Longitudinal Integrated Curriculum at Asheville

The third year academic calendar at Asheville is comprised of two types of clinical experiences - inpatient and longitudinal outpatient. The inpatient experience consists of a ten-week block (including  the six-week surgery clerkship, one week each of inpatient medicine, pediatrics, neurology, and OB L&D) and later in the year two additional weeks of medicine and OB L&D and one pediatric pulse weekend. The surgery clerkship consists of two weeks of general surgery in a rural setting, and one week each of general surgery, trauma, GYN oncology, and a surgical subspecialty in Asheville.

Students participate in the longitudinal portion for the remainder of the year. Each student is assigned to a community practice for the core specialties (internal medicine, OB, pediatrics, family medicine, neurology, and psychiatry), where they see a panel of their “own” continuity patients or work-ins.  Students are supervised by their attending physician, who reviews each case and care plan with them. If their patients are admitted or referred to another provider, the student will see their patients in the hospital or accompany them to that visit as well.  See sample week below.

Weekly student schedule

 Weekly Schedule

Additional experiences are gained through both inpatient and outpatient cardiology clinic.  The emergency medicine component consists of three shifts per month and affords students many opportunities for procedures. During the nine-month continuity schedule, students will have another one-week inpatient experience in internal medicine, OB L&D, and one weekend on pediatrics.

  • Unique features of the program also include:
    • Majority of teaching done by faculty
    • A purposeful ethics and humanism curriculum interwoven with clinical practice with the goal of producing physicians who are empathetic and caring
    • Bimonthly Art of Medicine meetings where faculty and students discuss other aspects of being an effective physician, dealing with ethical issues, and finding personal balance to avoid burnout
    • Monthly Master Clinician sessions where students lead an interesting case presentation followed by discussions from consulting specialists on the case
    • Participation in ABCCM free clinic for medically underserved, working with faculty and/ or residents and in collaboration with pharmacy students, nursing students, and medical ethicist
    • Added experience in emergency medicine, cardiology, and radiology.

Other Curriculum Components:

Orientation: Asheville students will complete the transition course in Asheville.  This will include an orientation to Mission Hospital and its ancillary services, training in all pertinent electronic health records, surgery skills lab, and orientation to surgical scrub/OR procedures.  Other student services include access to MAHEC library, UNC-A student health and gym services, and getting to know the community itself.

Didactics: Students meet weekly as a group for a variety of didactic sessions consisting of case studies, problem-based learning sessions, core lectures, direct observation with patients, and skills labs. 

Testing and evaluations:  All students will take the same standardized testing as their cohorts in Chapel Hill, including OSCE exams and NBME shelf examinations. These will be administered at or near the end of the third year.  The surgery shelf exam will be administered at the end of the inpatient weeks toward the end of November.   Students will be evaluated regularly by their faculty.

Fourth Year Curriculum: The fourth year curriculum will revert to block months. Because of the relatively small amount of hospital experience, students are required to take a second acting internship in addition to the four required 4th year selectives.   All the major specialties will be offered to students.  At least one month in the fourth year will be required in rural WNC.  A one month rotation in global health through Shoulder to Shoulder will be available to all students and can fulfill the Science of Medicine requirement.  Students will also be able to do other away rotations if desired.

Student Services: Students will need to find housing in the community but there is ample affordable housing.  We have a reciprocal agreement with UNCA for student health services and access to the gym and library.

Outcomes:

  • Asheville Campus students have scored above the national average and at least equal to their peers at UNC in both the SHELF exams administered in core clerkships and STEP 2 clinical knowledge and skills exams administered during the 4th year (2009 – 2013 mean score: 251).
  • Asheville students are able to obtain their first choice of residency programs.
  • We already have two students completing their residency in WNC, one in our geriatric fellowship program, and more have expressed they are planning to return after training.