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. The Airways, Blood, and Circulation Block - ABC
  3. The Health and the Individual Block – H&I
  4. The REGulationN Block - Renal, Endocrine, GI, and Nutrition
  5. The Health & Society Block – H&S
  6. The Pathogens & Host Defense Block - PHD
  7. The Life Stages Block
  8. The Brain, Mind, & Behavior Block - BMB
  9. The Diagnostic Reasoning Block - DR 

1. The Ground School Block

(6 weeks starting August through mid-September)

The Bridges Curriculum course, IDS 121A, the first block of Foundations 1, includes 3 primary components: Ground School, Clinical Microsystem Clerkship (CMC) and the Core Inquire Curriculum (CIC).  The Ground School element of the course introduces the enduring sciences pharmacology, pathology, and structural and microscopic anatomy.  Students will focus on principles of pharmacokinetics, as well as major categories of disease, including ischemic injury, inflammation and neoplasia.  Learning in Ground School takes place in small group sessions, laboratories, interactive large groups 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, through lectures and case-based learning, teaches the skills of scientific reasoning and analysis, as well as research methods, required for the lifelong practice of evidence-based medicine.

IDS 121A ends with a Physician Identity (PI Week) containing structured review of professional and competency development.

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

(ABC1 - cardiovascular is 5 weeks from mid-September to mid-October.  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.

3. Health and the Individual (Fall)

(3 weeks end of October until mid-November)

This block focuses on the experience of health and illness from the individual, family, and provider perspective through the social and behavioral sciences. This includes a focus on psychology, health behaviors, identity, bias, palliative care, and integrative medicine. This block also covers emerging wellness concepts including mindfulness and resilience—for both patients and healthcare professionals—included as part of the block content. This block focuses primarily on the Social and Behavioral domain of science.

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 Health & Society Block (Spring)

(3 weeks mid-March until early April)

H&S has been designed as the culminating 4 weeks of its sibling block, Health and the Individual, with a focus on the context in which individuals (patients and providers interacting within a larger system) experience health and healthcare. H&S introduces a broad, sociological view, including an emphasis on health and healthcare disparities, health policy, and social epidemiology. This block also includes content related to bias in medicine, clinical ethics, and an introduction to public and global health theory and metrics. H&S emphasizes the Population/Public Health, Systems, and Social & Behavioral science domains.

6. The Pathogens & Host Defense Block - PHD

(7 weeks from mid-April to end of May)

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.

7. The Life Stages Block

(6 weeks from early August to mid-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.

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

(7 weeks from late September to mid-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.

9. Diagnostic Reasoning Block - DR

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.

*Beginning with the Class of 2026, Assessment Reflection Coaching and Health (ARCH) Weeks were redesigned and renamed Physician Identity (PI) Weeks. 

Updated 9/30/2022