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Medical Student Education Moves Forward - Annual Report 2018

Medical Student Education Moves Forward

One hundred years ago, the Wisconsin Legislature granted the University of Wisconsin Graduate School’s two-year College of Medicine permission to begin planning a four-year course in medicine.

In the 92 years since the first clinical students arrived on campus, the Medical School has stood at the vanguard of medical education innovation and clinical discovery. From an alphabet soup of vitamin discoveries to Medical School Dean William Middleton’s novel “preceptorships” program wherein senior medical students are assigned to work with community practitioners throughout Wisconsin, the school has a long tradition as pioneers in medical education. However, the core structure of medical student education – four years of study – two of basic science followed by two of clinical experiences – had been the norm for almost a century.

In 2016, instead of a four year study model the UW School of Medicine and Public Health (SMPH) shifted this paradigm with the introduction of the Forward Curriculum. Forward Curriculum features three phases, each with unique blocks that fully integrate basic, public health and clinical sciences.

“We medical student educators recognized — and have been discussing for years, that today’s healthcare requires a different type of physician,” states Daniel M. Knoch, MD, associate professor and director of medical student education, “In many ways the students are actually driving the new curriculum. Armed with a library of medical information in their pockets and a thirst for relevance, they are resetting the baseline of what and how they learn.”

The new ForWard curriculum focuses on team-based learning in small groups, with hands-on applications of new knowledge in clinical and community settings, in order to motivate this new type of learner.

“When you can relate what you learn in the didactic sessions to something that happens in the clinic or operating room within a few days, the integrated knowledge stays with you."

Timothy Choi

Given the opportunity, Dr. Knoch was highly motivated to engage in a new curriculum design for the ophthalmology rotation based on several new challenges. In 2013, SMPH cancelled the rotation he had directed since he joined the department in 2007 – a required week of a four-week neuroscience clerkship. He made the strong case that every practicing physician needs to know basic ophthalmic clinical care. Dr. Knoch notes, “I frequently get notes from former students who are now emergency room physicians or in primary care practices, letting me know that a piece of something they learned during their rotation with us years ago was key in a diagnosis or trauma situation.“

Dr. Knoch frequently met with the medical curriculum design team, and, bolstered by the Association of University Professors of Ophthalmology (AUPO) Medical School Education (MSE) Council and American Academy of Ophthalmology’s (AAO) white paper outlining the curriculum that every medical student should master prior to graduation, Ophthalmology instruction found a home in the Phase 2 Block of the ForWard curriculum in Surgical and Procedural Care.

The ophthalmology education team is currently designing a four-week rotation in the Phase 3 Block, Career Focused Basic Science that should be active in 2019.

Timothy Choi, a medical student who participated in the first Phase 2 ophthalmology selective, is enthusiastic about the new curriculum and his enhanced learning experience.

Dr. Knoch continues to improve the ForWard curriculum and medical student education as a whole. His passion for teaching medical students resulted in Dr. Knoch’s selection as a co-director of the Surgical and Procedural Care Curriculum in partnership with Ann P. O’Rourke, MD, MPH, FACS, associate professor in acute care surgery, burn and surgical critical care. Dr. Knoch believes he and Dr. O’Rourke make a good team and have a mutual goal to learn from this first year of the Phase 2 curriculum, and adjust and make enhancements as needed.

Nationally, Dr. Knoch drives his educational approach and passion forward through his posts as a member of the AUPO MSE Curriculum Committee, Program Committee and Council, as well as chairing the MSE AAO Website Committee. For his efforts at the national and local level on behalf of medical student education, he received AUPO’s 2018 Excellence in Medical Student Education Award.

SMPH is among the few innovators currently involved in the implementation of this integrated, hands-on curriculum.“It is an extremely exciting time to be an ophthalmology medical student educator, and I look forward to the challenges ahead,” says Knoch.