Uniformed Services University

General Questions

Q: Why is the USU School of Medicine reforming its curriculum?
The USU School of Medicine is reforming its curriculum to keep pace with the changing needs of the military and public health systems. Evaluating our program and innovating the way students learn allows USU to stay on the cutting edge of medical education.

Our school is not alone in the challenge to create a revised academic blueprint. More than half of American schools have undertaken a major revision of their curricula in the last decade.

Q: When will the new curriculum be launched?
The entering class of 2015 is the first to learn under the new model of scholarship. They began the new curriculum in the fall of 2011.

Q: Who is designing the new curriculum?
Designing the new curriculum is a collaborative effort. At the helm, Drs. Alison O'Brien, Louis Pangaro and Arnyce Pock have sought the advice and expertise of USU faculty members, students, alumni and leaders in the military and public health systems in order to understand what the future medical physician should look like.

Q: What changes will be incorporated into the new curriculum?
The curriculum reform team analyzed various models of scholarship to understand which program elements best aligned with the mission of the USU School of Medicine. Goals of the new learning modality include: better integration of the basic and clinical sciences, earlier exposure to learning in the hospital setting and careful attention to assessing student competency throughout all four years.

The hallmark of excellence in military medicine continues as a core value in the new program.

Specific Questions

As the reform is progressing and the new curriculum takes shape, more specific questions are being asked. We will continue to add to the list below in order to give you the most current information possible.

Step 1 Preparation and Exam

Q: If students return to USU for Advanced Didactics & Step I in January of their MS-III year, will this mean that they'll have less time to visit prospective GME sites?
A: No! In fact, the revised curriculum actually allows for an increased number of clinical and/or elective rotations.

Q: If the Step I exam is delayed until after completion of the core clinical clerkships, will Program Directors attending the late November/early December Joint Service GME Selection Board still have access to the scores?
A: Yes! Under the current plan, GME Program Directors would not only have access to scores from Step I exams, but they would also have access to scores from other key exams. These scores, coupled with the detailed narratives that are composed following the conclusion of each clinical rotation, provide a portrait of each student's strengths and abilities.

Core Clerkships

Q: Why are the traditional Core Clerkships (Surgery, Internal Medicine, Pediatrics, etc) organized into 16 week blocks?
A: One of the goals of the revised curriculum is to provide an opportunity for some geographic continuity, allowing students to remain in a single location for a longer period of time. Not only does this give the faculty/staff a chance to get to know students better, it allows students to develop a more in-depth sense of the workings of a given GME site. It also provides some extended clinical continuity, as it may be possible to follow a patient from the inpatient environment to the outpatient milieu. An additional benefit is that it limits the need to learn a new set of rules and/or computer systems every 5-6 weeks.

Q: Since the Core Clerkships are organized into three 16-week blocks does this mean that students will be limited to a maximum of 3 different rotation sites? Do all clerkships need to be taken in the same location?
A: Not at all! The goal for the Class of 2015 is for each student to have at least one 16-week block of geographic continuity, and for the Class of 2017 to have an opportunity for two 16-week blocks of geographic continuity; however, that is an end-state goal. Some of the Core Clerkships as well as Clinical Electives will continue to be accomplished at various locations across the Military Health System (MHS).

The Capstone Project

Q: What does the "Capstone Project" refer to?
A: The Capstone Project provides each student with an opportunity to design, complete, and present an in-depth research project of his/her choosing, under the guidance of a faculty mentor. For some students, the Capstone Project will provide an opportunity to engage in bench research, while for others, it may be a means of researching answers to a clinical question, setting up a clinical trial, or helping to address a specific operational issue. The possibilities are endless, and could even involve planning for and/or participating in a humanitarian mission or disaster response effort. Students will be encouraged to start thinking about a possible Capstone Project early in their MS-I year. While most students will spend approximately 3 months of their MS-IV year working on the actual project, some students may be able to start working on their Capstone Projects earlier. Regardless of the project chosen, all students will continue to participate in some form of direct clinical care while working on their Capstone Projects.

Q: Why is a Capstone Project important?
A: Completion of a Capstone Project is our way of fulfilling the growing expectation that U.S. medical students graduate with a solid understanding as to how new knowledge is generated, and that they are able to demonstrate competence in the areas of inquiry and analysis. (Inquiry being the new term for scholarship.).

Faculty-Oriented Questions

The Pre-Clerkship Curriculum

Q: Who will provide oversight and direction for development of each of the integrated modules?
A: Each of the integrated modules is led by a team of two Directors: one from the basic sciences and one from a clinically-oriented domain. The Director and Co-Director are assisted by representatives from the Department of Military Medicine and by one or more student representatives.

Q: Who is leading each of the integrated modules?
A: The Module Directors/Co-directors have been identified. You may access the list at http://www.usuhs.edu/curriculumreform/pdf/moduleleadership.pdf

Q: Who oversaw the selection of the Module Directors/Co-Directors?
A: Prospective Module Directors/Co-Directors were identified by a sub-group of the Curriculum Reform Steering Committee and their names forwarded to the dean for confirmation.

Q: Where can the faculty see the "master plan" for the revised pre-clerkship period?
A: The pre-clerkship curriculum can be found on our "New Curriculum" page: http://www.usuhs.edu/curriculumreform/newcurriculm.html#preclerkship

Q: How dependent is the curricular reform effort on Information Technology (IT)?
A: The curricular reform effort can certainly be enhanced by the use of advanced IT, but pro-active faculty involvement is actually the more critical element. Advanced IT facilitates the use of spaced learning techniques and periodic self-assessments, both of which help reinforce retention of key concepts in clinical and scientific arenas.

Q: Has the infrastructure been capable of meeting the demands of the new curriculum as far as IT, military personnel, new hires, space and financial support?
A: We believe the needed infrastructure is in place to support implementation of the new curriculum. Specifically, that the pre-clerkship elements were ready as the class of 2015 entered this first phase in August 2011; that the clerkship elements were ready in January of 2013, and so forth.

In order to do so, the Course Directors and Departmental Chairs provided input, on a master spreadsheet, as to what additional resources — if any — they needed in order to support the new curriculum, as well as for the period in which the "old" and "new" curricula overlap. Once all the requirements were identified and a corresponding analysis completed, a prioritized list was developed and forwarded to the Dean for action and/or assistance, as appropriate, and some additional staff were assigned.

Q: Who are the Module Directors, how were they selected (volunteer or tasked), and how will they be compensated for their increased duties?
A: A sub-group of the Curriculum Reform Steering committee identified a slate of suggested Module Director/Co-Directors, reviewed and confirmed by the Dean, who were invited to serve in this capacity. Participation is completely voluntary.

As for compensation, the Dean is committed to recognizing and rewarding those who have dedicated themselves to making the curriculum reform effort a success. Specific details are under development, but civilian faculty may be eligible for merit pay and bonuses. Appropriate recognition will also be afforded to contributing military members, although DoD regulations preclude the offering of direct fiscal remuneration in this regard.

Q: Were the final plans crystallized in time for the faculty to prepare the necessary new material?
A: The Dean established 15 March 11 as the date by which a detailed outline of the pre-clerkship period was to be finalized and made available to faculty and staff. We anticipated that a significant proportion of the existing teaching material would simply need to be re-aligned and/or altered for presentation in small groups or independent study. A comparatively small component needed to be developed de novo, so meeting the target date still provided a full five months of lead time for those involved in the Fundamentals module, with increments of two additional months for those involved in subsequent modules.