On this page: First and second years | Third and fourth years
The curriculum
The curriculum at the University of Missouri-Columbia School of Medicine offers students an innovative approach to their medical education and training. In 1993, after five years of study and planning, the school implemented a new curriculum that substantially reduced the use of lecture in favor of problem-based learning. The curriculum emphasizes problem solving, self-directed learning and early clinical experiences and integrates the basic sciences into clinical cases.
In 1990, after studying trends in medical education, a faculty task force recommended:
- A problem-based curriculum with a multidisciplinary approach to teaching basic and clinical sciences
- Evaluations emphasizing problem solving and clinical skills rather than memorization
- Clinical experiences beginning in the first year
- Integrated clinical experiences with a focused review of the basic sciences in the clinical years
The first and second years each consist of four, 10-week blocks. The third
year includes six eight-weeks core clerkships. The fourth year consists of advanced
clinical selectives, advanced biomedical selectives and general electives.
First and second
years
Years one and two consist of four 10-week blocks. Weeks one through eight are for learning. All evaluation occurs during Week 9. Week 10 is a break between blocks. Each block has two components: Basic Science/Problem Based Learning (BSci/PBL), and Introduction to Patient Care (IPC). There are no department or discipline-based courses as are found in traditional medical schools. During the Basic Science/PBL component, student work through 32 authentic clinical cases in groups of eight students with a faculty facilitator. The facilitator is not a content expert, but rather guides the group as they work through the case seeking a diagnosis and patient care plan. The clinical cases guide learning and the application of basic science concepts in clinical scenarios. A few lectures and laboratory experiences teach concepts that supplement the cases. Each week, the students experience about 10 hours of problem-based learning with about 10 hours of traditional teaching such as lectures. (This is often referred to as the 10/10 rule.)
IPC themes change with each block and focus on clinical skills. The primary learning strategies also emphasize small-group learning with supporting lectures and laboratory experiences.
The Ambulatory Care Experience (ACE) is required during Blocks 2 through 4. During ACE, each student spends half a day twice a month with a role-model faculty or community physician-preceptor.
The Advanced Physical Diagnosis (APD) is required during Blocks 5 through 8. During APD, students are assigned to clinician mentors for the entire academic year. Times and frequency of meetings are at the discretion of the faculty member and the students; however, it is recommended that they meet at least twice each month. The emphasis of the APD experience is on history and physical exam skills and clinical reasoning.
Third and fourth
years
Year 3 includes seven clerkships in family medicine, internal medicine, neurology, obstetrics and gynecology, pediatrics, psychiatry, and surgery. During these core clerkships, students learn the fundamentals of good patient care, and faculty assess student competencies. Clerkships must be supervised by Columbia-based School of Medicine faculty or community faculty appointed through the School of Medicine. Students may take up to three clerkships at community sites through the University of Missouri Area Health Education center (AHEC).
The fourth year consists of three one-month advanced clinical selectives (sub-internships), in the core disciplines, four one-month general electives, and a one-month Advanced Biomedical Sciences (ABS) course. One of the advanced selectives must be in a surgical area and one must be in a medical area. A minimum of four fourth-year courses must be taken under the supervision of Columbia-based School of Medicine faculty.
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