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Duke School of Medicine Changes Curriculum to Meet Future Health-Care Challenges

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Duke Health News 919-660-1306

DURHAM, N.C. – In the coming year, Duke University School of Medicine will
institute significant curriculum changes to better prepare its
graduates to cope with the rapid advance of medical science and
to address such major issues as emerging diseases, the obesity
epidemic and economic pressures in health care.

The new curriculum, planned over the past five years, will
include such changes as integrating courses by topic instead of
discipline, reflecting the blurred boundaries between basic and
clinical sciences such as cell biology and genetics, said R.
Sanders Williams, M.D., dean of the School of Medicine. The
curriculum will emphasize teaching students about technological
advances that may improve health care, such as personal digital
assistants. They also will learn how to evaluate advances in
technology and independently access information that will
enhance the learning experience, he said.

"Our goal is to give students the tools they need to be
proficient in their fields, while never losing sight of the
reason they came to medicine -- to heal and help people," said
Williams.

"Modification of the medical school's curriculum is a
never-ending process," said Edward Halperin, M.D., vice dean of
the School of Medicine. "We wish to have a curriculum that is
responsive to the development of new knowledge, while remaining
true to the historical traditions of Duke."

The gold standard four-year medical school curriculum --
with one year of basic science, one clinical year, one research
year and then one final clinical year -- has been retained,
said Williams. However, the basic first-year science courses
will now focus on three overarching topics: molecules and
cells, the healthy body and the body and disease.

"With the exploding knowledge base in medical sciences, the
boundaries between disciplines in both the basic and clinical
sciences have blurred to such an extent that traditional
packaging of subject material is no longer adequate," said
Edward Buckley, M.D., associate dean for curriculum
development.

The second and fourth years -- when students have direct
contact with patients -- were modified so that students'
mastery of knowledge does not come solely through traditional
apprenticeship on the wards, said Williams. Fourth-year
students also will be required to take a "capstone" course,
designed to bring them up to date on the latest in scientific
research, health systems and the economics of health care.

Another new course offered to students in the fourth year
will cover the underlying causes of obesity and various
treatment options, including surgery. Because obesity is not
considered a disease, students have not traditionally been
trained in this area. Duke is one of the first medical schools
to develop a multidisciplinary course, Clinical Management of
Obesity, on this topic.

The medical school also has accommodated the shift toward
more ambulatory care, emphasizing the need for a broad range of
clinical skills, through a practice course in which students
focus on doctor-patient relationships. Meeting once a week for
three years, students learn to counsel patients, conduct
patient interviews, and handle managed care.

The third year, devoted to independent research, has been
maintained and strengthened in the new curriculum.

"Providing information is no longer enough," Buckley said.
"We will teach students how to access information and how to
evaluate emerging technologies, as well as how to work in a
team environment. That's where the future lies."

Duke School of Medicine also has expanded its educational
programs internationally. In 2003, a memorandum of
understanding was signed to establish Singapore's first
graduate medical school in collaboration with the National
University of Singapore. Agreements are due to be finalized
this summer.

The new Graduate Medical School will be based on the U.S.
model, with students enrolling after earning a bachelor's
degree. It will follow Duke's newly updated curriculum and
incorporate Duke's Prospective Health Planning initiative,
stressing preventive care and individualized plans for
achieving health-care goals.

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