The BUSM Curriculum is guided by the principle of integration of foundational science, clinical medicine, and health equity.
PISCEs (Principles Integrating Science, Clinical Medicine, and Equity)
PISCEs is a longitudinal integrated course during the preclerkship phase of the curriculum that prepares students with the medical knowledge needed to care for patients. It integrates foundational science, pathophysiology, and disease management. The course is broken into three foundational modules followed by eight systems-based (e.g., cardiovascular, neuro/psych) modules. Woven into each of these modules are longitudinal threads that include oncology, infectious disease, anatomy, microbiology, pharmacology, and pathology, as well as the school’s health equity curricular themes. The last 10 weeks of the preclerkship curriculum, called the Integration Weeks, focus on integrated cases based on the BUSM Core patient presentations that deliberately revisit prior foundational, clinical, and social science content in patient cases to help students consolidate and integrate the material. The cases begin with a patient presenting to a clinic or ER and then evolve over the course of the week. The case patient’s signs, symptoms, labs, and imaging enable students to apply what they have learned in a clinical context to prepare them for how they will subsequently see clinical information and apply medical knowledge during their clinical clerkships. The cases will be based on real patient cases that represent the unique populations at our primary teaching hospital (Boston Medical Center), and will highlight knowledge and skills needed to address our curricular key themes and populations. Finally, students collaborate in small groups to solve clinical problems, simulating the clinical team in medical practice and review, as well as prepare for the USMLE Step 1 exam. The PISCEs curriculum uses multiple instructional design strategies to support active learning, peer learning, and team development.
Health Equity Key Themes
A primary outcome for the curriculum at BUSM is to train students as leaders in addressing health equity. It is a mission of both our medical school and medical center to serve marginalized and vulnerable patient populations. We integrate health equity content in multiple ways. The first is during the first week of each preclerkship academic year (two weeks total) called Health Equity weeks, which focus on knowledge and skills related to health equity. In addition, health equity objectives have been added into our PISCEs and Doctoring courses and are woven and integrated as described above. The LEADS curricula also incorporate advocacy skills, so students are prepared to address health equity.
Our Health Equity content includes poverty, social determinants of health, health equity, racism in medicine, behavioral medicine, and population health. The patient populations highlighted in diagnostic cases will include refugees and immigrants, gender and sexually diverse patients (LGBTQIA+), and Black, indigenous, and other people of color (BIPOC). Diagnostic cases will also include patients with substance use disorder.
LEADS (Learn, Experience, Advocate, Discover, and Serve) weeks
Students explore an area of professional focus through the LEADS (Learn, Experience, Advocate, Discover, and Serve) curriculum. There are seven LEADS weeks in total, spread throughout the preclerkship curriculum. These weeks allow students to have time within the formal curriculum to immerse themselves in activities that allow for personal and professional development as well as service learning within the required curriculum.
During the first LEADS week in September of their first year, students are introduced to the LEADS areas of foci which will include: Biomedical Research, Gender and Sexual Diversity, Global and Refugee Health, Community Health, Homeless Health, Interprofessional Teamwork, Well-being and Integrated Health, Social Determinants of Health, Racism in Medicine, and Addiction Medicine by the faculty lead in each area. Students will study the impact these topics have on patient care and the changes in health that have resulted from advocacy and relevant research. By January of the first year, students determine an area of focus and then enter these mentored LEADS foci. In the next six LEADS curricular weeks, students participate in both a structured didactic content learning the evidence, science, methods, and innovations. Students will also participate in experiential learning in places such as community organizations, clinics, health centers, or labs in their area of focus. A core curriculum for all students will also be woven throughout these six LEADS weeks, regardless of their area of focus. This core curriculum includes research, medical education and quality improvement methods, leadership and change management, and advocacy skills. In the fourth LEADS week, which precedes the summer break between first and second year, we will prepare students for opportunities to immerse themselves in their areas of focus during their summer break if they so choose. Students can choose to continue their LEADS projects during a four-week elective in third year and multiple electives in fourth year to complete a capstone with a scholarly product.
LEADS weeks also include PISCEs Integrated Cases. During the seven LEADS weeks, in addition to the LEADS focused work, students are also presented with several patient cases that emphasize foundational science concepts presented in prior weeks to help students reintegrate content from multiple systems previously presented. The cases: 1) present student with signs and symptoms that demonstrate how physiologic and anatomic processes lead to patient presentation, 2) present diseases that are multisystem and highlight multiple processes at once, 3) integrate clinical schema to emphasize the approach to developing a differential diagnosis based on patient presentation, and 4) introduce students to the BUSM Core, which are the 44 chief complaints and 15 health prevention/chronic diseases/other conditions we expect students to be able to clinically reason through before they graduate.
The curriculum described below applies to the four-year program.
The first-year curriculum includes:
- Principles Integration Science, Clinical Medicine, and Equity (PISCEs)
- Foundations 1—Molecules and Genes
- Foundations 2—The Human Body: Tissues to Structure
- Foundations 3—Disease, Defense and Drugs
- Genomic Medicine
- Reproduction and Endocrinology
- Learn, Experience, Advocate, Discover, and Serve (LEADS)
- Principles Integration Science, Clinical Medicine, and Equity (PISCEs)
- Integrated Case-Based Weeks
- Consolidation and Preparation for Clerkships (CPC) Course
This is the core clerkship year. Students complete their initial clinical rotations, participating in active ambulatory and inpatient practices on major teaching services:
- Medicine—8 Weeks
- Surgery—8 Weeks
- Family Medicine—6 Weeks
- Obstetrics/Gynecology—6 Weeks
- Pediatrics—6 Weeks
- Psychiatry—6 Weeks
- Neurology—4 Weeks
- Third-Year Elective (Radiology, Emergency Medicine)—4 Weeks
- The Enrichment office also offers a limited number of research electives that are available to students during the third-year elective block.
Students work with house officers and attending physicians in the care of a broad range of patients and clinical conditions through a series of required and elective clinical blocks.
In the fourth year, students complete advanced clinical rotations in geriatrics and home care, a sub-internship in the specialty of their choice, a back to the classroom course where foundational science concepts are revisited through a clinical lens, a boot camp for internship, and a minimum of 24 weeks of elective time with opportunities to pursue clinical and basic science research, teaching, as well as independent study programs.
Study Abroad and Research
Many students choose to spend some of this time at other institutions, either in the US or abroad in BUSM’s very active International Health program.
BUSM is a major research institution and students may return to research interests they have pursued in the past or try out research projects for the first time. Stipends are available for those rising second-year students who wish to undertake a summer research fellowship.