Just coming out of college, it's natural to wonder how students come to master the depth of medical school courses that are needed for a doctorate in healthcare. In the David Geffen School of Medicine at UCLA, you might be interested in learning why we use the block curriculum.
Subject-based vs. organ-based
"In college, you're probably used to learning subject-by-subject, so you might think we organize medical school the same way as a class in biology, a class in pharmacology [or] a class in anatomy," explains Dr. Janet Pregler, MD, professor of clinical medicine and director of the Iris Cantor-UCLA Women's Health Center. "But we [don't] think that is the best way to teach medical students. In a typical subject-based curriculum, you might learn the anatomy of an ovary in October in anatomy class, look at it under a microscope in December in a histology class, and in June you might find out how it works in a biology or biochemistry class. Even later, you will learn separately what can go wrong with the ovary and what drugs are given for a diseased ovary."
In an integrated organ-based curriculum, according to Dr. Pregler, you learn what the ovary cells look like, what the ovary itself looks like, what the ovary does and how it works as a whole. You'll also discover how it relates to the other organs and systems in the block at the same time. The information in each of your courses is complete and relevant to the rest of the material on your mind at any one time.
"We feel it is helpful to learn the histology and anatomy of each organ and system together, but especially for topics that are conceptually difficult such as biological chemistry and pharmacology. It is even more helpful to learn each as it relates to each organ system," says Dr. Pregler, who co-chairs the Block 3 curriculum, which includes gastrointestinal, endocrine and reproductive medicine.
First-year medical students often don't know why these three systems even exist in the same block. "Most blood tests that people have during a physical or in the hospital actually relate to elements of those systems," she clarifies. "That's why we group them in one block."
What the 'block chair' does
The job of a "block chair" and co-chair — usually consisting of one practicing physician and one research physician — is to think creativity about all the elements of each organ group and system, beyond what it looks like and what it does, and how these things fit together in a cohesive way. "This way, we give our students the basic scientific and clinical information they need in a format that brings that information together for specific organ systems," says Dr. Pregler.
There are nine blocks spanning a student's first and second years of medical school courses at DGSOM, and the length of each depends on the amount of content (and organ systems) that sits together. During year one, students learn about the anatomy of each system and how they work. In the second year, these system groups are revisited, allowing students to explore what happens when something goes wrong in these organs and how they are treated. In this way, topics are repeated many times to build upon previous knowledge about a given organ, the system as a whole and how they relate to each other.
Along with the block chairs, Dr. Pregler explains, there are "thread chairs" who are in charge of generic topics — or threads — that apply to every organ and system, such as the elements of being a doctor. The thread chairs make sure these topics are integrated in every block across the entire first two years of medical school.
By Naomi Mannino