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Washington University (School of Medicine)

The School of Medicine has a rich, 115-year history of success in research, education and patient care. It pioneered bedside teaching and led in the transformation of empirical knowledge into scientific medicine. From the earliest days, there has been an understanding that “investigation and practice are one in spirit, method and object.”

The School of Medicine selects applicants who, in addition to possessing keen minds, demonstrate an ability to perceive and serve their patients' best interests. U.S. News & World Report ranks Washington University School of Medicine one of the top five in the nation and places its students first in terms of academic quality. An outstanding education from Washington University School of Medicine provides graduates with solid opportunities for highly sought-after residencies and fellowships, engaging and challenging research endeavors, and successful, rewarding medical careers.

Washington University School of Medicine provides students with a supportive, stimulating and challenging environment in which to acquire a thorough foundation in scientific medicine and develop skills, professional attitudes and personal commitments necessary for the practice of medicine at the highest possible level of excellence. In addition, the medical school fosters a commitment to collegiality, respect of individuality, community involvement and leadership through many extracurricular organizations and activities supported by the school.

The Washington University School of Medicine has one of the finest faculties of any medical school in the nation. Recognized for their distinguished achievements in original research, 12 faculty members are among the fellows of the prestigious National Academy of Sciences. Nineteen Nobel laureates have been associated with the School of Medicine.

During Fiscal Year 2005, 145 members of the faculty held individual or career development awards: 87 from the National Institutes of Health; two from the American Gastroenterological Association for Digestive Health and Nutrition; one from the American College of Surgeons; one from the American Diabetes Association; one from the American Federation for Aging Research; nine from the American Heart Association; three from the American Lung Association; one from the American Society for Bone and Mineral Research; one from the Aplastic Anemia and MDS International Foundation; three from the Arthritis Foundation; one from Bayer Healthcare; four from the Burroughs Wellcome Fund; one from the Jose Carreras Leukemia Foundation; two from the Crohn’s and Colitis Foundation of America; one from the Dermatology Foundation; one from Enzon Pharmaceuticals; one from the Foundation for Anesthesia Education and Research; one from the John Douglas French Alzheimer’s Foundation; three from the Juvenile Diabetes Research Foundation International; three from the Robert Wood Johnson Foundation; one from the W.M. Keck Foundation; three from the Knights Templar Eye Foundation; one from the Leukemia Society of America, Inc.; two from the Muscular Dystrophy Association; one from the National Alliance for Research on Schizophrenia and Depression; one from the National Hemophilia Foundation; three from the Orthopaedic Research and Education Foundation; two from the Pfizer Pharmaceuticals; two from Research to Prevent Blindness, Inc.; one from the University of Missouri – Columbia Alzheimer’s Disease and Related Disorders Program; and one from the Whitaker Foundation.

The School of Medicine has 19 faculty members with Method to Extend Research in Time (MERIT) status, a special recognition given to only a few NIH grantees, which provides long-term, uninterrupted financial support to investigators who have demonstrated superior achievement during previous research projects.

In 2005-2006, the School employed 1,507 full-time, salaried faculty members in its 20 preclinical and clinical departments. The clinical departments are further strengthened by 1,153 part-time faculty members, a group of physicians who practice their medical specialties in St. Louis and are members of one or more of the staffs of the hospitals in the Washington University Medical Center.

The School of Medicine attracts a student body of exceptional quality. The 2005 Entering Class of 123 students was selected from a pool of 4,080 applicants. The School is a national institution with 47 states and 32 countries represented in the current enrollment.

In 2006, the School conferred the M.D. degree upon 88 individuals. In addition, nine students received the M.A./M.D. degrees and 22 students graduated with the M.D. and the Ph.D. degrees. Graduating students who participated in the 2006 National Residency Matching Program matched in programs recognized for high quality and selectivity. In the Alphabetical List of Students area of the Register of Students section, the graduates are listed by name, hometown, undergraduate and graduate schools attended and year of degree, type of postgraduate residency program, name of hospital and the city in which it is located.

The student body of the School of Medicine numbers 592 medical students. Programs also are conducted for 412 students who are pursuing graduate degrees in health administration, occupational therapy, physical therapy, psychiatric epidemiology or genetic epidemiology. The Division of Biology and Biomedical Sciences has extensive graduate training programs for 592 students seeking the Doctor of Philosophy degree in areas of Biochemistry, Computational Biology, Developmental Biology, Evolution Ecology and Population Biology, Immunology, Molecular Biophysics, Molecular Cell Biology, Biochemistry, Molecular Genetics, Molecular Microbiology and Microbial Pathogenesis, Neurosciences, Plant Biology and Quantitative Human and Statistical Genetics.

The 230-acre Washington University Medical Center, spread over portions of 20 city blocks, is located along the eastern edge of Forest Park in St. Louis. Along the western edge of the park is the 169-acre Hilltop Campus of the University. A regularly scheduled shuttle bus, operated for the benefit of students, faculty and staff, brings the two campuses within 10 minutes of each other.

The medical center was incorporated in 1962. It now consists of the Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis Children’s Hospital, Barnard Hospital and Central Institute for the Deaf, and is affiliated with BJC Health System. Two integral units of the Medical Center are the world-famous Mallinckrodt Institute of Radiology (MIR) and the Center for Computational Biology.

The medical center generates an annual financial impact of more than $2.3 billion for the St. Louis area, according to an economic model maintained by the St. Louis Regional Commerce and Growth Association. With nearly 20,000 employees, the combined medical center institutions are the second largest employer in the metropolitan area.

Unprecedented growth has occurred at the Medical Center over the past 10 years. At the School of Medicine alone during the past five years, more than $350 million has been expended on renovation and new construction. Capital improvements and strategic purchases have added 545,000 square feet of space to the medical school during this same period. In the most recent fiscal year, more than $100 million of capital improvements were made at the School.

In the last 10 years, School of Medicine expansion has included the CSRB North Tower Research Addition, the East McDonnell Sciences Building, the Specialized Research Facility - East, the McDonnell Pediatric Research Building, the Southwest Tower, the Center for Advanced Medicine, the acquisition of the Central Institute for the Deaf buildings, and the school's first dedicated teaching facility — the Farrell Learning and Teaching Center. This 110,000-square-foot, six-story facility, located at the corner of Scott and Euclid avenues, is the home for all of the medical school teaching labs, small-group and seminar rooms, and all individual student study areas. A new lecture hall, case-study hall and café are located on the first floor of the building, which opened in September 2005.

The 10-story Clinical Sciences Research Building (CSRB) North Tower research addition, 201,349 gross square feet, consolidates all medical school specialized research into one structure. The top three floors of the addition house wet lab research space. The new 230,000-square-foot McDonnell Pediatric Research Building adds new, state-of-the-art research facilities, 4.5 floors for the Department of Pediatrics, three floors for the Department of Molecular Microbiology, and one half floor for the Department of Medicine, is located on the corner of Euclid Avenue and Children’s Place. This new building includes a Barnes & Noble bookstore with a coffee shop on the ground floor level. The 136,977-gross-square-foot, seven-story East McDonnell Sciences Building is a maximum-barrier research facility to accommodate higher brain function research and transgenic studies.

The Center for Advanced Medicine, located at the corner of Euclid and Forest Park avenues, is a shared facility between the School and BJC. This building brings all of the Medical Center’s clinics together under one roof. The School of Medicine occupies 243,400 square feet in the Center for Advanced Medicine and 75,000 square feet on three floors in the new Southwest Tower. Located in the heart of the Center for Advanced Medicine is the 66,150 square foot Alvin J. Siteman Cancer Center. The Siteman Cancer Center is the only NCI-designated comprehensive cancer center in the region.

In addition, major renovations to existing buildings continue, with emphasis on research facilities. Within the last two years, renovations totaling $95 million have been completed. The Department of Genetics expanded in 2002 through renovations on the seventh and eighth floors of McDonnell Sciences Research Building and together with the Department of Pharmacology recently started up the Center for Genomics and Human Genetics with wet lab renovation of 15,000 square feet on the 5th floor of 4444 Forest Park, with a second phase of 15,000 sf of lab renovation to begin in the fall of 2006. The Department of Biochemistry added another Nuclear Magnetic Resonance (NMR) Spectrometer in a small addition to Cancer Research Building. The Department of Ophthalmology expanded wet labs and offices on the 7th floor of McMillan and Maternity buildings. The Departments of Cell Biology and Internal Medicine jointly renovated research labs on the 5th floor of McDonnell Medical Sciences building. Ongoing improvements to the campus infrastructure are being made through the Public Realm Project, which is focused on landscape and streetscape enhancements.

The School of Medicine is divided into two segments. Clinical departments are predominantly located on the west side of the Medical Center, adjacent to hospital and patient areas. Preclinical departments are to the east. Research and instructional endeavors occupy the greater portion of the facilities, with more than 1.8 million gross square feet devoted to these activities. In the aggregate, the medical school occupies more than 5 million gross square feet of space.

The focal point of the preclinical teaching activities is the McDonnell Medical Sciences Building, the center of activity for entering medical students. The McDonnell Building, with 300,000 square feet of first-class research laboratories and classroom space, was made possible by James Smith McDonnell III, a generous benefactor of Washington University. Rising nine floors above ground, it contains administrative offices and two lecture halls on the first floor. Three floors of wet lab space were completely renovated in the last 3 years. Offices and research laboratories for the seven basic science departments, are located on the upper floors. Modern centralized animal quarters are housed in the basement.

The North and South Buildings, in which the work of several Nobel laureates has centered, have been renovated extensively. Along with the Cancer Research Building, they continue to provide space for laboratories, offices and some departmental facilities. The East Building houses an MRI facility, a cyclotron, computer installations and other components of the Mallinckrodt Institute of Radiology. The East Building also houses several administrative office suites.

A network of pedestrian bridges provides the ability to move freely among the major facilities, enhancing the interaction of all Medical Center institutions and benefiting research and patient care.

The Washington University Medical School library is one of the oldest and most comprehensive medical libraries west of the Mississippi. The Bernard Becker Medical Library serves as an information and technology services hub for the Medical Center and extends its services and resources to the global health science community.

The facility, completed in 1989, integrates biomedical information resources and information technology. The eight-level, 114,000-square-foot structure has a capacity for more than 300,000 volumes. The biomedical resource collection includes more than 290,000 volumes, some 1,200 audiovisual items and over 3,300 current journal subscriptions.

Information Services, part of the library’s Communication and Outreach Division, answers a wide range of questions covering biomedical and general information. Staff may be contacted by telephone, (314) 362-7085, electronic mail,, or at the Information Services Desk on Level 1 of the library. Information Services offers individual and group training in database searching. They can also design audience-specific classes for Medline, Evidence Based Medicine, information management software, and Bioinformatics tools. Training sessions can be held in the library or off site. The Division also provides a liaison for every department and program in the Medical Center.

Becker catalog provides complete and current information about the library’s collections. It includes access to over 3,100 electronic full-text journals, 230 online books, 26 databases, and numerous selected web sites. Ovid Online is the library’s premier tool for searching and retrieving biomedical journal literature. Other valuable electronic resources include the Web of Science, Journal Citation Reports, UpToDate, Scopus, and the Cochrane Library. Remote access for most of these products is available for office or home use. Materials not owned by Becker Medical Library can be obtained through interlibrary loan and document delivery service.

By conferring the M.D. degree, the University certifies that the student is competent to undertake a career as a doctor of medicine. It certifies further that, in addition to medical knowledge and skills, the graduate possesses qualities of personality — compassion, emotional stability and a responsible attitude — essential to an effective professional life.

A course of medical education for the M.D. degree ordinarily consists of a minimum of four years of study. Students recommended for the Doctor of Medicine degree must be of good moral character, they must have completed an entire academic course of instruction as matriculated medical students, they must have passed all required subjects or the equivalent and have received satisfactory grades in the work of the full academic course, and they must have discharged all current indebtedness to the University. The school requires that students planning to practice clinical medicine take the USMLE Step 1 and Step 2 examinations.

At the end of the final academic year, students who have fulfilled these requirements will be eligible for the M.D. degree.

The curriculum is an evolving product of prolonged and continuing study, by both faculty and students, of the present and probable future course of medical science and medical practice, and of the ways in which medical education can be kept abreast of this course. Our students enter medical school with diverse backgrounds and interests and upon graduation undertake a wide variety of careers. The curriculum provides the basic knowledge and skills essential for their further professional development. Modern medical education can no longer hope to be comprehensive; it must be selective. Yet students must develop facility in the understanding and use of several related technical languages: those of anatomy, chemistry, physiology and clinical medicine. They must share responsibility for the care of the patient. They also must learn how these areas of endeavor are interrelated, how the organization and needs of society influence the methods of providing medical care, and how new knowledge is acquired and old knowledge re-evaluated.

The curriculum includes a core experience based upon a sequence of courses that introduces students to the many domains and disciplines of medicine. The principles, the methods of investigation, the problems and the opportunities in each of the major disciplines of medical science and medical practice are presented in such a way as to help students select the career best suited to their abilities and goals.

In the final year of the medical school curriculum, the required elective program helps students to decide where major interests lie. It also enables them to benefit from the wide range of specialized knowledge and skills found in the faculty and lays the foundation for lifelong learning and application of principles. The elective program permits students to select, according to their desires, the areas they wish to explore or to study in depth.

Washington University’s extensive clinical facilities, large patient population and superlative faculty provide an environment of exceptional clinical training. Our students
play an integral role in patient care alongside senior faculty, residents and fellows.
In the process, they learn how the areas of medical science interrelate and how leadingedge technology is applied.
Students are taught by a faculty that is among the most prestigious in the country.
Many are nationally and internationally recognized for clinical excellence. Best Doctors in America includes 237 Washington University physicians, while 122 are listed as among the nation’s best by America’s Top Doctors. In addition, the school’s faculty are authors of the Washington University Manual of Medical Therapeutics, the most widely sold medical textbook
in the world. Many faculty perform dual roles as basic scientists and clinicians, bringing the most current knowledge and methods of inquiry from the laboratory
to the bedside.

Clinical training emphasizes not only the science of medicine, but the art of effective communication with patients. A fully elective fourth year supports students in customizing their preparation for the years of professional development that follow medical school.

The faculty and administration of Washington University are extremely proud of the school’s medical students. They not only meet the highest academic standards in the country but also possess many talents and interests outside of medicine, including visual arts (painting, drawing, sculpture, photography), writing, dancing, music, literature, singing and athletics. Each class is diverse; current students come to the school from 46 states plus the District of Columbia and from 31 foreign countries.

Although the medical curriculum is rigorous, our students still find time to relax and have fun, often with classmates. “Study hard, play hard” is their unofficial motto, reflecting the intensity, drive and sense of exploration they share. Camaraderie is an overriding quality of the school; classmates provide a built-in source of personal support and friendship.

School name:Washington UniversitySchool of Medicine
Address:660 S. Euclid Ave.
Zip & city:MO 63110 Missouri

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School of Medicine Medical School Location

School of Medicine Courses

FIRST YEAR The first-year curriculum focuses on the acquisition of a core knowledge of human biology, as well as on an introduction to the essentials of good patient care. Diversity among matriculants in undergraduate background, and in approaches to learning, is recognized and fostered. The courses are graded Pass/Fail, and a variety of didactic means are made available including lectures, small groups, extensive course syllabi, clinical correlations, and a Lotus Notes computerized curriculum database. The Practice of Medicine I uses regular patient interactions and integrative cases to teach students to skillfully interview and examine patients, as well as the fundamentals of bioethics, health promotion/disease prevention, biostatistics, and epidemiology. An optional summer research program between the first and second year provides an opportunity for students to explore various areas of basic science or clinical research. COURSES : * Cell and Organ Systems Biology : The structure of cells, tissues and organs is studied with regard to the functional significance of the morphological features. Lectures integrate histology with cell biology and physiology. The laboratories consist of the study of prepared slides, electron micrographs, and digital images. A dual view microscope will be provided for each pair of students. Limited space is available for non-medical students with instructor's permission. This course is cross-listed in Department of Cell Biology and Physiology. * Human Anatomy and Development : The course is based largely on the dissection of the human body. Lectures on functional and topographic anatomy emphasize the principles of organization of the various systems of the body. Lectures on developmental anatomy stress organogenesis as an adjunct to understanding the normal and abnormal anatomy. An extensive museum of labeled dissected specimens is housed in the dissecting room for ready reference by students who encounter abnormalities or variations in their dissections. Frequent use of CT and MRI scans, radiographs and cross-sections aid in the synthesis of knowledge gained through dissection into clinically useful information. Radiologic anatomy and clinical correlation conferences further aid in this process. * Immunology : This course consists of lectures, laboratories, laboratory exercises and small group discussions. It covers all aspects of the immune response — general properties of the immune system, effector molecules, cells and their function, cellular interactions, and immunological diseases. The Immunology course requires a strong background in biochemistry, genetics and cell biology. Some of the basic concepts from these fields should be reviewed during the course. There are two laboratory sessions. These will cover the areas of blood typing/blood banking and allergy. In these laboratories, students will type their own blood and be tested for allergies. POPS (Patient Oriented Problem-Solving System in Immunology) will also be utilized; they contain a clinical problem that is analyzed and solved during the session. There are five hours of small group clinical discussion sessions. In these sessions, students meet with physicians to discuss the role of immunology and a particular human disease. The Immune System (second edition) by Peter Parham is used. For the small group clinical sessions, the latest edition of the textbook Case Studies in Immunology: A Clinical Companion (fourth edition) by Rosen and Geha will be used. There will be two formal exams (consisting of multiple choice and true and false questions) and one take-home exam (consisting of essay questions) on the topics described in the lectures and in the laboratory sessions. This course is restricted to medical students only. * Medical Genetics : This course focuses on the fundamentals of genetics including the basic structure of genes, gene expression and regulation, patterns of inheritance, types of mutations, the consequences of mutations, and molecular diagnostic strategies. Discussion includes the structure of DNA and its means of replication, the organization and packaging of eukaryotic genomes, chromatin structure and the nucleosome, the processing of their primary transcripts, and the molecular basis for transcriptional and translational regulation including the use of transgenic mice to study cell-specific gene regulation, and how these concepts can be applied to an understanding of medical genetics through discussion of principles of Mendelian genetics, the molecular basis for various inborn errors of metabolism, their diagnosis and prenatal screening, and the genetics of cancer. Ethical issues raised in diagnostic and prognostic efforts are also discussed. * Microbes and Pathogenesis : The challenge of this course is to emphasize the importance of understanding molecular and cellular paradigms of how pathogenic microbes interact with their hosts and cause disease. Selected pathogenic microbes, including bacteria, viruses, parasites and fungi, will be utilized as models to explain general principles of host-pathogen interactions and their consequences. Mechanisms by which microbes evade host defenses to cause acute and chronic infections will be highlighted. Problems facing the medical community in the 21st century such as rising antibiotic resistance and tropical diseases will be addressed. The main objective of this course is to teach students how to think about microbial pathogenesis in a way that will provide them a conceptual framework that relates mechanisms of pathogenesis to symptomology and pathophysiology. * Molecular Foundations of Medicine : This course is designed primarily for medical students and will cover fundamental aspects of biochemistry and cell biology. The course begins with a treatment of protein structure and the function of proteins in the cytoskeleton and cell motility. The principles of enzyme kinetics and regulation are then discussed and basic pathways for the synthesis and metabolism of carbohydrates and lipids are introduced. This leads into a discussion of membrane structure and the function cellular organelles in biological processes including energy production, protein degradation and protein trafficking. * Neural Sciences : Neural Sciences is an intensive seven-week course that covers the structure, function and development of the nervous system as seen from molecular, cellular and systems-oriented perspectives. The emphasis is on the organization and function of the nervous system in health, but there is frequent reference to the clinical relevance of material presented. The course includes regular lectures, conference sessions and laboratories, plus a number of clinically oriented presentations. Computer-aided instructional programs, accessible from a variety of locations, provide auxiliary modes of self-paced learning and review. The midterm and final emphasize the core body of important facts and principles presented in lectures and laboratories. * The Practice of Medicine I : This course employs a variety of teaching techniques, instructors, and venues. Some, like lectures, will be familiar. Others, such as one-on-one interviews in the hospital, will be new. Some course material is easily formatted into solid blocks such as the teaching of statistical methods. Other content streams throughout the course, like interviewing techniques and history interpretation. Particular areas may be stimulating and rewarding, and other areas may seem irrelevant or overemphasized. As with patients, each of you comes with a unique past and active history, previously formed interests, and individual goals. Your prior contacts and personal experiences in science or medicine also influence you. It is impossible to account for all of these unique features so we designed the course to accommodate a variety of learning interests and styles. Some will resonate with you; others may not. We hope to provide an opportunity for you to hone the skills that you already possess and acquire new skills necessary and important to the practice of medicine. * Selectives SECOND YEAR The second-year curriculum is focused on human pathophysiology and pathology. Through lectures, small group discussions, laboratory exercises and independent study, students acquire broad, detailed knowledge of mechanisms of disease pathogenesis, clinopathological relationships and fundamental principles of therapy. The Practice of Medicine II continues students’ introduction to the fundamentals of patient care, and emphasizes organizing and interpreting clinical information to form a problem list, differential diagnosis, and treatment plan. Students also learn how to accurately document and concisely present clinical information. Supervised clinical experiences and small group discussions further engender development of the professional attitudes and high ethical standards required for the third-year clinical clerkships. COURSES : * Cardiovascular Disease : The purpose of this course is to consider the mechanisms and manifestations of acquired and congenital cardiovascular disorders as well as their pharmacologic treatment. Lectures and small group discussions that emphasize the major areas of cardiac pathophysiology and pharmacology are provided. * Dermatology : The Dermatology second-year course is designed to teach medical students how to describe skin lesions and the pathophysiological basis and clinical characteristics of major dermatologic diseases. Major categories of clinical skin diseases and their most prominent constituents will be discussed, including papulosquamous diseases, blistering diseases, infec-tious diseases, and benign and malignant neoplasms. * Diseases of the Nervous System : The goal of this course is to provide an introduction to diseases of the central and peripheral nervous systems, including their clinical manifestations, pathology, pathophysiology and pharmacotherapy. The course includes reading assignments, lectures, laboratories, conferences and clinical presentations. This course emphasizes the diagnosis of major psychiatric illnesses in adults and children. Psychiatric diseases are described in terms of epidemiology, clinical presentation, natural history, genetics, differential diagnosis and clinical management. Interviewing techniques and performance of the mental status exam will be demonstrated by patient interviews. * Clinical Topics in Otolaryngology : This course consists of eight introductory lectures on common diseases of the head and neck, including head and neck carcinoma, hearing loss and dizziness, otitis media, sinusitis, otolaryngologic emergencies, and facial fractures. Each lecture is highlighted by case presentations and treatment options in addition to pathophysiology. This course follows the physical examination practicum given earlier in the academic year. * Endocrinology and Metabolism : This course aims to develop understanding of the pathophysiology, clinical manifestations and diagnosis of common endocrine disorders. History, physical examination and interpretation of diagnostic laboratory tests are emphasized. Principles of treatment of endocrine disorders and pharmacology of relevant drugs also are discussed. Students are expected to apply their knowledge in clinical case discussions. * Gastrointestinal and Liver Diseases/Nutrition : This course discusses the pathophysiologic mechanisms related to the diseases of the gastrointestinal tract including esophagus, stomach, small and large intestines, liver, gallbladder and pancreas. The emphasis is on changes that occur in normal physiology, biochemistry, anatomy, immunology and cell biology that result in human gastroenterologic diseases. Included also are lectures on the pharmacology of gastrointestinal drugs and basics of human nutrition in clinical practice. Lectures are supplemented by group seminars that focus on clinical case presentations. * Hematology and Oncology : The hematology and oncology pathophysiology course exposes students to common hematologic disorders and hematologic malignancies. The course utilizes lectures, clinical case discussions and practical sessions involving microscopy. * Infectious Diseases : The infectious disease pathophysiology course emphasizes both organism-specific and organ-specific approaches to diseases caused by microbes. The course expands on material presented briefly in the first year concerning bacteria, viruses, fungi and parasites, and their involvement in human disease. Mechanisms of disease production, clinical manifestations and therapy are discussed, along with public health implications. In addition to lectures, small group case discussions enable students to apply the information they learn to clinical situations. * Obstetrics/Gynecology : The obstetrical component of this course emphasizes the physiologic basis of normal pregnancy, parturition, and labor and delivery, and adaptations of other organ systems to pregnancy. Pathophysiology of pregnancy and deviations from normal labor will also be introduced. The gynecologic component of the course reviews embryology and includes the topics pediatric and adolescent gynecology, amenorrhea, abnormal uterine bleeding, menopause, surgical anatomy, and diagnosis and treatment of gynecologic neoplasms. * Pathology : This course provides a comprehensive survey of the biology and morphology of human disease through a combination of lectures and laboratory/case study sessions. The year begins with a review of basic disease mechanisms at the cellular and molecular level. Subsequently, the pathogenesis and characteristics of important diseases involving each organ system of the body are presented. Considerable emphasis is placed on learning the “language” of human disease. During the year, students become familiar with the methods of contemporary pathologic analysis. They also learn how the results of pathologic studies are used in the clinical setting to establish diagnoses, to assess prognosis and response to therapy, and to evaluate the quality of patient care. * Pediatrics : Students are introduced to pediatrics and to the faculty through a series of lectures and symposia designed to acquaint them with the concepts of human growth and development and the effects of age and maturity on reactions to injury and disease. The unique aspects of the physical examination of the infant and child are presented in the Introduction to Clinical Medicine course. Members of the faculty are active participants in the second-year Pathophysiology course. * The Practice of Medicine II : The goal of The Practice of Medicine course (POM) is to provide students with a set of knowledge, skills and attitudes essential to patient care regardless of specialty. POM II is a continuation of POM I and will continue to address various interfaces between patients, physicians and society and will also introduce approaches to clinical thinking and decision-making in the context of today’s socio-economic and cultural environment. The sections of POM II include Advanced Physical Examination, Case Development, Communication, Ethics and Health Policy, Health Promotion/Disease Prevention, Interpreting Illness, Ophthalmology, Patient Sessions, Radiology and Scientific Methods. The learning objectives for each section of POM II emphasize topics and skills utilized in all fields of medicine, and the majority of the coursework will be taught in small groups or through clinical experiences. * Selectives THIRD YEAR The overall goal of the third year is implementation of fundamental interactive clinical skills necessary for the practice of medicine at the highest possible level of excellence. Students achieve this goal by participating in intensive, closely supervised training experiences in the core clinical clerkships involving inpatient and ambulatory settings and interactions with patients who present a spectrum of emergent, urgent, routine and chronic clinical problems. Through these experiences, students exhibit growth and maturation in their abilities to take medical histories, perform complete physical examinations, synthesize findings into a diagnosis, formulate treatment plans, and document and present information in a concise, logical and organized fashion. During the clinical clerkships, students learn to use the biomedical literature and other educational resources in the service of their patients and in self-directed learning. Students also use their personal experiences and rapidly expanding knowledge of human behavior and ethnic, cultural, socioeconomic and other social factors to develop their own personal standards of compassionate, respectful and ethical behavior in the practice of medicine. COURSES : * Integrated Surgical Disciplines Clerkship : During the 12-week surgery clerkship, students are assigned to three separate rotations. Each student is assigned to a required general surgery rotation at Barnes-Jewish Hospital, Christian Northeast Hospital, or the Veterans Administration Medical Center. In addition, each student selects elective rotations in other general surgical fields, surgical subspecialties and related disciplines of critical care. The student is an active participant in the daily care of patients on each service and attends the service teaching conferences and rounds. For the duration of the 12-week rotation, there are weekly small-group tutorial sessions with faculty members and a biweekly lecture series. * Medicine Clerkship : The medicine clerkship provides supervised study of patients in both inpatient and ambulatory settings. The 12 week clerkship is divided into 3 4-week rotations, 2 inpatient and 1 outpatient. For the inpatient rotations, students are assigned as clinical clerks to patients admitted to the cardiology and general medical teaching services of Barnes-Jewish Hospital and the John Cochrane Veterans Administration Medical Center. For the outpatient rotations, students are placed with community-based internal medicine or family practice physicians. Teaching is provided by the chief of service, attending physicians, house staff, consultants, chief residents, community-based preceptors and regularly scheduled conferences. Formal instruction is given regarding core internal medicine topics during the clerkship. Teaching activities include Chief Resident Rounds, Core Lecture Series, Physical Diagnosis Rounds, Radiology Rounds, Professor’s Rounds, and other departmentally based conferences. * Neurology Clerkship : A full-time, four-week clerkship is provided on the inpatient neurology services at Barnes-Jewish Hospital south. Patients are assigned to students who evaluate and follow them with the resident staff and discuss them regularly in conferences with the senior neurological staff. Students also work in the neurology clinic under staff supervision and attend a series of lectures on neurosurgical problems. The goal of this rotation is to gain expertise in the evaluation and treatment of patients with neurologic diseases. Up to two students may elect to obtain their clerkship experience on the neurosurgery service. Up to two students may elect a two-week experience in outpatient pediatric neurology. Students participate in the neurology specialty clinics at St. Louis Children’s Hospital, working under the supervision of pediatric neurology fellows and senior staff. * Obstetrics/Gynecology Clerkship : Comprehensive study of the reproductive health needs of women is the focus of the curriculum. Opportunity for supervised active participation is emphasized in outpatient clinics, routine and high-risk obstetrics, care of the infertile and oncology patient, including surgical case management. Students are assigned as clinical clerks to rotations at Barnes-Jewish Hospital and Missouri Baptist Hospital. Faculty, house staff and nurse practitioners provide teaching for this rotation. Students participate in all teaching conferences offered by the department; core curriculum topics are presented in a seminar series and in small group sessions with faculty preceptors. * Pediatrics Clerkship : This six-week curriculum emphasizes pediatric pathophysiology and normal growth and development from birth through adolescence. This rotation consists of three two-week combinations of the following: Regular or special-care nurseries at Barnes-Jewish or Missouri Baptist hospitals spent assessing newborns, seeing patients in the pediatric emergency department and Hematology/Oncology outpatient service and in St. Louis Children’s Hospital on a variety of inpatient services. Emphasis is on performing a pediatric history and physical examination and developing an appropriate differential diagnosis. Daily rounds with house staff and attending physicians, as well as weekly case management conferences and grand rounds, further this emphasis. A core lecture series also is offered on Mondays and Thursdays during this six-week clerkship. * The Practice of Medicine III : In this course, themes and topics introduced in POM I and II are revisited and refocused on the students’ ongoing clinical experiences. The course has quarterly sessions. Each session begins with a short talk or panel discussion. Faculty preceptors then facilitate small group discussions as students reflect on their recent clinical experiences and dilemmas. * Ambulatory - Emergency Medicine : The WUMS III Ambulatory Care Rotation takes place in the main emergency department of Barnes-Jewish Hospital. Three to five students at a time are assigned to this four-week rotation. Students will spend their first day in an orientation session that will include a brief survival in the ED introduction and a suture lab. Domestic violence is covered during this four-week rotation. A course "text" will be provided for the students on orientation day and is theirs to keep. On day two, students will begin primarily evaluating non-emergent patients in the emergency department (EM 2) and report directly to an attending or senior resident. There are four hours of mandatory conferences per week: 8-10 a.m. on Tuesdays and 8-10 a.m. on Wednesdays. There will be an opportunity to participate in EMS. Students can expect to gain a wide range of skills in evaluating a variety of complicated and non-complicated patients. At the end of their rotation, students should be familiar with the approach to complex medical conditions like heart attacks, undifferentiated abdominal pain, and complications of pregnancy as well as the "bread and butter" of complaints of ambulatory medicine such as lacerations, simple respiratory tract infections and minor trauma. * Ambulatory - Family Medicine : The Family Medicine clerkship offered in the third and fourth years allows medical students to work one-on-one with board-certified family physicians in outlying areas of Missouri and Illinois, and in other states. Students may review preceptor profiles and comments that previous students made about preceptors. The clerkship makes every effort to accommodate student preferences for working with specific preceptors. Most students will work with a single preceptor for the duration of the four-week rotation. Students may work with small groups, potentially including family medicine residents. The student will work closely with preceptors on a daily basis in the physician's office. Students often accompany their preceptor on nursing home visits, hospital rounds, medical conferences and other educational activities. Housing will be provided to students working outside the immediate St. Louis vicinity. Weekend call schedules are arranged with the preceptor: students can often return to St. Louis on the weekends. Each student will receive a description of the goals and objectives for the four-week rotation, a physical copy of the Manual of Family Practice textbooks, and handheld computers with additional commercial clinical reference materials to use during the rotation. Students maintain patient encounter logs on hand-held computers, and receive short email assignments during this rotation. Grades are calculated from preceptors’ subjective evaluations (normalized for the preceptor), essay responses, and an evaluation of students’ attention to primary care issues. * Psychiatry Clerkship : Up to 11 students spend four weeks on the inpatient psychiatry service of either Barnes-Jewish Hospital or Metropolitan St. Louis Psychiatric Center. At either site, students evaluate and treat patients under the supervision of house staff and an attending physician, attend teaching conferences, including small group sessions with a psychiatrist to learn psychiatric interviewing and the mental status exam, and complete other assigned learning experiences. * Dermatology Clerkship : The goal of the dermatology clerkship is to provide a guide for the student to appreciate dermatology within the broader perspectives of medicine and biology. The student will develop familiarity with dermatologic vocabulary, learn to recognize and initiate therapy of common dermatologic disorders and become cognizant of uncommon or complicated dermatologic problems that require specialty care. Emphasis will be placed on careful history taking and physical examination. Students will always work under the direction of the resident physician and the attending physicians in the clinic setting. The student will participate in outpatient care at the following hospitals and affiliated clinics: Barnes-Jewish Hospital, Children’s Hospital, Barnes-Jewish West County Hospital, the Veterans Administration Medical Center and Connectcare Hospitals. These hospital settings will provide the student with ample exposure to a diverse patient population. Students will attend all clinical teaching rounds and conferences in addition to the basic science and cutaneous histopathology conferences. Normal workday hours are 8 a.m. to 5 p.m. with no night or weekend on-call responsibilities. Each student is provided with copies of the two recommended textbooks, Principles of Dermatology by B. Looking and The Color Atlas and Synopsis of Clinical Dermatology by T. B. Fitzpatrick for use during the clerkship; the textbooks are returned to the clerkship coordinator at the end of the clerkship for use by other students rotating in the dermatology division. The rotation attending physician and the resident physician will submit an evaluation based on the student’s clinical skills, presentation, attitudes, overall performance and the end-of-rotation written exam score. * Geriatrics Clerkship : The primary goal of the four-week clerkship in Geriatrics is to provide an opportunity for students to gain proficiency in the principles of geriatric evaluation, including the medical, psychological, social and functional assessments of older adults. Direct, hands-on experience with patients is a major feature of the clerkship. Students are expected to participate in the evaluation of three to five patients per week, in a variety of settings including the hospital Acute Care for the Elderly (ACE) unit on 3200 North Campus, the Older Adult Outpatient Assessment Program (Storz Building) and the Long Term Care Setting (Barnes Extended Care in Clayton). Students will also participate on the gerorehabilitation service, hospice and geropsychiatry rounds, and attend geriatric conferences while on the rotation. Students are assigned to a variety of attendings to enhance the experience. There is no night call or call on weekends. Participation on the hospital consult service will occur depending on volume. The day normally begins at 8 a.m. and is usually finished by 5 p.m. There will be time to read the detailed syllabus/bibliography. Students will be asked to present a brief topic of their choice at the end of the rotation and demonstrate knowledge of the geriatric screens and assessments. * Radiation Oncology Clerkship : The four-week clerkship in radiation oncology will provide students with an introduction to the evaluation and management of a broad range of patients referred for consultation regarding radiation therapy. Clerkship activities will take place entirely within the Barnes-Jewish Hospital/Siteman Cancer Center complex. Students will conduct inpatient and outpatient evaluations under the supervision of radiation oncology department residents and faculty. Students will also attend and participate in regularly scheduled departmental conferences at 12:00 noon Monday – Wednesday and 8:00 a.m. on Friday. Students will also have the opportunity to attend the appropriate multi-disciplinary conferences (such as pediatric neuro-oncology, cardiothoracic oncology, lymphoma, GYN oncology, neuro-oncology and ENT) pertaining to their rotation schedule. Instructional materials are available for students on the rotation. (Students are NOT expected to purchase any curricular materials for the clerkship). Student performance will be evaluated by faculty members who supervise the student over the course of the 4-week clerkship. * Selectives FOURTH YEAR The overall goals of the fourth year are to consolidate, enhance and refine the basic clinical skills developed during the clinical clerkships and to explore specialty areas within the field of medicine. This is accomplished by providing each student with optimal preparation for selecting and pursuing graduate medical education opportunities in his/her chosen field of medical practice and/or research. Students may select from a broad array of clinical rotations and research experiences and may arrange extramural experiences. To qualify for the Doctor of Medicine degree at Washington University School of Medicine, fourth-year students are required to participate in a minimum of 36 weeks of electives (full-time clinical or research courses). Two-thirds of the minimum required time for the Elective Year must be taken exclusively in residence in the Washington University School of Medicine elective course program. A complete listing of fourth-year elective offerings at Washington University School of Medicine is available through the Office of the Associate Dean for Medical Student Education. Students may participate in clinical electives of four weeks duration. If a student takes a research elective, that elective must be of at least six weeks’ duration. A maximum of 12 weeks’ credit is allowed for full-time elective coursework taken at other academic institutions. These may be clinical or research electives. Students desiring credit for work to be done at other institutions must petition the Associate Dean for Medical Student Education. Absolutely no credit will be granted for electives undertaken prior to approval from the appropriate administrative committees. Credit may be given for elective work done at any point in the standard four-year Doctor of Medicine degree program so long as participation conforms to current elective guidelines, and a) the student is a duly registered, full-time student for a minimum of three years and nine months, including scheduled vacation time, and tuition is paid for four complete academic years; or b) if transferring into the third-year class, the student is a duly registered, full-time student for a minimum of 22 months and tuition is paid for two complete academic years. Students are encouraged to take lecture-seminar elective courses, but such offerings are optional. Clock hours for the year total 1,386 (36 weeks). Remuneration for work done while participating in electives for credit is prohibited.

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Saint Louis University (School of Medicine)

YEAR 1 COURSES : * Human Anatomy : It is very appropriate for Human Anatomy to be the first block of Phase 1’s Fundamentals of Biomedical S...
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