Phase 3

by sanand | Jan 20, 2023 | Curriculum Re-Envisioning

The 16-month Phase 3 of the medical education program is designed to equip students with advanced clinical skills in semi-independent and team-based patient care. It provides opportunities for students to explore their interests through internal and external electives and focused sessions in their chosen areas of concentration. The phase aims to prepare students for the transition to residency while also allowing them to differentiate their interests.

During this phase, students must complete a mandatory 4-week Acting Internship in fields such as emergency medicine, general surgery, medicine, pediatrics, or one of six surgical subspecialties. The Transition to Residency course is a 2-week capstone course that helps students to develop patient care and self-care skills, preparing them for successful internship and residency.

In addition to these clinical experiences, students continue their Scholarly Project aligned with their area of concentration (AOC) or specialty, with the guidance from the Medical Student Research Office (MSRO) to ensure timely completion. During the latter part of Phase 3, students get the opportunity to present their scholarly projects through a dedicated day for dissemination.

At the end of Phase 3, students undergo a one-week Periodic Assessment of Knowledge and Skills (PEAK), which evaluates their acquisition of basic science, clinical knowledge, and practical application to patient scenarios encountered throughout all phases. The assessment also measures practical demonstration of clinical skills required for a successful transition to internship and residency, in line with the achievement of the ISMMS medical education program objectives (MEPOs).

Ambulatory Patient Experience (APEX)

The Ambulatory Patient Experience (APEX) provides early and longitudinal exposure to patient care for medical students in Phases 1, 2, and 3. It develops their clinical skills, fosters engagement with patients, and promotes a patient-centered approach to medical care.

APEX continues during Phase 3 as the Chronic Care Clerkship, which focuses on the management of chronic diseases in an outpatient setting. Students are provided with opportunities to practice patient-centered care and to work as part of a multidisciplinary team.

Phase 2

by sanand | Jan 12, 2023 | Curriculum Re-Envisioning

The medical education program’s Clerkship Phase lasts for 14 months and is divided into two distinct phases. The first 12 months focus on acute and emergent care clinical experiences, covering rotations in medical specialties including Medicine, Pediatrics, Psychiatry, Surgery-Anesthesiology, Emergency Medicine, Neurology, Geriatrics-Palliative Medicine. The remaining clinical care period is dedicated to a non-contiguous chronic disease management and health promotion block. Coaching and Mentoring Pauses (CAMPs) are incorporated to enable students to reflect on their clinical performance and prepare for upcoming rotations.

At the end of Phase 2, students undergo the Periodic Assessment of Knowledge and Skills (PEAK) to evaluate their clinical knowledge and practical skills acquired throughout the Clerkship Phase. This phase offers a comprehensive clinical education with opportunities for both acute and chronic care experiences. With the incorporation of CAMPs and the PEAK assessment, students receive additional support and feedback as they progress through the program.

Ambulatory Patient Experience (APEX)

The Ambulatory Patient Experience (APEX) provides early and longitudinal exposure to patient care for medical students in Phases 1, 2, and 3. It develops their clinical skills, fosters engagement with patients, and promotes a patient-centered approach to medical care.

In Phase 2, APEX sessions continue through the placement of students in clerkship-specific ambulatory care sites throughout the Mount Sinai Health System and its affiliates. The program provides students with hands-on experience in clinical settings and helps them to develop clinical skills and medical knowledge.

Phase 1

by sanand | Jan 10, 2023 | Curriculum Re-Envisioning

The Pre-Clerkship Phase is 18 months long and includes an orientation and acclimation course, followed by instruction in basic scientific and medical knowledge required for the clinical practice of medicine. BaseCamp is a 2-week course designed to facilitate and acclimate students to their new roles as medical students. The curriculum includes Foundations I and II, a 10-week sequence of foundational basic science content and a 50-week sequence of six integrated pathophysiology systems-based blocks, each teaching relevant content in Gross Anatomy, Embryology, Histopathology, Pathology, Physiology, Genetics, Pharmacology, and Imaging. Each integrated systems-based block covers a different area of medicine, and there are ICON weeks devoted to group exercises that ensure the synthesis of concepts and their practical applications.

Phase 1 Weekly Layout

The Phase 1 weekly template is designed to minimize cognitive load and promote effective content delivery and integration. The curriculum is structured to provide early and continuous clinical experiences, increase time for lifelong learning and critical thinking skills, and frequent learner feedback to track progression. The first week of each curricular block includes an introductory session, small group interactive sessions, and independent learning study blocks. The second week and succeeding weeks are divided into three learning groups with rotating block sessions that focus on clinical skills, inpatient sessions, goal-driven exploration, and ambulatory patient experiences. The focus on clinical experiences, hands-on group exercises, and self-directed learning opportunities helps to prepare students for active participation in clinical experiences while the use of rotating block sessions and learner feedback also helps to keep the curriculum engaging and relevant to student needs.

Clinical Skills Course

The Clinical Skills Course in Phase 1 focuses on the development of clinical skills necessary for Phase 2 and future medical practice. The course provides a strong foundation for future clinical practice, as well as ethical and professional conduct. It consists of two educational cores: Medical Decision-Making and Professional Identity Formation. The Medical Decision-Making core includes the use of simulations and standardized patients to develop clinical skills, while the Professional Identity Formation core focuses on developing medical students as future physicians with a strong professional identity. Topics covered in this core include medical ethics, health disparities, social justice, and communication skills for sensitive issues.

Rotating Block Sessions

The four Rotating Block Sessions are designed to provide medical students with a well-rounded and comprehensive learning experience during Phase 1 of their training.

• The first session is the Clinical Skills Course Session (Clinical Skills) where students learn clinical skills through simulation using mannequins or standardized patients. These simulation-based learning sessions occur twice every 4 weeks for the first 6 months of Phase 1 and once every 4 weeks thereafter.
• The second session, the Clinical Skills Course Session (patient-centered experience), replaces the second Physical Diagnosis session after 6 months and involves structured inpatient sessions directed by Clinical Skills Course Directors.
• The third session is Goal-Driven Exploration, which involves student-driven activities stemming from Progress and Planning (PROP) sessions. These activities are monitored and may include skill or knowledge development, wellness activities, career exploration through structured clinical shadowing, Careers in Medicine (CIM) activities, or research. This allows students to explore areas of interest and develop their skills and knowledge.
• The fourth session is the Ambulatory Patient Experiences (APEX), where students are assigned to primary care clinic offices for the entire Phase 1. This monthly activity occurs in the 4th week of the block. APEX provides a unique opportunity for students to learn and observe the delivery of primary care.

Ambulatory Patient Experience (APEX)

The Ambulatory Patient Experience (APEX) provides early and longitudinal exposure to patient care for medical students in Phases 1, 2, and 3. It develops their clinical skills, fosters engagement with patients, and promotes a patient-centered approach to medical care.

In Phase 1, students are assigned to a primary care site one afternoon each month and are expected to direct their own learning by utilizing the clinical site as a “laboratory” to contextualize what they have been learning in the classroom. This helps to increase student engagement with patients and their care, and introduces students to primary care and urgent/emergent care shifts every 4th month.

New Curriculum Structure

by sanand | Dec 13, 2022 | Curriculum Re-Envisioning

The new curriculum at the Icahn School of Medicine at Mount Sinai provides multiple opportunities for extensive and integrated training in the foundational sciences and clinical disciplines of medicine. There are three distinct phases:

Phase 1

This phase is 18 months long and is a one-pass curricular instruction. Integrated within the learning of foundational, normal biological and physiological concepts is instruction in pathophysiology and abnormal function due to injury and/or illness.

Phase 2

This 14-month period focuses on direct care of patients in the various core disciplines of medicine. The first 12 months of this biphasic period are devoted to the care of patients in acute and emergent/urgent settings. This is followed by a 2-month clinical rotation focused on chronic disease management and health promotion.

Phase 3

This 16-month phase offers clinical rotations that emphasize the acquisition of advanced clinical skills related to semi-independent and team-based patient care as well as preparatory sessions for PGY-1 level skills and procedures. Phase 3 is also the period of individualized differentiation through the exploration of areas of interest via internal and extramural rotations and focused sessions related to one’s chosen Areas of Concentration (AOC). The Phase culminates with the completion and dissemination of the scholarly product graduation requirement.

Periodic Assessment of Knowledge and Skills (PEAKS)

At the conclusion of each phase of the curriculum, students are provided an opportunity to demonstrate the competencies they have achieved.  The Periodic Assessment of Knowledge and Skills (PEAKS) are summative assessments that gauge students’ achievement of defined competencies and of phase-level program objectives.

Next Steps

As the new curriculum structure takes shape, the phase working groups will focus on content and how it will be delivered.