Course Descriptions

Population Health and Epidemiology

The course instructs the student how to look at population health, epidemiological issues, cultural issues within a community, biostatistics, health policy, and financial considerations in health care. Computer-based exercises requiring the use of medical informatics and retrieval and real-life examples to promote lifelong learning skills for the students. Geriatric issues also are used in population health as a focus to prepare students for future population concerns.

Primary Care/Osteopathic Manipulative Medicine

The curriculum in the Primary Care/Osteopathic Manipulative Medicine (PPC/OMM) course is built to train students as family practice physicians first, giving a base knowledge in primary care to those who practice medicine. A number of family physicians have shown proficiency in the practice of osteopathic manipulation, as well as other medical specialties by integrating osteopathic manipulation into their practice.

Effective Communication - The Family Medicine course teaches students to listen attentively and compassionately, and to communicate clearly with patients, families, and other health care team members. Clinical experiences where students are given the opportunity to use and assess their skills are included. Documentation is taught utilizing the most modern technologies.
Basic Physical Diagnosis and Clinical Skills - The content instructs students in the skills of obtaining an appropriate history and to perform skillful, comprehensive physical examinations in a variety of patient care encounters. The student also learns to correctly select, proficiently perform, and accurately interpret clinical procedures and laboratory findings. Clinical experiences are included where students learn to discern normal and abnormal physical exams.
Prevention - Students are taught to assess risk factors in patients, to educate patients regarding the prevention of common health problems, to maintain health, and to perform lifestyle intervention. Clinical experiences reinforcing the preventive approach to patients and the community accomplish this curriculum.
Self-Awareness and Self-Care - The student is required to identify his/her limits, strengths, weaknesses, and personal vulnerabilities, including health, risk factors, and lifestyle. The student also is required to assess personal values and priorities to balance personal and professional commitments.
Community in the Context of Health Care - The curriculum requires the student to approach the broader context of medical practice and to provide guidance and interventions in the community to influence health and disease prevention.
Cultural Awareness - Students are taught the external factors that affect health care including cultural, familial, psychological, economic, environmental, legal, and political factors.
Spirituality - Students are taught how the spiritual aspects of an individual affect health care. Seminars and clinical experiences reinforce this learning.
Addiction Medicine - Students are taught the behavioral and biomedical factors affecting addiction. Students develop the skills to assess patient addiction and the medical and psychological approaches to intervention.
Osteopathic Manipulative Medicine - This curriculum in primary care reviews the four key principals of osteopathic philosophy into clinical practice. Those principals are: (A) the person is a unit of body, mind and spirit; (B) the body is capable of self-regulation, self-healing, and health maintenance; (C) structure and function are reciprocally interrelated; and (D) rational treatment is based upon an understanding of the basic principals of body unit, self-regulation, and the interrelationship of structure and function. The student is taught the full scope of the art and science of osteopathic manipulation including clinical applications for the primary care physician. The course will familiarize students with the history of osteopathy, research contribution, future projections for the profession, and the anatomical and physiological basis of osteopathic medicine. Students will be instructed in the biomechanics of posture, of normal and abnormal conditions of the various joints and how to manage the somatic dysfunction utilizing muscle energy, indirect, and high velocity techniques. The curriculum uses a function and dysfunction approach as it relates to the spine and appendages. The course addresses management of musculoskeletal disorders in adults, children, geriatric patients, and in pregnancy. Students will learn to integrate osteopathic principles with clinical medicine through clinical based presentations. The course will correlate clinically the material presented in human anatomy, physiology, and clinical case correlations. An introduction to cranial techniques is also reviewed; however, this is not a part of the standard curriculum.

Professionalism and Medical Ethics

This course introduces the student to the ethical dimensions of medical practice and health policies and assists the student in identifying alternatives in difficult ethical choices; in analyzing systematically the conflicting considerations supporting different alternatives; and in formulating, defending, and effectively carrying out a course of action that takes into account this ethical complexity. The student learns the importance of recognizing the nature of the value systems of patients and others with a commitment to his/her own value system. The curriculum introduces the student to medical jurisprudence and the role of this dimension in the ethics of medical practice and health policy. Students analyze cases of medical malpractice as to ethical standards and judgment, complex issues in patient care. The curriculum includes discussions on licensing issues, state board issues, and review of actual cases of physicians who have received sanctions.

Anatomy

The course covers the architecture of the human body, including anatomical variations within the population and how some of these variations lead to or stem from human disease. Anatomy is divided into three sub-disciplines. This course runs from block 2 through 7.

Gross Anatomy - The clinically oriented anatomy curriculum introduces the student to the macroscopic structure of the human body by using a regional approach. The course emphasizes the correlation between anatomical structure and function, clinical application, and usage of correct anatomical terminology. Resources used during the laboratory portion include cadaver dissection, radiographs, MRI CT scans, OP&P, and orthopedic clinical correlation. In the neuroanatomy curriculum the morphology, circuitry, function, and clinical application of neuroanatomy are presented in lecture, clinical conference, and laboratory sessions. Laboratory studies use human specimens and high-resolution video to learn brain and spinal cord topography, meninges, and blood vessels. This course emphasizes the development of fundamental neuro-analytical skills. A gross anatomy laboratory experience is a required part of the course.
Histology - Combined lecture and laboratory presentations explore the microscopic architecture of each organ system. Study of basic cell structure, functions of cellular organelles, and relationships between structure and cellular function provide foundations for further study of the basic sciences. Presentations further highlight the intimate relationship between structure and function through the study of the functional morphology of diverse cell types, their organization into tissues, and the properties of these tissues. In addition, this course examines contributions made by coherent organization of tissues into organs to human form (gross anatomy) and function (physiology) and provides a foundation for how its distortion correlates with disease.
Embryology – This curriculum describes the developmental anatomy of each organ system, with special emphasis on abnormal development leading to congenital malformations. The format includes lectures and online modules.

Genetics and Introduction to Human Embryology

This course provides the foundational knowledge of genetics pertinent to the practice of medicine. Topics include the structure and function of genes and chromosomes, cytogenetic aberrations, mutation and its consequences, Mendelian and non-Mendelian modes of inheritance, pedigree analysis, multifactorial inheritance, cancer genetics, population genetics, genetic screening and genetic counseling. Emerging topics such as pharmacogenetics, gene therapy and the genetics of aging are also examined. The embryology component of this course discusses the developmental anatomy of the human body, from gametogenesis through body folding and organogenesis. The topics of developmental genetics and teratology are also presented. The rest of the embryology curriculum is taught is embedded within the anatomy course.

Cell Biology and Physiology

Human cell biology/biochemistry and physiology provide a foundation for understanding the many disease processes that affect man. This course examines the human body at the molecular, cellular and organ system level, with an emphasis on integration and control. Foundational material presented in Block 1 includes protein structure and function, storage and expression of genetic information, lipid metabolism and membranes, energy metabolism and cell signaling. Blocks 2-7 include the biochemistry and physiology specific to the organ systems being covered. Neurophysiology is also a component of this course.

Nutrition

Nutrients are the constituents of food necessary to sustain the normal functions of life. These constituents provide both energy and “essential” molecules that either cannot be synthesized by the body or cannot be synthesized at a rate sufficient to meet the demands of growth and maintenance. Essential nutrients include specific amino acids, fatty acids, vitamins, and minerals. Classic vitamin deficiency will be presented from a historical perspective, while the main emphasis of the course concentrates upon nutrition and chronic disease, e.g., coronary heart disease, diabetes, alcoholism, and cancer. Additionally, clinical modules are presented including nutritional considerations in health and disease and the special dietary requirements of pregnant women, neonates, athletes, and the elderly are discussed from the viewpoint that correct nutrition can improve the health and lifestyles of all individuals.

Immunology

This curriculum covers all of the major topics in basic and clinical immunology. Topics include: cells and organs of the immune system,
B cell development and activation, T cell development and activation, major histocompatability complex, antigen processing and presentation, antibody diversity, tolerance, complement, cytokines, inflammation, hypersensitivity, vaccination, autoimmunity and immunodeficiency diseases, and host pathogen interactions.

Microbiology

This course presents virology, bacteriology, mycology, and parasitology from a medical standpoint, with an emphasis on morphology, physiology, life history, pathogenicity, epidemiology, diagnosis, and prevention. An introductory course is presented in foundations followed by common infections found in each system. In year two, infectious disease cases are presented with treatment.

Mental Health and Psychiatry

The course is designed to give the student an introduction to maintaining mental health, performing general psychiatric assessment and current diagnostic modalities. Topics range from those psychiatric and behavioral disorders most often encountered in primary
care to acute or chronic psychiatric interventions. The curriculum is designed to provide the second year student with a background in clinical evaluation, examination procedures, diagnosis, and treatment of psychiatric disease.

Pathology

The course addresses the pathological conditions that are caused by environmental factors, pathogen invasion or genetic abnormality, and the pathophysiological response of the body, at every level from the molecule to the whole person. The curriculum provides
an introduction to the diseases of humankind, beginning with a systems approach, and introduces intelligent use of the clinical laboratory. A genetic curricular thread runs throughout the course. The course is presented through 75 in-class lectures and 150 computerized case tutorials.

Pharmacology

This curriculum is offered in a foundations of clinical medicine section which is an in-depth study of medical pharmacology that emphasizes the basis for applied clinical therapeutics, followed by a thread of major classes for each system of pharmacological agents that today’s physician uses in management. Cellular mechanisms of action are studied in detail, particularly with regard to pathological abnormalities. In each block, students have Pharm D rounds at VCOM’s core hospitals which reinforce the pharmacology curriculum for the block.

Clinical Case Correlations

Symptom-based clinical case presentations are presented through pre-case tutorials and in class presentations. In year one, the cases are basic and correlate the basic science principles taught within the system with the diseases and their presentations. Each case has a precise information presentation in on line tutorials where the student completes and answers problem based questions relating to the case. This is followed by an in-class facilitated case presentation. Students learn to use problem-solving skills to integrate the basic science principles and history and physical exam findings to form a differential diagnosis.

Cardiovascular Disease, Respiratory Health and Disease, and ENT Systems -The cardiovascular conditions that affect humans are introduced through lectures and clinical cases. These conditions include the signs, symptoms, differential diagnosis, and management of the most common cardiovascular disorders. Students review common cardiovascular medical and surgery approaches to care. Pulmonary clinical cases focus on examination, acute and chronic disease states, and treatment options for diseases of the upper airways, the ear, nose and throat, and the lower respiratory tract through a symptom based, case based approach. Students learn the basic diseases and their clinical correlations in the systems courses and the diagnosis and management in this clinical course.
Ophthalmologic Disorders - This curriculum is designed to teach the student knowledge of anatomical abnormalities and ophthalmologic diseases, thorough examination and includes treatment options of various diseases. Both acute and chronic conditions are included.
Renal and Urogenital Health and Disease - The curriculum in this block of clinical case correlations introduces the student to the signs, symptoms, and differential diagnosis in renal diseases, the complex management of fluids and electrolytes in renal complications of other disease processes, and the management of common emergent, acute, and chronic renal and urological conditions. The course covers both the medical and surgical approaches.
OB/GYN - This curriculum introduces students to women’s health, the normal and abnormal obstetrical conditions that a physician may encounter, and the gynecological disorders and their treatment. Optimal health for mother and infant are emphasized.
Endocrinology within this block covers the diagnosis and management of the common endocrinology disorders including diabetes and thyroid disease. The courses also discuss the appropriate use of endocrinologist consults and endocrinology presentations for management of complications or of more advanced disorders of the endocrinology system.
Gastrointestinal - These cases focus on the most common gastrointestinal disorders, their signs and symptoms, differential diagnosis and the management of the most common disorders in primary care, gastroenterology, emergency medicine, and surgery.
Pediatrics - The pediatric curriculum introduces students to the diagnosis and treatment of diseases in infants and children. The PPC and CCC pediatric thread runs through each system in years one and two and collectively introduces the student to caring for healthy children and children with the most common disease states.
Hematology and Oncology - The hematology and oncology curriculum covers the primary care management of common hematologic conditions, cancer incidence and screening, and oncologists’ approaches to the most common malignancies and runs throughout the clinical case correlations course.
Surgery/Anesthesia - This thread runs through clinical case correlations in all systems and covers basic surgical principles, the surgical approach to patient care, and basic surgical skills students will need for primary care, as well as for clinical rotations. Surgical cases are integrated throughout the curriculum; however, this course is a more intense review of basic surgical and anesthesia skills to prepare the student for the surgical clinical setting. Surgical skills are taught in the early clinical experiences and the clinical skills labs.
Emergency Medicine - The emergency medicine curriculum runs through clinical case correlations and includes all systems. The curriculum covers the most important principles of care for medical or traumatic emergencies. Students must master basic ACLS protocol and, clinical skills for emergency medicine in the clinical skills course. A computerized program prepares the student for taking ACLS, and they complete a mock ACLS and Trauma lab.
Infectious Disease – This thread extends though all blocks of clinical cases. The curriculum covers the major pathogens of each organ system. Each lecture is team taught with a minimum of one basic scientist and one clinician.
Dermatology - The student is introduced to the various skin lesions including skin rash, growths and tumors. The approach is through in class presentations where the faculty member reviews the differentials and management of the most common skin disorders.

Evidence-Based Medicine, Medical Informatics, and Critical Thinking

Students examine a series of health care issues including bioinformatics, pharmacogenetics, population health, and evidence-based medicine applications to pediatric, geriatric, surgical, and medical cases that require retrieval, analysis, and synthesis of the material in applying it to a clinical context. Students work in teams to prepare preventive medicine presentations in health care by using fundamental of teaching and medical informatic skills. Students then give presentations to appropriate rural community sites. This is an online course taken in year three.

Clinical Skills

During each block and immediately prior to the third year, students are introduced to competency based clinical skills where they will review and acquire some of the most important clinical skills they will utilize in years three and four. Students will perform skills from the most basic history and physical review, admissions procedures, basic surgical procedures and suturing, EKG and PFT performance, airway labs, ACLS, ABG performance and interpretation, heart sounds, venipunctures, and the skills needed in order to care for patients in the most critical of conditions from trauma to cardiac arrest.

VCOM College Catalog 2009-2010