Curriculum

The Curriculum at VCOM is innovative and modern. The faculty of VCOM recognizes students learn in a number of ways. Students generally assimilate a knowledge base through instruction, reading, and experience. Students who are in problem based, case based, or discipline based curriculums, often complain of repetition and lack of variety. VCOM has developed a hybrid curriculum consisting of lectures, computerized case tutorials, laboratory experiences, clinical skills laboratories and clinical experiences throughout the four years.

All courses at VCOM are available to students on the computer through Blackboard. The computer based materials are placed on Blackboard in order to augment student learning where minimal note taking is required in class. This leaves valuable classroom time for faculty/student interaction. Computer based instructional cases are the backbone of the clinical curriculum and demand preparation and performance prior to classroom instruction. Classroom instruction becomes concise case overviews rather than a detailed re-read of the text. The clinical cases are examples whereby students learn to apply their knowledge base to problem solving in clinical medicine. VCOM recognizes students also learn by pattern recognition. The symptom based, case based presentations advance students through the clinical curriculum and prepare them for the third year clinical rotations.

Clinical experiences occur throughout the first and second years and include Geriatric centers, free clinics, Pharm D rounds, hospital rounds, and primary care experiences.

The third and fourth year curriculum is predominately clinical and provided in the hospital setting. Academics are presented in the clinical setting through advanced didactics including morning reports, case presentations, and grand rounds. The didactics are shared through telecommunications to all third year clinical sites. This will allow a continuous curriculum and an opportunity to learn through a spiraling of medical knowledge.

Osteopathic Manipulative Medicine (OMM) is taught throughout the curriculum by faculty physicians who practice primary care and osteopathic medicine and sports medicine. The OMM curriculum is reinforced in the clinical years by providing clinical experiences with this same faculty, demonstrating the incorporation of the manipulative medicine skills into clinical practice. Osteopathic manipulative medicine skills labs continue through the third year.

The curriculum is directed toward the development of a primary care physician. VCOM faculty believe that the students who choose medical specialties will benefit from a broad based primary care curriculum and a whole patient approach to care. There are fellowship and curriculum specific tracts within the VCOM clinical curriculum for students who qualify and wish to enter research or missionary medicine training.

Block 1 – begins the curriculum at the cellular level with courses including:
Biochemistry, Microbiology, Genetics and Reproductive Medicine, and Embryology. In addition students are introduced to a course in Professionalism and Ethics as well as Communication skills in Principles of Primary Care.

Blocks 2 through 6 – include Anatomy, Physiology, and Immunology.
Clinical Case Correlations brings in Infectious Disease and patient cases that correlate with each system. Principles of Primary care is extended throughout all blocks and includes Physical Diagnosis, Introduction to Osteopathic Manipulation, and Behavioral Medicine topics.

Blocks 7 through 12 – include a Pathology and Pharmacology core.
Clinical Case Correlations bring in the cases with the medical disciplines aligned with the blocks. These include Immunology and Hematology, Dermatology, Cardiopulmonary system, Neurological, Psychiatry, and Musculoskeletal Systems, Gastrointestinal and Endocrine Systems, and Renal and Genitourinary systems. Principles of Primary Care allows students to refine physical diagnosis skills and increase their skills in osteopathic manipiulation.

Students also have Early Clinical Experiences throughout the second year which include experiences such as: Pharm D rounds, Geriatrics, Palliative care, Free Clinics, Appalachian Medical Missions, Gynecologic experience, Clinical Skills training, Radiology rounds.

OSTEOPATHIC MEDICAL SCHOOL YEAR THREE

VCOM third year medical students are required to complete nine third year clinical rotations. Each rotation is estimated at 180 hours, with 160 in the regular program and 20 hours or greater on call per month. The following are the list of third year required rotations that must be successfully completed to progress on to the fourth year. Students must complete these rotations at a Core VCOM site. The Core rotations are:

Clinical Modules

Students are provided with required curriculum during the third year. Independent Learning Objectives are provided for the Core Discipline rotations. Campus clinical conferences occur and are broadcast to each clinical site. Students are required to attend the monthly clinical conferences.

Students are also provided with web-based teaching including clinical case modules and interactive web based instructional programs. These programs provide additional hours of Curriculum Instruction. The modules contain clinical material, basic science review/integration, and osteopathic principles and practices. Clinical cases include:

Family Medicine	20 hrs.
Rural Primary Care	20 hrs.
Internal Medicine	20 hrs.
Surgery	20 hrs
Obstetrics/Gynecology	20 hrs
Pediatrics	20 hrs.
Emergency Medicine	20 hrs.
Psychiatry	20 hrs.
Geriatrics	20 hrs.

Some departments require additional curriculum such as Emergency Medicine Sim-cases. Requirements are listed on each clinical chairs web pages.

EXAMINATIONS

A post-rotation test follows each third year rotation and a comprehensive exam is given at the end of the first 36 weeks of the third year. Students who do not pass the post-rotation exam are given one chance to remediate. If the exam is failed twice, the student will be given an F and the case will be sent to the promotion board. Students must pass the comprehensive exam at the end of the year in order to progress to fourth year.

A Clinical Performance Examination also is given to assess clinical skills at the end of the 36 weeks. Students must take and pass the Objective Structured Clinical Exam and Standardized Patient Exams in order to progress to the fourth year.

The exams cover the educational objectives in the Learning Objectives for Ambulatory Care Rotation guide, the Learning Objectives from the Core Disciplines guide, and the material found in the Web-Based Instruction. Students must successfully pass the Comprehensive MSIII examinations prior to taking required fourth-year rotations.

Note;  Clinical Rotations are 160 hours each for 4 week rotations, and 80 hours each for
2 week rotations – minimum requirements)

Medical and Surgical Selectives are to be completed at VCOM sites where VCOM has established rotations, affiliation agreements, and faculty.  An exception may be granted for up to 2 selectives in an outside region where AOA approved residencies occur and where VCOM has established affiliation agreements. A list of these sites can be obtained through the 4th Year Rotation Coordinator.

OSCE Testing will take place during June 2008.

Attendance at Senior Week and Graduation is mandatory.

Most rotations are scheduled on a monthly basis.  The scheduling document accommodates for the approved 2 week rotations.  Rotations cannot be split.

Choosing In-Region Medicine and Surgical Selectives:
In-Region Selectives are scheduled for you.  Request dates and specialties and include desired preceptor if known.  Clinical Affairs will schedule the rotations according to the availability of rotation and numbers of requests.  Please do no make your own arrangements for these rotations.  They cannot be honored.

Choosing an AOA approved residency Selective site:
VCOM does not arrange your Selectives that are outside our regional sites.  If you choose to do one or two Selectives at hospitals where AOA accredited post-graduate programs exist, you must arrange those rotations yourself.  You may do two Selectives where AOA accredited post-graduate programs exist or at a military facility (HPSP students).

VCOM will not approve Selectives to be taken outside of the VCOM region at a hospital where only ACGME residencies exist or at a hospital where no residency exists.  Do not ask for an exception as it cannot be provided.

VCOM sites are Alleghany, Bluefield, Norton, Clinch Valley, Montgomery Regional Hospital, Danville, Carilion Roanoke Memorial, Lewis Gale, Carilion New River Valley, Wytheville, Pulaski, Salem VAMC, Russell County (Lebanon), Johnston Memorial (Abingdon), W.G. Bill Hefner VAMC (Salisbury, NC), Spartanburg Regional Healthcare System, Front Royal/Winchester, Riverside, Fayetteville, UMDNJ.

VCOM Selectives are chosen from the VCOM Surgical and Medical Selective lists and are based on a student's self-assessment of areas where they would benefit most from further education and patient exposure, along with input from the Associate Dean for Clinical Affairs based upon student performance.

Electives (4) may also be scheduled outside VCOM regional hospital sites however each elective site must be pre-approved through the Associate Dean for Clinical Affairs.

Formal curriculum delivery continues in years three and four.

• Clinical rotations, online case studies, post rotation exams, and oral case presentations constitute the curriculum in year three.
• In year four, the curriculum consists of clinical rotations and a thesis level written case presentation or publication for original research, and periodic internet delivered presentations.
  

MEDICAL AND SURGICAL

Medicine Selective Rotations

Surgical Selective Rotations:

ELECTIVE CHOICES

Elective rotations include:

• All rotations outlined in the 3rd year Core.
• All rotations included in the Medical Selective List
• All rotations included in the Surgery Selective List
• The additional rotations of: Occupational Medicine, Forensic Pathology, Pathology, Pediatric subspecialties, Addiction Medicine, Adolescent Medicine, Maternal/Fetal Medicine, Reproductive Endocrinology, Radiology, Dermatology, OMM, Palliative Care, Gynecology, Clinical Research,  Trauma, Biomedical Research, Proctology, Pain Management, Urgent Care, Rural Medicine, CDC, NIH, or other federally sponsored rotations.

The annual and monthly Academic Calendars may be found on the VCOM website and are updated periodically. Visit the calendar home page in the Student Resources section.

National Boards

Students are required to successfully pass COMLEX 1 and 2 and the performance exam (PE) section of COMLEX (Comprehensive Osteopathic Medical Licensing Examination) to graduate. COMLEX 1 must be taken by November of the third year and must be passed within five years of the date of matriculation. COMLEX 1 must be passed to be promoted to the fourth year. COMLEX 2 and the PE section of COMLEX must be passed within six years of the date of matriculation and prior to graduation. If a student does not meet these requirements, he/she will be dismissed. Students may be placed on Administrative leave who have passed all curricular requirements to be promoted to the next year, but have not passed boards. Once boards are passed, students may resume their academic program. This is dependent upon the student passing within the five and six year restrictions outlined above. Passing any portion of an examination is not a substitute for passing a course. If a student is in a five year program (fellowship, etc.) or is in a combined degree program, the timeframe to pass may be extended accordingly by the Dean. Approval for any other exceptions to any portion of this policy must never be assumed and must be obtained in writing from the Dean in advance.

Procedures for registering for both exams will be provided to students from the Office of the Registrar.

Graduation Requirements

The degree of Doctor of Osteopathic Medicine is granted to and conferred upon candidates who are of good moral, professional, and ethical character; who have satisfied all academic requirements; who have passed Level I, Level II, and the PE section of the National Board of Osteopathic Medical Examiners examination (COMLEX); and who have settled all financial obligations with VCOM and its academic and clinical affiliates and collaborative partners.

To become eligible for the fourth year, each third-year student must take and pass Level 1 of the COMLEX National Boards. To become eligible for graduation, each fourth-year student must have passed the written COMLEX Level 2 and the COMLEX Performance Exam (PE).

A student must have completed a minimum of 40 months at VCOM (or another eligible institution which is AOA COCA or LCME accredited) between the date of matriculation and graduation. In addition to this requirement, the student must have been enrolled at VCOM during his/her final two years of education.

A VCOM student must complete to the satisfaction of faculty, as determined by the individual course directors and clinical rotations supervisors, through the promotion board, all prescribed courses and clinical experiences to graduate. As part of its requirements for academic progress and for graduation, VCOM requires all students meet its core competencies. Core competencies are essential for effective performance of an osteopathic physician. The Dean makes the final determination on any appeals from promotion board recommendations. A VCOM student must attend the commencement program to receive a diploma. Students must meet with the Registrar, Office of Financial Aid, and the Department of Medical Education to complete all required exit forms to receive a diploma.

A VCOM student must demonstrate the ethical and professional qualities deemed necessary for success and continued study and practice of osteopathic medicine; the suitability for the practice of medicine by dutiful and responsible acceptance for patient care; and must demonstrate integrity in the conduct of clinical duties. Professional and ethical competencies are required for graduation and students may be dismissed due to lack of these competencies. See Behavioral Board section.