Washington University is debuting a new medical curriculum in 2020. It will ensure that our students are not only exceptional physicians, but are prepared to lead the transformational changes needed to improve the future of our field.
The Gateway Curriculum consists of three phases over four calendar years. In addition the Gateway Curriculum’s Explore component allows students to examine their own career goals and gain exposure to areas of interest.
Phase One will begin with Gateway Orientation. Gateway Orientation will give incoming students a chance to launch their medical education journey—getting to know each other, their new school, and their community in St. Louis—culminating with the White Coat Reflection.
Phase One continues with eight Foundational Science Modules of variable length incorporating basic, clinical, social and systems science knowledge. Modules will center on function (primary physiological organization) and forms (secondary anatomical organization) of the human body in an integrated fashion including the basic and clinical sciences and the impact of the social and health systems science. Each module will have similar large-scale structure to facilitate consistency and familiarity.
The majority of instruction in Phase One will typically occur in the mornings, Monday through Friday. Activity-orientated content will occur typically two afternoons per week (e.g., clinical skills training, activities directed at students’ areas of passion such as community engagement, advocacy, education and research).
Evidence based active learning strategies and educational technology are used to augment medical student engagement and learning (e.g., team-based learning, case-based collaborative learning, flipped classroom strategies, labs).
Three 3-week Clinical Immersion experiences will rotate students through three clinical environments: Ambulatory/ED, Inpatient, and Procedural. During Clinical Immersions attention will be given to clinical skills, the social and health systems sciences and professional identity formation.
Phase Two consists of six 8-week core clinical clerkships where students rotate through internal medicine, surgery, pediatrics, OB/GYN, neurology and psychiatry.
The components of the core include preparation, clinical immersion and consolidation. In preparation, the clerkship begins with 1-3 weeks of specialty specific foundational material, consisting of purposeful reiteration and expansion of prior material (helical learning) and new material with signs and symptoms framework to facilitate core knowledge transfer to clinical reasoning. During clinical immersion, the student joins the patient care teams with more engagement in advanced clinical work than Phase One. Finally, during consolidation the clerkship ends with a one-week period for revisiting concepts, filling in knowledge gaps, and including assessments, reflection, coaching, and community (ARCC).
Students particularly interested in a career in science have the option of completing 8-16 weeks of research beginning in January of Phase Two.
During Phase Three, schedules and activities are tailored to individual passions and career aspirations. All students are required to complete a 4-week Internal Medicine Subinternship. Additionally, students are required to complete four 4-week Advanced Clinical Rotations (ACR) which are subinternship-like experiences in areas selected by the students and three 4-week Keystone Integrated Science Courses (KISC). KISCs provide deep explorations into the science of a broad array of topics (basic, clinical, social and health systems science), will be transdisciplinary and will take students from cell to society around an important or emerging area. Up to eight weeks of credit-bearing study/preparation time may be used for USMLE exams: Step 1, Step 2 CK and Step 2 CS. Finally, students are required to complete a 4-week Gateway to Residency (AKA Capstone) course early in their graduation year. The remaining 10 months are entirely elective. It is anticipated that the vast majority of our students will do some form of research early in Phase 3 that is focused in an area of their interest.
By the completion of Phase Three, students will complete their achievement of the core competencies and develop competencies and an identity consistent with their chosen profession. They will dive deeply into the foundational, clinical, social and systems sciences relevant to their chosen field. They will continue exploration of their passions and have opportunities to take deep dives into those passions.