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t m c » p u l s e | au g u s t 2 0 1 7 28 Building Better Doctors McGovern Medical School at UTHealth is one of many medical schools updating its curriculum S ince the beginning of the 1900s, most medical education has been divided into two parts: two years of basic science training followed by two years of clinical experience. That format was the status quo for more than a century, but medical schools began to recognize that students needed to engage with patients earlier in their training. By waiting until the third year of medical school to interact with patients, stu- dents didn't have as much time to translate what they learned in the classroom into a meaningful connec- tion with a real-life patient. In recent years, medical schools across the country have started to put their programs under the micro- scope. McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) was among those seeking a better curriculum. Established in 1969, McGovern Medical School—then known as UT Medical School at Houston—first changed its curriculum in the 1970s when it shifted from a three-year program, in which students met six days a week, to the traditional four-year format. But as the seventh-largest medical school in the country, more change was necessary to keep a competitive edge. "For those of us who have been teaching for a long time, you always do what you can within your discipline and within your scope to try to keep up with the times," said Leonard Cleary, Ph.D., vice chair of the curriculum committee, chair of the curriculum revision subcommittee and assistant dean for educational programs at McGovern Medical School. "But at other schools, they had taken a broader perspective and asked what they needed to do with the curriculum as a whole. That's where we needed to go at McGovern." A group of faculty members, staff and students joined forces in 2012 to develop a new curriculum that reduced the pre-clerkship curriculum by two months, integrated overlapping com- ponents into a single course and—most importantly—introduced students to patient care during their first year. Another goal was to use the new curriculum "as a recruiting tool for our incoming students in terms of what they're interested in, as well as preparing them best for what we think is the future of medicine, which is obviously rapidly changing," said Philip R. Orlander, M.D., associate dean for educational pro- grams and chair of the medical school's curriculum committee. Under the new curriculum, imple- mented Aug. 1, 2016, basic science elements that were once taught separately are integrated into a single course, "Foundations of Medicine," during the first semester. This change marked a significant departure from the traditional siloed approach that proved—more often than not—to be tedious, time-consuming and ineffective. "In the old system, students just took classes in these individual science disciplines, like biochemistry, anatomy, physiology, etc.," explained David Savage, an M.D. and Ph.D. student at McGovern Medical School and member of the curriculum revision subcommit- tee. "A lot of times, there was not much collaboration between the people who ran those courses. They just taught the thing they always taught, so you would sometimes get exposed to something two or three times over the course of several different classes." The school even changed the curriculum at a pedagogical level by using a "flipped classroom" approach. Before, professors would lecture to a largely vacant classroom because students watched the recorded lecture videos in lieu of attending. However, in the flipped classroom model, students are assigned to watch video lectures on their own and then apply them to exer- cises, projects and discussions in class. "I think this is the start of a gradual process of faculty members changing the way that they are interacting with the students," Cleary said. "Just giving a lecture, which is a summary of text- books or other sources, is not going to generate that interaction with the students." B y S h a n l e y C h i e n Medical student David Savage interviews a standardized patient as Eugene Toy, M.D., assistant dean for educational programs at McGovern Medical School, looks on. It's not just about getting the best board scores or about getting the best residency matches. It's about making the best possible physicians for future patients. — DAVID SAVAGE M.D. and Ph.D. student at McGovern Medical School and member of the curriculum revision subcommittee