Phase 2 – MD Curriculum
Phase 2 of the ForWard Curriculum consists of four, 12-week thematic blocks that emphasize clinical experiences and applications, fully integrating clinical care, basic science and thread topics.
Phase 2 Timeline
Phase 2 Blocks
Specialized Care of Obstetric, Gynecologic and Pediatric Patients
Specialized Care of Obstetric, Gynecologic and Pediatric Patients is a 12-week block in Phase 2 that is centered on the care of those populations, and emphasizes taking care of vulnerable populations, as well as working with caregivers.
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 occur in a range of settings such as pediatric primary care, labor and delivery, and obstetrics/gynecology. Structured educational sessions include a series of integrated case-based learning sessions that guide students to apply foundational concepts considering the unique needs and physiology of these patients. They employ varied modalities including podcasts, real-time case discussions, webcasts, independent readings and online nationally-supported modules.
Required Clinical Experiences
- Prenatal care: Assist in providing office-based prenatal care
- First trimester bleeding: Observe the evaluation of a patient with first trimester bleeding
- Normal spontaneous vaginal delivery: Assist a normal labor and spontaneous vaginal delivery
- Cesarean delivery: Assist with a cesarean delivery
- Post-partum depression screening: Perform a screen for post-partum depression
- Neonatal jaundice: Assist the evaluation of a newborn with jaundice
- Well child care-infant: Assist an infant well-child exam (age newborn to 12 months)
- Well child care-preschool: Assist a young well-child exam (age 15 to 60 months)
- Well child care-adolescent: Assist an adolescent well-child exam
- Child with chronic medical problem: Assist the evaluation of a child with a chronic medical problem (e.g., asthma, diabetes, epilepsy, cystic fibrosis, genetic syndrome)
- Pediatric cough/wheeze: Assist the evaluation of a child with cough or wheeze
- Pediatric ear pain/otitis media: Assist the evaluation of a child with ear pain or otitis media
- Pediatric fever: Assist the evaluation of a child with fever
- Pediatric gastrointestinal complaint: Assist the evaluation of a child with an active GI problem (e.g., vomiting, diarrhea, abdominal pain)
- Pediatric atypical growth or development: Observe the evaluation of a child with abnormal growth or development
- Pediatric rash: Observe the evaluation of a child with rash
- Menstrual abnormalities: Assist the evaluation of a patient with menstrual abnormalities
- Sexually transmitted infection: Assist the evaluation of a patient with a sexually transmitted disease
- Bimanual pelvic exam: Perform a bimanual pelvic exam
- Speculum exam: Perform a speculum exam
- Pap smear: Perform a pap smear
- Cervical dysplasia: Assist the evaluation of a patient with cervical dysplasia
- Cervical cultures: Perform cervical cultures
- Menopause: Assist the evaluation of patient with menopause
- Hysterectomy: Assist with a hysterectomy
- Laparoscopic abdominal/pelvic surgery: Assist with a laparoscopic abdominal/pelvic surgical case
- Breaking bad news: Observe breaking bad news to a patient
Chronic and Preventive Care
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 occur in primary care, behavioral health and other ambulatory and community-based settings that focus on chronic disease management. Continuity occurs in primary care clinics over the 12 weeks as well as 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 employ varied modalities including podcasts, real-time case discussions, webcasts, independent readings and online simulation.
All students participate throughout the 12 weeks in a field experience with community health engagement.
Required Clinical Experiences
- HEENT exam: Perform an HEENT examination of a patient
- Shoulder exam: Perform a musculoskeletal shoulder examination of a patient
- Plan of care: Communicate the plan of care with a patient
- Chronic mental illness: Assist in the evaluation, management and disposition of a patient with chronic mental illness (severe mood disorder, schizophrenia or schizoaffective disorder) by interacting with a member of the patient’s outpatient mental health system
- Imbalance assessment: Evaluate a patient with a balance complaint and develop a differential diagnosis
- Patient evaluation: Evaluate at least two patients (may be done in conjunction with one of the experiences listed above)
- Writing a prescription: Write a medication prescription accurately and safely in a clinical setting
- SBIRTs and motivational interviews: Perform at least one SBIRT and one Motivational Interview with a patient in clinic
- Dermatologic exam: Obtain a focused history and exam and formulate a prioritized differential diagnosis for a patient presenting with a dermatologic concern
- Diabetic foot exam: Obtain a focused history and perform a foot exam for a patient with insulin dependent diabetes mellitus
- Pulmonary disorders: Obtain a focused history and exam and formulate a prioritized differential diagnosis for a patient presenting with a pulmonary concern
- MSK/rheumatological history: Obtain a focused MSK/rheumatological history in a clinical setting
- Substance use: Incorporate screening for substance use disorders as a routine part of clinical practice using evidence-based screening tools
- Patient preferences: Incorporate patient preferences when discussing prevention guidelines
- Religion and spirituality: Address aspects of a patient’s religion or spirituality that impact his or her health and health care in a clinical setting
- Metabolic disorder counseling: Counsel patients on behavioral strategies and recommend appropriate treatment to minimize morbidity due to different types of metabolic disorders
- Mental health counseling: Counsel patients on behavioral strategies and recommend appropriate treatment to minimize morbidity due to different types of mental health disorders
- Interpreter use: Assess a patient for the need of an interpreter
- HealthLink: Use HealthLink (or other clinical decision support) during patient care and demonstrate the integration of information technology into the process of clinical care, especially clinical decision-making
- Patient instructions: Demonstrate the ability to generate thorough and understandable patient instructions in the after-visit summary
- X-rays: Demonstrate a systematic approach for interpreting skeletal X-rays
- Diagnostic tests: Order common diagnostic tests for core clinical conditions in clinical settings
Resident Video
Acute Care
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 are 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 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 complete an integrated patient-centered experience by participating in the care of a patient from an urgent admission through inpatient treatment and discharge.
Required Clinical Experiences
Core clinical conditions: Students will participate in the care of patients with core clinical conditions:
- Myocardial infarction
- Atrial fibrillation
- Sepsis
- Pneumonia
- Heart failure
- Respiratory distress
- Suspected venous thromboembolic disorder
- GI bleed
- Liver disease
- Glucose disturbance
- Stroke/TIA
- Altered mental status
- Blood pressure disturbance
- Syncope
- Suicidal ideation
- Behavioral disturbance
- Acute Kidney Injury
- Electrolyte Imbalance
- Medication reaction
Resident Video
Surgical and Procedural Care
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 take place in the clinics, emergency department, inpatient wards, inpatient and outpatient operating rooms and procedure suites. Structured educational sessions 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 complete a longitudinal patient care experience by participating in the pre-operative preparation, anesthesia care, operative care and post-operative care of one inpatient.
Required Clinical Experiences
- Abdominal pain: Participate in the care of a patient with abdominal pain
- Colorectal or anal disease: Participate in the care of a patient with colorectal or anal disease
- Hepatobiliary disease: Participate in the care of a patient with hepatobiliary disease
- Consent: Observe at least one instance of informed consent, paying particular attention to communication skills, potential for bias, and physician/patient power imbalance during the interaction
- Gown and glove: Gown and glove in sterile environment
- Suture skills: Suture and tie knots
- Trauma: Participate in the care of a trauma patient
- Multi-D conference: Observe or participate in multidisciplinary conference (e.g., tumor board, multi-D cancer management conferences, vascular anomaly working group, multi-D discharge planning)
- IV catheter: Place an intravenous catheter (must be performed no less than three times)
- Airway management: Manage a patient airway, including mask ventilation and either laryngeal mask airway (LMA) or endotracheal tube placement (must be performed no less than three times)
- Multiple exams: All students are expected to participate in the care of at least four patients with one or more conditions:
- Ear pain
- Throat pain
- Neck mass
- Joint disease
- Back or neck pain
- Spinal disease
- Peripheral arterial disease
- Venous disease
- Cardiac disease
- Lung disease
- Skin and/or soft tissue disease
- Breast disease
- Benign genitourinary disease or injury
- Malignant genitourinary disease or injury
- Eye disease
- Intracranial mass