The profession of medicine: an integrated approach to basic principles.

Objective The University of South Florida College of Medicine developed and implemented an innovative three-week course entitled, "The Profession of Medicine: An Integrated Approach to Basic Principles" to introduce new medical students to topics and skills that are important to their successful study of medicine. Demonstrating the clinical relevance of the basic sciences, the importance of lifelong learning, and ethics and professionalism in medicine were emphasized. Basic physical examination techniques, searching the medical literature and evidence-based medicine, and study and computer skills were introduced in addition to traditional orientation topics. Description Four interdisciplinary "state of the art" presentations demonstrated the importance of lifelong learning and the clinical relevance of basic science concepts. Lectures on acute myocardial infarction, breast cancer, duodenal ulcer, and pulmonary prematurity were presented as if the lectures were being given in 1980. Students attended lectures on basic science principles relevant to these topics, and then met in small groups with librarians, content experts, and small-group facilitators to begin investigating an assigned topic. For example, student groups researched the development of EMS and chest pain centers, thrombolysis and percutaneous coronary intervention, and the psychological implications of acute myocardial infarction for patients and families. Students were introduced to effective literature-searching techniques, the tenets of evidence-based medicine, and effective computer skills in the context of studying their assigned topics. Each group then selected a student presenter to deliver an eight-minute PowerPoint presentation of its 2001 "state of the art" findings, making particular note of scientific advances and new therapeutic protocols developed since 1980, such as the use of artificial surfactant in premature babies, the role of H. pylori in duodenal ulcers, and the discovery of the genetics of breast cancer. These projects as well as a series of small-group educational programs enabled students and faculty to develop a strong sense of team-work and cohesiveness. Students had opportunities to practice components of the history and physical examination on standardized patients relevant to the four clinical topic areas, such as cardiac and abdominal examinations with emphasis on anatomic principles. Basic ethical principles and their application to cases that pertained to the four clinical topics were introduced, and students participated in a small-group ethics case conference. Throughout the course, students and faculty were required to wear specially designed nametags. By the time the course concluded with the White Coat ceremony, the 75 participating faculty and 104 students knew one another, making the ceremony particularly meaningful. Discussion The pace at which scientific findings revolutionize the practice of medicine continues to accelerate. While it is important for undergraduate medical students to master the basic and clinical science foundations of medical practice, it may be even more important to teach students how to find and interpret medical information, form professional relationships with mentors and peers, and make a commitment to lifelong learning and professionalism. It is critical that students understand that the curricular program at any college of medicine is only the beginning of a life of study.