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MD Program - ForWard Curriculum

Our ForWard Curriculum is a new model and vision for the Doctor of Medicine (MD) Program at the University of Wisconsin School of Medicine and Public Health that builds upon our long tradition of educational excellence that has produced top graduates year after year. Generously supported by the Wisconsin Partnership Program, this innovative curriculum is the result of more than 200 faculty, staff and students coming together to guide the development and implementation of this curricular transformation.

 

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Revolutionary changes in health care demand a different type of physician. In response, we have developed the ForWard Curriculum, which replaces the traditional model of medical education - two years of basic science followed by two years of clinical experiences - with a model that fully integrates basic, public health and clinical sciences throughout our medical students' education.

 

The ForWard curriculum has the following key features:

  • Competency-based curriculum requiring collaboration of medical educators across all years of the curriculum
  • Deliberate developmental sequencing of 10 important content areas or “threads” across the curriculum
  • Intensive longitudinal coaching by some of our very best teaching faculty to assist students in their professional skill development
  • High-quality interprofessional and team-based educational opportunities
  • Longitudinal public health and system-based practice opportunities with special emphasis on “hands-on” application of knowledge in clinical and community settings
  • Earlier entry into clinical clerkships to facilitate career exploration and competitiveness for residency selection
  • Advanced learning opportunities for better internship preparation

The new Doctor of Medicine (MD) curriculum emphasizes team-based learning with a special emphasis on the hands-on application of knowledge in clinical and community settings. Many aspects of the new curriculum have already been successfully piloted and will also be available to current students since we want as many of our students as possible to benefit from the changes!

 

The ForWard Curriculum is delivered in three phases:

 

Phase 1 focuses on basic science while fully integrating clinical science and public health and is completed within 18 months of matriculation.

 

Phase 2 emphasizes clinical applications, fully integrated with longitudinal themes of basic science and public health, and lasts 12 months.

 

Phase 3 is dedicated to specialty-specific competency development and internship preparation with opportunities for individualized electives, advising and projects.

 

Learn more about our ForWard Curriculum by clicking on the courses below.

If you do not see the graphic below, view a mobile-friendly version of the ForWard Curriculum

 

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Curriculum Threads


These 10 critical content areas are carefully sequenced and monitored across the curriculum by faculty expert in these areas.

 

The 10 UW School of Medicine and Public Health threads are:

  • Ethics
  • Evidence-based medicine
  • Health information technology
  • Interpersonal and communication skills
  • Interprofessional health and team-based care
  • Patient care
  • Professionalism and lifelong learning
  • Public health
  • Quality improvement and patient safety
  • Scientific inquiry

Thread Directors

 

Parvathy Pillai, MD, MPH, thread director of public health, evidence-based medicine, scientific inquiry

Department of Population Health Sciences

Scott Mead, MD, thread director of ethics, health information technology, interpersonal and communication skills, patient care, professionalism and lifelong learning

Department of Medicine

Robert Holland, MD, thread director of interprofessional health and team-based care and quality improvement and patient safety

Department of Medicine

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Patients, Professionalism and Public Health


Integrated block leader:
Scott Mead, MD

Department of Medicine

Patients, Professionalism and Public Health seeks to establish a strong foundation for a student’s professional identity formationas a physician. Therefore, our focus in week 1 will be on what matters most: the patient. Through “Faces of Patients,” we will see the impact of health and illness on the lives of patients and their loved ones. The concept of patient-centered care will be introduced and practiced through real and standardized patient interviews. We will also start to look beyond immediate measures of health toward the many upstream determinants of health that impact their patients’ lives.

 

In week 2, we will explore how patients’ culture, community, religion and spirituality impact their health and experience of illness. We’ll apply this when we explore Madison and its communities, highlighting the principles of assessment and engagement to improve community health.

 

In week 3, we will consider the various health-related systems that can impact a person's health and illness, including the health care system, the public health systems and the role of quality improvement. We will see how effective health care can only be delivered by working as a part of an interdisciplinary team.

 

The block finishes in week 4 by contemplating the importance of each individual physician in health promotion. The first anatomic dissection allows further exploration of the sacred role of physician and the unique privilege and responsibilities of the profession. Basic concepts of medical ethics will be introduced. The course ends with “Faces of Physicians,” where we will delve into the myriad ways that physicians can advocate for health, whether it be for a single patient or for an entire population.

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Body in Balance


Director: Beth Altschafl, PhD

Integrated block leader:
Beth Altschafl, PhD

Department of
Neuroscience

Body in Balance covers the key processes involved in maintaining internal balance in the body. In this course, you will follow the path of the red blood cell and will pause to review normal function and disease at each step of the journey.

 

You will begin with the birth of the red blood cell in the bone marrow and a discussion of anemia. Following our red blood cell through the circulation, you will stop to review the mechanical and electrical functions of the heart. Atherosclerosis is introduced as the underlying process of cardiovascular disease, and the rupture of a coronary plaque triggers the initiation of — and our discussion of — the clotting cascade.

 

Next, you will follow our red blood cell as it travels through the pulmonary circulation, where it participates in gas exchange as you review lung function and common lung diseases. As our red blood cell returns from the lungs to the left side of the heart, it is then transported into the systemic circulation. You will discuss the dynamic control of vascular function, along with the importance of the lymphatic system.

 

The final stop on the circulatory tour is through the kidneys, which function in waste disposal as well as regulation of hemodynamics, water and electrolyte balance, and acid/base status. The close coordination of the cardiovascular and renal systems as long-term regulators of blood pressure will be highlighted via discussion of congestive heart failure and hypertension. The course closes with a discussion of various causes and manifestations of renal dysfunction.

 

Examples of integrated longitudinal threads include a discussion of the ethics and stewardship of transplantation in chronic kidney disease and an exploration of biostatistics in key areas of clinical research related to the organ systems covered.

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Food, Fasting and Fitness


Block director: Gary Lyons, PhD

Integrated block leader:
Gary Lyons, PhD

Department of Cell
and Regenerative Biology

Food, Fasting and Fitness explores the chain of events by which food is converted to energy, highlighting the key role of nutrition and exercise in the maintenance of optimal health. Starting with food on a plate, you will learn the importance of the various macro- and micronutrients and healthy food choices. You will explore the role of nutrition in maintaining the health of individuals as well as the health of communities.

 

Next, you will learn about the digestive system and the processes that allow food to become nutrients in the bloodstream. The absorption of these nutrients is sensed, prompting endocrine signals that inform cells that nutrients are available for uptake and use. You will learn about these signals and also the cellular biochemical processes involved in the burning and storing of energy by cells.

 

Following this, you will compare and contrast the fed state with processes that are instituted by the body to allow survival in between meals and with prolonged fasting. Understanding of these mechanisms underpins discussion of the increasing health threat of metabolic disorders such as diabetes, obesity, and lipid disorders. You will explore the metabolic changes that occur with exercise and the role of exercise and fitness in good health.

 

Finally, discussion of nitrogen metabolism and the removal of waste products and toxins completes an integrated picture of metabolism. Examples of integrated longitudinal threads include advocacy surrounding nutrition in communities, use of the electronic medical record and quality improvement in diabetes care, discussion of health literacy in the setting of diabetes care, and fundamental principles of scientific inquiry explored via critical examination of nutrition guidelines.

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Human Family Tree


Block director: Gregory Rice, MD

Integrated block leader:
Gregory Rice, MD

Department of Pediatrics

Imagine that you are a new family medicine physician in a busy practice. Your 11 o'clock appointment is a young couple that recently moved to town. The couple (Tom and Sara Mendel) wishes to establish a primary care medical home with you. During the visit, they inform you that they are hoping to start a family soon.

 

Human Family Tree will follow your journey with this couple and their family, through the remainder of their life cycle. You will explore the molecular, genetic, embryologic, hormonal, anatomical and physiological factors that govern fertility, cell growth, fetal development, and pregnancy as well as the congenital anomalies that can occur when those processes are aberrant.

 

Your journey with the family will continue through the birth of their child, when you will discuss lactation and newborn screening while later exploring childhood growth and development. You will grapple with difficult issues that can affect families such as domestic and child abuse. You will follow their child's development into young adulthood and learn about the biological basis of puberty and discuss issues affecting adolescents and young adults, including sexually transmitted infections and gender identity issues.

 

We will explore the genetic basis of human disease and how to screen the family for conditions that might impact their health and/or reproductive risk. You will learn about the hormonal and physiological changes in reproductive health with menopause and aging. You will also learn about the consequences of unregulated cell growth (cancer) to your patient and their family.

 

And finally, you will support the family through end-of-life issues brought on by cancer in a family member. Examples of integrated longitudinal threads include evidence-based medicine and health policy related to fertility treatments, health disparities in cancer prevention/screening, and reproductive ethics.

 

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Invaders and Defense


Block director: Erik Ranheim, MD

Integrated block leader:
Erik Ranheim, MD, PhD

Department of Pathology
and Laboratory Medicine

Invaders and Defense covers material in the areas of microbiology, immunology, infectious disease, autoimmune disease, hematologic malignancy, and dermatologic disease. Playing off the title of the block, you will learn about the “foot soldiers” of innate immunity — those charged with handling routine invasions and threats. The recognition that not all microbes are invaders — and some are allies — comes with exploration of the normal microbiome.

 

You will discuss the nature and clinical manifestations of the various types of biological invaders (bacteria, viruses, fungi and parasites). You will see that, when higher-level responses are needed to respond to more virulent invaders, specially-trained forces of T-cells and the targeted weaponry of antibodies are utilized. The importance of the integumentary system as the “coast guard” will be discussed, and dermatologic pathology will be reviewed.

 

The analogy continues to be helpful to understand the concepts of immune deficiency — where one or more elements of the normal defense system break down (or is purposely suppressed, such as in transplantation) — as well as autoimmunity, where normal tissues are attacked and damaged due to “bad intel” and “friendly fire.” Hematology malignancy presents as a “coup” — when some element of the immune system ceases to function within its role and overtakes and destroys normal immune function.

 

Examples of integrated longitudinal threads include evidence-based medicine in management of infectious disease, shared decision-making in antibiotic use, public health/ethics in immunization policy, and ethical issues/resource scarcity related to transplantation.

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Mind and Motion


Block director: Jason Stephenson, MD

Integrated block leader:
Jason Stephenson, MD

Department of Radiology

The final phase 1 block, Mind and Motion, brings together concepts in musculoskeletal medicine, neurology and neuroscience, and psychiatry. In this course, you will begin with the structural functions of the body, from the anatomic level to the specialized cellular function.

 

You will explore several common musculoskeletal conditions (hip fracture, joint pain, tendon rupture, or carpal tunnel syndrome). Through these common patient presentations, you will develop an understanding of limb anatomy and the specialized tissues of bone, muscle, tendon/ligament and nerve.

 

Moving centrally, you will turn to the spinal column and spinal cord, where you will explore how structural abnormalities can lead to neurologic symptoms, such as in back pain. The structure and electrical functions of neurons will be discussed, as well as their complex assembly into the brain and spinal cord. Here, neurologic and psychiatric disorders are presented and their underlying causes are explored.

 

The course ends with an in-depth exploration of how these topics intersect in clinical care, through examples such as trauma, headache, and substance abuse that will be used to illustrate and apply the content from this course and to explore issues including economics of healthcare, cultural bias in medicine, and understanding the role of systems-level issues in health outcomes.

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Care Across the Life Cycle


integrated block leader photo

Integrated block leader:
Kirsten Nackers, MD

Department of Pediatrics

Care Across the Life Cycle is a 12-week block in Phase 2 that is centered on providing health care across the lifespan. Activities emphasize taking care of vulnerable populations as identified in women’s and child health, working with caregivers and the special needs of geriatric patients.

 

It builds upon the fundamental science concepts introduced in Human Family Tree during Phase 1, such as embryology and teratology, genetic testing, and neurodevelopment.

 

Clinical experiences will occur in a range of settings such as pediatric primary care, labor and delivery, obstetrics/gynecology and geriatrics practices. Structured educational sessions will proceed chronologically through the 12 week block following the human life span and will employ varied modalities including podcasts, real-time case discussions, webcasts, independent readings, and online nationally supported modules.

 

All students will complete an integrated patient-centered experience where they will participate in caring for a woman as they follow her and her child through the late third trimester, childbirth, and newborn period.

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Chronic and Preventive Care


integrated block leader photo

Integrated block leader:
Mark Beamsley, MD

Department of Family Medicine and Community Health

Chronic and Preventive Care is a 12-week block in Phase 2 that uniquely positions students to identify the roles of physicians, interdisciplinary providers, health care systems, and communities in screening, treating, and preventing common, chronic conditions. Activities are centered on health promotion, outpatient-based chronic disease management, and community health.

 

Students’ clinical experiences will occur in primary care, behavioral health and other ambulatory and community-based settings that focus on chronic disease management. Continuity will occur in primary care clinics over the 12 weeks as well as by student participation in a longitudinal community health engagement project.

 

This block builds upon Phase 1 fundamental science concepts introduced in Food, Fasting and Fitness, Body in Balance, Invaders and Defense, Human Family Tree and Mind and Motion. Structured educational sessions will employ varied modalities including podcasts, real-time case discussions, webcasts, independent readings and online simulation. All students will participate throughout the 12 weeks in a field experience with community health engagement.

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Acute Care


integrated block leader photo

Integrated block leader:
Laura Zakowski, MD

Department of Medicine

Acute Care is a 12-week block in Phase 2 that is centered on assessing patients with urgent medical conditions, providing acute inpatient care,and transitioning patients to other care settings or home under the care of other professionals.

 

Activities emphasize providing acute care in outpatient emergent and inpatient ward settings, developing acute management plans and subsequent transition of care plans. Clinical experiences will be in acute care settings.

 

The block builds upon the fundamental science concepts introduced during Phase 1, including acid base balance, hormonal regulation, cardiac physiology and infection. Structured educational sessions will proceed through the 12-week block following an organ system-based approach and employ varied modalities including podcasts, real-time case discussions, webcasts, independent readings, and online nationally supported modules.

 

All students will complete an integrated patient-centered experience by participating in the care of a patient from an urgent admission through inpatient treatment and discharge.

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Surgical and Procedural Care


integrated block leader photo

Integrated block leader:
Ann O'Rourke, MD, MPH

Department of Surgery

Surgical and Procedural Care is a 12-week block in Phase 2 focused on the care of adults and children undergoing an operation or procedure, including the perioperative preparation, operative care and post-operative cares for core clinical conditions in the specialties of anesthesia, neurosurgery, ophthalmology, general surgery, otolaryngology, urology, cardiothoracic surgery, peripheral vascular surgery, orthopedics, plastic and reconstructive surgery and gynecology, as well as interventional radiology, procedural cardiology and gastroenterology.

 

The block builds upon the basic science concepts introduced in Phase 1, including cerebral spinal fluid production and flow, fluids and electrolytes, consciousness, inflammation and wound healing and cancer biology.

 

Patient care experiences will take place in the clinics, emergency department, inpatient wards, inpatient and outpatient operating rooms and procedure suites. Structured educational sessions will proceed through the 12-week block following an anatomic approach using case discussions, podcasts, curated independent reading, online nationally supported modules and simulation skills.

 

All students will complete a longitudinal patient care experience by participating in the pre-operative preparation, anesthesia care, operative care and post-operative care of one inpatient.

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Advanced Clinical Experiences


During required Inpatient and Ambulatory Acting Internship experiences, students will focus on building skills that are needed to function on day one of residency including:

  • Developing actionable management and treatment plans based on history, physical exam and targeted data
  • Communicating with colleagues in a variety of ways such as patient hand-offs, discharge summaries and clinic notes
  • Formulating questions based upon clinical dilemmas, researching the appropriate literature and databases to find the answers, and apply findings to the care of individual patients
  • Developing efficiency in accomplishing the day to day tasks necessary for the coordination and management of patient care
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Career Focused Basic Science


Phase 3 students can choose from a variety of electives that explicitly connect basic science to clinical practice and allow students to reinforce important basic science concepts taught in Phase 1 and 2. Specialty-specific opportunities will be available for students to build on the foundational science necessary for their future careers.

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Public Health Selectives


Phase 3 students can choose from a variety of electives that provide opportunities to explore key concepts and develop skills of public health practice, which they can incorporate into their professional work upon graduation. These electives build upon public health concepts taught in Phase 1 and 2. Electives emphasize interactive teaching methods and explore public health topics that include:

  • Patient safety
  • Health care financing/medical economics
  • Quality improvement
  • Global health
  • Community health
  • Health disparities
  • Health care systems
  • Environmental health
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Internship Preparation


New “bootcamps” or specialty capstone experiences occur at the very end of medical school training, once students have matched to residencies. The two-week, required internship prep course engages medical students through high-level, focused residency preparation in a specific specialty area, covering key concepts that allow students to practice essential skills to ensure success as they transition from medical school to internship. The internship prep course will consist of nuts and bolts practice of specialty-specific skills and close observation of skill development through formative, simulation-based learning opportunities.

 

Course director: Will Aughenbaugh, MD

Department of Dermatology

 

Co-director: Sarah Johnson, MD

Department of Medicine

 

Co-director: Jamie Hess, MD

Department of Emergency Medicine

 

Co-director: Amy Liepert, MD

Department of Surgery

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Graduation


 

ForWard Curriculum

Last updated: 04/14/2017
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