Overview of Phase 1: The foundations modules (Foundations 1, 2, and 3) provide the essential basic science knowledge and framework necessary for students to understand all aspects of medicine and the organ-based modules that follow. Problem-Based Learning (PBL) cases provide the framework for foundational science content which integrates with other elements and threads and emphasizes the primary role of basic science knowledge in the care of patients. Subsequent organ-based modules enable students to understand how each organ system develops and functions, the associated pathology, and how to diagnose, treat and maintain the health of that system. Standardized and actual patients help students acquire and practice clinical skills appropriate to each organ system.
Throughout Phase 1, basic science content integrates with clinical skills, ethical principles and social determinants of health in order for students to develop the skills of 21st century clinicians. This includes the ability to practice cost-effective, equitable, evidence-based, efficient, safe and patient-centered care. Each week, students have the opportunity to assess their progress and apply their knowledge in Synthesis and Application Sessions.
Foundations 1 is designed to provide an understanding of the biological processes critical to human health and disease at the molecular and cellular level. The goal of this module is to provide a strong framework of biochemistry, genetics, and cell biology knowledge in a clinically relevant context. In preparation for their clinical placements, students also gain the communication skills needed to open a patient encounter and elicit a medical history. Additionally, they learn to assess vital signs, among the most critical physical exam skills, along with the foundational principles of ethics.
Foundations 2 marks the introduction of systems encompassing pharmacology, embryology, anatomy, histology, and pathology, plus a continuation of genetics as it relates to human development and cancer. Basic concepts in these subjects as well as in the organization and economics of medicine set the stage for their application and further exploration in subsequent modules. Students also begin to acquire the basic skills necessary to interpret literature and apply evidence to clinical decision-making. Now immersed in their biweekly clinical placements, students spend time in the Clinical Education Center furthering their understanding of social determinants of health through motivational interviewing for behavior change and eliciting a sexual history from standardized patients. Ultrasound skill development begins in this module and helps to bring embryology to life through scanning of pregnant patients.
Foundations 3 is designed to provide a framework for understanding microbiology, the organization and function of the immune system in health and disease, and the relationship of micro-organisms and the immune system. The goal of this module is to give students the tools to understand the role of microorganisms and immunology in the care of patients. Students apply their understanding of behavior change through a personal behavior change plan they plan and monitor for themselves. Health equity is explored on a patient, community and global level. In Clinical Medicine, students learn the foundations of clinical reasoning by creating differential diagnoses, assessments, and written and oral presentations. The special skill of pediatric history-taking is also presented.
The Cardiovascular-Blood module consists of a sequence of learning sessions designed to prepare students for the fundamentals of cardiovascular medicine. The overall goal of this module is to prepare learners to prevent, diagnose and treat cardiovascular disease in the next phase of their education. The module contains basic information about blood composition and clotting mechanisms and the structure and function of the cardiovascular system. Team Based Learning (TBL) and simulation sessions integrate basic science and clinical concepts. Implicit bias and health disparities are explored in the context of cardiovascular health. Students practice and demonstrate the key components of the cardiac and peripheral vascular exams through work with heart sound simulators, standardized patients, ultrasound and students’ own real patients. Differential diagnosis practice continues as students interview standardized patients with the core chief concern of chest pain.
The Pulmonary module provides an understanding of the structure and function of the pulmonary system and focuses on the pathology, pathophysiology, diagnosis and treatment of patients with pulmonary diseases. Medical imaging and diagnostic techniques are introduced in this module, as well as the clinical skills necessary to evaluate pulmonary function. Patients are present to help students understand the social and economic ramifications of pulmonary disease. Students gain the four sentinel skills of the lung exam: inspection, palpation, percussion and auscultation; begin to interpret their pulmonary exam findings; and practice motivational interviewing for smoking cessation.
The Renal module is designed to teach basic renal physiology and renal pathophysiology with a focus on fluid and electrolyte abnormalities, acid/base abnormalities, acute kidney injury, chronic kidney disease, renal syndromes and renal pathology. The renal module provides an introduction to the treatment and management of kidney disease as well as exposure to societal and ethical issues related to the allocation of resources such as dialysis and organ transplants. The abdominal exam is added to students’ toolbox of clinical skills.
The Musculoskeletal-Dermatology module includes 4 weeks of Musculoskeletal content and 2 weeks of Dermatology content. The Musculoskeletal curriculum is designed to teach students the fundamentals of musculoskeletal structure and function at the cellular, organ, and gross anatomical level and to conduct a physical exam. In addition, this module introduces students to common orthopedic and rheumatologic conditions and their differential diagnosis and treatment. MSK anatomy is reinforced though the clinical examination of all joints in the clinical education center, dissection in the anatomy lab, as well as medical imaging and bedside use of ultrasound. Inter-professional teams in rehabilitation medicine and real patients of different abilities emphasize the importance of family-centered care. Students have the opportunity to interview patients with different abilities, deepening their understanding of social determinants of health. The Dermatology curriculum prepares students to diagnose and recognize common dermatologic conditions and understand their etiology, pathogenesis, and treatments. It also helps students begin to understand the impact dermatologic conditions may have on the quality of life of patients.
Head and Neck
The Head and Neck module is closely integrated with Neuroscience. The goal of this module is to emphasize how all of the body systems are integrated into the different regions of the head and neck and how they relate to anatomy, histology, embryology, physiology, pathology, and clinical considerations. In this module, students learn the general anatomy and embryology of the head and neck including the eye. Understanding of head and neck anatomy is enhanced by the use of ultrasound. Students examine the head, ears, nose, throat and neck through practice with simulators and peers in the Clinical Education Center and with real patients in their clinics. Students are given individual feedback on histories and physicals performed with hospitalized patients. The ethical considerations of cochlear implants are explored through small groups and interaction with patients.
The Neuroscience module teaches the molecular, cellular, physiological, anatomical and functional aspects of the nervous system. This module begins with the building blocks of neuroscience including neuroanatomy and neuropharmacology. The eye anatomy learned in the Head and Neck module is integrated into the study of the physiology and pathology of the eye. The Neuroscience module introduces students to the various nervous system disorders commonly encountered in clinical practice. Through Northwestern-produced videos and patient-based clinical correlations, students learn the techniques and interpretation of the neurological and eye exams, then practice these exams with standardized and real patients. They also engage in deliberate practice to cement the oral case presentation skills needed for their clinical work. The ethical considerations of brain death are explored as well as risk/harm assessment in medical decision making. Diagnostic testing skills continue to be developed in a case-based session on severe headaches. Healthcare systems for people with disabilities and delivery of optimized care are examined in health and society.
The Psychiatry module is designed to build core foundational knowledge in preparation for the psychiatry clerkship and to reinforce the principle and practice of behavioral medicine. This module is closely integrated with the concepts introduced in the Neuroscience module, and is designed to deepen student’s understanding of psychological processes that impact medical care, and reinforce the principles and practice of behavioral medicine. Real patients share their experience of illness in large group sessions, introducing the attitudes and skills needed to interview patients with psychiatric illness and addiction. In the Clinical Education Center, students then practice the mental status examination with standardized patients portraying affective and thought disorders. They also elicit histories and perform brief interventions for standardized patients who present with substance misuse, including opioid use disorder. The ethical and social considerations of mental health disorders and substance use disorders are also investigated during the Psychiatry module.
The Gastrointestinal module provides a comprehensive overview of gastrointestinal and hepatobiliary pathophysiology, anatomy, and their associated disease states. Basic physiologic and pathophysiologic concepts precede and intertwine with presentation of learning exercises describing clinical disease states. Students review and expand their skills in the abdominal exam and the differential diagnosis of abdominal pain. The role of screening and diagnostic testing in gastrointestinal disease are explored through small groups and interactive case-based sessions. The Gastrointestinal module also provides exposure to the global health aspects of hepatitis.
The Endocrine module is designed to give students an understanding of the following normal physiology of the various endocrine glands and hormones and how they integrate with other organ systems and the pathophysiology of the diseases of the various endocrine glands and hormones. This module also explores how abnormal hormone levels and endocrine diseases affect other organ systems. The Endocrine module introduces therapeutic modalities used to treat the abnormal hormone levels of endocrine diseases and their consequences. The clinical impact of obesity and the associated social stigma is assessed in this module in large and small group settings. Students examine real patients with thyroid abnormalities and put the finishing touches on their examination techniques by practicing the full head-to-toe physical exam.
The Reproductive/Genitourinary module addresses the numerous organ systems comprising the genitourinary and reproductive tracts of the male and the female. The goals of the module are to prepare students for their Phase 2 clinical training. Topics covered included the normal structure/function, physiology, pathology, pathophysiology, pharmacology, and clinical anatomy of the female/male genitourinary and reproductive tracts. Students develop clinical stills in the pelvic exam. This module provides insight and exploration into the societal aspects of reproductive and genital health including sexually transmitted infections, sexual violence, and social impacts on maternal health. In the Clinical Education Center, students work with simulators, then with experienced and skilled female gynecologic teaching associates and male urologic teaching associates to practice techniques of physical examination. Students also have the opportunity to engage with a panel discussion on healthcare of LGBTQ+ individuals.
The Hematology/Oncology module includes a two-week block focused on hematology and a 2 week block focused on oncology. The goals of the Hematology portion are to demonstrate an understanding of hematopoiesis and the normal function of blood cells and recognize abnormalities and diseases in the blood constituents. The goals of the Oncology portion of the module are to identify the molecular basis of neoplasia in hematology and oncology, to recognize the pathophysiology, morphology, and clinical characteristics of common tumors that affect various organ systems and to introduce the basic principles of cancer therapy and multidisciplinary cancer management. Cancer screening and diagnostic testing skills are developed in a number of sessions. In addition, students engage with topics essential to the clinical practice of Hematology/Oncology including mortality, spirituality, and delivering bad news to patients.