Designing a Shortened Preclinical Basic Science Curriculum: Expert-Derived Recommendations

Abstract

Purpose To generate an expert-derived list of recommendations for how medical schools should approach decisions about the placement of basic science topics within shortened preclinical curricula, which allow for early clinical immersion. Method A modified Delphi process was used to develop consensus on recommendations (March–November 2021). The authors performed semistructured interviews with national undergraduate medical education (UME) experts from institutions that previously underwent curricular reforms involving shortened preclinical curricula to elicit perspectives on how decisions were made at their institutions. The authors condensed the findings into a preliminary list of recommendations and distributed this list in 2 survey rounds to a larger group of national UME experts (from institutions that previously underwent curricular reforms or held positions of authority within national UME organizations) to gauge their level of agreement with each recommendation. Recommendations were revised based on participant comments, and those with at least 70% somewhat or strong agreement after the second survey were included in the final comprehensive list of recommendations. Results Interviews were conducted with 9 participants and resulted in 31 preliminary recommendations that were then sent via survey to the 40 recruited participants. Seventeen/40 (42.5%) participants completed the first survey, after which 3 recommendations were removed, 5 were added, and 5 were revised based on comments—resulting in 33 recommendations. Twenty-two/38 (57.9%) participants responded to the second survey, after which all 33 recommendations met inclusion criteria. The authors removed 3 recommendations that did not directly address the curriculum reform process and consolidated the final 30 recommendations into 5 succinct, actionable takeaways. Conclusions This study generated 30 recommendations (summarized by the authors in 5 succinct takeaways) for medical schools designing a shortened preclinical basic science curriculum. These recommendations reinforce the importance of vertically integrating basic science instruction with explicit clinical relevance into all curricular phases.

Flipping Tradition on Its Head: A Single-Institution Study on United States Medical Licensing Examination Step Order

“…A recent trend in medical school curricula has been the adoption of a shorter preclinical education, replacing that time with dedicated research periods. 9 These changes, in conjunction with the Step 1 pass/fail grading, have led to unintended consequences, especially for IMG or unaffiliated students. 10 , 11 As medical schools work to offer guidance, students currently lack evidence-based strategies on optimal Step examination order and preparation.…”

Perspectives from two recent medical school graduates on exposure to pathology during undergraduate medical education: A narrative inquiry

“…At its core, pathology is the basis of all of clinical medicine, so it is imperative students learn the basic material. However, when preclinical years get condensed to a single year, 1 , 14 , 15 , 16 pathology needs to find and advocate for innovative means of intercalating into other areas of medical education, including clinical education.…”

“…Additionally, changes in medical school curricula have either integrated pathology into other courses or shortened the amount of exposure to the specialty to increase the time devoted to the clinical training medical students receive. 1 Further, although the course concepts of human pathology and histology are critical to the formation of adequate clinicians and diagnosticians, they do not fully encapsulate the work of a pathologist or laboratory director. Exposure to the field is available to most students through a dedicated pathology elective during their clinical and elective years; however, this exposure typically ends up taking place later in the student's education and is often too late to serve as an effective recruitment mechanism.…”