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The University of Texas Southwestern at Dallas (Southwestern Medical School)




One of four medical schools in The University of Texas System, UT Southwestern Medical School admits more than 220 students each year, and admission is highly competitive. By law, 90 percent of students are from Texas, assuring the state a consistent source of high-quality physicians. The school has awarded more than 8,600 medical degrees since it was established in 1943.

Medical students are taught the basic sciences and fundamental mechanisms of disease during the first two years, along with basic clinical skills. For the second two years, they pursue clinical courses in a variety of medical specialties, which allow them to integrate their basic knowledge with practical patient care at UT Southwestern's affiliated teaching hospitals and clinics.

UT Southwestern's faculty members continue to educate physicians beyond medical school. They annually train more than 2,000 clinical residents and fellows. Faculty members also provide continuing medical education to physicians and other health professionals through seminars, teaching rounds, and instruction on and off campus in new techniques. Attendance in 2005 totaled more than 59,000 participants at more than 1,600 activities.

Since 1974 UT Southwestern Medical School has enrolled approximately 200 freshman students each year. In addition to the 800 students in the four-year undergraduate medical curriculum, more than 1,000 clinical residents and postdoctoral fellows receive training at the school and its affiliated hospitals each year.
The educational programs are conducted in attractive modern buildings on the campus and in the clinical facilities of the affiliated hospitals.

The school is dedicated to the education of physicians who are thoroughly grounded in the scientific basis of modern medicine, who are inspired to maintain lifelong medical scholarship and who will care for patients in a responsible and compassionate manner. The faculty and staff are committed to serve society not only by educating future medical practitioners but also by
contributing to future medical developments through research. The majority of graduates eventually practice medicine, and the general curriculum is oriented toward this goal. Many graduates will combine the practice of medicine with careers in teaching and research. For students who wish to pursue careers in research,
opportunities are available either through summer
research experience, year-round research experience or formal training leading to combined M.D. and Ph.D. degrees.

The excellence of any educational institution is determined by the caliber of its faculty. The faculty at UT Southwestern Medical School has many distinguished members, including four active Nobel laureates, more than any other medical school in the world; 15 members of the National Academy of Sciences; 13 members of
the American Academy of Arts and Sciences; and
16 members of the Institute of Medicine.
Faculty members of the medical school have reached positions of prominence in American and international medicine. Many of the more than 1,500 full-time faculty members have been elected to the presidencies of national or international professional societies, have chaired major national and international medical committees, have been members of study sections for
the National Institutes of Health, or are editors or
members of editorial boards of medical and scientific
journals.

The number of UT Southwestern students placing at the top in national competitive examinations and earning residency positions in outstanding postgraduate programs demonstrates a high degree of teaching effectiveness.


School name:The University of Texas Southwestern at DallasSouthwestern Medical School
Address:5323 Harry Hines Boulevard
Zip & city:TX 75390 Texas
Phone:214-648-3111
Web:http://www8.utsouthwestern.edu/home/education/medicalschool/index.html
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Southwestern Medical School Courses


FIRST YEAR

The first-year curriculum begins with a study of the normal human body and its processes at the molecular and cellular levels. Biochemistry, genetics, anatomy and embryology are presented concurrently for the first portion of the year, building together the concepts of macromolecular and cellular interactions within tissues. Introductory courses in clinical ethics in medicine and critical thinking are provided at this time as well. The spring term is composed of interdisciplinary courses in physiology and neuroscience as well as courses in cell biology and human behavior and psychopathology. Endocrinology completes the first year.

COURSES :

* Anatomy : This course offers a basic understanding of the structure and function of the human body as it relates to the practice of medicine. By using surface, radiological and cadaver anatomy, students may acquire a three-dimensional understanding of structural relationships in the living body. Students, working in groups of four, dissect the major structures of the body. Prosections and demonstration specimens are provided for amplification and clarification of adult anatomy. The laboratory work is further supplemented by sessions in which radiological techniques are used to illustrate parts of the bony skeleton, as well as the thoracic and abdominopelvic viscera. Videos that illustrate the anatomy of selected regions of the body are available for repetitive viewing by students. Lectures by faculty stress the more important aspects of anatomy, especially as they relate to the practice of medicine.

* Biochemistry : This course is designed to introduce students to the fundamentals of modern biochemistry as applied to medicine. The course covers topics such as the nature and properties of enzymes; bioenergetics and the metabolism of carbohydrates and nitrogen compounds; lipids and hormones; and storage, transmission and expression of genetic information. Particular emphasis is placed on those aspects of biochemistry relevant to medical problems.

* Cell Biology : This is a lecture and laboratory course designed as an introduction to the study of cells, organized tissues and organ systems at levels of the light and electron microscopes. Emphasis is on structurefunction interrelationships between specific cell types in organized tissue systems. The first part of the course covers the functional morphology of cells and their organelles, chemical composition of cellular components and products, cell surfaces and movement, and a histological and ultrastructural survey of cells and tissues. The bulk of the course is devoted to the systematic survey of the histology of the organ systems of the body. Approximately 50 laboratory hours are devoted to studies in ultrastructure and histology.

* Clinical Ethics : In order to do ethical analysis, students must understand certain issues in clinical medicine and behavioral medicine. In this course, students are divided into small groups to discuss cases in a problem-based format. Each group has two faculty facilitators who guide the discussions. Cases revolve around important contemporary issues, including confidentiality, doctor-patient relationship, advance directives, informed consent, competence, allocation of scarce resources, assisted suicide and domestic violence.

* Embryology : This course is organized primarily by organ system, covering embryologic development from ovulation through birth. There is an introductory summary lecture. The remainder of the course is given in a self-study format. The course materials include a complete syllabus with self-study questions, the companion Web curriculum Web site, a CD-ROM with animations of embryologic development and supplementary textbooks on reserve in the library. The course is graded on a pass/fail basis after a multiple-choice examination.

* Endocrinology : This course presents a multidisciplinary approach to endocrinology and reproductive physiology. The course offers an overview of the structural, functional and biochemical aspects of the cells and organs of internal secretion and of those tissues that are prime targets of hormones secreted by endocrine glands. The course provides an indepth consideration of hypothalamic, pituitary, thyroid, endocrine pancreas, parathyroid, adrenal and gonadal function, as well as detailed discussion of such hormonally responsive organs as the mammary glands and the skeleton. Special emphasis is placed on human reproduction, including sexual differentiation, ovulation, fertilization, implantation and pregnancy, and contraception. Although the course consists primarily of basic science material, a significant portion is devoted to the presentation and discussion of selected clinical cases that exemplify derangement of endocrine and reproductive function.

* Genetics : This course introduces the basic principles of human genetics and their application to clinical medicine — chromosome abnormalities, genetic patterns of inheritance, inborn errors of metabolism, multifactorial inheritance, population genetics, gene mapping and identification, genetic screening, cancer genetics, pharmacogenetics, gene therapy, genetic counseling, and ethical issues and decision making in medical genetics.

* Human Behavior & Psychopathology : This course combines discussion of the basic sciences concerning human behavior with the pathogenesis, clinical features and treatment of mental disorders. The semester-long course uses a range of educational techniques (small-group teaching, patient interviews, lectures, computer media and objective-criterion examinations) to permit a flexible approach to mastery of the course material. The course examines human psychosocial development, explores the biopsychosocial underpinnings of behavior, and provides an introduction to the clinical features, causes and treatment of mental disorders. While mastering this content, students may develop their first skills in clinical interviewing and examining patients, understanding their own and others’ reactions to illness, and other aspects of the physician’s professional role.

* Neuroscience : This course consists of lectures and small-group laboratory sessions. It is offered by Neurology and Neuropathology with assistance from the departments and/or divisions of Cell Biology, Physiology, Psychiatry, Anesthesiology and Pain Management, Neuroradiology, and the Center for Basic Neuroscience. Basic concepts in anatomy, cellular physiology and neural-systems physiology are covered in the course. Emphasis is given to the practical application of these basic anatomical and physiological priniciples to human neuroscience and neuropathology.

* Physiology : This course examines the physiological function and regulation of major organ systems of the human body and their components. Topics include membranes and transport mechanisms; skeletal, cardiac and smooth muscle; and the cardiovascular, respiratory, renal and gastrointestinal systems. Instruction consists of lectures, problem-solving and case-study sessions, and clinical correlations. The course not only emphasizes mechanistic and integrative functions of normal physiology but also introduces and explores abnormal function that occurs in many human diseases.

SECOND YEAR

The second year offers the student an opportunity to begin a study of disease processes and the way man may interfere with those processes therapeutically. The material is presented in an integrated fashion. The year begins with the core principles from each of the major disciplines, clinical medicine, microbiology, pathology and pharmacology. System blocks follow in late fall and throughout the spring. Contact with patients begins early in the second year with history taking, physical examination, and visits to the hospital wards and various outpatient clinics. Students will usually take the U.S. Medical Licensing Examination Step 1 at the conclusion of the second year.

COURSES :

* Clinical Medicine : The course serves as a transition from the basic science courses to the clinical clerkship year. The goal is to help the student acquire the knowledge, skills and attitudes necessary to participate in the active care of patients in the context of a healthcare team. The course addresses the pathophysiology of important diseases and the differential diagnosis of cardinal symptoms. The course will help the student become proficient in data gathering, clinical reasoning and judgment, and practical skills, as well as understanding and demonstrating an attitude of professionalism.
The course includes educational and evaluative components. The educational components are designed to facilitate the student’s learning through practicing the skills and applying the knowledge learned without being evaluated. The evaluative components provide two types of feedback to the student. Formative feedback occurs throughout the course and alerts the student to areas where improvement is necessary. Summative feedback occurs as a grade is assigned at the end of the course that reflects the student’s overall performance.

* Microbiology : The program in medical microbiology is designed to familiarize medical students with the fundamentals of immunology and infectious diseases and their etiology, pathogenesis, diagnosis and prevention. Initially, there is an introduction to the basic principles of host immune system and its functions and to microbiology as a basic science through discussions concerned with microbial physiology and genetics. As the course proceeds (in integration with pathology, introduction to clinical medicine and pharmacology courses), host-parasite interrelationships for specific groups of disease-producing agents in organ systems are discussed. Throughout the course, concepts and basic information on medical microbiology are accompanied by clinical correlates. Instruction includes lectures, laboratory exercises, and case- or clinical-based small-group discussion facilitated by the faculty.

* Pathology : This course offers the pathological basis for the practice of medicine by presenting the etiology, pathogenesis and pathophysiology of general disease processes and of specific diseases of organ systems, as well as the clinical results of disease. The course extends through the second year. Students may acquire information from several sources, using comprehensive learning objectives from each topic as a guide. Synthesis of this information is facilitated in case-based small-group discussions, guided by faculty and residents. Students employ computer-assisted independent study complemented by assigned textbook readings to prepare for case discussions. Self-study time is incorporated into the course schedule. Additional components of the course include lectures, demonstrations of autopsy and surgical specimens, study of glass slides, and attendance at autopsies.

* Pharmacology : The course in medical pharmacology is designed to offer students a sound background in pharmacology as a basic biomedical science; students thereby have the opportunity to prepare for the further study of therapeutics and clinical pharmacology. After a thorough introduction to the general principles of pharmacodynamics and pharmacokinetics, the pharmacological and toxicological properties of the major classes of drugs are discussed. Emphasis is placed on understanding the mechanisms of drug-induced modifications of physiological functions in man. Lectures are supplemented with clinical correlations on the rational use of drugs in the management of disease.

THIRD YEAR

The third and fourth years offer intense clinical experiences involving the student in direct patient care. The third year is a 12-month year. It offers rotations of eight weeks each in surgery and pediatrics, six weeks each in psychiatry and obstetrics, four weeks in family practice and neurology and 12 weeks in internal medicine.

COURSES :

* Family Medicine : The third-year clerkship in family medicine exposes students to primary-care role models and ambulatory clinical experiences in contemporary health-care delivery away from the tertiary-care setting. This four-week clerkship has both didactic and clinical portions.
The clinical portion of the clerkship is based primarily at family medicine residency programs affiliated with UT Southwestern and the family medicine residency program located at UT Tyler and John Peter Smith Hospital. Some students also are based at private practitioner offices in Arlington, Colleyville and Bedford that are designated clerkship sites. The UT Southwestern-affiliated sites include Charlton Methodist Hospital, Dallas; UT Southwestern University Hospital-St. Paul, Dallas; McLennan County Family Practice Center, Waco; and UT Southwestern-Parkland Family Medicine Residency Program, Dallas. Each of these sites is staffed by UT Southwestern faculty. Students see patients at the family medicine centers and in a variety of other practice sites, including private offices, under the supervision of adjunct clinical faculty.
The didactic portion of the clerkship consists of lectures and small-group activities that focus on clinical topics and patient and family issues commonly encountered in a family medicine environment. Clerks prepare and present a patient study to faculty at each site and participate in conferences.

* Internal Medicine : Each student spends 12 intensive weeks as a clinical clerk on internal medicine inpatient services. Six weeks are Each student spends 12 intensive weeks as a clinical clerk on internal medicine inpatient services. Each student spends fours weeks at Parkland Memorial Hospital, four weeks at Dallas Veterans Affairs Medical Center and four weeks at either UT Southwestern University Hospital-St. Paul or Baylor University Medical Center.
The student is assigned patients in rotation under the supervision of house staff and attending physicians. The clinical clerk is responsible for written admission workups, progress notes and oral presentations as well as for participation in the ongoing care of patients.
The objectives of the clerkship are to develop proficiency in approaching the diagnosis and therapy of serious medical illness, to foster an appreciation of disease as the expression of deranged physiology, to inculcate habits of critical inquiry and self-education, and to enhance an appreciation of the physician’s responsibility to the patient.
Teaching is carried out on rounds with house staff and attending physicians and at conferences and lectures specifically organized for the clerks. Each student must undertake a systematic program of daily reading in standard texts and journals. Attendance at departmental events such as Grand Rounds, Clinical-Pathological Conference, the case presentations at noontime Potpourri and Residents’ Conference completes this educational experience.

* Neurology : A comprehensive and intensive neurology clerkship has been designed to offer instruction in the diagnosis and management of neurologically ill patients. The students participate actively in the evaluation and care of patients on neurology services such as those at Parkland Memorial Hospital, Dallas Veterans Affairs Medical Center and Presbyterian Hospital of Dallas. Clinical conferences, tutorial seminars and didactic teaching sessions are important parts of the clerkship. The clerkship prepares the student to evaluate neurological disease and to apply knowledge of anatomy, physiology and pathology to the formulation of an appropriate differential diagnosis.

* Obstetrics and Gynecology : Each third-year medical student spends six weeks on the obstetrics and gynecology service. The time is evenly divided between obstetrics and gynecology. Students are divided into small groups, and their clinical activities are supervised by house staff and faculty.
During obstetrics, students rotate through postpartum and antepartum care of medical complications of pregnancy. Students also provide care in the labor and delivery area of Parkland Memorial Hospital, the triage area of Parkland and the prenatal clinic at Maple Plaza. Under supervision of house staff or certified nurse midwives, students deliver babies of uncomplicated pregnancies. The student also assists in the management of complicated pregnancies during the labor and delivery process and follows the patient postpartum.
During gynecology, the students are divided into small groups and rotate through gynecology clinic and surgeries at Parkland and other hospitals. One afternoon is spent in the Southwestern Center for Minimally Invasive Surgery learning laparoscopic techniques.
In addition to ward and clinical activities, each student spends four to five hours each week in formal conferences with faculty. These conferences are devoted to discussion of patients or clarification of information that the student has encountered elsewhere. Members of the faculty give lectures on the principles of obstetrics and basic gynecology.

* Pediatrics : The eight-week pediatric rotation is divided into four weeks on the inpatient service at Children’s Medical Center Dallas, two weeks in its outpatient department, one week in a private-practice office and one week in the newborn nursery at Parkland Memorial Hospital.
INPATIENT SERVICE: During the four-week inpatient rotation, students are placed on one of the general pediatric inpatient clinical services at Children’s for two weeks and on one of the four subspecialty services for two weeks. Students are part of the clinical management team under the supervision of a full-time faculty attending physician and an upper-level pediatric resident. The number of patients each student follows is determined by his or her individual educational requirements. Each student is expected to take initial histories, perform initial physical exams, write daily progress notes on his or her assigned patients and be prepared to present them on daily rounds.
OUTPATIENT ROTATION: Students spend two weeks in ambulatory pediatrics, one week in a private practice office and one week in the newborn nursery at Parkland. During the two weeks in ambulatory pediatrics, students spend most mornings in Medical Student Clinic, where they take complete histories and physicals and present to both full-time and volunteer faculty. The remaining time is spent in various pediatric subspecialty clinics and can be directed toward each student’s interest. During the private practice rotation, students spend three days under the supervision of a volunteer faculty member. The remaining days are focused on adolescent medicine and child abuse/child advocacy. During the newborn nursery week, students examine healthy newborns and may attend complicated deliveries.
The course in pediatrics is designed to emphasize normal growth and development and the impact of disease and its treatment on the developing child. Additionally, the prevention of disease and injury, along with the role of the physician as child advocate, is stressed.

* Psychiatry : An intensive six-week rotation in psychiatry actively involves the student in a variety of psychiatric services. Students are assigned to two three-week sites for their primary clerkship experiences.
These sites include inpatient psychiatry, consultation/liaison psychiatry, community health care and emergency psychiatry in a variety of hospital settings, including Parkland Memorial Hospital, UT Southwestern University Hospitals, Dallas Veterans Affairs Medical Center, Children’s Medical Center Dallas and Presbyterian Hospital of Dallas. These primary clerkship experiences are supplemented by part-time experiences in outpatient psychiatry and emergency psychiatry.
Students also are able to see clinical care unique to psychiatry, such as electroconvulsive therapy. In addition to diverse clinical exposure, students also spend one half-day a week in didactic teaching sessions focusing on the diagnosis and biopsychosocial treatment of psychiatric disorders and have the opportunity to access interactive computer-based psychiatric cases. Students attend weekly departmental Grand Rounds and participate in teaching conferences on their primary service site.

* Surgery : The junior surgical clerkship is designed to introduce students to the theoretical and practical aspects of surgical patient care. Emphasis is placed on the underlying pathophysiology rather than technical aspects. Students are fully involved in the daily care of surgical patients and participate in diagnostic and therapeutic decision making. This eight-week experience includes didactic teaching sessions as well as small-group interactions with full-time faculty.

FOURTH YEAR

The fourth year consists of four-week clinical rotations in acute care, ambulatory medicine and medicine subinternship. Four four-week electives are chosen from an extensive list of options to fulfill the remaining course requirements. Certification in advanced cardiac life support is also a requirement for graduation. Although not an academic requirement for graduation, the USMLE Step 2 must be taken and passed before completion of medical school.

COURSES :

* Acute Care: : This four-week clerkship offers instruction in the diagnosis and management of an acutely ill or injured patient. Students select a rotation from a variety of clinical settings, including intensive care units, critical care services and emergency departments.
The selection sites for this clerkship include Parkland Memorial Hospital’s burn ICU, critical care unit, emergency department, neonatal ICU, surgical ICU and trauma service; Dallas Veterans Affairs Medical Center’s cardiovascular anesthesia and surgical ICU; and Children’s Medical Center Dallas’ emergency department, pediatric ICU and pediatric cardiac critical care unit.
During this clerkship the student functions as an integral member of the medical team providing a high level of care to acutely ill or injured patients. Under the supervision of residents, fellows and attending physicians, the student may gain an enhanced knowledge of stabilization, resuscitation and management of such critically ill patients.

* Ambulatory Care : Students spend one month in outpatient clinics or private physicians’ offices for internal medicine, family medicine or women’s health. Students are expected to interview patients and obtain vital information for patient care, interpret data and discuss the treatment plan with the patient and family, promote general health maintenance and disease prevention, and consult with specialty services to coordinate care. Students should demonstrate knowledge about a wide variety of medical illnesses and apply this knowledge to patient care. Students also should be able to assimilate scientific evidence to improve patient care.

* Medicine Subinternship : Students spend four weeks on an inpatient service in either internal medicine, pediatrics, or obstetrics and gynecology. Students are expected to interview patients and obtain vital information for patient care, interpret data and discuss the treatment plan with the patient and family, promote general health maintenance and disease prevention, and consult with specialty services to coordinate care. Students should be able to provide the differential diagnosis of a chief complaint and a treatment plan to investigate the cause. Students also are expected to apply current clinical knowledge to arrive at a unifying diagnosis with the health-care team. Students should be able to assimilate scientific evidence to improve patient care and be able to communicate effectively with the health-care team, patients and patients’ families.

* Advanced Cardiac Life Support : ACLS includes didactic information about the management of cardiac arrest, including rhythm recognition, drugs and protocols. The course also has skills practice for airway management including intubation; management of bradycardia, tachycardias, ventricular fibrillation, asystole, pulseless electrical activity, and shock and heart failure; and use of defibrillators and automated external defibrillators. Students must master techniques for basic life support for health professionals, such as one- and two-rescuer cardiopulmonary resuscitation, infant CPR, child CPR, and management of obstructed airway for all ages, before practicing skills for advanced techniques. Examinations include a written examination and demonstration of proper technique for intubation and ability to serve as team captain for a cardiac-arrest scenario. The student must pass each section for certification.

* Electives : The elective program has a twofold purpose: 1) to aid the student in a career choice and 2) to offer an opportunity to build strengths in related fields should a career choice have been made by the senior year. Four months of the fourth year of medical school are available for electives.
Students may take more than four months of electives by using the unscheduled four weeks in the junior year; however, academic credit will not be awarded for the same elective taken more than twice. Students may take electives off campus if approved by the chair of the relevant medical school department and then by an associate dean for student affairs. Some students may choose to spend their elective time on a research project.
An elective handbook listing the various offerings is published each year. Included are electives in the major clinical disciplines and in the medical and surgical subspecialties. Occasionally a student may, with faculty approval, design an elective to meet a special need. Selection of electives is guided by individual counseling from faculty when needed.
More than 100 elective courses are offered by many departments, including Anesthesiology and Pain Management, Cardiovascular and Thoracic Surgery, Clinical Science, Dermatology, Family and Community Medicine, Internal Medicine, Neurology, Neurological Surgery, Obstetrics and Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology - Head and Neck Surgery, Pathology, Pediatrics, Pharmacology, Physical Medicine and Rehabilitation, Plastic Surgery, Psychiatry, Radiology, Surgery, and Urology.

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