Phase I – Foundations
Forty years ago, a medical student’s main job was to memorize. In this century factual knowledge is necessary but not sufficient for competent medical practice. A solid curriculum is one that provides students the opportunity and impetus to learn how to think, how to act, and how to learn. A central component of the first curricular phase is problem-based learning (PBL), where students undertake intensive exploration of patient cases that simulate the real-life processes of being a practicing physician. PBL is supplemented by didactic basic science instruction, the majority of which is taught by physicians who emphasize clinically relevant information.
Students also take on the equally important tasks of developing new roots in the community through service learning, learning the basic practical skills of being a doctor, and honing analytic skills. A scholarly project is initiated during this phase, which provides both firsthand experience with the scientific method and a relationship with a faculty mentor.
Phase II – The Longitudinal Interleaved Clerkship (LInC)
Traditional clerkship curricula separate the major specialties into discrete blocks that students experience in a linear fashion, with a large summative written exam at the end of each one. While immersive, this approach suffers from a large “forgetting curve” that occurs when students move from one block to the next.
The Kirk Kerkorian School of Medicine at UNLV’s curriculum is different. Students complete the six core clerkships (and selectives) longitudinally across the entire year, which is broken into 22 sequential units. Each unit consists of 2-weeks in a given specialty, and the units are interleaved to balance primary learning with long-term retention. The summative specialty exams are administered twice during the year, once at the midpoint and once at the end. This structure is designed to mitigate the “forgetting curve.” At the end of the year students have command of an enormous fund of knowledge, which positions them for exceptional performance on USMLE Step 2 CK.
Phase III – Career Exploration and Scholarship
When graduation appears on the horizon, medical students become focused on three essential goals: (1) settling on a specialty of choice, (2) assembling a competitive application for the residency match, and (3) preparing to take on a new level of responsibility as newly minted physicians.
The final phase of the curriculum balances core educational needs with the flexibility that students need at this stage. Three rotations are required: a sub-internship or intensive care month, Nevada Community Medicine, and Capstone. The remainder of the year consists of electives, with ample unscheduled time to permit residency interviews, research, additional educational experiences, and perhaps a well-earned vacation.