Yale University School of Medicine.
Medical Education Program Highlights Yale School of Medicine (YSM) is committed to the scholarly training of physicians and other health care providers with the goal that they will be the leaders of their generation. Our educational mission is “to educate and inspire scholars and future leaders who will advance the practice of medicine and the biomedical sciences.” Consistent with our commitment to educating scholars and future leaders, we have a class size of 104 students, with 20% in our MD–PhD program. The Yale System creates a highly collaborative learning environment that gives our school its distinct identity and character and makes us unique among medical schools. In place since 1931, it is considered the school’s most powerful educational strength and is a major factor in our ability to consistently attract extraordinarily talented students. In the Yale System, medical students are viewed as mature, highly motivated, and self-directed learners. There is a reduced emphasis on grades and no class rank to limit competition. Instead, self-assessment and collaborative learning are emphasized. There is a flexible curriculum to accommodate individual learning styles and allow students to pursue individual interests. Since 1839, Yale has required a dissertation based on original research. The MD thesis is an essential part of the Yale System, and time for this scholarly activity is built into the curriculum. It is designed to promote scientific inquiry, foster critical thinking, and prepare students for lifelong learning. Importantly, the thesis requirement gives students the opportunity to work closely with faculty in a mentoring relationship. Curriculum In 2015, following 5 years of extensive planning, a new curriculum was implemented. Eight overarching goals form its foundation, focusing on areas essential for successful future practice: Health promotion and disease prevention Mechanisms and treatment of disease Clinical reasoning Patient care Professionalism and communication Responsibility to society Creation and dissemination of knowledge Physician as scientist See Supplemental Digital Appendix 1—Curriculum Overview—at https://links.lww.com/ACADMED/A951. Curriculum changes since 2010 Integrated course curriculum: Basic and clinical science content is organized and integrated across 8 sequential theme-based master courses and 3 longitudinal courses. Interprofessional longitudinal clinical experience: Medical students work with physician associate and nursing students as a team and are directly involved in patient care from the beginning of medical school, with an emphasis on interprofessional education, team-based care, and knowledge of the health care system. Clinical skills: Teaching and assessment of clinical skills is coordinated and integrated across the 4 years of the curriculum, and emphasize competencies in medical history and communications, physical examination, medical procedures, clinical reasoning, and professionalism. Clinical clerkships: A remodeled clerkship year begins earlier in the curriculum; includes integration across disciplines; provides opportunities for greater continuity with patients, teams, and mentorship; and allows students the flexibility to explore career interests. Enhanced flexibility: The final 17 months are an advanced training period where students create schedules based on their individual needs and career choices. This includes time for their research, electives and subinternships, residency interviews, and required USMLE Step examinations. Assessment YSM adopted and incorporated the AAMC’s Physician Competency Reference Set as the expected competencies for our medical students. These competencies map to our overarching goals through the individual learning objectives represented in the courses, clerkships, and electives throughout our curriculum. See Table 1—Program Objectives and Assessment Methods.Table 1: Program Objectives and Assessment MethodsYSM hired an associate director of student assessment to focus on assessment “for learning” while ensuring assessment “of learning.” This approach relies on guided self-assessment, reflection, and self-regulation in learning and professional development, and uses an integrated, developmental, and competency-based approach. In addition, faculty are assisted and supported in the development of various formative and summative assessments used in the curriculum. Pedagogy YSM uses a broad range of pedagogical approaches, including team-based learning, simulation, case-based workshops, standardized patients, iBooks, and augmented and virtual reality, along with more traditional learning approaches using lectures and laboratories. We recently completed a major renovation of education space to support the emphasis on small-group and team-based learning. Clinical experiences Throughout the first year and a half of medical school, students participate in longitudinal clinical experiences focused on communication, professionalism, and the skills of taking a patient-centered history and physical examination. Direct patient contact and small-group tutorials with faculty are highlights of these early clinical experiences. Core clerkships and electives occur at Yale New Haven Hospital and Health System, the VA Connecticut Health Care System, Connecticut Mental Health Center, and Yale University Health Services. In addition, global health electives are available in a variety of international and domestic locations including Appalachia Grundy County, Tennessee; Argentina; Chinle, Arizona Indian Health Service; China; San Francisco Free Clinic; South Africa; and Uganda. Curricular Governance The deputy dean for education is responsible for oversight and coordination of the education programs and services. The Educational Policy and Curriculum Committee is chaired by the associate dean for curriculum. This committee oversees the policies that govern the medical education program, provides centralized oversight and review of the curriculum, and is responsible for ensuring that the curriculum addresses the school’s educational objectives. The curriculum directors coordinate the development, implementation, and review of the curriculum. The integration of content throughout the 4 years is fundamental to their roles. In addition, they chair the Curriculum Review Committees that assesses each component of the curriculum and provides feedback to each course, clerkship, and elective director. The Thesis Committee is chaired by the associate deans for student research and is responsible for the oversight, coordination, and management of the thesis required of all medical students. See Figure 1—Organizational chart of deans.Figure 1: Organizational chart of deans.See Figure 2—Curriculum management and governance.Figure 2: Curriculum management and governance.Education Staff Multiple offices collaborate to support undergraduate medical education, including admissions; curriculum; diversity, inclusion, community engagement, and equity; financial aid; global health education; MD–PhD program; student affairs; and student research. Faculty Development and Support in Education The YSM Teaching and Learning Center (TLC) provides expertise in curriculum development, pedagogy, assessment, and use of learning technologies. The TLC also provides a variety of professional development programs and services to support educators, including: Individual consultations Direct observation of faculty teaching with peer feedback Seminars and workshops on teaching methods Support/mentorship for educational research, grants, and scholarship Letters to the appointments and promotions committees summarizing the educational contributions, leadership, and impact of faculty educators in support of promotion/tenure decisions Initiatives in Progress Since its implementation, the curriculum has been continuously and rigorously evaluated. In response, initiatives currently underway to improve the curriculum include: Health equity and social justice in medicine Sex, gender, and minority health Addiction medicine
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