Second Year
The second year of medical school has three purposes. The first is to present to students the underlying pathogenesis that explains abnormality in the structure and function of the human body. The second is to introduce basic principles of pharmacologic therapeutics that attempt to redress abnormality. The third is to continue to master principles of communication and data collection through the medical interview and the physical examination of hospitalized and ambulatory patients.
The basic physiology of organs and major systems is explored along with the continued development of skills and development of a greater understanding of issues of critical importance to the practice of medicine today. At year's end, both epidemiology and a comprehensive exercise link the basic preparation of years one and two to the tasks of the next two years.
MSSM YEAR 2 COURSES
The Art & Science of Medicine II
It is the mission of The Art and Science of Medicine (ASM) Course (I & II) to provide pre-clinical medical students with the core knowledge, clinical skills and professional attitudes essential for a seamless transition into the clinical years. Fundamental to this mission is a vision of competent physicians who provide compassionate patient-centered care dedicated to a psycho-bio-social approach to health care delivery.
At the end of the course, the ASM II students should be able to gather clinical information accurately from history, physical examination, and chart review that includes all relevant factors. They should be able to communicate accurately the information both orally and in writing. They should have consistency in clinical skills when they interact directly with patients and reliability in basic physical exam skills. They must be able to differentiate normal findings from abnormal ones and identify new clinical problems. ASM II students are acculturated to interact professionally with patients, caregivers, staff and other members of the patient care team.
Brain & Behavior
The nervous system is perhaps the most complicated human organ system and possessing basic knowledge and understanding of its anatomy, function and pathophysiology is essential for any physician. This interdisciplinary course addresses structural, functional, and biochemical aspects of the nervous system, and introduces students to neurologic illnesses commonly encountered in clinical practice. Through patient-based small group discussions students gain insight into the scientific basis for evaluation and treatment of clinical phenomena such as pain, weakness, depression, coma, sleep disorders, stroke, etc. The goal is to enable each student to reach a basic understanding by which normal and abnormal nervous system functioning can be interpreted. The Psychopathology component of Brain & Behavior introduces students to the basic pathophysiology of a range of mental illnesses, and prepares students for the Year 3 Psychiatry clerkship. This component of the course is taught in seminar format and small groups facilitated by practicing psychiatrists.
Pharmacology
The pharmacology course presents an overview of the general principles governing the actions of drugs on the human body and on invading organisms, as well as the way drugs enter, are distributed in, and eliminated from the body. The therapeutic and adverse actions of major classes of clinically used drugs are discussed. The course goal is not to teach therapeutics per se, but the pharmacological basis for rational drug prescribing. Clinical case presentations and problem-solving sessions are conducted in intermediate to large group formats by basic science and clinical faculty.
Medical Genetics
Medical genetics is one of the most rapidly advancing fields of medicine, and understanding of its principles is now integral to all aspects of biomedical science. This course introduces basic concepts and some major topics in human genetic medicine including cytogenetics, molecular genetics, biochemical genetics, pharmacogenetics, genetic testing and screening, developmental genetics and dysmorphology. Basic knowledge of the principles of human genetics and their application to a wide variety of clinical problems will be required of the modern practitioner.
Musculoskeletal Pathophysiology
The Musculoskeletal course introduces students to a series of diseases that overlap the disciplines of Pathology, Radiology, Orthopedics and Rheumatology. It is the first "transitional" course of the Second year because it bridges the gap between basic science and its clinical application to the diagnosis and treatment of connective tissue diseases. By the end of the course, students will have developed a rational, clinical approach to the patient with musculoskeletal complaints.
Cardiovascular Pathophysiology
This course provides students with a comprehensive review of anatomy, hemodynamic function and electrophysiology of the normal cardiovascular system. This is coupled to in-depth study of the pathophysiology of cardiovascular diseases including cardiomyopathies, valvular heart disease, ischemic heart disease, vascular diseases, and congenital heart disease.
Gastrointestinal-Liver Pathophysiology
This course provides an overview of diseases affecting all components of the digestive system. Emphasis is placed on understanding the mechanistic basis of digestive diseases, with a strong underpinning in pathology. This fosters skills in developing appropriate differential diagnoses and gaining an appreciation of the diagnostic evaluation of patients. Students will learn how diseases of the GI tract and liver interface with other systemic conditions. Approaches to treatment are discussed mainly to reinforce pathophysiologic principles.
Blood (Hematology) Pathophysiology
Hematology is the study of the blood. Students are taught about the normal physiologic production and regulation of red blood cells, white blood cells, platelets and about the normal system of blood coagulation. They learn about the pathophysiologic events leading to disruption of the normal blood system, resulting in hematologic diseases. Through lectures, case-based small group sessions, “virtual” and “actual” morphology sessions they are taught to recognize the presence of hematologic abnormalities, understand the pathophysiology of the clinical manifestations, formulate a differential diagnosis and develop a strategy for investigating these diagnoses. Although primary hematologic diseases, like acute leukemia, are quite rare, hematologic complications of other medical conditions are extremely common. Students will develop the knowledge and skills that will enable them to feel comfortable in evaluating patients with hematologic problems.
Human Sexual & Reproductive Health and Disease (OB-Gyn Pathophysiology)
This course introduces students to the fundamental issues of female sexual and reproductive health, and provides a foundation for their understanding of the pathophysiology of obstetrics and gynecology. This clinically oriented course conducts a case-based tour of the female genital tract, using patient-centered cases that include symptoms, work-up & procedures, pathology findings, and outlook. Students are exposed to viewpoints of: obstetricians, gynecologists, specialty pathologists and patients. Laboratories and small group discussion sessions help to integrate major course themes and introduce concepts of patient management.
Endocrine Pathophysiology
Endocrinology is about the communication between tissues by chemical mediators called hormones. The course reviews general endocrine physiology and explains the pathophysiology of endocrine diseases such as diabetes mellitus, osteoporosis, thyroid diseases and other disorders of hypo- and hyper- function of various endocrine tissues. Students become familiar with the signs and symptoms of endocrine diseases and learn to formulate a differential diagnosis and a diagnostic workup to rule in or rule out endocrine disorders in patients.
Dermatology Pathophysiology
This course introduces students to the basic pathophysiology and the myriad expressions of skin disorders. The key topics addressed are skin structure and function, how to describe skin lesions, and dermatology-related pharmacology. We then take a pictorial journey through skin related infectious, immunologic, and neoplastic diseases.
Pulmonary (Respiratory) Pathophysiology
This course is taught and coordinated with Renal Pathophysiology at the end of Year 2. Given this placement in the second year curriculum, respiratory pathophysiology is intended to bridge the basic sciences with that of clinical care of the patient. Although the main focus of the course is geared toward an understanding of basic respiratory pathophysiology and its application to patient care, students are introduced to the concepts at distinct clinical entry points (i.e. dyspnea, cough, fever, etc.). Teaching modalities include standard lectures, which form a foundation for clinical case-based seminars, pathology lab sessions and patient presentations. The course culminates in a combined clinico-pathologic conference where students participate in panel discussions under the guidance of faculty from both the respiratory and renal courses.
Renal - Genitourinary (GU) Pathophysiology
The Renal-GU course introduces students to the kidneys' remarkable ability to maintain homeostasis, as manifested in the myriad of disorders arising in the disease state. The course covers pathophysiology of electrolyte disorders, acid-base disorders, glomerular disease, tubulo-interstitial disease, acute renal failure, chronic kidney disease, basic concepts of renal replacement therapies, and urology. Lectures are integrated with clinical and pathology small groups, designed to reinforce learning. The course will teach students how to use their knowledge of pathophysiology to diagnose and explain problems seen in clinical medicine.
COURSES WITHOUT WALLS (CWW)
Essential themes in medical education are uniquely coordinated with the content of regular courses. At Mount Sinai we have elected to call the themes our “Courses Without Walls” curriculum, as these threads of knowledge are woven throughout the core curriculum: they are taught in progression and reinforced in depth and breadth as students advance in their training. The themes include: Ethics, Communication Skills, Cultural Competency, Clinical Laboratory Medicine, Palliative Care, Sexual & Reproductive Health, Library Science, Evidence-Based Medicine, Diagnostic Radiology, Disaster Preparedness, Career Development, Health Policy, Global Health, and Nutrition.
The manner in which these topics are taught in a host course/clerkship will vary and may include: case-based discussions, seminars, PBL sessions, web-based tutorials, clinical skills seminars, etc. Ultimately, the CWW theme builds into a matrix that is horizontally and vertically integrated over the 4 year core curriculum, and is represented in the content and assessments of many host courses.
Compass I – Comprehensive Clinical Skills Assessment at the End of ASM II
By the End of Year 2, students have begun to develop the critical thinking and problem-solving skills required to diagnose and manage patients. This end-of-year, comprehensive clinical assessment exercise includes 2 written exercises, 3 standardized patient encounters and small groups. The goals/objectives include assessing students’ abilities to: • Integrate and apply Pathophysiology information from the first 2 years, and to focus data gathering and interpretation skills • Recognize the ethical issues, identify your professional responsibilities and apply ethical principles in your communication with and the care of patients • Identify learning issues (what you do not know and need to know in order to care for a patient) • Take a history, perform a physical exam and communicate with patients in a patient-centered, culturally competent manner
CLINICAL SKILLS WEEK
Clinical Skills Week provides rising third year medical students with the basic tools necessary to successfully transition from the pre-clerkship years into clinical training. We offer students a basic orientation to the third year (policies, procedures and requirements), interactive seminars (maximizing learning, evidence based practice, medical errors and career opportunities) and skill based sessions (basic procedures, note writing, and communication skills).
