The School of Medicine of Case Western Reserve University has long been recognized as a national leader in curriculum innovation and development. The educational philosophy and guiding principles include organ systems teaching by interdisciplinary teams of faculty, introduction to patients in the first year, pass/fail evaluation, student anonymity in grading examinations, elimination of class ranking, flexibly scheduled time, and student responsibility for self-education. These factors provide a stimulating and congenial learning environment, which is combined with large and diversified research programs and excellent facilities for patient care and clinical education.
The goal of the educational program is to develop responsible, competent, and humane physicians with the capacity and motivation for continued learning, and with the flexibility to recognize, adapt to, and influence future changes in medicine, healthcare delivery, and society.
The four years in medical school can be considered as the general professional education of maturing students who, after graduation from medical school, will obtain hospital and/or laboratory training as specific preparation for their chosen careers in medical practice or scientific investigation. Therefore, one objective of the medical school phase of a physician's education is to provide the basic knowledge and skills which are common to all physicians. Another objective is to enable students to develop habits of self-education, methods for solving unfamiliar problems, and enthusiasm for the continuing study of medical sciences. A third objective is to assist students to develop appropriate attitudes with respect to their responsibilities to their patients and to become skillful in meeting these responsibilities.
The governance of the educational program resides in the Faculty of Medicine. Each class of students selects representatives who become voting members of the Faculty of Medicine. All teaching activities are coordinated through faculty bodies and program coordinators who report to the Committee on Medical Education. The majority of the members of the Committee on Medical Education are elected by the Faculty; student representatives also serve on this committee and its various subcommittees.
The greatest emphasis is placed on the creation of a graduate school intellectual environment in which students have the opportunity to demonstrate initiative and to assume a large measure of responsibility for their own education. Much value is attached to personal and informal communication between students and instructors, which is facilitated by small group teaching. During the first two years lectures are used for approximately half of the teaching activities; small group conferences, multidisciplinary laboratories carried out in integrated teaching areas, clinical correlations, and symposia are other educational approaches.
The medical school program is distinguished by traditions of openness and collegiality as well as by its process of continuing self-renewal. Our revitalized curriculum, implemented in August 1985, has preserved and built upon the strengths of the renowned Western Reserve curriculum.
The four-year curriculum consists of three broad-based components: the Core Academic Program, the Flexible Program, and the Patient-based Program. The goals of these three programs are:
Students must demonstrate satisfactory performance in all three components of the program in order to be eligible for graduation. Formal requirements, while kept to a minimum, are to be completed and the overriding concern is a balanced and coherent educational program
The fundamental goal of the CAP is to provide a strong conceptual and factual foundation in the biomedical and behavioral sciences as a basis for understanding mechanisms of illness and the diagnosis and treatment of important diseases. Operational goals are to focus teaching on core content, to provide opportunities for review, reinforcement and enrichment of that core, and to promote active learning by the students.
The CAP is a two-year program. It consists of sections representing major content areas. Recurrent subject material, themes, or disciplines, such as anatomy, behavioral sciences, biochemistry, ethics, histology, molecular biology, pathology, pharmacology and physiology, cross-cut these sections and promote integration among them. The purpose of organizing the CAP into a few large content sections, rather than into many small sections, is employed to encourage comprehensive planning by key representative faculty and thus improve content integration within and among sections. Sections are further divided into subject committees. The overall framework of the program is a three-tier structure of Foundation, Development, and Case-oriented Problem Solving.
The Foundation introduces the language and conceptual basis for molecular, cellular, organ system, and whole body biology, and for behavioral development. The social and economic context of medicine is introduced. The Cellular and Developmental Biology Section and Homeostasis I (Cardiovascular, Pulmonary and Renal committees) form the content and focus on normal biology.
The Development introduces principles of disease mechanisms and pathophysiology of the organ systems with consideration of ethical, social, and economic issues. Development sections include Biological Basis of Disease I and II, Metabolism-Gastrointestinal Fundamentals of Therapeutic Agents, Endocrine-Reproductive Biology, Musculoskeletal and Integument, Nervous System-Mind, and Homeostasis II (Cardiovascular, Pulmonary and Renal committees).
During Years 1 and 2, the Core Physician Development Program introduces students to the tools of clinical decision making, including instruction in the critical reading and application of the medical literature and the application of case-oriented problem-solving approaches emphasized in the Patient-based Program. Instruction is provided through a combination of lectures and small groups, with the latter using a student-directed, problem-based learning model. Self-directed learning skills, peer education, both self- and peer-assessment and the promotion of student-student and student-faculty collegiality are emphasized throughout the course.
The first five days of medical school are devoted exclusively to the CPDP. Students in groups of 12 develop a position paper on a controversial topic in screening or preventive services. This activity provides students with an overview of the goals of the course.
During the first year, students focus on population-based issues, including the study of epidemiology and biostatistics, developing skills in reading the medical literature, identifying and studying the impact of economic, public health and ethical issues, and applying basic science information presented concurrently in the Core Academic Program.
During the second year, the course focuses on individual patient issues. The first half of the year is devoted to learning the basic skills of physical diagnosis including histories, physical examinations and development of problem lists. During the second half of the year, students are presented with increasingly complex cases which focus on clinical problem solving and management issues, including efficient test selection, economics and ethical issues.
Throughout both years, students develop skills in self-directed learning, peer education, self- and peer assessment, and group process skills. Each class is divided into six groups of 24 students, named longitudinal learning groups (LLG), and all of the students' small group activities occur within that group. One LLG from Year I and one LLG from Year 2 are linked in a "college," which serves as the basis for additional educational activities.
The Flexible Program offers students the opportunity for in-depth exploration within areas of concentration and across traditional disciplinary boundaries. The purpose of this program is to provide a variety of educational opportunities which honor the varied skills, backgrounds, and goals of a diverse student body. Students are encouraged to participate in both scholarly and applied experiences and to achieve a distinctive competence in a given area of concentration. The requirements of this program are fulfilled in course work, research, and independent study during the afternoons throughout the first two years, through a series of month-long, or longer, options in the fourth year, and in other unscheduled time as indicated by the student's interest and commitments. Evaluation is based upon progress in these activities.
The Flexible Program includes two pathways: Areas of Concentration and Diversified Medical Sciences. An Area of Concentration is a pathway offering courses designed by faculty groups with natural affinities and focused on appropriate subjects. Students who do not choose an Area of Concentration participate in the Diversified Medical Sciences pathway. This path is intended to appeal to those students whose interests have not been refined to the point where they feel comfortable in committing themselves to the in-depth pursuit of a single area. The opportunity also exists for students to develop individual programs centered around their particular interests.
During the first two years, six mornings per week are devoted to the Core Academic Program. Part of the afternoon time is devoted to the Flexible Program, and the remaining afternoon hours are unscheduled time. Students are expected to advance their education in their own way during this time, but they are not accountable to the faculty for the use they make of the time.
The Patient-based Program is a four-year continuum. It begins with early involvement with patients in the preclerkship activities of the first two years and builds toward intensive clinical experience in the clerkships of the final two years. The emphasis in the Clinical Science Program is concurrent progress in professional maturation in acquiring clinical skills, knowledge, and attitudes. An essential foundation for supervised responsibility for patient care in graduate training, it reinforces and builds on the information base introduced in the Core Academic Program and is complemented by the Flexible Program. The Core Physician Development Program component of the Core Academic Program provides a unique link among these activities.
The coordinator of the Patient-based Program, the chief faculty officer, guides the implementation of faculty policy, working closely with the vice dean, the associate dean for student affairs, the coordinator of the Flexible Program, the director of the Clinical Science Program, and the director of the Physical Diagnosis Program, with the support of the Office of Medical Education.
The three components of the Clinical Science Program are: the Lecture Series/Preceptor Groups, the Family Care Program, and the Interviewing Program. Physical Diagnosis completes the pre-clerkship portion of the Patient-based Program. Year One features all three components of the Clinical Science Program; Year Two focuses on Physical Diagnosis, but activities of the other three components continue.
The process of professional maturation requires developing skills, attitudes, and behavior consistent with being a competent, humane and open-minded physician. This process continues throughout the four-year continuum, but the primary focus of the Clinical Science Program and Physical Diagnosis in the first two years is on the various perspectives involved in professionalization.
Tuesday morning lectures or panels are presented from 9:15 - 10:15 a.m., September through March, of the first year. Recent topics have included basic interviewing, data gathering and dissemination, the doctor-patient relationship, medical student and physician stress and coping, life cycle events, reconciliation of differences, death and dying, and chemical dependency. Each lecture is followed by preceptor-led discussion groups consisting of 10-12 students and two faculty co-preceptors. These sessions give students the opportunity to discuss the presentations and the progress of their patients and families, to present assigned patients, and to practice interviewing techniques. Clinical Correlation Conferences are planned during the year, which provide experiences for preceptor groups in various medical areas such as chemical dependency, birth defects, aging, coronary care and renal dialysis. These conferences focus on the effects of disease on individuals and families, and provide opportunities to practice interviewing and the collection of medical history data and to become familiar with the roles of members of the healthcare team. The preceptor group discussions resume in the last quarter of the second year. Ethics and clinical practice, perspectives on malpractice, social responsibility of physicians, healthcare delivery, and preparation for the core clerkships are among the topics presented.
Early in the first year of medical school, each student is assigned to a pregnant woman. The alternative of a geriatric patient is available for a small number of students. The student has both an opportunity and a responsibility. The opportunity to observe and support the patient through her prepartum course, delivery, and the later care of her child is accompanied by a responsibility to be accessible to the patient. The student is the principal liaison to the physician's caring for the patient and as such is a part of the patient's healthcare team. The process of physical examination begins in this setting. The student attends each clinic visit with the pregnant mother, is with her throughout labor, and accompanies her to the delivery room. The student attends the well-child care visits of the baby through the second year of medical school. Workshops conducted by the medical directors of the Family Clinics during the first four weeks of medical school help prepare students for the family care experience. Workshop topics include the physical examination of the pregnant woman, the physiology and psychology of pregnancy, labor and delivery, and interviewing.
This program is designed to encourage and help students communicate effectively with patients. Students have three opportunities during the first year to conduct a tape recorded interview of a subject while a preceptor and a fellow student in another room observe and then review the video. At the end of the session a roundtable feedback discussion involving all participants (including the patient) helps the student analyze his/her strengths and weaknesses. Each successive interview emphasizes different skills. The interviewing program continues into the second year.
In a series of eight, four-hour afternoon and evening classes between September and mid-January, second-year students learn the basics of interviewing and physical exam methodology. These classes consist of students practicing regional physical exam techniques with self-selected student partners as well as interviews and examinations of hospitalized patients. Each regional exam being taught is coordinated with an appropriate small group case-based learning session from the Core Physician Development Program (CPDP) that same week. Whenever possible, these regions/organ systems also correspond to basic science material being taught in the Core Academic Program (CAP). Friday afternoon lectures and sub-specialty-oriented physical diagnosis laboratories supplement the material presented in small group format.
Following completion of this introductory class, students are assigned to individual internal medicine or family medicine faculty mentors from various affiliated hospitals to schedule a series of at least six complete "histories and physicals" using either hospital inpatients or patients in the ambulatory setting. The second-year physical diagnosis experience ends with a three-week pediatric physical diagnosis course emphasizing the unique aspects of the examination of the newborn, toddler and adolescent.
Required core clerkships in medicine, surgery, pediatrics, obstetrics/gynecology, and psychiatry are offered at 21 clinical services in affiliated hospitals in the Cleveland area. Each student is required to take a three-month clerkship in medicine plus four two-month clerkships in the other major disciplines. A one-month core clerkship in family medicine must be completed between July of the third year and September of the fourth year of the curriculum. This is a total of twelve months of required core clerkships which must be completed by the early part of the fourth year. In addition, each student must complete a one-month core clerkship in neurosciences by the end of the fourth year. The initial core clerkship for each student is on medicine, surgery, pediatrics, or family medicine.
A core clerkship in pediatrics, obstetrics/gynecology, or psychiatry at Henry Ford Hospital in Detroit can be arranged for students desiring a clerkship there. Permission to do this should be arranged through the coordinator of the Patient-based Program immediately after the schedules for the third year have been arranged.
A one-month required primary care preceptorship in an outpatient setting is offered at multiple sites in the Cleveland area. Each clerkship is directed by a Case Western Reserve University faculty member in family medicine, medicine, or pediatrics who is responsible for certifying to the School of Medicine that each student has successfully achieved the educational goals stated for the preceptorship. The preceptorship must be completed by the end of the fourth year.
The core medicine clerkship builds on the knowledge of human biology and pathophysiology developed in the Core Academic Program and the basic interviewing and physical diagnosis skills acquired by students in the clinical science program and physical diagnosis. The goals of the core medicine clerkship are that the student:
1. increase skills in obtaining reliable and accurate knowledge regarding the anatomy, biochemistry, and pathophysiology of a patient's illness from the interview, physical examination, laboratory and imaging data, and the medical record;
2. synthesize from this clinical data and his/her scientific, psychosocial, and medical knowledge plausible pathophysiologic hypotheses explaining that problem which is to be evaluated through an ordered, efficient, and cost-effective diagnostic algorithm;
3. develop a management plan which incorporates medical therapeutics, attention to psychosocial and economic dimensions, and, wherever appropriate, preventive management of disease;
4. develop appropriate professionalism; and
5. develop an adequate fund of knowledge of internal medicine.
This clerkship consists of inpatient and ambulatory experiences. During these rotations, students participate as active members of the healthcare team. They are expected to assemble and organize data and present patients to the attending physician. Students are also responsible for preparing written and oral reports, writing orders, providing patient education and counseling, and performing procedures for their patients under supervision of house staff and attending physicians. Students are expected to work up an average of two to three patients per week during the clerkship and one or two patients per ambulatory session. Students are on call every fourth night during ward rotations, and are assigned to general medicine and medicine subspecialty experiences during the ambulatory rotation. Didactic material is presented throughout this clerkship in regularly scheduled meetings with service chiefs, clerkship directors, and attending physicians.
Student progress is assessed by attendings and residents throughout the clerkship, and students are given increased responsibility for patient management consistent with their proven ability. Students complete a patient encounter log for each patient they work up during the inpatient and ambulatory experiences. These logs must be turned in for the student to receive a grade in the clerkship. The cornerstone of evaluation is the clinical evaluation form completed by each of the student's attending physicians and residents. Student clinical skills are assessed during the two-and-one-half hour objective structured clinical examination (OSCE) conducted two weeks before the clerkship ends. During the last week of the clerkship, student cognitive knowledge is assessed using the two-hour NBME Medicine Subject Examination. Final grades are based on the total number of points accrued from the clinical evaluation forms, the OSCE, and the NBME.
This one-month rotation will be in either the third or fourth medical school year. Completion of a core clerkship in medicine, surgery or pediatrics is preferred prior to this clerkship.
Students will learn to perform and understand the neurologic examination, use a clinical database to localize lesions within the nervous system, and characterize the disease process in terms of pathogenetic mechanisms. They will also actively diagnose and manage inpatient and outpatient neurological and neurosurgical diseases under the supervision of neurology and neurosurgery house officers and attendings. Students will participate in outpatient clinics and as members of the inpatient ward team on the neurology or neurosurgery service. Those choosing the neurosurgical clerkship will become familiar with the techniques involved in common surgical procedures as well as neurologic intensive care.
Students are expected to take night call every fourth night. They will be responsible to "work up" eight patients over four weeks and will be responsible, along with the house staff, for the care of these patients. Each Thursday, there will be approximately six hours of didactic sessions taught by the attending staff of neurology and neurosurgery. Final grades are based on assessments by attendings and house staff and a written exam on the final day of the clerkship.
The goal of the clerkship is to teach the basic principles of obstetrics and gynecology and to apply these principles involved in health care for women. The emphasis is on the pathophysiology of the reproductive tract. Students are expected to gain an understanding of normal reproductive physiology and the medical and surgical complications of pregnancy. Students also gain experience in the diagnosis and treatment of common gynecological problems, insight into the meaning of pelvic disease, and exposure to a major patient care field as a possible career choice.
Students participate in ambulatory and in-patient services as well as in operating and delivery room activities. Roughly half of the time on the clerkship is spent in obstetrics and the other half in gynecology. Students are expected to learn to take a full medical, gynecologic, obstetric, and sexual history and to perform the physical examination of the reproductive system. The number of patients and the number of nights on call vary at each clerkship site. The students perform normal deliveries and assist with complicated ones. They also assist in performing obstetrical and gynecological surgical procedures, such as caesarean section and hysterectomy. Special opportunities for learning on the clerkship include exposure to subspecialty clinics in high risk obstetrics, endocrinology, oncology, and infertility. Didactic material is presented during teaching rounds, meetings with the Service and/or Clerkship Director, conferences, and self-education opportunities.
The goals of the pediatrics clerkship are to provide an introduction to the field of pediatrics and to promote an awareness of the concept of disease in a rapidly growing person. There is an emphasis on developing the student's competence in skills necessary for the case study method of patient care; i.e., effective data collection through the history and physical examination, synthesis and presentation of information, problem solving, patient management, and communication with patients and their families.
Students are exposed to the complete range of pediatric experiences (infancy through adolescence), problems of normal growth and development, ambulatory practice, and tertiary inpatient care. Students work as members of the ward team and are directly involved, with the appropriate supervision, in managing patients. They are expected to collect data (history, physical examination, and laboratory tests) on their patients, write orders, perform routine procedures, and present their findings to the attending physician. Students generally follow three to five patients when on inpatient service and are on call twice a week. Didactic material is presented through teaching rounds, sessions with the attending and Clerkship Director, conferences, and opportunities for self-education.
Proficiency in acquisition of pediatric knowledge is measured by an oral and a written examination.
The recommended adjunct text is Essentials of Pediatrics by Behrman and Kliegman (W.B. Saunders Company).
The goal of the family medicine clerkship is to provide an overview of the content and practice of family medicine. This one-month clerkship combines comprehensive office practice with interactive classroom learning experiences. Guided by an individually tailored learning program, students work side by side with a community of hospital-based family physician preceptor. Students participate in comprehensive diagnosis, assessment, and management of patients of all ages with undifferentiated and commonly encountered problems in the broad spectrum of family medicine.
After an initial assessment, students develop an Individualized Educational Prescription to refine and improve clinical knowledge and skills. This clerkship is constructed to sharpen the medical skills of history taking, physical examination, interviewing, organizing data, problem-solving, and office procedural skills. Other instructional activities include case-based attending rounds and problem-solving seminars on commonly-encountered problems (e.g. hypertension, diabetes, substance abuse, and prevention). Minicourses are offered in topics such as pharmacotherapeutics and dermatology. Hands-on workshops focus on such topics as office orthopedics, radiology, office skills and procedures, and family assessment.
Evaluation is based on preceptor assessment of student performance, cognitive exam, family medicine project, and participation in teaching rounds and conferences.
The adjunct text is Essentials of Family Medicine by Sloane, Slatt, and Curtis.
During this one-month clinical experience the student will function in the role of a primary care physician (Family Practice, General Internal Medicine, or General Pediatrics) offering comprehensive, continuity-based ambulatory care for patients, under the supervision of faculty. The student will use an evidence-based approach to the diagnosis and management of undifferentiated problems commonly seen in primary care and to detect early manifestations of uncommon or potentially serious, treatable diseases. The student will learn to focus basic clinical skills such as the medical interview, physical exam, and clinical decision-making in the ambulatory setting, where the presence of continuity of care and the need for efficiency alter the approach to the patient. Site placement with community-based primary care physicians will be encouraged.
The rotation will also emphasize principles and applications of health promotion, disease prevention and patient education in a diverse patient population. Patient care efforts will stress sensitivity to biopsychosocial, familial, and community/cultural influences on medical problems and an appreciation of professional and ethical issues as they apply to the practice of primary care. Under supervision of faculty, the student will utilize a patient-centered approach to the student doctor-patient encounter, eliciting patient concerns and expectations for the visit, and involving patients in generation of the treatment plan. The student will develop an awareness of economic issues that impact the patient and physician in primary care settings. Evaluation will involve assessment of clinical performance by the preceptor and completion of weekly assignments focusing on prevention, patient education, ethics in the ambulatory setting, and cost and quality of care.
The psychiatry clerkship provides intensive clinical experience on the inpatient service, in outpatient clinics, and on the consultation liaison service. Clerkship didactics and clinical work will build upon the didactics, group, and interview experiences from the mind committee. The student's experience is further broadened by a series of field trips focusing on forensic psychiatry, alcoholism, and the state hospital system.
The objectives of the psychiatry clerkship are to develop the skills and knowledge essential to the psychiatric evaluation, the mental status examination, interviewing techniques, and selection and implementation of treatment modalities. Emphasis is placed on descriptive characteristics of psychiatric disorders and therapies, the rationale for the use of a variety of psychiatric therapies, psychopharmacology, the major psychodynamic mechanisms, and unconscious processes and their applications in clinical situations. Students acquire the clinical experience needed to make accurate psychiatric diagnoses, gain a working knowledge of psychopharmacology, learn principles of treatment sufficient to make referrals, and expand their own understanding of the psychological effects of illness.
In this clerkship the student receives intensive supervision by faculty, and works closely with the patients in a team setting. This includes evaluation and diagnosis as well as development and application of a treatment plan for the hospitalized and ambulatory patient. Students are exposed to both in- and outpatient care settings and are responsible for two to five inpatients at a time. Students learn principles of evaluation and treatment of psychiatric emergencies, including suicide risk, through taking night call with the resident staff. Emphasis is placed on distinguishing medical, neurosurgical and psychiatric conditions with similar presentations.
The goal of the surgery clerkship is to provide students with a broad clinical experience in which to develop and improve their skills for data collection, the organization, integration and presentation of data, procedural skills, recognition of treatment priorities, and management of emergencies. The emphasis in this clerkship is on problems unique to the surgical discipline and on participation in frequently used surgical therapeutic methods. At the same time it becomes clear that surgical judgment and technical approaches require a broad background knowledge of the basic sciences as well as a firm clinical fund of knowledge from the nonsurgical fields.
Objectives of this clerkship are to acquaint students with surgery as a discipline and to give them an appreciation for working with other members of the team. Students find this a useful time for review of basic anatomy and physiology and are expected to acquire a basic understanding of the pathophysiology of surgical disease and the rationale for surgical treatments. Students learn to formulate a differential diagnosis of surgical and surgically related diseases and to understand the correlations of the pathophysiology with disordered surgical anatomy, as well as to understand the metabolic and physiological alterations of trauma and infection. An additional objective of the clerkship is to emphasize the special aspects and consequences of a surgical decision.
During the clerkship students are an integral part of the surgical team. They are assigned patients, are responsible for the history, physical examination, differential diagnosis, and for formulation of a plan of action and follow-up for these patients. They are instructed in and participate in diagnostic and therapeutic procedures and other aspects of patient care. Didactic material is presented through student lectures, conferences, rounds, and self education. The students are exposed to a broad-based general surgical service and have opportunities to rotate through the surgical intensive care unit, anesthesiology, and various surgical specialties. The specialties will vary at the different clerkship sites.
Acting Vice Dean: C. Kent Smith, M.D.
Interim Chairman, Committee on Medical Education: Peter V. Scoles, M.D.
Core Academic Program Coordinator: Charles Malemud, Ph.D.
Flexible Program Coordinator: Tarvez Tucker, M.D.
Patient-based Program Coordinator: Jay B. Wish, M.D.
Clinical Science Director: Theodore V. Parran, M.D., Kathy Cole-Kelly, R.N.
Physical Diagnosis Director: Bahaudden Arafah, M.D.
Acting Director of Curriculum Administration: Philip W. Hall III, M.D.
Cellular and Developmental Biology: William Merrick, Ph.D.
Homeostasis I: Jay Wish
Biological Basis of Disease: Debra Leonard, M.D., Ph.D., Michael Lederman, M.D., Magdalena Tary-Lehmann, M.D., Ph.D.
Gastrointestinal-Nutrition-Fundamentals of Therapeutic Agents: Lansing C. Hoskins, M.D.
Core Physician Development Program (CPDP)
Course Director and Coordinator: Nora Lindheim, M.D.
Musculoskeletal/Integument: Brian Victoroff, M.D., (Orthopaedics), Chad Deal, M.D. (Rheumatology)
Integument: Gary Wood, M.D.
Endocrinology/Reproductive Biology
Section Leaders: Cynthia Austin, M.D., David Aron, M.D., Thomas Murphy, M.D.
Nervous System/Mind:
Section Leaders: David Katz, M.D., and David Agle, M.D.
Homeostasis II
Section Leader: Edmond Ricanati, M.D.
Biological Basis of Disease II
Section Leaders: Joan Trey, M.D., and Nancy Rosenthal, M.D.
Mechanisms of Infection
Section Leaders: Phillip Lerner, M.D., and Philip Spagnuolo, M.D.
Years Three and Four Clerkship Medicine: Bruce Berger, M.D., Joann Findlay, M.D., Sally Hodder, M.D., Janice Quan, M.D., Louis Rice, M.D.
Pediatrics: Steven Czinn, M.D., Deborah Kohrman, M.D.
Obstetrics/Gynecology: Marjorie Greenfield, M.D., Irwin Kornbluth, M.D., Emmett Simonson, M.D., Eric Strasberg, M.D.
Surgery: Christopher Brandt, M.D., Marjie L. Persons, M.D., Jeffrey Ponsky, M.D., Raymond Staniunas, M.D.
Psychiatry: Jean Berggren, M.D., Richard Corradi, M.D., Jonathan Dunn, M.D., John Fisher, M.D., James Psarras, M.D.
Neurosciences: Alan Cohen, M.D., Tarvez Tucker, M.D.
Primary Care: Jason Chau, M.D., (Exec. Dir.)
Family Medicine: Patricia Moore, M.D., (Exec. Dir.)
Consistent with its history of educational innovation, this institution is moving forward with a major initiative to train leaders in primary care for students who wish to pursue careers as general internists, family physicians and general pediatricians. Students who have an expressed interest and commitment to primary care will find the Primary Care Track a program focused on their educational needs, as well as the needs of the future health care system.
After admission to the School of Medicine, students may apply for admission to the Primary Care Track (PCT) early in the first semester of Year One. In addition to the Core Academic Program of the School of Medicine during the first two years of medical school, PCT students spend one afternoon a week devoted to the special goals of the Track. This program covers an early introduction to physical diagnosis and medical history taking, work with a clinical preceptor in his or her practice on an on-going basis, and small group sessions that focus on selected topics in primary care. An opportunity to develop a relationship with a role model and guide in developing the student's personal and professional goals is available to each PCT student through the advising program. PCT students spend the summer between first and second year engaged in a funded summer fellowship project that combines clinical work with the practical application of disciplines such as epidemiology, biostatistics and medical decision-making that are tools for the primary care physician of the future.
The third year of medical school for PCT students is an integrated, year-long program that students may pursue in Cleveland at MetroHealth Medical Center or University Hospitals of Cleveland/Veterans Affairs Medical Center, or in Detroit at Henry Ford Health System. The PCT Year Three curriculum emphasizes the vertical integration of levels of care in medicine, so that students have the opportunity to learn as their patients move through the health care system. Training in internal medicine, family medicine, obstetrics and gynecology, pediatrics, surgery and psychiatry will explore the complexity of these fields, but also will emphasize core clinical skills, judicious and timely referral patterns, and management techniques that employ a cooperative approach to care.
Years Four through Seven of the Primary Care Program encompass the transition into residency. Students have two one-month requirements in health policy and neurosciences to complete during Year Four. Otherwise there is a great deal of flexibility in the fourth year electives program. In addition, there is an opportunity to apply for one of the accelerated residency programs offered in Cleveland in internal medicine or family medicine. Plans are currently being developed for PCT residents in general internal medicine, family medicine or general pediatrics at the three program institutions. Two defining milestones for all students are completion of requirements for awarding of the M.D. at the conclusion of the fourth year and completion of criteria for board certification in the relevant discipline after the seventh year.
Development of the Primary Care Track is supported in part by the Robert Wood Johnson Foundation's Generalist Physician Initiative and by the Henry Ford Health System in Detroit, Michigan, as well as affiliated hospitals in Cleveland.
All inquiries about admission and application to the School of Medicine should be addressed to:
Office of Admissions
10900 Euclid Avenue
Case Western Reserve University School of Medicine
Cleveland, Ohio 44106-4920
The CWRU School of Medicine is a cooperating member of the American Medical Colleges Application Service (AMCAS), sponsored by the Association of American Medical Colleges (AAMC). Applications to this school must be initiated through AMCAS as follows:
1. An application is obtained from AMCAS, AAMC Division for Student Services, 2450 N Street, N.W., Washington, D.C. 20037-1131 or from a premedical adviser's office of an undergraduate college.
2. Upon receipt of the AMCAS packet the candidate completes the form in accordance with the AMCAS directions and lists Case Western Reserve University on the designation sheet which is included with the application materials.
3. The completed application is returned directly to the AMCAS office, where it is processed, and a copy is forwarded to Case Western Reserve University.
Since selection of the class begins in October, candidates initiating an application after that date are at some disadvantage. No application will be considered if it is received by AMCAS after the published deadline, currently October 15.
The school uses a two-step procedure in evaluating applications:
1. The AMCAS form is used for initial screening. No personal letters, supporting documents, or separate materials are required or considered in this procedure because such items are not available from all candidates at the time of the initial evaluation. On the basis of data on the AMCAS application, the Admissions Committee will either provide the candidate with materials for completing a final application or send him or her a letter advising that chances for acceptance do not appear good enough to justify his or her going to the trouble and expense of submitting a final application. For the 138 places in the 1995 entering class, there were 7,701 AMCAS applications and 2,744 candidates who submitted complete final applications. Under these conditions, it is necessary for all candidates to recognize that submission of either an AMCAS or a final application to this school is by decision of the applicant. Every application will be subject to the standard review process established by the Admissions Committee. Unfortunately, because of the number of applicants, the school cannot accept an obligation to interview every candidate or to engage in frequent or personalized correspondence with all candidates who choose to submit an AMCAS or final application.
2. The final application form is provided to the candidate by the school. Letters of recommendation from a college premedical advisory committee or individual instructors and a non-refundable application fee of $60 are required. Final applications will not be accepted unless they are postmarked on or before the published deadline, currently December 15.
The Medical College Admission Test (MCAT), sponsored by the Association of American Medical Colleges, is a requirement for admission to the School of Medicine. It is given twice a year (usually in April and August); MCAT applications are available through college premedical advisers.
Admission to the medical school is limited because facilities are available for only 138 students in each class. From the many well-qualified applicants, the Admissions Committee selects the ones it believes most likely to respond well to the particular environment and program of this school.
A visit to the school and a personal interview with the Admissions Committee are considered an important part of the selection of a candidate.
The number of applicants predictably will exceed the number of individuals who can be accommodated in our interview schedule. Therefore, the granting of interviews must remain at the discretion of the Admissions Committee.
3. An applicant whose final application is complete and who is so far from Cleveland that an interview at the school is not possible may advise us that he or she has had interviews at other medical schools. At the discretion of the Admissions Committee, he or she may then be requested to authorize one or more of these schools to provide an interview report to us.
Because there is an inadequate number of minority group physicians, the school is actively interested in attracting candidates who can help make the student body more representative of the population and more realistically informed about social problems that affect the delivery of health care in this country.
In addition to meeting the high intellectual standards which have been established for admission, students are expected to possess superior personal qualifications and sound moral character. The School of Medicine welcomes applicants and accepts students without regard to race, age, sex, color, sexual orientation, or ethnic origin. With respect to handicap, technical standards are available upon request. Because the School of Medicine receives financial assistance from the State of Ohio, 60 percent of our entering students (currently 83 of 138) will be residents of Ohio. Applications from out-of-state residents are strongly encouraged, however.
Admission to the School of Medicine depends on the satisfactory completion of undergraduate college work. Because of the severe competition for places in medical school, an applicant is not likely to be admitted unless his or her academic record places him or her in the upper third of his or her college class. However, high scholastic standing alone does not ensure acceptance to the school, because the Admissions Committee places great emphasis on its appraisal of the character, personality, and general background of the applicant.
Places are offered only to candidates whose college work has been done in an institution approved by accrediting agencies acceptable to the Executive Council of the Association of American Medical Colleges.
The Admissions Committee places more emphasis on the quality of course work than on the field in which it is done, and wants students who are mature and who have demonstrated that they set high standards for themselves and can work effectively to reach their goals. Although, the minimum requirement for admission is three years of college study, no candidates without a bachelor's degree has been admitted in many years. Specific course requirements, which have been kept to a minimum to permit maximum flexibility in the selection of able students, are as follows:
| Year | Courses (or equivalent) |
| Chemistry (total) | 2 |
| General | 1 |
| Organic | 1 |
| Biology or zoology | 1 |
| Physics | 1 |
| English |
(Freshman composition or its equivalent is required. One course in literature is recommended.)
Because of the great importance of chemistry, mathematics, and physics as the foundation of modern biological and medical sciences, the committee gives special attention to competence in these areas.
Since verbal skills are of major significance in both scientific and clinical aspects of medicine, the committee attaches considerable importance to evidence of candidates' ability to use language effectively in the organization and communication of their knowledge. Performance in English courses and in the sections of the MCAT which measure verbal ability, and the manner in which the application is completed, are among the criteria used in this appraisal.
Not all medical schools have the same minimum requirements. Students are advised, therefore, to consult the catalogues of all schools to which they may wish to apply for admission.
Applicants who are two or more years removed from full-time college course work should plan to take challenging, advanced level (junior, senior, or graduate level) courses in the biological sciences to prepare themselves for entry into the School of Medicine.
Applicants who have excellent credentials and are certain that Case Western Reserve University is their first choice are encouraged to apply for Early Decision. The preliminary application must be received by AMCAS no later than July 31 and the applicant will be notified by this school no later than October 1.
Because the educational program in the School of Medicine is integrated in basic and clinical sciences and is different from that in many medical schools, it is not possible to accommodate transfer students at the second-year level. It is rarely possible to accept transfer students into the school at the third-year level because the expansion of our enrollment provides for transfers from the CWRU graduate school of candidates in the M.D.-Ph.D. combined degree program.
Requirements for admission may change. The most recent information can be found in "Medical School Admissions Requirements," a publication of the Association of American Medical Colleges which is revised and published annually. Potential applicants should examine the current edition of this guide.
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