Curriculum Directory

About the Curriculum Directory

The AAMC's Curriculum Directory provides a comprehensive description of medical student education programs at the 125 U.S. and 16 Canadian medical schools. It includes information on curriculum characteristics and current trends and innovations of interest to applicants, faculty and deans. This updated online directory enables searches for instructional and curricular innovations, grading intervals, required courses and clerkships, and combined degree programs. Data published in the Curriculum Directory has been generated from the AAMC's online Curriculum Management & Information Tool (CurrMIT), except as noted. (More on CurrMIT can be found by scrolling down to the end of this page.)

The AAMC Curriculum Directory is a resource about the diversity and scope of the American medical education process, and embodies several Association priorities:

Diversity of Curricula
Within a framework that protects the quality of the educational experience, individual medical schools are free to develop their own academic programs. This freedom has fostered a diversity in educational programs that is an important strength of American medical education. Experimentation and innovation to improve the educational process are hallmarks of our system and are reflected in the AAMC Curriculum Directory.

Applying the Curriculum Management & Information Tool
CurrMIT is a password-protected database, accessible only to AAMC member schools. Each school administers its own data, monitors and manages its curriculum in depth, and is able to view detailed information about other curricula. The AAMC Curriculum Directory includes selected data generated from CurrMIT, including information of interest to applicants, students, researchers, faculties, deans, and all those responsible for the education of the physician.

The Medical Student Education Program

Overview

Medical student education programs, although quite varied, share the goal of preparing students in the art and science of medicine, and providing them with the background necessary to enter the period of graduate medical education. The four years of medical school preceding graduate medical education are typically divided into a preclinical phase and a clinical phase.

Preclinical Curriculum/Basic Sciences

Although students have clinical experiences throughout medical school, the first two years are often called the "preclinical" phase. The preclinical phase typically occupies the first two years after matriculation. The basic science departments are largely responsible for the content of the preclinical curriculum, where the normal structure and function of human systems are taught through gross and microscopic anatomy, biochemistry, physiology, behavioral science, and neuroscience. The educational focus shifts to abnormalities of the body's structure and function, disease, and general therapeutic principles through courses in microbiology, immunology, pharmacology, and pathology

Throughout the first two years, the clinical significance of basic science material is stressed. The preclinical phase always includes a course introducing students to the concepts of physical examination and interviewing. Students often interview "standardized patients" (people with actual physical findings or people trained to simulate particular cases or findings) in their introduction to clinical medicine courses.

In addition to the sciences basic to medicine, students are exposed to a wide variety of required topics including the doctor/patient relationship, nutrition, medical ethics, genetics, preventive medicine, geriatrics, human sexuality, and community and population health.

Teaching Methods

Lectures now account for less than half of the scheduled contact time at the majority of medical schools. Small-group discussion, self-instruction, laboratories, case studies and other educational experiences make up the remainder of the scheduled time. The use of computer technology and computer-assisted instruction in the preclinical phase of medical student education have also introduced new approaches to the delivery and acquisition of the sciences basic to medicine.

Most schools include small-group tutorial/discussion sessions organized around patient cases that emphasize problem solving. This approach requires students to take responsibility for obtaining information themselves and encourages students to become active learners. It also prepares them for continuous learning throughout their professional lives.

Approximately 10 percent of the schools have organized their preclinical curriculum into organ system units. In this approach, the basic science disciplines are taught in the context of their relevance to each organ system.

Clinical Curriculum

The clinical phase of the curriculum usually occurs during the last two years of medical school and is devoted to education in the clinical setting. The periods of instruction are called clerkships, and may range in length from approximately 4 to 12 weeks. During clerkships, students work with patients and their families in inpatient and outpatient settings.

Required "core" clerkships in all schools include internal medicine, pediatrics, psychiatry, surgery, obstetrics/gynecology, and family medicine. Depending on the school, required clerkships can also include family medicine, primary care, neurology, and community or rural medicine.

While in a hospital setting or a hospital clinic, students work under the supervision of physician faculty members (known as "attending physicians") and residents, and work with other members of the health care team, including nurses, social workers, psychologists, pharmacists, and other technical staff. Students frequently experience "preceptorships"--that is, they are assigned to community physicians' offices to gain first hand knowledge about how a practice of medicine functions.

Whether in a hospital or community setting, students are responsible for "working-up" a number of patient cases during the clerkship, by collecting relevant data and information from patients, and presenting the data to fellow students, attending physicians, faculty members and residents. Students are assigned to a medical team, and participate in the ongoing clinical care of patients, and they gain skills in clinical decision-making and patient management.

Ideally, students follow their patients over time, either during hospitalizations, in their preceptorships, or through the course of outpatient treatment. Standardized patients (SPs) are used during the clinical years to supplement the kinds of diseases and conditions the students observe. SPs are also used for assessment of student knowledge, attitudes and skills. Other teaching methods in the clinical phase include "rounds" (discussion of inpatient cases), bedside teaching, case-based lectures and small group discussions.

Electives

Elective courses in the basic, behavioral, and clinical sciences permit students to explore career options and augment aspects of their medical student education program. Clinical electives include clerkships in the primary specialties and subspecialties. Students may complete electives on their own campuses, at other medical schools, at federal and state agencies (e.g., the Institute of Medicine, the Indian Health Service, the Centers for Disease Control and Prevention, and others), in international settings, and through external non-academic organizations.

Assessment of Medical Students

Each medical school's faculty is responsible for establishing the criteria for assessing student performance, promotion, and graduation. Many faculties have written learning objectives for the medical education program and for individual courses or segments of the curriculum. Students are assessed by a combination of written, and/or oral examinations and by direct faculty observation of their interactions with patients and standardized patients. The frequency and patterns of assessment vary from school to school.

The United States Medical Licensing Examination (USMLE) is the sole examination pathway to licensure and all physicians who wish to be licensed are required to pass the USMLE Steps 1, 2 and 3. Many schools use either or both Steps 1 and 2 of the USMLE as a component of the promotion and graduation process for their students.

Grading in less than half of the schools is pass/fail or honors/pass/fail. Medical schools are paying particular attention to the assessment of the clinical abilities and general knowledge of the graduating medical student, especially as the direct observation of clinical skills is now a requirement of the LCME. The National Board of Medical Examiners has decided to institute a second part of the USMLE Step 2 that will require students to interview and perform limited physical examinations on a series of standardized patients in order to pass Step 2.