University of California San Francisco
UCSF School of Medicine UCSF Medical Center

Foundational Sciences (blocks)

Foundational Sciences (blocks)

The World Health Organization’s major causes of morbidity and mortality are used as an organizational framework. The curriculum draws on the epidemiology of the Bay Area (The UCSF 49) for illustrative examples of diseases, signs and symptoms, diagnostics and therapeutics, and prevention strategies, ensuring our curriculum is grounded in the population we serve. Students take the following Foundational Science blocks in sequence: 

  1. The Ground School Block
  2. Justice and Advocacy in Medicine Block - JAM
  3. The Airways, Blood, and Circulation Block - ABC
  4. The REGulationN Block - Renal, Endocrine, GI, and Nutrition
  5. The Pathogens & Host Defense Block - PHD
  6. The Life Stages Block
  7. The Brain, Mind, & Behavior Block - BMB
  8. The Diagnostic Reasoning Block - DR 

1. The Ground School Block 

(5 weeks starting August through mid-September)

The Bridges Curriculum course IDS 121A, the first course of Foundations 1, includes three primary components: Ground School (Foundational Sciences), Clinical Microsystem Clerkship (CMC) and the Core Inquiry Curriculum (CIC). The Ground School element of the course introduces the fundamental principles of pharmacology, physiology, genetics, pathology, and anatomy. Students focus on principles of pharmacodynamics and pharmacokinetics, autonomic physiology, methods of inheritance, genetic & genomic testing, and major categories of disease, including ischemic injury, inflammation, and neoplasia. There are six 3-hour anatomy labs in Ground School that focus on the musculoskeletal system. Learning in Ground School takes place in small group sessions, laboratories, interactive large group settings, in-person lectures, and online recordings. During IDS 121A, the CMC is incorporated through classroom work and a week-long clinical immersion experience. The CIC element teaches research methods and the skills of scientific reasoning and analysis; these components are required for the lifelong practice of evidence-based medicine, and are achieved through lectures and case-based learning.

2. The Justice and Advocacy in Medicine Block - JAM 

(Three 2-week blocks: JAM1 - late September, JAM2 - early January, JAM3 - early April) 

The Justice and Advocacy in Medicine (JAM) block explores how the health care system can affect various communities and identities differently, impacting their health outcomes and resilience. Students will learn advocacy practices to address inequities and promote fairness, focusing on issues like racism, ableism, and patriarchy. By understanding the historical and current causes of health inequities and emphasizing trauma-informed care and structural competency, JAM aims to equip students with the tools to create positive change. Additionally, students will envision a more equitable health care system by learning from community expert knowledge and examining the influence of economic and political factors on health policies and practices.

3. The ABC Block - Airways, Blood, and Circulation 

(ABC1 - cardiovascular is 4 weeks from early October to early November.  ABC2 – pulmonary/heme is 4 weeks from mid-November to mid-December)

This block introduces cardiovascular and pulmonary physiology and pathophysiology, and red blood cell/ platelet function and dysfunction (anemias and platelet/coagulation disorders). Relevant pharmacology is included. Key cardiovascular and pulmonary diseases (arrhythmias, valvular heart disease, ischemic heart disease, heart failure, hypotension, hypertension, asthma, obstructive and restrictive lung diseases, pleural diseases, cystic fibrosis, and lung cancer) are presented. Key microcytic, normocytic, and macrocytic anemias as well as common coagulation disorders are presented. Students also complete skills sessions in ECG reading, basic ABG analysis and participate in two unknown scenarios in simulation settings. 

IDS 121B includes a Physician Identity (PI Week 1) week containing structured review of professional and competency development.

4. The REGulationN Block - Renal, Endocrine, GI, and Nutrition 

(8 weeks from mid-January to mid-March)

This block focuses primarily on the Clinical and Biomedical domains of science. This block introduces the gastrointestinal, endocrine, and renal systems, and addresses applied nutrition and obesity medicine. Important topics that apply across multiple organ systems include electrolyte imbalances and acid-base disorders, and metabolic biochemistry. This course focuses on topics that are relevant to important sources of morbidity and mortality in the United States and global populations, those that illustrate important pathophysiological processes, and those that students are likely to encounter on the boards, on the wards, and as future physicians.

5. The Pathogens & Host Defense Block - PHD 

(8 weeks from mid-April to mid-June)

This block provides the core foundational science content for immunology/rheumatology, microbiology/infectious diseases, and leukemia/lymphoma.

The central theme of the block is to explore the interaction between humans and the microorganisms around them.  Students will learn about the complexity of the immune system through its ability to protect us from pathogens and cancer. We also explore immune system dysfunction through states of immunosuppression and autoimmunity.  Some common autoimmune diseases are explored with rheumatologists; they will share the clinical manifestations of these diseases, tools for diagnosis, and treatments modalities.   

In the microbiology and infectious diseases portion of the course, students will learn about the broad range of interactions microorganisms can have with humans, some reciprocal and others antagonistic.  They will learn about the many common clinical diseases caused by pathogens, ways to identify these organisms in the laboratory setting, how antimicrobials can treat these infections, and ways to prevent infection. 

Students will also be introduced to leukemia/lymphoma to expand their understanding of neoplastic diseases, which they began learning in earlier blocks.

6. The Life Stages Block 

(7 weeks from early August to late September) *First course of second year of medical school

Overall the theme of this block is "Health and Illness at Every Stage of Life" with a focus on human reproduction, development, and aging. This is a unique block that spirals on the themes of the previous blocks and bridges the biomedical sciences to clinical care as students begin to prepare for clerkships. 

Part 1 of the block begins with the reproductive years, covering menstrual cycle physiology and pathophysiology, common gynecological disorders, the anatomy of the pelvis and reproductive organs, and basic embryology. Students will learn about placental pathology, prenatal care and screening, the physiology of pregnancy, complications of pregnancy, and the basics of labor and birth. The block will introduce students to pediatrics, beginning with the neonatal transition at birth, neonatal disorders, normal growth and development of the infant/child and adolescent (including puberty), and abnormalities of growth and development in childhood and adolescence. Contraception and abortion are also covered in the first half of the block.

Part 2 of the block begins with cancers and pathology of the breast, ovary, uterus, cervix and prostate. Students will learn about common urologic conditions. Finally, we discuss the principles of geriatrics, including normal aging, common age-related conditions and syndromes, relevant pharmacology, the social determinants of health and health systems that affect older adults, the intersections of geriatrics and other fields of medicine, and end of life issues.

7. The Brain, Mind, & Behavior Block - BMB 

(7 weeks from early October to late November during the second year of medical school)

This block provides the basis of the normal anatomy, development, physiology, and radiological features of the human nervous system. It teaches current concepts regarding consciousness, perception, emotion, and other aspects of the mind. This course also covers major features (including clinical, pathological, and etiological) of common neurological, neuromuscular, neurosurgical, and psychiatric disorders. Relevant pharmacology and genetics are included. This block introduces the clinical assessment of the nervous system, including mental status with a focus on the function of both brain and mind.

8. Diagnostic Reasoning Block - DR 

(3 weeks from early December to mid-December during the second year of medical school)

This synthesizes the foundational science, inquiry, and clinical work and learning over the first phase of the curriculum by focusing on advanced skills in one unifying activity: clinical reasoning at the individual patient level and critical thinking at the population level. Students begin by focusing on how clinicians move from a patient's history and exam to a prioritized differential diagnosis, and appropriately use tools to move from diagnosis to management.

The course covers key concepts in clinical reasoning including:

  • a framework for understanding how doctors think
  • an approach to building clinical knowledge using schemas and compare/contrast strategies
  • an approach for communicating critical thinking to others and generating a prioritized differential diagnosis based on an effective problem representation
  • an appreciation of heuristics and biases which can lead to error, along with strategies to reduce this risk
  • the ability to utilize probabilistic reasoning, rooted in evidence-based medicine, to inform thresholds for diagnostic testing

Concepts of clinical reasoning are viewed through the lens of patient-centered, high-value care with an eye toward encouraging the early adoption of habits of mind that encourage reflection and self-improvement.

Updated 10/28/2024