Duke School of Medicine Changes Curriculum to Meet Future Health-Care Challenges

Duke University Medical Center
Monday, 7 June 2004

In the coming year, Duke University School of Medicine will institute significant curriculum changes to better prepare its graduates to cope with the rapid advance of medical science and to address such major issues as emerging diseases, the obesity epidemic and economic pressures in health care.

The new curriculum, planned over the past five years, will include such changes as integrating courses by topic instead of discipline, reflecting the blurred boundaries between basic and clinical sciences such as cell biology and genetics, said R. Sanders Williams, M.D., dean of the School of Medicine. The curriculum will emphasize teaching students about technological advances that may improve health care, such as personal digital assistants. They also will learn how to evaluate advances in technology and independently access information that will enhance the learning experience, he said.

"Our goal is to give students the tools they need to be proficient in their fields, while never losing sight of the reason they came to medicine -- to heal and help people," said Williams.

"Modification of the medical school's curriculum is a never-ending process," said Edward Halperin, M.D., vice dean of the School of Medicine. "We wish to have a curriculum that is responsive to the development of new knowledge, while remaining true to the historical traditions of Duke."

The gold standard four-year medical school curriculum -- with one year of basic science, one clinical year, one research year and then one final clinical year -- has been retained, said Williams. However, the basic first-year science courses will now focus on three overarching topics: molecules and cells, the healthy body and the body and disease.

"With the exploding knowledge base in medical sciences, the boundaries between disciplines in both the basic and clinical sciences have blurred to such an extent that traditional packaging of subject material is no longer adequate," said Edward Buckley, M.D., associate dean for curriculum development.

The second and fourth years -- when students have direct contact with patients -- were modified so that students' mastery of knowledge does not come solely through traditional apprenticeship on the wards, said Williams. Fourth-year students also will be required to take a "capstone" course, designed to bring them up to date on the latest in scientific research, health systems and the economics of health care.

Another new course offered to students in the fourth year will cover the underlying causes of obesity and various treatment options, including surgery. Because obesity is not considered a disease, students have not traditionally been trained in this area. Duke is one of the first medical schools to develop a multidisciplinary course, Clinical Management of Obesity, on this topic.

The medical school also has accommodated the shift toward more ambulatory care, emphasizing the need for a broad range of clinical skills, through a practice course in which students focus on doctor-patient relationships. Meeting once a week for three years, students learn to counsel patients, conduct patient interviews, and handle managed care.

The third year, devoted to independent research, has been maintained and strengthened in the new curriculum.

"Providing information is no longer enough," Buckley said. "We will teach students how to access information and how to evaluate emerging technologies, as well as how to work in a team environment. That's where the future lies."

Duke School of Medicine also has expanded its educational programs internationally. In 2003, a memorandum of understanding was signed to establish Singapore's first graduate medical school in collaboration with the National University of Singapore. Agreements are due to be finalized this summer.

The new Graduate Medical School will be based on the U.S. model, with students enrolling after earning a bachelor's degree. It will follow Duke's newly updated curriculum and incorporate Duke's Prospective Health Planning initiative, stressing preventive care and individualized plans for achieving health-care goals.

For more information, or to contact Duke University Medical Center, see their website at: www.mc.duke.edu