Curriculum

 PUGSOM CSU

PUGSOM has an integrated systems-based curriculum for its graduate medical programme and uses a variety of approaches to its teaching and learning activities. These include lectures, case based sessions, small group discussions, virtual microscopy classes, independent learning, clinical skills sessions and clinical training with patient contact.

 Teaching learning activities are in par with the different themes in each module. The early exposure of students to clinical experiences emphasizes the importance of the basic sciences to its clinical application and serves to stimulate students’ interest in medicine.

 The current curriculum provides an excellent broad foundation in medicine that prepares students for all career options. Faculty and educational leaders at PUGSOM monitor educational outcomes to ensure that all career options are facilitated by this curriculum and that the programme is designed to meet educational objectives.

 The PUGSOM curriculum was designed as an integrated curriculum that attempts to eliminate or minimize the often arbitrary distinction between basic science and clinical science.  In all years of the curriculum, translational science is emphasized as the context for understanding the scientific basis for health and disease.  Basic science integration occurs across the continuum of all 4 years of the curriculum.  During clinical education in Year III and IV, basic science topics are re –introduced in a clinical context within each clerkship but also formally during “Intersessions”.  These are week long blocks in between clerkship periods that integrate Translational Science and Topics in Interdisciplinary Medicine, such as metabolism, inflammation, and immunology, with a re-emphasis on application of basic science knowledge to clinical practice.

Years 1 & 2:

Medical Sciences

The Module is divided into the following themes: 

  1. Induction week and Anatomy (1 week + 12 weeks) 
  2. Human physiology (2 weeks) 
  3. Biochemistry & macromolecules (2 week) 
  4. Genetics (2 weeks) 
  5. Pharmacology (2 weeks) 
  6. General pathology (2 weeks)
  7. Microbiology & Immunology (6 weeks)
  8. Public health (2 weeks)
  9. Clinical and Communication skills  (16 weeks, running concurrently)
  10. Exam break (3 weeks)
  11.  Intersessions (3 x 1 week each)

 This is followed by the systems modules, which are divided into the following themes: 

  1. Cardiovascular system
  2. Respiratory system
  3. Hematology system
  4. Gastrointestinal system
  5. Renal system
  6. Reproductive system
  7. Endocrine system
  8. Musculoskeletal system 
  9. Nervous system
  10.  Longitudinal clerkships (1 year, running concurrently)
  11. Capstone Medical Sciences
  12. Intersessions (3 x 1 week each)

Early Clinical exposure, and Years 3 & 4:

The Foundations of Clinical Medicine course, runs for 17 weeks in the first semester of Year 1.  It is during that course that students are introduced to interviewing skill, history taking, chart organization, and physical examination.  The educational settings include classroom, small group, clinical skills unit, and simulation center.  Simulated patients are used extensively during this course for the students to develop skills in communication, interviewing, history taking, physical examination, history write-ups, and oral presentations.   During Clinical Foundations, students receive specific instruction on selected specialty domains such as domestic violence, sexual history, pediatric history, and cross-cultural interviewing.  After completion of Clinical Foundations, students begin the 1-year Longitudinal Clerkship, where they spend approximately ½ day per week in a community-based setting with a dedicated ambulatory preceptor.   During this course, students are not meant to shadow, but are expected to further develop their communication, examination, and presentation skills by direct patient contact.  During Longitudinal Clerkship there are periodic structured small group sessions focusing on clinical reasoning.  After completing Longitudinal Clerkship before beginning Core Basic Clerkships, students have a 4-week Transition To Wards.  This course combines advanced clinical critical analysis utilizing problem-based learning modules with advanced clinical skills training (including ECG, Radiology, IV line placement, informed consent, clinical ethics, clinical reasoning, teaching skills) in small group settings in the Simulation Center.  Each Core Basic Clerkship (Internal Medicine, Paediatrics, Surgery, Ob/Gyn, Neurology/Psychiatry) has a 1 week PRECEDE section that utilizes small group and simulation to develop clinical skills (interviewing, examination, presentation) specific to the ensuing clerkship (e.g., interviewing parents for Paediatrics; suturing for Surgery).  Finally, before graduation the TRIPLE course serves as a capstone before internship/houseman training to develop highly clinical skills necessary for a functioning physician.   The 2-week TRIPLE course is based in the Clinical Skills Unit and Simulation Center.

The clinical clerkships include the core areas in medicine, surgery, O & G, neurology and psychiatry and the other areas include paediatrics, orthopaedics, family medicine, anesthesia, critical care, community medicine, geriatrics.

Ethical principles are a horizontal stand of the curriculum that is integrated into each course of the entire four-year curriculum.  They are addressed in the context of patient communication, interviewing, and examination in Clinical Foundations.  The scholastic discipline of Ethics is first addressed formally in the Public Health and Ethics Foundation course in the first semester of Year 1.  Subsequently, ethical principles are integrated into all aspects of all non-clinical and clinical course through didactic, small group discussion, workshops, advanced clinical skills development, and clinical courses.  For Core Basic Clerkships, the ethical issues specific to that clerkship are taught and discussed in years 3 & 4.

Student Mastery of Objectives

As a measure of their competence and mastery of knowledge, skills and behavioural objectives, every graduate of the PUGSOM will be required to demonstrate attainment of the following objectives through written examinations and individualized assessment of skills and behaviours/communication:

The Science and Practice of Medicine

  • Apply scientific principles and a multidisciplinary body of scientific knowledge to the diagnosis, management, and prevention of clinical problems.
  • Understand the variation in the expression of health and disease through critical evaluation of biomedical research.

Clinical Competence

  • Obtain a sufficient level of medical knowledge to understand the basic facts, concepts, and principles essential to competent medical practice.
  • Exhibit the highest level of effective and efficient performance in data gathering, organization, interpretation and clinical decision making in the prevention, diagnosis, and management of disease.
  • The Social Context of Medicine
  • Understand and respond to factors that influence the social, behavioural, and economical factors in health, disease and medical care.

Communication

  • Demonstrate effective and compassionate interpersonal communication skill toward patients and families necessary to form and sustain effective medical care.
  • Present information and ideas in an organized and clear manner to educate or inform patients, families, colleagues and community.

Professionalism

  • Display the personal attributes of compassion, honesty and integrity in relationship with patients, families, and the medical community.
  • Adhere to the highest ethical standards of judgment and conduct as it applies to the health care milieu.
  • Demonstrate a critical self-appraisal in his/her knowledge and practice of medicine, as well as received and give constructive appraisal to/from patients, families, colleagues and other healthcare professionals.

Lifelong Learning

  • Understand the limits of personal knowledge and experience and will demonstrate the intellectual curiosity to actively pursue the acquisition of new knowledge and skills necessary to refine and improve his/her medical practice or to contribute to the scientific body of medical knowledge.