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SECOND YEAR
MEDICAL STUDENTS
PATHOLOGY / PATHOPHYSIOLOGY TEACHING PROGRAM
The medical Pathology/Pathophysiology
courses I (Fall Semester) and II (Spring Semester) at New York
Medical College were designed by Reinhard E. Zachrau, M.D.,
Professor of Pathology, and are conducted by Dr. Zachrau and faculty
of the Departments of Pathology, Medicine, Pediatrics, Community and
Preventive Medicine, Neurology, Surgery, and Dermatology, among
others. Beginning with the 1992/1993 academic year, these courses
have been characterized by an approach to teaching and learning that
places enhanced emphasis on
- Allocation of our students' time
to active study rather than passive learning, with reduction of
conventional lectures by approximately 70%
- Faculty-guided independent
learning
- Student-faculty contact in
laboratories and small-group problem-solving exercises
- Participation in an autopsy and
subsequent independent preparation of a comprehensive report
with an analysis of the relation between clinical observations
and pathological findings
- Utilization of electronic
resources as appropriate in the primary learning process and for
case studies requiring integrated application of information
derived from multiple sources
- Collaborative efforts ("team
work"), not just in conjunction with the exercises but in
studies overall.
While our students certainly
receive guidance and supervision from the faculty, they are –
aside from prescribed exercises – encouraged to utilize their
time and the provided learning resources in the way they judge
most effective for themselves. Mastery of the subject is the
ultimate goal (mastery denoting more than mere passing of
multiple choice examinations, of course). The scheduled
exercises and examinations provide "litmus tests" for our
students to determine whether their chosen approach to learning
the material has been as effective as they had expected it to
be.
The described course format raises the level of the students'
responsibility in the learning process – which is one of our
objectives. It also raises the level of pride students can take
in their achievements. Above all, our hope and expectation are
that our students' active participation in the learning process
now will prepare them for the demands of life-long learning,
which will be required of them.
The experiences of both students and
faculty over the past several years suggest that this teaching
format is beneficial in a variety of aspects, including – but
certainly not limited to – performance on both internal and
external examinations. The last six classes completed our
program with cumulative passing rates of 100,100,100, 98, 98,
and 97%, respectively. Furthermore, the mean scores achieved by
these classes in Step 1 of the USMLE were all significantly
above the national reference values. Aside from these numerical
assessments – and most gratifying – the feedback from our
students after their exposure to the challenges of the clinical
clerkships has been almost invariably favorable, as has been the
feed-back from the clinical faculty working with our third- and
fourth-year students.
The Pathology/Pathophysiology
courses I and II cover all major general and systemic pathology
topics, the latter with integration of correlated clinical
aspects of disease taught by clinical faculty.
Basic textbooks, which the students
are required to obtain, are supplemented by annually updated
detailed syllabi provided by the faculty of the Departments of
Pathology and Medicine, which specify for each major learning
block
- Objectives stating what the
students are expected to master at the end of each learning
block and including reading and, if applicable, case study
assignments
- Clinico-pathological
correlation/laboratory exercise materials
- A perspectives text with
accompanying pictorial materials, which is reviewed with the
students by the faculty member responsible for the
respective learning block
- Case-based materials for the
problem-solving exercises.
For minor learning blocks,
either objectives or, when applicable, lecture notes are
provided. In addition,
pathology-related software is made available on the New York
Medical College Intranet. Provided software includes, aside
from faculty-authored materials,
- Interactive Pathology
case studies, covering a wide range of topics
- Interactive clinical
management exercises in Infectious Disease
- Ten interactive programs
addresses topics of Nutrition in Medicine
- The Harvey ("Umedic")
Multimedia Curriculum in Cardiology software for use
independently or in conjunction with the Harvey
Cardiology Training Mannequins
- Specific "Exercises with
Harvey" for second-year medical students focusing on the
normal heart and aortic and mitral stenosis and
insufficiency.
Laboratory sessions
comprise clinico-pathological correlation exercises,
topic reviews, gross specimen reviews, a microscopic
examination and diagnosis and a urinalysis exercise, all
conducted by one faculty member per group of
approximately 20 students.
Problem-solving exercises are conducted by one faculty
member per group of 10 or 11 students. In these
exercises, scheduled at the end of a related learning
block, the students are challenged to apply their newly
acquired knowledge, supplemented by additional resources
including literature searches, to specific problems.
As indicated earlier, it is
a Pathology/Pathophysiology course requirement that
students observe and participate in an autopsy, in
groups of four to eight students, and prepare a written
report, which must include
- An abstract of the
patient's clinical records, including symptoms,
physical findings, laboratory tests, clinical
course, and the final clinical diagnosis with the
considered cause of death
- A description of the
autopsy procedure
- A description of the
findings on gross examination of the organs
- A description of the
microscopic findings from the prepared slides
- The final
pathological diagnoses
- A discussion of the
clinico-pathologic correlation, i.e., history,
clinical findings and clinical course correlated
with the pathologic findings, including a discussion
of etiology, pathogenesis, appropriateness of
therapy, and a succinct discussion of the major
disease process encountered.
Each written autopsy
report is graded, followed by an individual,
autopsy-related quiz conducted with each student by
senior faculty (i.e., Drs. Zachrau and Argani). The
combined grade becomes a component of the final
grade for Pathology/Pathophysiology II.
Three integrated
in-house examinations, i.e., including questions
prepared by both pathology and clinical faculty, are
administered per semester. In addition, a National
Board-type comprehensive Pathology examination
("Mini-Board") is given as the final examination at
the end of the academic year. |
