Medical diagnosis and treatment relies on synthesis of knowledge from diverse scientific fields. Despite this, medical science has traditionally been taught as discrete disciplines such as biochemistry, pharmacology, genetics, and cell and molecular biology. The objective of this course is to integrate these fields into a cohesive approach to learning the cellular and sub-cellular structures and processes which impact health and disease.
The goal of the course is to teach students facts and concepts of medicine that will form a basis for continuing growth throughout one’s professional life, with an emphasis on the use of electronic resources to access and interpret the latest scientific advances impacting medical practice.
The course will include lectures which address major concepts. The small group active learning sessions will often focus directly on the application of scientific concepts to clinical scenarios. Knowledge and skills taught in this course are selected to provide a foundation and will be revisited during subsequent blocks of the first year and beyond. Each block will build on the previous just as medical knowledge builds on itself over a lifetime of practice and learning.
The course is organized into clinical focus areas. Each clinical focus area will start with a clinical case presentation. The subsequent modules (lectures, small group activities, expert panel discussions and patient interviews) will contain information relevant to the clinical case presentation. That will seldom be the main focus of the lecture modules, but the instructors will be aware of the clinical case focus and will point out correlations as they arise. You will generally be following two or three clinical focus areas simultaneously (not unlike the actual practice of medicine). To help you better understand the organization of the course you will find a document called Content Groupings on the Resource page of the course web site that lists all of the clinical focus area along with the associated lectures and small group activities.
Upon completion of this course medical students should be able to:
- Understand the clinical impact of the basic sciences and their importance to your development as a physician
- Gain an appreciation of the integrated aspects of medicine that span molecules to society
- Understand the role of gene replication, repair, and expression in health and disease
- Appreciate the use of molecular biology techniques in clinical diagnostics and in clinical research
- Know the value of protein structural and functional information for understanding protein folding diseases, how many mutations lead to disease and for drug development
- Understand the structure and function of cell organelles and how these can relate to human disease.
- Understand the role of metabolism in normal physiological responses and the metabolic changes associated with disease processes
- Understand the role of hormones and cellular signaling processes in health and disease.
- Appreciate how fundamental cellular processes, such as vesicle trafficking, endocytosis, secretion, cell migration and adhesion, function in health and disease.
- Recognize patterns of human inheritance in health and disease and understand the utility of such recognition for clinical medicine
- Demonstrate the ability to analyze search questions, select relevant resources, build concise search strategies using clinical information resources such as PubMed, drug databases, and Up-to-Date.
- Understand the basic principles of Evidence Based Medicine and how to search the literature to support its practice.
- Appreciate that when a drug acts on the body, the concept of a drug receptor is key, i.e., that the drug-receptor interaction is responsible for drug selectivity and the quantitative relationship between dose and effect.
- Appreciate that when a drug enters the body, that the lifetime of the drug within the body is determined by the processes by which the body acts on the drug, i.e., by the roles the body plays in the processes of absorption, distribution, metabolism, and elimination.
- Recognize that membranes throughout the body act as barriers to drug movement, and that the physicochemical properties of both the membranes and the molecules are pivotal to the absorption, transmembrane movement, binding to macromolecules, distribution to tissues, and drug concentration at receptors in target tissues.
- Appreciate that metabolic reactions (biotransformations) of drugs play important roles in drug activation and deactivation, the latter process being required for termination of a persistent drug effect by conversion of the parent to an inactive, more polar metabolite that is more readily excreted by the kidney.
- Understand that genetics and age-related physiological differences are important factors in drug disposition and toxicity.