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University of Pennsylvania (School of Medicine)




The University of Pennsylvania School of Medicine was the first and only medical school in the thirteen American colonies when, in the fall of 1765, students enrolled for "anatomical lectures" and a course on "the theory and practice of physick." They enrolled at the College of Philadelphia, which was the name of the University of Pennsylvania in pre-Revolutionary times.

The founder of the School of Medicine was a young Philadelphia physician, John Morgan. The early faculty, including Morgan, had earned medical degrees at the University of Edinburgh and supplemented Edinburgh's courses with further study in London. London offered advanced training in anatomy in private schools owned by men who had become famous in this field. The clinical practice of medicine was taught by eminent preceptors in the great city hospitals.

Because of their training abroad, the University's founding faculty introduced two important elements in American medical education. With the University of Edinburgh as their model, they chose to build their medical school within an institution of higher learning. With the background of their hospital experience in London, they chose to emphasize the need to supplement medical lectures with bedside teaching, which for some time had been provided to apprentice physicians by practitioners at the Pennsylvania Hospital. Founded by Benjamin Franklin, this hospital was located within a few blocks of the college.

For more than a century, the pattern of medical education established in 1765 remained relatively unchanged. Not all medical schools, it is true, followed Pennsylvania's lead in forming academic ties; in fact, the growth of non-academic proprietary schools became something of a scandal. It is also true that bedside teaching under a preceptor was a traditional practice rather than a requirement. But, though often violated, the standards and procedures introduced by Pennsylvania remained the guiding force in medical education throughout most of the nineteenth century.

During this period, Pennsylvania enjoyed an unchallenged eminence as the grand old father of them all. The School of Medicine's faculty was famous throughout the country-Benjamin Rush in medicine, Philip Syng Physick in surgery, Robert Hare in chemistry and, around mid-century, William Pepper in medicine and Joseph Leidy in anatomy. In 1847, when a group of physicians organized the American Medical Association, they acted to ensure the new organization's prestige by naming the Professor of Medicine at Pennsylvania, Nathaniel Chapman, as first president.

The need for a change in curriculum has been recognized throughout many generations at the School of Medicine. Since 1968, the school has undertaken several major curricular innovations. In 1970, 1981 and 1987, curricular redesigns were implemented that emphasized flexibility, early exposure to clinical medicine, increased integration between physiology, pathophysiology and pathology, increased ambulatory exposure, bioethics and nutrition education.

The most recent curricular revision, Curriculum 2000® (CU2000®) was implemented in 1997. CU2000® is an integrated, multidisciplinary curriculum which emphasizes small group instruction, self directed learning and flexibility. CU2000® was developed by focus groups comprised of department chairs, course directors, and students and is based on three themes; Science of Medicine, Art and Practice of Medicine and Professionalism and Humanism. Each component of CU2000® was developed simultaneously and collaboratively, thus providing for significant integration between clinical medicine and the basic science disciplines. During the basic science period, there is significant amount of unscheduled time during which students may pursue optional opportunities both within the medical school and with the University of Pennsylvania.

Clinical experiences begin the first day of school and continue throughout the program. Required clinical clerkships are a mix of inpatient and ambulatory experiences and basic science is reinforced throughout the clinical curriculum. Following the required clinical clerkships, significant time is available for electives and scholarly experiences.

The components of the new system are the Medical Center (including the School of Medicine and the Hospital of the University of Pennsylvania), a new integrated provider network (the Clinical Care Associates of the University of Pennsylvania), a managed care office, a management services organization and other provider entities. The system creates a regional network that provides patients with access to primary care providers, both physicians and nurses.

The development of the new components of the University of Pennsylvania Health System provides the faculty of the School of Medicine with opportunities to address, through the educational process, the changes in health care delivery which will be in place when current medical students begin their medical careers. The development of the Clinical Care Associates provides new sites for educating students in primary care medicine and allows the students exposure to alternative practice environments.


School name:University of PennsylvaniaSchool of Medicine
Address:3620 Hamilton Walk, Suite 295
Zip & city:PA 19104-6055 Pennsylvania
Phone:215-898-8001
Web:http://www.med.upenn.edu
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School of Medicine Courses


MODULE 1

Module 1 is devoted to core concepts that underlie the foundation of Basic Science and Clinical Medicine.
The courses in Module I are divided into three areas.

COURSES :

* Developmental and Molecular Biology
* Genetics
* Embryology

* Cell Physiology and Metabolism
* Physiology
* Biochemistry
* Immunology
* Microbiology

* Human Body Structure and Function
* Histology and Gross Anatomy

MODULE 2

Module 2 or Integrative Systems and Disease begins in January of the first year and ends in December of the second year. There is a 1-week spring break and an eight-week summer break.

COURSES :
Topics are organized by organ systems in the following standardized structure:

* Normal development
* Normal processes
* Abnormal processes
* Therapeutics and disease management
* Epidemiology and evidence-based medicine
* Prevention and nutrition

The Module is comprised of ten separate "blocks" or courses. The schedule is as follows:

* Mechanisms of Disease and Therapeutic Intervention (6 weeks)- includes basic pathology, hematology/oncology, rheumatology and pharmacology.
* Brain and Behavior (10 weeks) - includes neuroscience, neurology, neuropathology, anatomy, psychiatry and substance abuse
* Reproduction (3 weeks)
* Endocrinology (2 weeks)
* Gastrointestinal and Nutrition (4 weeks)
* Summer Break
* Cardiology (5 weeks)
* Pulmonary (4 weeks)
* Dermatology (1 week)
* Renal (5 weeks)
* Differential Diagnosis (1.5 weeks)
* Infectious Disease (1.5 weeks)

Each block is organized as follows:

* Functional Anatomy and Structure (Gross Anatomy and Surgery)
* Imaging (Radiology)
* Microscopic Anatomy (Histology and Pathology)
* Embryology and Post-natal Development (Embryology, Pediatrics, and Pathology)
* Normal Organ Physiology and Pharmacology (Physiology and Pharmacology)
* Organ Pathology, Pathophysiology and Pharmacotherapeutics (Pathology and Medicine, Radiology, Pharmacology)
* Organ System Oncology (Pathology and Medicine)

MODULE 3

Many of the overarching goals of Curriculum 2000 are evident in the structure and organization of the first 18-months at Penn Med. Three afternoons of unscheduled (open) time provide flexibility for students to pursue other experiences in the university, laboratory or community. Module 3, running two-afternoons per week for 18-months (concurrent with Modules 1 and 2) from matriculation to the start of the clinical clerkships (Module 4), provides a home for three major interdisciplinary courses (Introduction to Clinical Medicine, Clinical Evaluative Sciences, and Health Care Systems), and allows for the expansion of early clinical experiences. Humanism and Professionalism courses (Module 6) share time with Module 3 for the first 18 months of Curriculum 2000.

Module 3, titled Technology and Practice of Medicine, consists of three large courses, Introduction to Clinical Medicine, Clinical Evaluative Sciences and Health Care Systems. Clinical experiences begin in the first semester of medical school with the first component of Introduction to Clinical Medicine (Patient-Doctor Relationship) and continue for the next 18 months. Two of the major components of Introduction to Clinical Medicine (History Taking and Putting It All Together) include experiences in ambulatory settings, community preceptors and standardized patients. These early ambulatory, community experiences are later amplified and extended in the core primary care clerkships (Module 4).

Module 3 is home to two innovative courses, Clinical Evaluative Sciences and Health Care Systems, both of which emphasize medical informatics and self directed, life-long learning. Small-group sessions and case-based learning are prominent features of Clinical Evaluative Sciences, a three-part course that showcases the integration of the biomedical and evaluative sciences with clinical medicine and introduces students to the foundations of population-based medicine and clinical decision making. To our knowledge, Clinical Evaluative Sciences Part III: Clinical Decision Making is structured in a manner that is unique among U.S. medical school, clinical decision making being addressed in small group sessions led by students from four separate perspectives - patient, physician, insurer and public policy maker.

Health Care Systems, perhaps the most interdisciplinary course taught at Penn Med is designed to prepare students for the rapidly changing U.S. and international health care environment prior to entry into the clinical clerkships.

Other courses and sessions included in Module 3 are Emergency Medicine, Basic Life Support, Violence and Abuse Seminar and Phlebotomy.

MODULE 4 : CLERKSHIPS

* Family Medicine
* Pediatrics
* Internal Medicine
* Obstetrics / Gynecology
* Psychiatry
* Emergency Medicine
* General Surgery
* Surgical Sub - Specialties

MODULO 5 AND 6

Module 6 - Humanism and Professionalism - runs from September of year 1 to May of year 4. The goal of the module is to preserve and promote humanism, multi-culturalism and idealism in the pursuit of medical education, the cultivation of medical collegiality, and the development of the doctor-patient relationship. The small group format encourages discussion and helps build supportive relationships among group members. The module addresses core issues while allowing students to explore topics of particular interest in depth. It also helps to develop essential leadership and teaching skills.

COURSES :

* Ethics of Human Subjects Research
* Introduction to Humanism and Professionalism (Predoctoring)
* Doctoring I
* Doctoring II
* Bioethics and Professionalism

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