Stanford is committed to be a premier research-intensive medical school that improves health through leadership, collaborative discoveries, and innovation in patient care, education and research.

Stanford's medical curriculum

The Stanford MD curriculum integrates basic science and clinical experience with in-depth study and independent research throughout the years of medical school. Other major themes of the new curriculum include:

  • Integration

    • Streamlined content and optimized course sequence
    • Melding of basic science and clinical concepts throughout the curriculum

  • Individual Opportunities

    • Blocks of unscheduled time for individual or group study, elective coursework, and research
    • Option of a fifth or sixth year of study and opportunities for earning joint degrees

  • Scholarly Concentrations

    • Area of academic focus, or "major," designed to ground the student's education in an area of passionate interest
    • Enhance student satisfaction with the study of medicine and foster a lifelong commitment to investigation and cross-disciplinary thinking
  • Strengthening of doctor-patient communication and clinical skills instruction
    • Broad clinical science education in the first two years with early exposure to patient care and the practice of medicine
    • Early entry into clinical clerkships
    • Broader emphasis on doctor-patient communication, ethics, and the art of medicine
  • Advising and Mentoring
    • Mentors for each student help develop the student's personal and professional goals
    • An enhanced advising program to proactively assist students through the rigors of medical school and career planning

    Basic and clinical sciences and scholarly work are woven together throughout all years of medical education. The barriers among these disciplines are broken down by mixing elements of investigation, basic science, and clinical practice within individualized educational blocks called scholarly concentrations.

Differences Between the Old and New Curricula

The hallmark of the new curriculum is the Scholarly Concentration, a curriculum component similar to a major, that is designed to promote integration of biomedical science, clinical medicine, and applied investigation while validating each student’s reasons for choosing medical school (i.e., scientific discovery, patient advocacy, clinical leadership, community service). Although this central element is new, it is only one of many revised curricular elements. The new curriculum also incorporates new defined learning blocks, each of which is designed to integrate basic and sciences from the beginning through to the end of the medical school years, improves course sequencing, increases time spent in direct patient-oriented learning, and ensures in-depth coverage of important, cross-disciplinary clinical elements (cultural competence, ethics, substance abuse, geriatrics, death and dying, etc.).

i. Scholarly Concentrations (New Element)

The Scholarly Concentration is analogous to a major and provides medical students with independent, creative scholarly experiences in areas of personal interest. This required component of the curriculum develops critical thinking, skills in evaluation of new data, and hands-on experience with the methods by which new scholarly information is generated. We consider these to be essential elements for future leadership in medicine.

The Scholarly Concentration component of the new curriculum, while new, builds on Stanford’s previously successful Medical Scholar’s program—a system of sponsored, mentored research quarters for medical students. Approximately 90% of our students took advantage of the Medical Scholar’s program, and two-thirds stayed at Stanford at least one extra year in part to take advantage of these opportunities. The concentrations add more structure to the Medical Scholar’s program, require students to work closely with faculty advisors to develop their intellectual goals, and give the students greater grounding in a discipline before proceeding with hands-on investigation.

ii. Foundations of Medicine (Block 1)

This block provides building blocks for organ-based learning and integrates with the Practice of Medicine (POM) Block through weekly clinical correlates. Foundations of Medicine is broken into a number of smaller elements, some of which are completely new and others of which are greatly revised. Changes with each element are listed in parentheses below:

  • Molecular Foundations of Medicine (completely new; replaces some elements of Molecular Biology and Biochemistry);
  • Cells and Tissues (completely new; replaces building block elements of histology and cell biology);
  • Anatomy [markedly revised; now in 21 weeks rather than 12 weeks with fewer classroom hours, better integration with Cells and Tissues (first quarter), Neurobiology (second quarter) and the physical examination
  • components of POM, and given in concert with an elective Radiographic Anatomy course]
  • Biochemistry on-line (completely new; a tutored on-line course for students without prior biochemistry)
  • Developmental Biology (expanded)
  • Genetics (now offered on two levels for students with prior background)
  • Immunology (integration changes)
  • Neurobiology (fewer hours, integration with anatomy of head and neck)

iii. Human Health and Disease (Block 2)

This organ-based system block is completely new (we previously had discipline-based courses). The block is divided into 8 separate units in which students learn about normal organ systems and then the diseases that occur in these systems.

By intertwining the previous discipline-based system at Stanford of separate courses in physiology, histology, pharmacology, microbiology, and pathology, the health and human disease block gives students a more integrated view of human disease and therapy.

iv. Practice of Medicine (Block 3)

The Practice of Medicine course is new. This block—which comprises the elements of patient oriented learning—weaves together 8 threads over 6 quarters of medical school. This stretching of the threads across the two years provides the opportunity to reemphasize important principles on several different occasions, in different scenarios, and linked to different biomedical scientific principles.

POM replaces 12 previous courses, including: Physical Diagnosis A, B, and C, Physicians and Patients, Psychiatric Examination, Fundamentals of Clinical Investigation, and Health Policy.

v. Clinical Clerkships (Block 4) and Translating Discoveries (Block 5)

Prior to the initiation of our new curriculum, we had made several changes in the clinical clerkships, including requirement of a Critical Care rotation, expansion of the Ob/Gyn clerkship from 4 to 6 weeks, and addition of an 8-week ambulatory care clerkship. We anticipate further changes will occur as our curriculum rolls out over the next several years. In particular, we added elements of translating discoveries to the latter years of medical school, including “new advances” intersessions, medical-student-focused seminars within clerkships, returns to anatomy, metabolism, evidence-based medicine, etc.

Additional Features of Stanford's Curriculum Reform:

  • Early start date for fall quarter

Fall quarter instruction begins three weeks (16 teaching days) before the first week of classes in the university. In 2003, the start date is Tuesday, September 2 (following Labor Day) for the first year class only. In 2004, both first year and second year medical students will begin fall quarter instruction approximately three weeks prior to the first day of instruction for the main campus.

  • Anatomy course redesigned and sequenced over two quarters

The prior anatomy course taught its entire content (including anatomy of the head and neck) in the fall quarter of year 1. The human anatomy course has been redesigned and restructured to include two afternoons/week in the fall quarter and one afternoon/week in the winter quarter, with new instruction to be developed in the clinical years. Winter quarter instruction will focus on head and neck anatomy with some correlation to the neurobiology course.

  • Early introduction to biochemistry principles through an online course

The biochemistry courses have been restructured to develop basic concepts earlier and build upon the knowledge of entering students. A new online course in metabolic chemistry has been developed.

Beginning in 2003-04, entering students with sufficient background in the above topics are exempted from taking the online course. Students without this background have the option to complete the online course during the summer prior to matriculation or in the fall quarter following the Molecular Foundations of Medicine course (see below). A course on metabolism in the latter two years of the curriculum is being planned as part of the new Stanford curriculum.

  • New Molecular Foundations of Medicine course introduced in the Fall of 2003

A new course entitled Molecular Foundations of Medicine is taught in the first four weeks of fall quarter (Q1) to emphasize principles of biochemistry and molecular biology and to lay the groundwork for courses in developmental biology and genetics which follow.

  • Histology restructured and integrated across Q1-Q5

Basic structure of cells and tissues introduced in the first 4 weeks of the fall quarter (Q1), with key topics to be integrated into neuroanatomy and immunology in the winter quarter (Q2) and into the organ system blocks (Q3-5).

  • Winter quarter (Q2) reorganized with two major threads

Q2 serves as the transition to the integrated organ system block curriculum, organized along two major threads: nervous system, brain and behavior; and immune system. Each of these threads will include related histology and pathology, as well as other possible relationships currently under development.

  • New teaching methods being employed

We are using several new methods to teach our material. POM, for example, includes many small group sessions, team learning, more standardized patients, and enhanced learning simulations. Many of these methods will be enhanced with the construction of the SMILE building.

  • Integrated organ system curriculum to be developed in Q3-Q5

The old curriculum previously taught courses by individual discipline. Starting in Q3, the new curriculum will use an organ-system approach. The disciplines of Histology, Physiology, Infectious Diseases (Microbiology), Pharmacology, and Pathology are integrated by organ system across Q3-5. The organ system blocks are Cardiovascular, Pulmonary, Renal/Urinary tract, Gastrointestinal, Endocrine, Reproductive/Women's Health, Brain, Hematology, and Systemic Infections.

  • Q6 redesigned as intensive 4-week introduction to clerkships

Q6 has been redesigned as an intensive 4-week practical training experience in physical diagnosis and patient management to prepare students for clinical clerkships. Students may be able to begin clerkships as early as late April (Period 11 of the existing clerkship calendar).

  • Extensive use of clinical correlates in Q1-Q5

The new curriculum includes more time for discussion of complex cases with the goal of integrating and contextualizing basic science knowledge. Cases will be designed through collaboration of course/organ block instructors with members of the clinical sciences working group.

Clinical correlates have been developed to provide deliberate, explicit linkages between basic science facts and concepts and their practical application to the clinical care of individual patients and groups of patients.