Curricular Reform in Undergraduate Medical Education

1. Sh.Yazdani F.Hosseini Curricular Reformin Undergraduate Medical Education

2. Phase I Basic Medical Sciences

3. Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology

4. Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology Non-Core Core

5. Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology Non-Core Organ System Core Introductory

6. Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology Non-Core Cardiovascular Endocrine Gastrointestinal Core Respiratory Hematology Musculoskeletal Introductory

7. Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology Non-Core Cardiovascular Endocrine Gastrointestinal Core Respiratory Hematology Musculoskeletal Introduction to Basic Medical Sciences

8. Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology Non-Core Cardiovascular Organ System EndocrineOrgan System GastrointestinalOrgan System Core RespiratoryOrgan System HematologyOrgan System MusculoskeletalOrgan System Introduction to Basic Medical Sciences

9. Beyond-Core Anatomy Beyond-Core Physiology Beyond-Core Histology Beyond-Core Embryology Beyond-Core Biochemistry Beyond-Core Biophysics Beyond-Core Immunology Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology Non-Core Cardiovascular Organ System EndocrineOrgan System GastrointestinalOrgan System Core RespiratoryOrgan System HematologyOrgan System MusculoskeletalOrgan System Introduction to Basic Medical Sciences

10. Beyond-Core Anatomy Beyond-Core Physiology Beyond-Core Histology Beyond-Core Embryology Beyond-Core Biochemistry Beyond-Core Biophysics Beyond-Core Immunology       Anatomy Physiology Histology Embryology Biochemistry Biophysics Immunology Non-Core Cardiovascular Organ System 20% Clinical Content Vertically Integrated into Organ Systems EndocrineOrgan System GastrointestinalOrgan System Core RespiratoryOrgan System HematologyOrgan System MusculoskeletalOrgan System Introduction to Basic Medical Sciences

11. Cardiovascular  • Respiratory • Hematology • Gasteroenterology  • Musculoskeletal  • Nervous  • Endocrinology  • Reproduction  • Renal and Urinary • Dermatology • Ophthalmology • Otolaryngology Systems Systems:

12. Semester I Introduction to Basic Medical Sciences III General Units Information Technology Study Skills Introduction to Basic Medical Sciences II Introduction to Basic Medical Sciences I

13. Semester II Musculoskeletal Organ System General Units Elective Courses Public Health Psychology Integument Organ System Cardiovascular Organ System

14. Semester V Gastrointestinal Organ System General Units Microbiology Nutrition Early Patient Contact II Community Exposure I Hematology Organ System Reproductive Organ System

15. Semester IV Visual Organ System General Units Elective Courses Virology Clinical Genetics Early Patient Contact I Community Exposure I Auditory Organ System Renal Organ System

16. Interdisciplinary Group 1 Interdisciplinary Group 2 ………….. Interdisciplinary Group 11 Interdisciplinary Group 12 Conventional Educational Groups Conventional Educational Groups ……………… Conventional Educational Groups Conventional Educational Groups Curriculum Committee

17. IntegrationThroughCentralGovernance ofCurriculum           Fragmentedcurriculum,departmaents,andgovernance

18. IntegrationThroughCentralGovernance ofCurriculum           Curriculum Committee centralgovernanceondifferentdepartments

19. IntegrationThroughCentralGovernance ofCurriculum         Curriculum Committee Interdisciplinary Departments Centralgovernanceonteams,buildbyremovingthe wallsbetweendepartments

20. IntegrationThroughCentralGovernance ofCurriculum         Curriculum Committee Interdisciplinary Departments Integrated Curriculum Centralgovernanceonintegratedteamswhodeliver anintegratedcurriculum

22. Integration in course evaluation           anexamaftereach course                    

23. Integration in Summative Exams or  

24. آزمون جامع علوم پايه پزشکي اسفند ماه سال 1385 دانشگاه علوم پزشکي شهيد بهشتي – دانشکده پزشکي • 41 - پسر جواني بعلت اصابت جسم سنگين در قسمت فوقاني و لاترال ساق راست 3 سانتيمتر پائين تر از مفصل زانو دچار درد و تورم شديد شده است. در راديوگرافي ساده شکستگي چند قطعه اي گردن فيبولا ديده مي شود احتمال صدمه کداميک از اعصاب زير بيشتر است؟ • الفCommon peroneal • بsuperficial peroneal • جTibal • دDeep peroneal

25. Phase II & III Introduction to Clinical Sciences

26. Radiology Rotation Cardiology Rotation Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation Pathology Pharmacology Semiology Patho-physiology Radiology

27. Cardiology Rotation Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation OS Patho Pharmacology Semiology Patho-physiology Radiology Gen. Patho

28. Cardiology Rotation Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation OS Patho OS Pharm Semiology Patho-physiology Radiology Gen. Patho Gen. Pharm

29. Cardiology Rotation Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation OS Patho OS Pharm OS Semio Patho-physiology Radiology Gen. Patho Gen. Pharm Gen. Semio

30. Cardiology Rotation Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation OS Patho OS Pharm OS Semio OS Patho-physiology Radiology Gen. Patho Gen. Pharm Gen. Semio

31. Cardiology Rotation Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation OS Patho OS Pharm OS Semio OS Patho-physiology OS Radio Gen. Patho Gen. Pharm Gen. Semio Gen. Radio

32. Cardiology Rotation Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation Cardi Patho Cardi Pharm Cardi Semio Cardio Patho-physiology Card Radio GI Patho GI Pharm GI Semio GI Radio GI Patho-physiology Neph Patho Neph Pharm Neph Semio Neph Radio Nephr Patho-physiology Rheu Patho Rheu Pharm Rheu Semio Rheu Radio Gen. Patho Gen. Pharm Gen. Semio Gen. Radio Rheum Patho-physiology

33. Cardiology Rotation Card Path Card Pharm Card Semio Card Path-Phys Card Radio Gastroenterology Rotation Nephrology Rotation Rheumatology Rotation GI Patho GI Pharm GI Semio GI Radio GI Patho-physiology Neph Patho Neph Pharm Neph Semio Neph Radio Nephr Patho-physiology Rheu Patho Rheu Pharm Rheu Semio Rheu Radio Gen. Patho Gen. Pharm Gen. Semio Gen. Radio Rheum Patho-physiology

34. Cardiology Rotation Card Path Card Pharm Card Semio Card Path-Phys Card Radio Gastroenterology Rotation GI Path GI Pharm GI Semio GI Path-Phys GI Radio Nephrology Rotation Neph Path Neph Pharm Neph Semio Neph Path-Phys Neph Radio Rheumatology Rotation Rheu Path Rheu Pharm Rheu Semio Rheu Path-Phys Rheu Radio Gen. Patho Gen. Pharm Gen. Semio Gen. Radio

35. P T P T T P P T Cardiology Rotation Card Path Card Pharm Card Semio Card Path-Phys Card Radio Gastroenterology Rotation GI Path GI Pharm GI Semio GI Path-Phys GI Radio Nephrology Rotation Neph Path Neph Pharm Neph Semio Neph Path-Phys Neph Radio Rheumatology Rotation Rheu Path Rheu Pharm Rheu Semio Rheu Path-Phys Rheu Radio Gen. Patho Gen. Pharm Gen. Semio Gen. Radio

36. 3 6 5 4 3 2 1 12 11 10 9 8 7 Community Exposure Semiology Clinical Epidemiology Evidence Based Medicine Biostatistics General Radiology General Pharmacology General Pathology

37. 4  Community Exposure Orthopedics, Urology, Neurosurgery PBL, GDL Organ Specific Pathology Organ Specific Pharmacology Skill Lab 6  Orthopedics, Urology, Neurosurgery PBL, GDL 5  General Surgery PBL, GDL 4  General Surgery PBL, GDL 3 2       Internal Medicine PBL, GDL Internal Medicine PBL, GDL Internal Medicine PBL, GDL Internal Medicine PBL, GDL Internal Medicine PBL, GDL Internal Medicine PBL, GDL 1 Community Exposure Organ Specific Pathology Organ Specific Pharmacology Skill Lab 12 11 10 9  Neurology PBL, GDL 8 7 Organ Specific Radiology Organ Specific Radiology

38. P T P T P T T P Shift From Disease-Based To Manifestation-Based Cardiology Rotation Card Path Card Pharm Card Semio Card Path-Phys Card Radio Gastroenterology Rotation GI Path GI Pharm GI Semio GI Path-Phys GI Radio Nephrology Rotation Neph Path Neph Pharm Neph Semio Neph Path-Phys Neph Radio Rheumatology Rotation Rheu Path Rheu Pharm Rheu Semio Rheu Path-Phys Rheu Radio Gen. Patho Gen. Pharm Gen. Semio Gen. Radio

39. Chest Pain Circulatory Collapse Acute and Chronic Breathlessness Acute and Chronic Wheezing Haemoptysis Chronic Chough Upper Respiratory Infections (coughs, colds and sore throats) Palpitations Ankle Swelling Acute Abdominal Pain Chronic Abdominal Pain Abdominal Mass / Swelling Hernia / Abdominal Subcutaneous Mass Pelvic Mass Indigestion (dyspepsia) Dysphagia Loss of Appetite (anorexia) Nausea and Vomiting Weight Loss Haematemesis and Melaena Rectal Bleeding Jaundice Diarrhoea Constipation Perianal Pain / Itching / Discharge Rectal and Vaginal Prolapse Faecal Incontinence PBL-GDL Topics Sinuses, Fistulae and Stomata Obesity Acute Retention of Urine Urinary Frequency and Urgency Urinary Incontinence Pain on Micturition (dysuria) Acute Anuria Polyuria (polydipsia) Haematuria Testicular Pain Scrotal Swelling Ectopic / Undescended Testes Lump or Swelling on Breast

40. GDL Study Guide Format • Course Title • How to Use This Guide • Course Objectives • Introduction • Core concepts of the course • Presentations • Glossary

41. GDL Study Guide Format • Course Title (T) • How to Use This Guide • Course Objectives • Finding core concepts of the course • Applying Relevant Basic Sciences into Clinical Manifestations • Approach to Presentations • Familiarizing with Diseases • Developing Meta-competencies • Introduction (T) • Epidemiology and Importance (Prevalence, Incidence, Disease Burden, Economic Impact) • Classification (of diseases)

42. Core Concepts of the Course (T) • Pathophysiology • Diagnostic principles • History Taking and Physical Examination • Imaging • Laboratory • Miscellaneous • Pharmacology • Risk reduction

43. Presentation • Presentation Title • Case/Cases • Definition (T) • Basic Sciences (R) • Anatomy • Histology • Physiology • Pathology • Biochemistry (If Indicated) • Immunology (If Indicated) • Embryology (If Indicated)

44. Pathophysiology / Mechanism (T) • Etiologic Diagnosis (including pediatrics, geriatrics, and pregnancy considerations) (T) • Diagnostic Approach to Presentation (including pediatrics, geriatrics, and pregnancy considerations) (T) • History • Physical Examination • Paraclinic (Laboratory, Imaging, …)

45. Diagnostic Algorithm (Decision Tree) • Therapeutic Approach to Presentation (With Emphasis on Palliation and symptomatic relief) (including pediatrics, geriatrics, and pregnancy considerations) (T) • Professor Lemmas (with special emphasis on ethical, social, economic perspectives)

46. Self study of diseases • Level 1 diseases (R) • Level 2 diseases (R)

47. Questions • Including problems/cases • Further Readings • Textbooks • Handbooks • Journals • E. references • Glossary • Simple clincoepidemiologic script

48. Continuum of Roles of Educators • Special Mentor Training Programs • Tutor Guide; Preceptor Guide and Mentor Guide Instructor Tutor Preceptor Mentor

49. the term preceptorship is used to describe the interaction that bridges classroom theory and professional practice in all health sciences.

50. Preceptor Guide