Curriculum 2.0 -- a new medical school curriculum

For the last 80 years or so, medicine as we know it today has been delivered to patients in the same fashion. You become sick or have abnormal health condition(s), you get treated, you get well (hopefully). Why? Look no further than the training itself. Why do you fold your shirts into thirds or wash your veggies before you consume them? Why that's how you were taught, so of course that's how you do it. And the same goes for physicians.

The old approach: For the last ~80 years, "traditional" medicine has been practiced in the same manner-- year 1 of core prereq's (bio, chem, anatomy), followed by year 2 of foundations, and a disease focus, namely pharmacology, immunology, microbiology. You want more bazaar? Some schools teach one subject at a time! Everyday, the same subject for 8-week blocks. It's your standard turn and churn routine. But how does that make any sense, given that all of the systems and functions of the human body are inter-related in every aspect possible? At the end of year 2, students take the USMLE to test medical competency. In years 3 and 4, students begin rotations in various units and specialties, with year 4 seeing greater responsibility. Toward the end of year 4, each student must choose a focus area for their residency, which more or less means "hey choose what you want to channel all of your attention on". Subspecialties (e.g., anesthesiology) require additional years of training (called fellowships).

The new approach: Vanderbilt UMC and a few other med schools launched a new curriculum in the last 18 months, aimed at changing how students learn about medicine. Dubbed Curriculum 2.0, this new medical school model provides a deeper comprehension of the many scholarly fields essential to our understanding and practice of medicine. It more or less aims to instill a life-long learning model for all students, adapting to the every-changing shift in care practices and methods (based on research and outcomes data over time). After learning the core medical concepts (biochem, anatomy, etc), a personalized learning model shores up tailored course material as the student progresses. This aims to not only eliminate today's cookie cutter MD issue but also maximize the fit of clinician interest with both opportunity and curriculum. On top of it all, a longitudinal macro course ties is all together, helping to explicitly addresses the strengths and limitations of various diagnostic/therapeutic approaches and explain clinical reasoning as the student moves along on the journey called med school. This curriculum overlays onto the previous time span req't.

The gap: This new approach is eons better than the old approach. Doctors of old-- okay, let's be frank...all doctors in practice today-- learned on the archaic and ineffective legacy model or health care delivery, whereby students more or less are required to memorize the concepts and terminology in 40-50 2-inch text books, cram for exams/comps, followed up shortly thereafter with no recollection of what just happened. What did i just learn?! And if you are having a hard time relating to this, speak for 5 minutes in the foreign language you took in high school-- hell, even in college. Having issues? Yea, use it or lose it... that simple.

Although Curriculum 2.0 is a major advancement in the format of the curriculum, it's the curriculum itself that needs to be totally revisited. What do i mean? Today's medical field is littered with amazingly brilliant individuals, making immense strides in treatment and patient outcomes. But we have become so specialized in our care delivery that we have pigeon-holed ourselves when it comes to delivering a consistent and effective macro-patient care continuum. To address the pain in our chest, we now have to see 17 different specialists, of which 9 order separate MRIs with contrast. Brilliant. I'm not saying specialists aren't necessary; in fact, they are essential to our continued advancements in medicine. However, doctors are trained to focus on one specific area and no more. It reminds me of the days in school where we put up dividers during tests-- no cheating. Who am i fooling, cheating?! Every hospital/provider claims they provide the best care, but when is that ever possible without working together and/or sharing information? Bottom line-- no one provider has all the answers... impossible, in terms of both human retention AND time. But knowing who to turn to and what to look for/ask is within reach. That's more like it, eh?