We are responsible for the traditional core elements of the curriculum in each of four years, including Medical Interview, Physical Exam, Integrated Clinical Skills, and Introduction to Clinical Reasoning. However, our curriculum has unique tenets such as a special emphasis on military and public health medicine. This foundation prepares students for the important roles they will take on as uniformed physicians. Our program melds the study of basic science, the clinical practice of medicine and military leadership training to produce innovative doctors prepared for the challenges of Military Medicine.
The foundation of clinical medicine is the ability to obtain, understand, and act upon symptoms and observations (the clinical “data”). This ability to synthesize clinical “data” requires both the acquisition of factual knowledge and experience. The Introduction to Clinical Reasoning course provides our students with deliberate practice in clinical reasoning through a sequence of lectures and small group discussions of germane topics in medicine with the help of a cadre of inter-departmental physicians. This course is essential for helping students succeed in the clerkship years. There is little doubt that learning medical facts is an essential determinant of expert performance in medical practice. Yet, scientific principles and medical facts represent only one aspect of the cognitive demands on the physician.
Another demanding aspect is solving clinical problems including coherently synthesizing a patient's presenting clinical symptoms and findings, proposing a set of diagnostic hypotheses (a differential diagnosis), selecting tests to confirm or refute these hypotheses, and making decisions that encompass the trade-offs between the risks and benefits of tests and treatments. The Integrated Clinical Skills course teaches students how to acquire clinical information (the history and physical).
These two courses teach students how to use knowledge acquired to arrive at a problem list and differential diagnosis as well as how establish the diagnosis and a basic treatment plan. We introduce students to several ways physicians approach solving clinical problems, building problem solving skills that help them excel on clerkships.