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Medical Education
Bridges Curriculum

New Clinical Immersive Experiences in Emergency Medicine and Demystifying Pathology

March 15, 2018

Earlier this year, Foundations 2 (F2) medical students began Clinical Immersive Experiences (CIExes), new elective rotations as part of the Bridges Curriculum. 

“Clinical immersive experiences will give students the opportunity to explore clinical experiences in their own areas of interest,” says Leslie Sheu, MD, Assistant Clinical Professor, Co-Director for CIEx. “Through comprehensive planning with the F2 leadership and CIEx course leads, we are able to offer a diverse menu of CIEx opportunities, representing a broad range of specialties. We are continuing to work with educational leaders across the School of Medicine to develop innovative CIExes and expand student choice.”

“Our hope is that students will explore specialties and subspecialties of potential interest that are not traditionally represented in the core clerkships, helping them make informed decisions about residencies, while honing their clinical skills.” Learn more about new CIExes in emergency medicine and demystifying pathology. Read more about these CIExes based on interview experts below.

Demystifying Pathology: An interview with Marta Margeta, MD, PhD, Associate Professor of Pathology, UCSF School of Medicine

What is the general description for this CIEx? What motivated you to develop this CIEx for students? 

More often than not, diagnostic pathology represents a “black box” for practicing clinicians: a specimen comes in and the diagnosis comes out, but it’s very much a mystery what happens in between. The goal for the Demystifying Pathology CIEx is to enable F2 students to get a peek inside this black box by exposing them to the three main diagnostic pathology disciplines (surgical pathology, cytopathology, and autopsy pathology), by participating in departmental and interdepartmental conferences, and by following the workflow of specimens with different turn-around-times (from intraoperative consultations to routine processing of resection specimens).

What are the most innovative features of this CIEx? 

While the main goal is to expose students to the workflow involved in diagnostic pathology, we also want to develop their appreciation for the importance of clinicopathologic correlation and the role pathologists play in direct patient care. To this end, the students participate in several multidisciplinary clinicopathologic conferences including a gynecologic tumor board, dysplasia clinic, interstitial lung disease multidisciplinary conference, and a renal clinicopathologic conference.

 What are you most proud of for this CIEx, to date? 

I developed this elective in collaboration with my colleague and pathology co-steward, Dr. Raga Ramachandran. Raga and I are both proud and excited that this CIEx has generated a lot of interest among F2 students thus far: it seems to be meeting a real educational need! In addition, I am proud that we were able to get everything organized efficiently and on-track.

What skills and new knowledge will students develop in your CIEx?

In addition to acquiring a solid understanding of the diagnostic pathology workflow, students who complete this CIEx will get a chance to review their knowledge of normal and abnormal gross and microscopic anatomy and will start developing their ability to assess the level of diagnostic uncertainty based on the information provided in the pathology report.

What has been your faculty, residents, and students’ experiences in the CIEx so far? 

Early clerkship students don’t routinely rotate with us, so our faculty and residents have been delighted to take the CIEx students under their wings! Based on “exit interviews” with the students who have completed the elective and on their written evaluations, I believe they have had a very good experience and have learned a lot in a low-pressure environment.

What are your aspirations/future goals with your CIEx? 

Students thus far have had overlapping but different goals, backgrounds, and levels of comfort with the hospital environment. Building on these experiences, my future goals are to: continue fine-tuning the balance between the comfort of a structured schedule with an ability to incorporate students into less predictable but high-yield activities (such as attendance of an autopsy), and;develop a way to continue fulfilling the elective’s core objectives while simultaneously customizing the content to each student’s goals and backgrounds.

Emergency Medicine: An Interview with Aaron Harries, MD, Assistant Clinical Professor, Director of Medical Student Education, UCSF Department of Emergency Medicine

What is the general description for this CIEx?
The Emergency Medicine CIEx is an introduction to the evaluation and management of undifferentiated patients seen in the emergency departments at both UCSF and ZSFG. As part of the emergency department team, students practice procedural skills and learn to recognize, resuscitate, and stabilize acutely ill patients. 

What motivated you to develop this CIEx for students?
The UCSF Emergency Department embraces the new Bridges Curriculum of providing early clinical exposure to students and the opportunity to provide the Emergency Medicine CIEx was a natural fit to support this effort. Given that Emergency Medicine interacts with nearly all aspects of medicine, it is an ideal rotation for students to have early in their clinical training to provide a broad exposure to many different aspects of medicine and help guide student's future career choice. 

What are the most innovative features of your CIEx?
The hands-on didactic workshops for suturing, ultrasound, and splinting skills that students can actually start using on their very first shift in the emergency department. This rotation allows students to take the procedural skills (and history/physical exam skills) they have been learning about in the first two years of medical school and put them into practice. Additionally, the ability to provide an early exposure to Emergency Medicine for students early in their clinical years rather than the more traditional approach to wait until fourth year is new to UCSF. 

What are you most proud of for this CIEx, to date?
The first three cohorts of Emergency Medicine CIEx students brought an impressive enthusiasm and high level of engagement for this new course listing, and have performed exceptionally well.

What has been your faculty, residents, and students’ experiences in the CIEx so far?
We have received overwhelmingly positive feedback from both faculty and residents teaching the Emergency Medicine CIEx and the students themselves. Specifically, Emergency Medicine faculty have mentioned "How rewarding it is to have the opportunity to train students so early in their clinical years and help shape the outstanding physicians they will become."

What are your aspirations/future goals with your CIEx?
Given the initial positive reviews of the Emergency Medicine CIEx, we are hoping to expand this course with more frequent offerings throughout the year.