find an opportunity to contribute to your community your way.

Becoming a doctor requires long hours of hard work. But at Dartmouth that doesn't require you to sacrifice outside interests, a healthy lifestyle, or opportunities for social, personal, and emotional growth. The culture at Dartmouth fosters a balanced lifestyle. In fact most of the people here—students, doctors, researchers, nurses, residents—make sure they find the time for other interests. Dartmouth's Student Affairs Office, and the student-initiated Wellness Committee, are two key resources that can assist you in meeting the challenges of medical school while enjoying a balanced, fulfilling life. Assistance comes in many ways: through individual advising, mentoring, or peer relationships; through groups focused on professional or personal interests; through religious or spiritual connections; through service and advocacy; or through recreation or artistic pursuits. We are interested in physical and mental wellness, including the needs of students' families," says Dr. Lori Alvord, Associate Dean for Student and Multicultural Affairs, and the first Navajo woman surgeon. Her book, The Scalpel and the Silver Bear, describes her journey from the reservation to becoming a surgeon and her efforts to combine traditional healing with her Western practice. Multi-dimensional support," says Alvord, helps students become healers."

From orientation to the formal curriculum, DMS is committed to fostering an understanding and appreciation for cultural differences, while helping develop the clinical skills needed to work effectively with diverse patient populations. To support the unique needs of students from diverse and minority backgrounds, Dartmouth's Office of Multicultural Affairs provides a combination of individual support, resources, training, and programs. Students lead active chapters of the Student National Medical Association, a national organization addressed to students of color, the American Medical Women's Association, and qMD, an interest group for those concerned about health issues facing gay, lesbian, bisexual, and transgendered people.


School name:Dartmouth CollegeDartmouth Medical School
Address:1 Rope Ferry Road
Zip & city:NH 03755-1404 New Hampshire
Phone:603 650-1200
Web:http://dms.dartmouth.edu
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Dartmouth Medical School Courses


YEAR ONE

During the 39 weeks of Year 1, the curriculum focuses on the theme of the normal structure and function of the human body. The important biomedical basic sciences are introduced by faculty from various basic science departments in the classical medical disciplines of human anatomy and embryology, histology, physiology, biochemistry, cell biology, microbiology, immunology, and pathology. A recently developed multidisciplinary course in neuroscience (combining elements of neuroanatomy and neurophysiology) has proven to be very successful, and a redesigned course covering the fundamental disciplines of biostatistics and epidemiology has been very popular. In conjunction with these fundamental or basic biomedical sciences, students begin their clinical studies with the course "On Doctoring", which extends over the first and second years, and introduces them to the science and art of caring for patients. A variety of elective courses is also offered.

COURSES :

* Biochemical and Genetic Basis of Medicine

* Cells, Tissues & Organs : A coordinated series of lecture and laboratory sessions covering the microscopic anatomy of human cells, tissues, and organ systems. Emphasis in lectures is given to cell-tissue ultrastructure and its functional correlates. Laboratory exercises concentrate on "classic histology", i.e., the study of stained histological preparations by conventional light microscopy.

* Human Anatomy and Embryology I : The aim of this course is to help students acquire the basic anatomical background they will need to function as physicians, and to acquire facility with the anatomical terms used in discussions among medical professionals. During this dissection-based course, students will study all parts of the human body and their normal function, with occasional reference to common abnormalities of function. Regional, surface, systemic, radiologic, and endoscopic anatomy, as well as human embryology, will be considered. Lectures, laboratory dissection sessions, self-study, and group learning are all important components of this course.

* Metabolism : This course emphasizes physiological and medical aspects of metabolism in eight sections: A, Cellular utilization of glucose in the presence of absence of mitochondrial oxidation. B, Fuel metabolism: the shift from glucose to fatty acids in diabetes and starvation. C, Energy balance, exercise and obesity. D, Lipoproteins and atherogenesis. E. Nitrogen balance, kwashiorkor and marasmus. F. Nucleotides, gout. G. Digestion and hepatic functions. H. Micronutrients: Iron and vitamins. The course is designed to fit with and complement other courses in the first and second year of DMS curriculum.

* Biostatistics and Epidemiology : The overall objective of Biostatistics and Epidemiology is to introduce the scientific method as it relates to studies conducted in humans, where relationships and effects are often obscured by random variation. Emphasis is on the interpretation of the various study designs used today and the analysis methods used to evaluate the resulting quantitative data. Students who complete the course will be able to effectively read a published medical study by (i) identifying the research design used, (ii) quantitatively evaluating the effects observed, and (iii) interpreting the study with respect to its advantages and limitations. Topics include errors and bias, distributions and variation, hypothesis testing and confidence intervals, measurement of risk, confounding, analysis of means and contingency tables, regression methods, research design, evaluation of diagnostic tests, decision analysis, screening and prevention, and population statistics.

* General Pathology : The course is General Pathology uses a mix of lecture, small-group and laboratory exercises in 69 hours, spring term. The course focusses on the concepts of the various kinds of injury to cells and tissues, and the reactions of the cells and tisues to those injuries. Concepts from throughout the first year are included in explaining human diseases according to current understanding. In turn, the course serves as a basis for teaching the pathology of the organ systems throughout the Scientific Basis of Medicine.

* Neurosciences : The goal of the Neuroscience Course is to provide the student with the basic science background necessary to understand the clinical signs and symptoms of disorders of the human nervous system. The organization and function of the central and peripheral nervous systems will be presented from a correlated anatomical, physiological, and pharmacological perspective by means of lectures and conferences, and by laboratory exercises that incorporate dissection of the brain. Among the topics covered will be: the embryonic/fetal development of the nervous system; the gross and microscopic organization of the brain and spinal cord; the physiology of the neuron and neural transmission; control of motor and sensory functions; neuroendocrine control; control of involuntary functions; the special senses; the higher mental functions such as memory and language; the maintenance of consciousness and sleep; and the motivation and regulation of emotional states. In addition, the course will include an introduction to modern imaging modalities as they apply to neurological diagnosis and also will consider the interface between the brain and behavior.

YEAR TWO

During the 38 weeks of Year 2, the major theme shifts to a study of pathophysiology--what goes wrong during disease. During this year, faculty from virtually every basic science and clinical department participate in the Scientific Basis of Medicine Program (SBM for short), which coordinates 14 separate courses. Each course in SBM focuses on a separate organ system or process, whereas courses in Year One focused on separate scientific disciplines. The required courses in Year Two include studying the cardiovascular system, the respiratory system, the nervous system, psychiatry, hematology, the endocrine system, the reproductive system, oncology, the gastrointestinal system, dermatology, connective tissue and bone, the renal system, and nutrition. Each of these SBM courses combines elements of physiology, pathophysiology, genetics, medicine, surgery, and pediatrics. Much of the material is taught in seminars, conferences, or problem-based learning tutorial groups. Course directors coordinate closely with year-long courses in pharmacology and On Doctoring. For example, during the SBM course in Neurology, On Doctoring is likely to cover the examination of the nervous sytem, while the Pharmacology course covers the antiseizure medications. Near the end of the year, an additional course in childhood health and development is also offered. At the end of the year, students take Step I of the USMLE series of examinations leading to licensure, and attend a 3-day orientation session leading up to Year 3.

COURSES :

* Introduction to Medical Pharmacology : The major, conceptual modules are general principles, pharmacology of autonomic and central nervous system, cardiovascular pharmacology, endocrine and autacoid pharmacology, chemotherapy, and toxicology. Instruction is primarily through classroom lectures (67 hours) with three small group sessions on clinical pharmacology in Terms I and II. Emphasis is placed on understanding the dynamic mechanisms by which drugs modify normal biochemical or physiological functions and how they correct pathophysiological disturbances of those functions. Faculty lectures and small group facilitators. Prerequisite: permission of instructor. Instructors: Barchowsky (course director) and others.

* Cardiology : SBM/Cardiology presents a survey of cardiovascular disease and disease mechanisms. The primary emphasis is on pathophysiology (the "basic sciences"). Because it is becoming more important to the practice of medicine, attention is also directed to such "clinical sciences" as epidemiology, outcomes assessment, and decision-making. Finally, because "the person" is so central to cardiologic diagnosis and treatment, it also addresses the psychosocial and ethical issues encountered in dealing with cardiac patients.

* Respiration : SBM/Respiration reviews the fundamental pathologic and pathophysiologic changes that accompany a variety of respiratory disorders. In addition to lectures that present the core material, there are several laboratory sessions in pathology as well as a number of case conferences which provide an opportunity to apply pathophysiologic concepts to patients with respiratory disease.

* Neurology : SBM/Neurology offers a variety of learning formats. Some of us are better readers than lecture listeners, and may justifiably prefer to do their major studying from the text. Those who best glean their information from the lectures should also read the pertinent chapters, as few of the lectures will be able to cover all principles of any one topic in the allotted time.
The conferences should be prepared the night before each session. Questions at the end of each CPC should be answered as best possible, supplemented the day of the CPC by the preceding lecture. The seminar should then follow as a small group discussion of the CPC led by a faculty member who can answer any questions you might have. The seminars should not be considered quiz sessions. They will give you an opportunity to determine your understanding of a topic and the faculty a chance to see how the class as a whole is progressing. The CPCs cannot be comprehensive enough to cover a topic completely. They are a practical presentation of some of the principles outlined in the text and reinforced in lecture.

* Psychiatry : SBM/Psychiatry begins with an overview of data acquisition and general principles of psychiatric evaluation, including interviewing, mental status examination, diagnostic classification, and psychological assessment. The course also includes an introduction to psychopathology and addresses the clinical presentations, associated features, epidemiology, etiology, and treatment of major psychiatric disorders. Lectures are supplemented by classroom presentations of live patients, video material and written cases. Students acquire interviewing skills and exposure to clinical material by participation in a series of small groups with live patients. Problem-based learning also supplements the classroom material.

* Hematology : SBM/Hematology presents an approach to diseases of the blood focusing on the conceptual framework for disorders of red cells, white cells, platelets, and coagulation factors. It includes a section on blood banking. The course utilizes active learning principles with computer cases, consult cases, group learning exercises, participatory labs, and interactive lectures.

* Oncology : SBM/Oncology covers the approach to cancer as a disease of the molecule, the cell, the organ, the person, the family, and the community. It will focus on the basis for the care of the patient in all phases of the disease from preventative strategies, through approaches to diagnosis and treatment, to issues of palliative care and rehabilitation.

* Endocrinology : In this course, the molecular, cellular and pathophysiologic bases of the major endocrine diseases including diabetes mellitus and of several metabolic diseases are explored with special emphasis on small group and independent study. The course includes several patient presentations and pathology laboratories. The student is also introduced to major issues in the clinical diagnosis and management of these diseases.

* Reproduction : The goal of SBM/Reproduction is to provide an overview of male and female reproductive pathophysiology, that is, how does normal reproductive function in the male and female translate into a disease. Students will analyze specific areas in Human Reproduction to apply basic reproductive knowledge to problems of major reproductive disorders. This course is designed to examine reproductive dysfunction detected clinically, by medical history, physical examination, and the clinical laboratory as well as to define the general principles of therapy for the more common disorders.

* Gastroenterology : SBM/GI is an introductory course that reviews the normal physiology and clinically relevant pathophysiology of the Gastrointestinal tract [including the Esophagus, Stomach, Small and Large Intestine, Liver and Gallbladder, and Pancreas]. The course includes lectures, pathology labs, small case conferences, and 2 PBL cases.

* Bone and Connective Tissues : Bone is a comprehensive overview of the common disorders affecting the musculoskeletal system. It covers the epidemiology, pathogenesis, clinical features, and therapy of a broad spectrum of developmental, traumatic, metabolic, Immunologic, degenerative, and infectious diseases that affect the articular and periarticular structures. These include internal derangement of the knee and shoulder, disorders of the back, autoimmune diseases including rheumatoid arthritis, systemic lupus erythematosus, metabolic disorders including gout and pseudogout, and degenerative diseases, including osteoarthritis. An approach to diagnosis and treatment is covered.

* Dermatology : Dermatology focuses on common and important cutananeous diseases from clinical and pathophysiologic perspectives. Emphasis is placed primarily on disease mechanisms, though dermatologic description, classification, and the importance of lesion distribution and morphology in dermatologic diagnosis are presented. A physical diagnosis practicum, a problem based learning case, and computer learning modules complement the 24 hours of lecture format.

* The Kidney and Urinary System : This course emphasizes six areas as follows: sodium and water balance, acid base balance, normal renal function, acute renal failure, chronic renal failure, and pathology with emphasis on glomerulonephritis. Clinical correlations with basic physiology are stressed. Clinical problem solving is emphasized.

* Infectious Diseases : ID includes two major components: parasitology and the pathophysiology of infectious disease. The parasitology component includes lectures and laboratories on the principal pathogenic parasites. The infectious disease component covers the mechanisms of action and clinical use of antimicrobiol agents, the pathophysiology and clinical features of the major infectious disease syndromes (e.g., pneumonia, urinary tract infections, etc.), and infectious disease epidemiology. Small group problem sessions and a laboratory on mycobacterial skin testing are included.

* Nutrition : The SBM Nutrition Course is an introduction to nutrition principles and the use of nutrition in medical therapy. The purpose of the course is to stimulate a lifelong interest in nutrition. Students will analyze their own diet with the aid dietary computer software and review micronutrients in depth. Three therapeutic diets will be reviewed in detailed as examples of nutritional therapy: diet therapy for phenylketonuria, hypercholesterolemia and renal failure.

* Pediatric Health & Development : Pediatric Health and Development provides an introduction the practice and care of children from birth through adolescence utilizing a development approach. The student is expected to acquire a basic knowledge of the developmental continuum from birth through adolescence and the developmental tasks which define each stage of childhood. They are introduced to the issues and concerns that the physician assists with at each stage and how to approach the physical exam and interview children of different ages.
The format of the 12 hour course is lectures by faculty members of the Department of Pediatrics at DHMC supplemented by videotapes of children, case examples and direct observation and interaction with children (and their parents) of various ages, often in small groups whenever possible. The final exam is an open book, multiple choice (mostly short cases) with Pass/Fail grading. There are no other quizzes or exams, nor is an honors grade possible at this time.

YEAR THREE

Year 3 builds on the skills and knowledge acquired during courses taken in Year 1 and Year 2. The required clerkships of Year 3 offer students the chance to experience the major broad specialty areas of clinical medicine (e.g. internal medicine, psychiatry, surgery, obstetrics and gynecology, pediatrics, and family medicine) in a variety of settings and communities, well in advance of the Year 4 process of making career and residency decisions. These 48 weeks of required clerkships are carried out both at the major medical facilities of the Dartmouth-Hitchcock Medical Center (Mary Hitchcock Memorial Hospital, VA Hospital, and Dartmouth-Hitchcock Clinic) and at a variety of affiliated hospitals and ambulatory sites, where patient populations and styles of practice differ widely. About one-third of the total time is spent training in ambulatory clinic facilties, while about two-thirds of the rotations take place in hospital settings.

COURSES :

* Family Medicine : The Family Medicine Clerkship is an eight-week rotation with the first seven weeks at your primary precepting site. All students are given Thursday and Friday of week seven as personal time. If you are at a distant site, this would be considered travel time. Clerkship didactics occur weekly on Mondays for regional students with Web-based curriculum and final curriculum concluding on Monday and Tuesday of week eight for all students. All students are required to return for final evaluation and final curriculum on Monday and Tuesday of week eight prior to ICE sessions. Students wishing to take the final exam prior to personal time will be allowed to do so on Wednesday of the seventh week.

* Surgery : The Surgical Clerkship consists of one four-week rotation and one three-week rotation on two different services. Both rotations will be at an on-campus site (DHMC or VA Hospital @ WRJ, VT)
Under guidance of surgical housestaff and faculty, this course offers an experience in surgical illness and intervention. Utilizing the team approach of two separate surgical services, this experience provides an environment for enhancement of fundamental clinical competencies. Students encounter common clinical problems germane to all of medicine as well as specific surgical conditions and procedures. Despite the exposure to such specific cases, the surgical housestaff and faculty focus student attention to the principle learning objectives outlined below, with the evaluation process driven by student achievement in these principle learning goals.

* Obstetrics and Gynecology : The Obstetrics, Gynecology and Women's Health Clerkship provides a learning experience in women's reproductive and general health care for all age groups at a variety of settings: hospital-based surgery, gynecology, and obstetrics services, midwifery program, private offices, rural/urban settings, etc. students will see patients with obstetrician/gynecologists, family physicians, certified nurse midwives, and nurse practitioners. The longitudinal nature of the course allows students to practice preventive care, observe how patient's circumstances (such as expectations and social support) change over time, and to use time as a diagnostic test and treatment.
Exposure to research opportunities?
Many faculty members are involved in clinical, basic science, educational, epidemiological and other research. Students will have opportunities to see some of the projects in progress and to choose research electives in the future.

* Medicine (Inpatient) : This required core clerkship in inpatient internal medicine is typically taken during the third year at Dartmouth Medical School. Four weeks are spent at Dartmouth-Hitchcock Medical Center and 4 weeks at the White River Junction VA Hospital.
Students function as an integral member of a ward team caring for patients hospitalized on a general medical service. A minimum of 16 new patient workups is required. Learning objectives include improving skills in history taking, physical examination, and ordering of diagnostic tests, as well as written and verbal case presentations. Students will gain experience in doing basic medical procedures such as phlebotomy, IV insertion, arterial blood gas sampling, and others as the opportunity allows. Students receive specific instruction in interpreting electrocardiograms and chest xrays. Clinical reasoning skills used in the evaluation and management of internal medicine patients is stressed, as are the interpersonal skills required to deal with patients and their families.

* Medicine (OutPatient) : Students will spend 4.5 days each week at their practice site and return to Dartmouth on Friday afternoons for teaching sessions. These sessions will include case discussions on common outpatient problems and clinical reasoning.

* Pediatrics : The Pediatric Clerkship provides learning experiences in both inpatient and outpatient pediatrics. This clerkship addresses issues unique to childhood and adolescence by emphasizing principles of health supervision, normal and abnormal childhood growth and development, recognition and treatment of common pediatric diseases, and the role of the family, community and society on child health and well-being. The goal of the clerkship is to provide you with a solid foundation of pediatric knowledge and skills important in your education as a general physician, regardless of whether you ultimately become a pediatrician or gerontologist.
In the inpatient setting the student will be an integral member of the ward team, providing care for a wide range of hospitalized children. In the outpatient setting the student will be in a pediatric office, seeing patients for acute and chronic pediatric problems as well as well-child visits. A week will also be spent in a newborn nursery. During the nursery experience students will evaluate newborns and counsel new families prior to discharge.

* Psychiatry : Students are assigned to longitudinal treatment teams which involve inpatient, consultation, and outpatient treatment of patients. Students take both weekday and weekend on-call on a rotating basis.
Careful statistical studies demonstrated that approximately 1 out of every 4 patients seen by non-psychiatric physicians have significant psychiatric problems or a stress related component to their medical disorder. Hence, it is essential for all doctors to be able to identify, understand and effectively handle the majority of such individuals. It is with this aim in mind that the introduction to clinical psychiatry has been designed.

* Neurology : All students attend four weeks of neurology and are exposed to both in-patients and out-patients during this time. The emphasis is on recognition, diagnosis and management of neurologic illness involving both the central and peripheral nervous system on a case by case basis and on honing the clinical technique of the neurological examination. Students will complete the required neurology learning within: ward/consult( two weeks each part) VA, Pedi (only for students with a dedicated interest in pediatrics) or regional sites ( Littleton, NH; Manchester/Bedford, NH.
The Neurology Clerkship is four weeks long. We allow a maximum of 6 ward/consult students.
The VA Hospital Consult Service has a 1 student maximum. The New Zealand neurology clerkship accepts one student as does the Manchester and Littleton, NH clinics. The Regional rotation is flexible regarding numbers of students allowed at any given time (a maximum of 2). Splitting of the clerkship will not be allowed except for extremely unusual hardship circumstances.

YEAR FOUR

This final year of medical school offers each student the chance to complete several required clerkships, to begin to differentiate his or her clinical interests through a series of electives, to complete several outstanding courses designed to prepare our seniors for residency and for a career as a lifelong learner, and to work closely with a personal advisor to find the most appropriate postgraduate plan or residency slot. Along with required clerkships in Neurology and Women's Health and a subinternship of the student's choice, Year 4 students choose from a wealth of clinical and other electives offered on campus, across the U.S., and around the world. The DMS Medical Education Committee strongly encourages students to pursue at least one clinical experience in an off-campus setting. All seniors take excellent required courses titled "Health, Society, and the Physician," "Clinical Pharmacology and Therapeutics," "Advanced Medical Sciences," and "Advanced Cardiac LIfe Support."

COURSES :

* Sub Internship

* Health, Society and The Physician : This course is based on the need to provide students with a broader understanding and an appreciation for the reciprocal relationship between medicine and the society which it serves. Through the analysis of clinical cases, students will explore the role and the constraints of the physician as healer, counselor, advocate, and teacher. Using small group tutorials supplemented by weekly large group seminars the five-week course will encompass such topics as biomedical ethics, law, prevention and health promotion, family and social support systems, medical care organization and health policy.

* Clinical Pharmacology and Therapeutics : Clinical Pharmacology and Therapeutics is a five-week, required course offered during February and March of the fourth year. It is designed to help students learn the facts, skills, and attitudes that will contribute to rational therapeutics--treating patients with medications in a manner that maximizes the chances of efficacy, and minimizes the chances of toxicity. The course builds on previous courses in Basic Pharmacology and Clinical Clerkships to help students learn the drug-specific and patient-specific factors that need to be considered in order to design an optimal therapeutic plan for a given patient. Learning formats include interactive lectures, case-based problems, written consultations, and an emphasis on independent learning.

* Advanced Medical Sciences : The goal of this course is to update, integrate, and add depth to the student's knowledge and appreciation of the role of the medical sciences in the practice of medicine. This is accomplished by presenting clinically relevant fundamental and advanced concepts of the medical and biological sciences using whole class and small group teaching formats. Students also engage in discussion groups and the reading of original research papers. The course content stresses the clinical impact of very recent advances in molecular medicine, immunology, vascular biology, oncogenesis, genetics, and other medically related fields.

* Advanced Cardiac Life Support : The Advanced Cardiac Life Support Course teaches the essentials of cardiac resuscitation. It focuses on the first 10 minutes of a cardiac arrest. The format of the course includes lectures and small group practical stations where specific resuscitation skills are taught. Also offered is a module on trauma resuscitation using an interactive computer program.

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