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)

This Bridges Curriculum course (IDS 121A) includes the emerging science of health systems and, within the Foundational Science (FS) Ground School element of the course, the enduring sciences of structural & microscopic anatomy, cell biology, immunology, pharmacology, and pathology. IDS 121A introduces the longitudinal Clinical Microsystem Clerkship (CMC) element through classroom work and a week-long clinical immersion experience. IDS 121A also initiates the longitudinal Core Inquiry Curriculum (CIC) element, which teaches the skills of critical analysis of medical science advances necessary for life-long learning and evidence-based practice of clinical medicine. IDS 121A ends with an ARCH (Assessment, Reflection, Coaching, Health) Week, containing structured review of professional & competency development.

The last two weeks of the block focus on alterations to normal and on principles of pharmacokinetics. Students explore major categories of disease including neoplasia, inflammation, and circulatory/vascular disease. During each week of Ground School, the Inquiry component presents core scientific reasoning and analytic skills (e.g., how to read a scientific paper), introduces research methods for critical analysis of the cutting edge of medical knowledge, and delves into case-based inquiry. Learning in Ground School takes place in small group sessions, laboratories, interactive large group settings, online and live lectures, and in-class team activities. Starting in Ground School and throughout Bridges F1, students have designated Independent Learning Time (afternoons or mornings to study, complete required weekly formative quizzes and pursue activities that fit their interests, such as shadowing, electives, independent research, and self-care).

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

(7 weeks from mid-September to mid-November)

This block introduces cardiovascular/pulmonary physiology and red blood cell/ platelet function and dysfunction (hematopoiesis, anemias, coagulation, and hemostasis). Relevant pharmacology is included. Key cardiovascular/pulmonary diseases (arrhythmias, valvular heart disease, ischemic heart disease, CHF, hypo/hypertension, asthma, COPD, restrictive lung disease, 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 take skills sessions in ECG reading, basic ABG analysis and participate in two unknown scenarios in simulation settings. Some more specific topics such as Congenital Heart Disease are introduced in F2, while other diseases such as complex management of heart failure are revisited in F2 with a focus on differential diagnosis of causes and multi-modality treatment.

3. Health and the Individual

(4 weeks from mid-November until mid-December)

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

(7 weeks from mid-January to end of February/early March)

This block focuses primarily on the Clinical and Biomedical domains of science. This block introduces the gastrointestinal, endocrine, and renal systems. Core nutrition and metabolic biochemistry themes remain in the course, integrated with obesity and diabetes mellitus. Additional important topics include electrolyte imbalances and acid-base disorders, weight management, calcium homeostasis, and a brief intro to inborn errors of metabolism.

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

(4 weeks from early March to 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 health aging and development. This block begins with a patient panel of older individuals to set the stage for thinking about the many factors that affect health at every stage of life. We move into the reproductive years, beginning with the anatomy of the male/female pelvis, the embryology of the reproductive organs, and male and female sexual function and reproduction. We then cover clinical obstetrics, including prenatal care/screening, the physiology of pregnancy, complications of pregnancy, and the basics of labor and delivery. We move into 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.

Gynecologic disorders (bleeding, masses, pelvic pain), as well as cancers of the breast, ovary, uterus, cervix and prostate are discussed next. Finally, the principles of geriatrics, including normal healthy aging, common diseases of aging, and relevant pharmacology are discussed.

The block also builds on topics covered in previous blocks, such as ethical decision-making and issues of sexual and personal identity, as they apply to aspects of pregnancy/delivery, women's health, and development throughout infancy, childhood, adolescence, adulthood and old age.

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

(6 weeks from beginning of September to mid-October 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, and 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.