COLLEGE OF MEDICINE

62 S. Dunlap • Memphis, TN 38l63 Tel: (901) 448-5529

H. Pat Wall, M.D.
Interim Dean

Michael E. Dockter, Ph.D.
Associate Dean, Administration and Research

Richard Peppler, Ph.D.
Associate Dean, Academic and Faculty Affairs

Hershel Wall, M.D.
Associate Dean, Admissions and Student Affairs

Eugene Mangiante, Jr., M.D.
Associate Dean
Graduate Medical Education and Continuing Medical Education

Kristine M. Lohr, M.D.
Associate Dean
Outcomes Research and Improvement

Jeffrey R. Woodside, M.D.
Associate Dean, Clinical Affairs

Stephen T. Miller, M.D.
Associate Dean
Academic Program at Methodist University Hospital

Ronald G. Blankenbaker, M.D.
Associate Dean, Chattanooga

Michael R. Caudle, M.D.
Dean of Graduate School, Knoxville

GENERAL INFORMATION

Historical Perspective

The University of Tennessee College of Medicine traces its origin to 1851 as the Medical Department of the University of Nashville. In 1909, the Medical Department of the University of Tennessee and the Medical Department of the University of Nashville were consolidated as The University of Tennessee Department of Medicine. The Department continued in the Nashville location for two years. In 1911, The University of Tennessee Department of Medicine moved to Memphis and merged with the College of Physicians and Surgeons, founded in 1906, and with the Memphis Hospital Medical College, founded in 1876, to become The University of Tennessee College of Medicine. Later that same year, the name of the campus was changed to The University of Tennessee Medical Units, and the Colleges of Medicine, Pharmacy, and Dentistry were established. In the early 1970’s, the College moved toward a statewide system of medical education with the development of clinical education centers external to the Memphis campus. Since the opening of the Clinical Education Center in Knoxville in 1973, additional centers have been established in Chattanooga, Jackson, and Nashville. These centers have enabled the College to provide quality health care, education, and research throughout the State of Tennessee. The designation of the campus as The University of Tennessee, Memphis -The Health Science Center was adopted in 1985 by The University of Tennessee Board of Trustees and was changed to The University of Tennessee Health Science Center in 1999. The College has an enrollment of 150 students per class currently.

Degrees Offered

The University of Tennessee College of Medicine offers an educational program leading to the Doctor of Medicine (M.D.) degree. The College of Medicine also participates in the Doctor of Medicine (M.D.)/Doctor of Philosophy (Ph.D.) combined degree program, with the College of Graduate Health Sciences.

Accreditation

The College of Medicine is a member of the Association of American Medical Colleges (AAMC) and is accredited by the Liaison Committee on Medical Education (LCME), which represents the Council on Medical Education of the American Medical Association and the AAMC.

Educational Objectives for the M.D. Degree

Graduates of the University of Tennessee College of Medicine complete a medical education program sufficiently broad to prepare them for entry into a variety of advanced, differentiated physician training programs. To enable graduates to attain this long-term objective, the medical education program facilitates the development of the requisite knowledge, skills, attitudes and beliefs, and graduating students will be expected to demonstrate competency in the following areas.

Knowledge

The graduate should have a broad knowledge of:

(a)
the scientific basis of medicine, extending from its historic approach to its current status and future potential;
(b)
the scientific method and its application to problem solving and clinical reasoning;
(c)
normal human development and aging, including issues of gender and the beginning and end of life;
(d)
the recognition and resolution of disease processes, with attention to disease-specific age and gender issues of symptoms, diagnosis and treatment;
(e)
how a person’s interaction with the environment affects health and disease;
(f)
preventive medicine, health maintenance, and epidemiology;
(g)the contemporary practice of medicine in light of current societal needs, political priorities, economic considerations, and multicultural environments;
(h)
ethical and medicolegal issues relating to a physician’s responsibilities and obligations to patients, colleagues, the State of Tennessee, and society in general;
(i)
the fact that health and illness involve psychological, biological, and social components;
(j)
the physician’s relationship to other health professions;
(k)
the development of new medical knowledge; and
(l)
the patient as an individual with the respect for quality of life with appropriate balance of care and comfort versus cure.

Skills

The graduate should be able to perform each of the following tasks proficiently:

(a) establish an appropriate database for each patient;
(b) evaluate data, identify problems, and plan or institute proper action;
(c) obtain and evaluate appropriate information from references and colleagues;
(d) communicate with patients, other professionals, and the public;
(e) engage in a self-directed process of assessment of one’s own capabilities, evaluation of performance, and planning for continuing education;
(f) assume a leadership role in the management of health and medical care systems;
(g) demonstrate literacy in the use of computers, medical informatics, and other technology;
(h) develop an alliance with patients and communicate effectively with families and other professionals;
(i) understand the role of managed care and health care delivery systems; and
(j) plan for continuing education with the development of life long educational activities.

Attitudes and Beliefs

The graduate will have an appreciation for:

(a) the religious, spiritual, mental, emotional, and physical needs of patients and their families;
(b) health promotion and disease prevention as high priorities;
(c) population-specific issues in risks, symptoms, diagnosis and treatment;
(d) the qualities of integrity, compassion, empathy, and equanimity;
(e) critical introspection, including analyzing one’s own methods and results, comparing them with those achieved by other physicians, and accepting scrutiny by peers and others;
(f) scholarly inquiry and critical evaluation, especially regarding the continuation of one’s own professional education and growth; (g)professional responsibility built upon thoroughness, reliability, and availability;
(h) social responsibility and recognition of medicine as a social good, as well as a commercial commodity;
(i) the potential for personal impairment resulting from the high-stress environment of the practice of medicine, and the protection afforded by a well-developed sense of self-esteem and effective coping and adaptive skills;
(j) the provision of Healthcare to all patients regardless of one’s prejudices or beliefs.

*Objectives Adopted: 1972 Reviewed: 1984, 1986, 1989, 1990, 1991, 1994, 1995, 1996, 1997, 2003.

Admissions

Application for Admission

The University Tennessee College of Medicine admits one class, in August each year, composed of 150 students. Applicants must be citizens or permanent residents of the United States at the time of application. Applications are accepted from: (1) Tennessee residents; (2) residents of the eight states contiguous to Tennessee - Mississippi, Arkansas, Missouri, Kentucky, Virginia, North Carolina, Georgia, and Alabama; and

(3) children of UT System alumni regardless of their state of residence. As a state-supported institution, qualified Tennesseans are given priority in each entering class. A maximum of ten percent of the matriculants may be non-residents; therefore, nonresidents must possess superior qualifications to be seriously considered for admission.

The College of Medicine utilizes the American Medical College Application Service (AMCAS). Applications must be received by AMCAS no later than November 15 of the year prior to admission.

Upon initial review of AMCAS application, a supplemental application is forwarded to applicants considered competitive for further review by the Committee on Admissions. Pre-Professional evaluations and letters of recommendation should be sent after the supplemental application has been returned.

Technical Standards for Medical Students

The goal of The University of Tennessee College of Medicine is the broad preparation of students for the practice of medicine. This goal is achieved in part by undergraduate medical education, postgraduate medical education, and preparation for life-long learning. Modern medical education requires that the accumulation of scientific knowledge be accompanied by the simultaneous acquisition of skills and professional attitudes and behavior. Our faculty has the responsibility to graduate the best possible physicians; thus, admission to medical school is offered to those who present the highest qualifications for the study and practice of medicine.

Applicants to the College of Medicine must possess the following general qualities: critical thinking, sound judgment, emotional stability and maturity, empathy, physical and mental stamina, and the ability to learn and function in a wide variety of educational settings. In all phases of medical education, students of medicine must use their intellectual ability and must maintain emotional stability, particularly when under stress. Graduates of the College must have the knowledge and skills to function in a wide variety of clinical situations and to render a broad spectrum of patient care.

Prospective students must meet certain minimum technical standards. Candidates for the M.D. degree must have the following essential functions: motor skills; sensory and observational skills; communication skills; conceptual, integrative, and quantitative skills; and behavioral and social skills and professionalism.

  1. Motor Skills: Candidates should have sufficient motor function to elicit information from patients by palpation, auscultation, percussion, and other diagnostic maneuvers. Candidates should be able to execute motor movements necessary to provide general care and emergency treatment to patients.

  2. Sensory and Observational Skills: Candidates must be able to observe demonstrations and participate in experiments as required in the curriculum. They must be able to observe a patient accurately at a distance as well as close at hand and be able to obtain a medical history directly from the patient, while observing the patient’s medical condition. This observation necessitates the functional use of the sense of vision, hearing, and other sensory modalities.

  3. Communication Skills: Candidates must be able to communicate effectively and sensitively in oral and written form with patients. These skills must be demonstrated at times in clinical settings when the time available for communication may be limited.

  1. Conceptual, Integrative, and Quantitative Skills: These skills include measurement, calculation, reasoning, analysis, and synthesis. Problem-solving and diagnosis, the critical skills demanded of physicians, require all of these intellectual abilities. In addition, candidates must be able to comprehend three-dimensional relationships and to understand the spatial relationships of structures.

  2. Behavioral and Social Skills, and Professionalism: Empathy, integrity, concern for others, interpersonal skills, interest, and motivation are all personal qualities that will be assessed during the admissions process and throughout medical education. Candidates must possess the emotional well-being required for the full use of their intellectual abilities; the exercise of sound judgment; the prompt completion of all responsibilities attendant to the diagnosis and care of patients; and the development of mature, sensitive, and effective relationships with patients. Candidates must be able to tolerate physically taxing workloads and to function effectively when stressed. They must be able to adapt to changing environments, to display flexibility, and to learn to function in the face of the uncertainty inherent in the clinical problems of many patients.

In summary, the mission of the faculty is to prepare students for the comprehensive practice of medicine. The Committee on Admissions and the College of Medicine, in accordance with Section 504 of the 1973 Vocational Rehabilitation Act and the Americans with Disabilities Act (ADA) {Public Law 101 -3367}, has established the aforementioned essential functions of medical students and physicians. The Committee on Admissions will consider applicants for admission who demonstrate the ability to perform or to learn to perform the essential skills listed in this document. The College must ensure that patients are not placed in jeopardy by students or physicians with substantially impaired intellectual, physical, or emotional functions. Students will be judged not only on their scholastic accomplishments, but also on their physical and emotional capacities to meet the full requirements of the school’s curriculum and to graduate as skilled and effective practitioners of medicine.

Admissions Requirements

Three major areas are considered in admissions decisions: undergraduate academic preparation and achievement; personal qualities as assessed from interviews with members of the Committee on Admissions, the pre-professional evaluation, recommendations, and the personal statement included in the application; and scores on the Medical College Admissions Test (MCAT). Each of these areas is important with no one area seen as more significant in the admission decision than another. Criminal background checks may be a requirement for training at some affiliated clinical sites.

Undergraduate Academic Preparation

Because the College of Medicine recognizes the importance of a broadly based undergraduate education in the liberal arts and sciences, no specific major is required for medical school admission. Prospective candidates are encouraged to major in their area of greatest interest; and regardless of choice of major, are encouraged to pursue a course of study which achieves a balance between both science and non-science course work. Further, because of the relevance of a broadly based education to success in medical school, the Committee is particularly impressed by students whose education has provided a range of intellectual experience, including opportunities for analytical thinking and independent study. With rare exception, the completion of an undergraduate degree will be necessary in order to fulfill educational expectations. In addition to the pattern and content of courses taken, consideration is given to achievement in these courses. Generally, the average grade point average for entering classes is 3.5 overall and in prescribed course work. In support of this philosophy of education, the following are the only courses required for admission:

Required Courses

Subjects Semester Hours
Chemistry 16
Physics 8
Biology 8

English/Literature 6

Electives 52

TOTAL 90

Chemistry

A minimum of sixteen semester hours of chemistry is required — eight semester hours of organic chemistry and eight semester hours of inorganic chemistry, which may include analytical chemistry. Each of these courses must be a complete, standard, college-level course utilizing full laboratory facilities. In instances where students feel uncertain of their preparation in chemistry and wish to take additional course work, biochemistry is recommended.

Physics

Acceptable courses in physics must include laboratory credits and must adequately cover mechanics, heat, light, sound, electricity, and magnetism. Survey types of courses will not satisfy this requirement.

Biology

Eight semester hours in modern concepts of mammalian biology, including laboratory are required. Courses in botany do not meet this requirement. Applicants, particularly non-science majors, are strongly encouraged to pursue upper level coursework in the biological sciences beyond the minimum requirement. Such courses might include biochemistry, cell biology, comparative anatomy, embryology, general genetics, histology, immunology, mammalian physiology, microbiology or related courses.

English Composition

Facility in the use of both oral and written English is considered highly essential to the successful study of medicine. Introductory freshman English (six semester hours) will meet the admission requirement. Students who qualify for advanced placement credit in English will not be required to take additional English courses, although they are encouraged to do so.

Electives

In as much as the medical curriculum is devoted largely to the biological and physical sciences, a student should acquire a broad cultural background in the pre-medical preparation. The behavioral sciences, including psychology, sociology, etc., are considered valuable. Additional dimensions are derived from higher mathematics, computer sciences, languages, literature, philosophy, history, political science, economics, etymology and statistics.

Advanced placement credit or other non-traditional credit in prescribed science courses will be honored in fulfilling requirements for the College of Medicine, provided such placement has been followed by a more advanced course in the same discipline. (Example: A student granted credit for biology will be required to complete the eight semester hour requirement by taking advanced courses in that discipline.)

The Committee on Admissions will consider grade averages attained in both prescribed and elective courses. A grade of “C” or better in each of the prescribed pre-medical courses is required. If a prospective student is uncertain of the acceptability for premedical credit of a proposed course of study, and if the pre-professional advisor cannot advise in the matter, the prospective student is invited to make inquiry to the Office of Admissions, College of Medicine, The University of Tennessee, Memphis, TN 38163.

Personal Qualities and Motivation Toward Medicine

An applicant’s interest in and motivation toward the medical profession is an important factor in the admissions decision. In order to assess the motivation and personal qualities of an applicant, selected individuals are invited to campus for interviews with members of the Committee on Admissions. Both academic achievement and MCAT scores are considered by the Committee in determining who will be invited to interview. Each year, 350-400 applicants are invited for admission interviews. Interviews take place between October and February.

The personal statement on the application and recommendations submitted on behalf of the candidates allow further insight into the values and motivation of the candidates. A recommendation from the official Pre-professional Advisory Committee (where such a committee exists), or recommendation letters from three faculty members, is required. A maximum of three additional recommendations may be submitted.

Medical Experience

The Committee of Admissions considers it vital that prospective students enhance their knowledge of medicine through direct, patient-oriented clinical experience in a variety of settings. Such experience, which is frequently gained through volunteer work, should provide a greater understanding of the realities of medicine as well as an opportunity for service.

Medical College Admission Test (MCAT)

Candidates admitted to the College of Medicine must achieve a satisfactory score on the MCAT. Average scores for recent entering classes have been 9’s and 10’s. The MCAT is offered twice a year on a national basis by the Association of American Medical Colleges (AAMC). Registration for the MCAT is done online through the AAMC at www.aamc.org. The test must be taken no later than August of the year preceding the desired date of admission.

Deferred Matriculation

Students who are accepted for admission are offered the opportunity of deferring their matriculation for one year, with a guaranteed position in the following class. During the intervening period, students may earn money to finance their medical education, take advantage of additional educational experiences they may not have pursued otherwise, or take care of personal or family obligations. Those who desire to delay their entrance must notify the Associate Dean of Admissions and Student Affairs of the College of Medicine in writing by July 1, prior to the originally scheduled enrollment date

Advanced Standing

Transfer or advanced standing applications will be considered for the third year only. Regardless of availability of spaces, only students clearly demonstrating outstanding academic and personal achievement will be considered for transfer into the third year of the College of Medicine curriculum. The selection of transfer students is on a competitive basis. Deadline for application is April 1. In order to be considered by the Committee on Admissions, a candidate must supply evidence of the following:

  1. The completion of the basic requirements for admission to the College of Medicine, including Tennessee residency* at the time of admission to the medical school in which the student has been enrolled.

  2. Satisfactory completion of the equivalent of the biomedical sciences portion of the College of Medicine curriculum at an LCME accredited institution.

  3. A passing score on the Step 1 United States Medical Licensing Examination.

  4. Evidence of circumstances necessitating a transfer.

*By right of official affiliation with the UT College of Medicine, immediate family members of UT faculty and interns or residents selected for UT programs may apply for admission with advanced standing regardless of state of residence. However, as always, the candidates’ credentials will be the sole determinant of admission.

Special Programs

Underserved Areas Clinical Scholars Program

Applicants for the Underserved Areas Program must be accepted for admission to the UT College of Medicine in order to be eligible for consideration in the Underserved Areas Program. Additional information may be found at: www.utmem.edu/Medicine/ StudentAffairs/uap.html

NIH Medical Student Research Fellowship Program

The Research Program offers opportunities for medical students who have a serious interest in biomedical investigation to conduct research projects under the supervision of research faculty. A grant from the National Institutes of Health provides 24 fellowships per year including stipends for a maximum appointment of three months. Fellowship grants are available on a competitive basis to all College of Medicine students in good academic standing. A number of other research training programs are available in the Clinical Research Center, the University of Tennessee College of Medicine, St. Jude Children’s Research Center, the Graduate School of Medicine at the University of Tennessee Medical Center, Knoxville, and through various private foundations. For further information on research training opportunities, please contact the Office of the Associate Dean for Research.

M.D./Ph.D. Program

The M.D./Ph.D. Program provides highly motivated and unusually qualified students with an integrated clinical and basic biomedical training program leading to both an

M.D. and Ph.D. degree. The program’s goal is to prepare graduates with the skills needed to function independently in both clinical and basic research environments. The first and last two-year periods of the program contain the medical curriculum. The intervening two or three years are devoted to graduate study in a selected program of the College of Graduate Health Sciences. Students must be accepted to the College of Medicine to be considered for admission to the M.D./Ph.D. Program.

Information for Underrepresented Minorities

The University of Tennessee College of Medicine actively encourages applications from members of minority groups underrepresented in medicine. The Committee on Admissions evaluates nonacademic, as well as, academic factors in the selection process with consideration being given to the unique backgrounds and challenges of these applicants. Among American medical schools, The University of Tennessee Health Science Center College of Medicine is a national leader in the admission, matriculation and graduation of students from groups underrepresented in medicine.

Financial Aid

The University of Tennessee Health Science Center offers a comprehensive financial aid program to qualified students on the basis of need and ability. Financial aid is available to students in the form of grants, scholarships, loans, and part-time work. The University of Tennessee Health Science Center believes that the cost of education is the primary responsibility of the student and/or the student’s family. The purpose of aid is to reduce the difference between the cost of education and what a family can reasonably be expected to pay. A limited number of aid programs are available that do not require that students establish need. Personnel in the Financial Aid Office are available to help students explore possible financial aid sources to meet their individual needs. The goal of the office is to see that students do not forego an education because of financial need.

Careful and realistic financial planning is a necessary part of college preparation. Other services offered by the Financial Aid office include budget counseling, debt management information, and pre-loan counseling.

The Free Application for Federal Student Aid (FAFSA) is the only application required for financial aid at the University of Tennessee Health Science Center. Further information concerning the application process for financial aid and specific financial aid programs may be found at www.utmem.edu/finaid.

Policy on Employment

The College of Medicine supports the view that a successful medical school experience requires a full time commitment on the part of most students. Medical students’ primary responsibility must be to scholarship and to their academic pursuits. The College of Medicine recognizes that financing the cost of medical training may require, under very compelling circumstances, that some medical students seek employment during the academic year.

Any student considering employment is encouraged to contact the Office of Student Affairs to seek voluntary counseling. Students will be advised on (1) alternative employment options, especially those which promote further professional growth and development, (2) the impact that employment may have on academic performance, and (3) the availability of other sources of income.

Under no circumstances should the nature of the students’ work experience misrepresent the level of professional skill or knowledge. In addition, the work experience should not require a level of time commitment which could adversely affect academic performance. It should be clearly understood that the minimal standards for progress and promotion must be met by all students, regardless of employment.

Academic Policies and Procedures

Honor Code

The Honor Code of The University of Tennessee Health Science Center (UTHSC) is promulgated so that student academic affairs are conducted under the highest standards of individual responsibility. Students are bound by this Honor Code and pledge to act in accordance with the highest principles of ethical and professional conduct. These principles condemn any act of dishonor relating to the academic, clinical, research, and professional programs at UTHSC. The pledge states that any knowledge of a violation shall be reported in accordance with the provisions and procedures of the Honor Code. The College’s Honor Code has been in effect for more than 30 years. It is a tradition of which we can be proud.

Additional information may be found at: www.utmem.edu/Medicine/StudentAffairs/ groups.html.

Excerpts from the Honor Council Statement, College of Medicine, written by members of the Honor Council are as follows:

“Upon admission to the University of Tennessee College of Medicine, each student accepts the responsibility of acting with honor in course work, clinics and research, and requires the same of his peers. We have an Honor Code, a system based on the idea of personal integrity and the belief that we share a common responsibility to our profession. The success of this system rests firmly with each individual . . . rather than accept outside monitoring of our actions, we elected to monitor ourselves.

During our four years here, we face significant intellectual and personal challenges. The ethical challenges of medicine are just as important and just as demanding. If the University of Tennessee College of Medicine seeks to train good physicians and to promote a sense of honor and professional responsibility, then the Honor Code is a valuable institution. The medical undergraduate years are not too early to begin training ourselves to act with integrity and to expect the same from our peers.”

Student Records

A student’s official or permanent record pertains to academic progress, promotion and graduation, and is maintained in the Office of the Registrar. Academic, health, and disciplinary records are kept separately. Confidential records of all misconduct reports, investigations, and disciplinary actions are kept in the University of Tennessee Health Science Center Student Affairs Office. Medical records are maintained by the University Health Service, and financial aid records are maintained in The Office of Financial Aid. Transcripts of academic records are available to the individual student or his/her legal representative and to authorized members of the administration and faculty. Academic and health records are not available to others except by student request.

The University of Tennessee Health Science Center is in compliance with all provisions of the Family Educational Rights and Privacy Act of 1974, which provides enrolled students and former students the right to review the contents of certain student records which are maintained by the University. Students have the right of access to their permanent record maintained in the Registrar’s Office. Students do not have the right to access financial records of parents, or the personal memory notes of a University official or faculty member.

Student Evaluation

Biomedical Science (Years One and Two)

Examinations are given at periodic intervals during this portion of the curriculum. The content of each examination is established by the course director. The questions are generally multiple choice and computer graded. Each student’s individual examination score report is returned promptly through the student mailbox system. Scores are usually recorded in the course Blackboard site for student access.

It is the responsibility of each course director to establish the criteria for awarding course grades and the role of examinations in the determination of those grades. Any concerns relative to individual examination questions, criteria for course evaluation, or final grades should be directed to the appropriate course director. Laboratory performance, participation in small group activities, special projects, etc., may also influence the final grade in each course. Each course director is responsible for communicating this information on first day of class.

Students are expected to take examinations as scheduled. Those unable to take a scheduled examination because of illness or emergency situations must notify the Office of Academic and Faculty Affairs and the appropriate course director prior to the examination.

All students must take the United States Medical Licensing Examination (USMLE) Step 1 and pass at the national standard in order to be officially promoted to the clinical portion of the curriculum. This examination is taken by all students following the sophomore year, unless specifically deferred by the Office of Academic and Faculty Affairs.

Clinical Clerkships (Years Three and Four)

Student evaluation in the clerkships portion of the curriculum includes written examinations as well as an increased emphasis on other forms of evaluation. The clerkship examinations are normally multiple-choice type and computer graded. Oral examinations are utilized in some clerkships and are administered by faculty and house staff. In addition, clinical performance is evaluated by attending faculty and house staff in such areas as:

*
fund of information
*
interest in learning and intellectual aggressiveness
*
history taking
*
physical examination
*
technical skills
* organization of data/formulation of hypothesis
*
ability to relate to patients
*
thoroughness, consistency, and reliability with responsibilities

The methods of evaluation are established by each clerkship director and are communicated to students during each clerkship orientation. Student evaluation reports are filed with records located in the Office of Student Affairs and are available for review by the student. Student evaluations are also maintained by departmental offices.

General Guidelines for Professional Behavior and Conduct in the Third- and Fourth-Year Clerkships

The clinical rotations in the third and fourth years of medical school place demands and requirements on the students that go significantly above and beyond academic achievement as measured by performance on tests and by the ability to field questions learned through didactic instruction and reading. The student also is accountable for his or her behavior in each of the following areas:

  • Professional and Ethical Conduct: The welfare of patients and their families is of foremost concern. Students must show respect and courtesy for patients and their families, even under difficult situations such as being challenged or provoked. Students must safeguard their patients’ confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA). For example, there are to be no casual communications regarding patients in public places, such as hallways, elevators, cafeterias, gyms, etc.

  • Punctuality, Responsibility and Reliability: Students are expected to be available and present for all scheduled clerkship activities. Any absences must be approved by the clerkship director in advance. Make-up assignments will be determined by the clerkship director; absences due to illness may require a physician’s statement. Tardiness is unacceptable. Students are expected to conform to the prevailing schedule at the sites where they are assigned for their clinical instruction.

  • Getting Along with Other Members of The Medical Team: Good relationships with nurses, aides, ward clerks, and anyone else involved in the care of the patient are absolutely essential. Students are expected to be courteous to all medical staff at the sites where they are assigned for their clinical instruction.

  • Getting Along with Staff: Students need to be polite and respectful to people other than the patients, faculty and residents, and hospital employees. Much of the daily work in keeping a clerkship going falls on the shoulders of administrative assistants, secretaries, receptionists, and other staff. Students are expected to be considerate of and courteous to all of these employees.

  • Getting Along with Peers: Students are expected to have pleasant working relationships with their fellow students. This includes an equitable sharing of the workload and helping and supporting each other.

If clerkship directors receive consistent complaints about a student in any of these areas, the student’s grade may be affected. Serious documented problems with unprofessional or unethical behavior, in the judgment of the clerkship director, may result in a failing grade even if the student has passed the written or oral examinations and has otherwise satisfactory clinical ratings. Also, consistent or serious complaints about unprofessional or unethical behavior may be reflected in the Medical Student Performance Evaluation (Dean’s Letter).

There may be times when a student has a personal problem or a personality conflict that impairs his or her ability to function properly on the clerkship. It is the student’s responsibility to promptly notify the clerkship director when this first occurs and not after the fact.

General Policy on Retaking Examinations in the Core Clerkships

Students who fail the written examination but have passed the clinical portion of a core clerkship can retake the written exam once. The student will be assigned a letter grade of “R” until the written examination is retaken. The retake must be done by the end of Block 8, the year prior to graduation. A second failing score on the exam, or failure to retake the exam on time, will result in the assignment of a failing grade for the clerkship.

A student unable to take a clerkship examination due to illness or other emergency situation must notify the director of that clerkship. Concerns affecting individual examination questions or other forms of evaluation, as well as final grades, should be directed to the appropriate clerkship director.

United States Medical Licensure Examinations (USMLE)

All students must take the computer-based USMLE Step 2 CK (Clinical Knowledge) Examination and the USMLE Step 2 CS (Clinical Skills) Examination, and pass at the national standard in order to be certified for graduation. Students must take the examinations no later than the end of Block 12 of their graduation year in order to be certified for graduation.

Grading System

The faculty evaluates the academic achievement, acquisition of skills, and attitudes of medical students and uses the marks of A, B, C, D, F, W, WP, WF, I, and R in all official reports. In certain instances, some courses may be graded on a PASS/FAIL basis. The performance level and quality value assigned to performance are outlined in the following

table:
Grade Performance Level Quality Points
A Consistently outstanding 4
B Exceeds expectations 3
C Satisfactory 2
D Marginal 1
P Pass 0
F Failure 0
WP Withdrew Passing 0
WF Withdrew Failing 0
W Withdrew Before Evaluation 0
I Incomplete 0

R Retake of Written Clerkship Exam 0

The letters “WP” or “WF” are recorded to indicate pass or failure in those instances in which a student withdraws from a course/clerkship before completion, and is either passing or failing, respectively. The letter grade of “W” will be recorded when a student withdraws from a course/clerkship before there has been evaluation of the student to determine whether he/she is passing or failing.

The designation of “I” (Incomplete) will be used when a student is unable to complete the course/clerkship at the regular time. In such cases, arrangements will be made by the course/clerkship director for the student to complete the requirements, and the “I” will then be replaced by whatever grade the student earns. It is the responsibility of the student to work with the course/clerkship director in determining when and under what circumstances the “I” grade can be changed.

The designation of “R” will be recorded in those instances in which a student completes all requirements in a clerkship and passes the clinical portion but fails the written examination. The student will retake the written examination and the appropriate grade will be assigned by the clerkship director.

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Role and Calculation of the Cumulative Grade Point Average

The cumulative grade point average recorded on the transcript from the Registrar is used by the Progress and Promotions Committee (PPC), in part, to make recommendations about the promotion and continuation of students in the curriculum.

For a student who must retake either courses or clerkships to correct academic deficiencies, the cumulative grade point average (GPA) is calculated by averaging the final grades attained in all courses or clerkships in which he/she has been enrolled for academic credit. This includes those courses or clerkships repeated at the University of Tennessee Health Science Center and those courses approved by the PPC to be taken at other AAMC institutions.

Repeating First- and Second-Year Courses

A student withdrawing from courses in the first or second year will receive either a “W”, or “WP”, or “WF”, as appropriate, on his/her official transcript. When a student does not complete a first- or second-year course at the University of Tennessee Health Science Center, he/she must repeat the course at the Health Science Center.

The Progress and Promotions Committee has the option of recommending that a student who completes but fails first- or second-year courses, or a student who has “D” grades with a cumulative GPA less than 2.0 at the end of the first or second academic years, may correct the academic deficiency or unacceptable cumulative GPA requirement by successfully completing either courses taken at other institutions, courses repeated at the University of Tennessee Health Science Center, or both. Any student earning the grade of “D” in two or more courses in any of the first two academic years irrespective of cumulative GPA will have his/her academic record reviewed by the appropriate Progress and Promotions Committee. The Committee may make one of the following recommendations concerning this student: a) re-evaluation in specified course(s); b) repeat part or all of the particular academic year; and c) no recommendation. All courses taken for academic credit are recorded on the official transcript and computed in the GPA.

Promotion

A Progress and Promotions Committee (PPC) is appointed for each matriculating class. The committee is charged by the Dean of the College of Medicine with monitoring and making recommendations concerning the results of individual student performance in the curriculum until graduation. Special requirements for promotion during each year are outlined below:

Freshman and Sophomore Years:
  1. Each student must obtain a passing grade (D or better) in each course. Students having a grade of “D” in two or more courses will have their academic record reviewed regardless of GPA.

  2. Each student must obtain an overall cumulative grade point average (GPA) of 2.0 (on a 4.0 scale) at the end of each year.

  3. Each student must obtain a passing score at the national standard on the USMLE Step 1 before matriculating into the clinical program.

Junior and Senior Years:
  1. Each student must obtain a “C” or better, or “P” grade in each clerkship.

  2. Each student must obtain a “C” or better, or “P” in each elective.

  3. Each student must obtain a passing score at the national standard on the USMLE Step 2CK before graduating.

  4. Each student must obtain a passing score on the USMLE Step 2CS Examination before graduating.

Requirements for the Degree of Doctor of Medicine

The College of Medicine offers an educational program leading to the Doctor of Medicine (M.D.) degree. The program is designed so that the student can complete this academic program over four calendar years.

The M.D. degree is awarded after completion of degree requirements at the next regularly scheduled commencement, which is held in May and December of each year. The diploma, as well as each student’s official transcript, reflects the awarding of the M.D. degree.

The transcript will be posted with the date of completion of all degree requirements for those students who complete requirements for the Doctor of Medicine degree out of phase. However, the degree will not be awarded until the next regularly scheduled commencement.

Licensure Examination

Each individual state determines requirements for licensure to practice medicine in that state and maintains the standards of medical practice in accordance with its own rules and regulations. To this end, each state has a medical licensure board charged with maintaining the standards for licensure in that state and in evaluating credentials submitted to them for licensure. Regulations of state licensing boards are subject to change without notice and each board should be contacted concerning the specific requirements for licensure in that state.

The Federation of State Medical Boards of the United States (FSMB) and the National Board of Medical Examiners (NBME) have established a single common uniform examination for medical licensure in the United States, the United States Medical Licensing Examination (USMLE). The USMLE is a single examination program with three complementary steps. Step 1 assesses whether an examinee understands and can apply key concepts of basic biomedical science, with an emphasis on principles and mechanisms of health, disease, and modes of therapy. The USMLE Step 2 has two components. Step 2 CK (Clinical Knowledge) assesses whether an examinee possesses the medical knowledge and understanding of clinical science considered essential for the provision of patient care under supervision, including emphasis on health promotion and disease prevention. The Step 2 CS (Clinical Skills) assures that examinees have the information gathering and communication skills necessary to enter supervised postgraduate education and for subsequent licensure.

A passing score on the Step 1, 2 CK, and 2CS Examinations is a requirement for the MD degree at the University of Tennessee College of Medicine A student will normally sit for the Step 1 Examination at the end of his/her sophomore year and will sit for the Step 2 Examinations by December 31 of his/her senior year.

Step 3 assesses whether an examinee possesses the medical knowledge and understanding of biomedical and clinical science considered essential for the unsupervised practice of medicine.

To be eligible for the Step 3 Examination, an individual must obtain the MD degree and must have completed successfully Step 1, Step 2 CK, and Step 2 CS Examinations. The USMLE Step 1 and Step 2 exams are administered by the National Board of Medical Examiners for all eligible examinees. Further information can be found at www.nbme.org. The Step 3 Examination is administered by licensing authorities for the State of Tennessee. Information can be obtained from the Tennessee State Board of Medical Examiners.

Curriculum and Course Listing

Four-year Curriculum at a Glance —

The University of Tennessee College of Medicine

STATUS FIRST YEAR

Doctoring: Recognizing Signs and Symptoms (DRS)

Prevention, Community and Culture (PCC)

Molecular Basis of Disease

Physiology

Gross Anatomy

Interprofessional Health Practice

SECOND YEAR

DRS

PCC

Microbiology

Neurosciences

Pathology

Pathophysiology

Pharmacology

Interprofessional Health Practice

Step 1 - United States Medical Licensing Examination

THIRD YEAR

DRS/PCC - 2 weeks

Family Medicine - 8 weeks

Medicine - 8 weeks

Obstetrics & Gynecology - 8 weeks

Pediatrics - 8 weeks

Psychiatry/Neurology - 8 weeks

Surgery - 8 weeks

Interprofessional Health Practice

FOURTH YEAR

DRS/PCC - 1 week

Ambulatory Medicine - 4 weeks

JI - Any - 4 weeks

JI - Medicine - 4 weeks

Specialty Clerkship - 4 weeks

Surgery Specialties - 4 weeks

Interprofessional Health Practice

Patient Safety/Quality Improvement Clerkship - 4 weeks

Electives - 16 weeks

Optional Blocks - 12 weeks

Step 2 - United States Medical Licensing Examinations —
CK (Clinical Knowledge) Exam and CS (Clinical Skills) Exam

Begin Residency Training as M.D.

First Year

The biomedical sciences portion of the curriculum is approximately 72 weeks in duration. The first year curriculum runs from August through March, and is devoted to the courses of Prevention, Community and Culture; Doctoring: Recognizing Signs and Symptoms; Gross Anatomy; Molecular Basis of Disease; Physiology, and Interprofessional Health Practice.

The first year format consists primarily of basic science activities in the General Education Building. Approximately twenty hours weekly are devoted to scheduled activities.

Conferences/ Required Courses Lecture Small Group/ Total Semester Hours Lab Hours Hours Hours

Doctoring: Recognizing Signs

and Symptoms 10 50 60 3 Prevention, Community, and Culture 21 16 37 3 Gross Anatomy 87 92 179 7 Molecular Basis of Disease 113 44 157 9 Physiology 112 69 181 9 Interprofessional Health Practice

Fall and Spring Semesters

111 DRS- Doctoring: Recognizing Signs and Symptoms (3 credit hours). This introductory course in the art and science of patient care is presented in five block-weeks throughout the fall and spring semesters. DRS is a hands-on course that introduces skills such as patient communication, medical history-taking, physical examination, case presentation, and chart documentation. Also presented are basic skills in recognition and interpretation of signs and symptoms of health and disease. Learning activities include interactive small group sessions with upper class students and clinical faculty, and a community preceptor experience with a practicing physician in the Memphis area. Assessment of clinical skills is by participation in learning activities, written assignments modeling patient charting, and ratings on observed standardized patient encounters at the end of the spring semester.

111 PCC- Prevention, Community, and Culture (3 credit hours). This curriculum introduces patient care through cases structured along a preventive medicine theme. The course also includes human behavior issues, ethics, professionalism, alternative and complementary medicine, nutrition, and epidemiology. The case discussions occur in small groups facilitated by clinicians and require self-directed learning, synthesis of information, and presentation skills. In addition, a community (service learning) project is required in which the student will learn the challenges of community organizations in providing services for clients. The course is taught in five week-long blocks spanning the first year.

PCC and DRS are components of a longitudinal curriculum that spans all four years.

IP 844 - Interprofessional Health Practice - Provides a framework for students to discover the benefits of a practice that actively engages all health professions. The course focuses on the role and scope of practice of various health professionals; how teams function and the benefits of teamwork; and effective patterns of communication and collaboration among health care team members. IP844 consists of three phases. Phase 1 is web-based and introduces the student to different healthcare professions; Phase 2 consists of small group sessions designed to introduce teamwork; and Phase 3 allows the student to experience interprofessional activities. Most face-to-face sessions will take place during the two hours set aside every Thursday for Chancellor’s Hours. The course is longitudinal, with 3-semester credit hours awarded in the last semester of the degree program and is graded Pass/Fail.

111 GA- Human Gross Anatomy (7 credit hours). A study of the gross anatomical structure of the human body by means of complete dissection supplemented by lectures and the study of cross sections. Human embryology is included in the program.

111 MBD - Molecular Basis of Disease (9 credit hours). MBOD is an integrated course covering the principles of biochemistry, cell biology, genetics, and molecular biology, with an emphasis on clinical applications. The course focuses on the basic interdisciplinary concepts underlying modern biomedical science. The principles of medical genetics are woven throughout the course giving the student a basic and practical fund of knowledge that can be used in the clinical clerkships. The course is a blend of lectures, clinical correlations (some involving patients), small group problem-solving sessions, and large group conferences.

123 PHYS - Medical Physiology (9 credit hours). Integrated histology and general organology with the functioning of the human body is considered, ranging from cellular to higher organ-system levels. Lectures are supplemented with weekly or biweekly conference meetings of small groups of students with individual faculty for demonstrations, special clinical correlations, and problem-solving exercises.

Beginning in the late spring of the first academic year, students are exposed to basic concepts in Immunology, which is a part of the Microbiology course, Neurosciences, Pathology and Pharmacology. These courses continue into the second year with credit awarded at the completion of the entire course.

Conferences/ Total Hours
Required Courses Lecture Small Group/ First
Hours Lab Hours Academic Year
Microbiology (Immunology) 20 20
Pathology 9 9
Neurosciences 23 10 33
Pharmacology (Basic Concepts) 22 22

212 MICR - Medical Microbiology (6 credit hours). A course that presents the concepts of immunology and immunity, the basic aspects of microbial morphology, growth metabolism and genetics, the actions of anti-microbial agents, and the role of microorganisms in infectious diseases. Laboratory experiences complement and expand the didactic material. Grades are assigned in the spring semester of the second year.

212 NEUR - Neurosciences (7 credit hours). This is a lecture/laboratory course dealing with the anatomy and function of the central nervous system (CNS). The course includes the anatomy of the brain and spinal cord, location of nuclei and their interconnections, and the origin and termination of major fiber pathways in the CNS. Localizing neurology, disorders of cognitive function and the major classes of neurologic disease are discussed. Problem-solving sessions related to clinical application are emphasized. The course allows the student to achieve an understanding of a clinical approach to neurologic disease. Grades are assigned in the spring semester of the second year.

214 PATH - Pathology (9 credit hours). The course develops the principles of the discipline of pathology. Normal organology and integrated histology are part of the course which presents disease by organ systems. The methods of instruction include lecture, laboratory experiences, demonstrations, and group discussions. Grades are assigned in the spring semester of the second year.

222 PHA- Medical Pharmacology (6 credit hours). The medical student is introduced to the pharmacologic concepts of the action of drugs and other xenobiotics. The classification, mechanisms of action, and toxic effects of pharmacologic agents are stressed. Discussion of representative examples of major drug classes are emphasized, and treatment modalities, whenever appropriate, are presented. This basic course uses lectures, clinical correlative discussions, and independent study to assist the student in understanding pharmacologic therapy in the clinical phase of his/her medical education. Grades are assigned in the spring semester of the second year.

Second Year

Some concepts in the courses of Neurosciences, Microbiology, Pathology, and Pharmacology are presented in the months of April and May and these courses continue into the second year along with Pathophysiology. Students also participate in a series of Clinical Pathology Conferences (CPC), which are integrated small group case discussions focusing around related content from Pathology, Pathophysiology and Pharmacology. PCC and DRS continue in the second year in 5 week-long blocks, and students may participate in Phase 3 of IP 844.

Total Hrs. Conferences/ Second Required Courses Lecture Small Group/ Academic Semester Hours Lab Hours Hours Hours

Prevention, Community and Culture 22 16 38 4 Doctoring 10 50 60 4 Microbiology 64 11 75 6 Neurosciences 68 0 68 7 Pathology 61 48 109 9 Pathophysiology 121 31 152 12 Pharmacology 66 8 74 6

Fall and Spring Semesters

The courses of Microbiology (212 MICR), Pathology (214 PATH), Neurosciences (212 NEURO) and Pharmacology (222 PHA) described above continue in August and run through March of the second year. In addition, students participate in the following courses.

212 PAPH- Pathophysiology (12 credit hours). Based on the concept that pathophysiology is the study of alterations in or derangements of normal bodily function that result from disease processes, this multidisciplinary course is designed to bridge the gap between the basic sciences and the clinical disciplines. The main goal is to correlate the anatomic, biochemical, physiologic, and pathologic mechanisms that underlie commonly encountered clinical problems. The course is particularly important in creating an awareness in the medical student that basic science is highly relevant to clinical medicine, and that knowledge of the underlying pathophysiology of a disease process facilitates the understanding of its etiology, clinical presentations, and therapeutic alternatives. In addition to traditional lectures, emphasis is placed on non-lecture formats, such as laboratory sessions, small group integrative seminars, and related clinical correlation conferences. Grades are assigned in the spring semester of the second year.

211 DRS- Doctoring: Recognizing Signs and Symptoms (4 credit hours). Continuation of the course in the art and science of patient care presented in five week-long blocks throughout the fall and spring semesters.

211 PCC- Prevention, Community, and Culture (4 hours credit). This course continues the discussion of patient care through case discussions in small groups requiring self-directed learning, synthesis of information, and presentation skills. Community projects continue through the second year.

The Biomedical Science component of the curriculum is completed in March. Students then sit for the USMLE Step 1 Exam prior to beginning clerkships.

Third Year Begins May

Students proceed directly into the Third Year Clinical Clerkships upon 1) successful completion of the Biomedical Sciences, and 2) obtaining a passing score on the United States Medical Licensing Examination (USMLE), Step 1. Occasionally, students may elect to delay entry into the clerkship program in order to pursue graduate studies.

Criminal background checks may be a requirement for training at some affiliated clinical sites. Based on the results of these checks, an affiliated clinical site may determine to not allow your presence at their facility. Additionally, a criminal background may preclude licensure or employment.

Students begin the third year with a week-long DRS/PCC block which focuses on providing clinical skills essential to success in the clerkships. During the clerkships, students focus their attention and efforts on patient problem-solving and experience an increasing level of responsibility throughout the rotations. Student workload in the third year is controlled by the director of each clerkship. The total amount of time allotted for third-year clerkships is 48 weeks, which is taken over a 64-week period.

After completion of a minimum of three core clerkships, students may choose one or more electives to enhance their skills and understanding in a specific discipline before

completing all six required clerkships.
Clerkship Duration
DRS/PCC 2 weeks
Family Medicine 8 weeks
Medicine 8 weeks
OB/GYN 8 weeks
Pediatrics 8 weeks
Psychiatry/Neurology 8 weeks
Surgery 8 weeks

These clerkships provide a breadth of clinical experiences in the major care areas. Students become an integral part of the health-care team in an academic setting involving both house staff and faculty as well as ancillary services of the teaching hospitals. Programs are available in facilities in Memphis, Knoxville, Chattanooga and Nashville.

DRS/PCC-3001/F - Prevention, Community, and Culture (2 credit hours). The M3 DRS/PCC course consists of a week of “Preparing for Clerkships” and periodic workshops. The content of the introductory week includes charting skills, ECG and radiology workshops, “what to do in a code,” suturing and knot tying sessions, venipuncture, and TB mask fitting. Clinical reasoning and differential diagnosis of common complaints, such as abdominal pain and headache, are reviewed. Workshops include interdisciplinary topics such as HIV/AIDS, hospital nutrition, end-of-life care, smoking cessation, complementary and alternative medicine, and medical disabilities.

FME1-3001/F - Core Clerkship in Family Medicine (14 credit hours). The Family Medicine Clerkship is an eight-week clinical experience during which students participate in a unique breadth of patient care in the context of family and community.

Students experience traditional office-based practice under the supervision of a community-based family physician preceptor. With the office practice as a base, the family physician serves all aspects of patient care involving both inpatient and outpatient settings, ranging from the hospital to the nursing home. Students are placed with family physicians that practice the full breadth of the discipline, including obstetrical care, whenever feasible.

The department maintains a wide array of approved clinical training sites throughout the state of Tennessee and works closely with students to identify mutually agreeable clinical assignments. Student hardships will be considered in making the final assignment.

The clerkship is a full-time learning experience, typically mirroring the family physician preceptor and including both weekend responsibilities and night call. Students have several written assignments to complete as well as assigned readings during the eight weeks. This clerkship is also offered in Knoxville (FME2-3001/F) and Chattanooga (FME3-3001/F).

MED1-3001/F - Core Clerkship in Medicine (14 credit hours). The clinical clerkship in medicine is designed to provide the medical student with an opportunity to learn by experience in patient care and by the examples set by the faculty and house staff. The student is a participating member of the clinical team responsible for patient care which includes residents and the attending physician. A student is expected to: 1) acquire skill and efficiency in history taking and physical examinations, in technical procedures, in the assembly and interpretation of laboratory data, and in patient diagnosis and management; 2) apply to clinical problems the knowledge and facts acquired in the biomedical sciences; and 3) read current medical journals as well as textbooks. Each student is assigned to the University Medical Services at the Veterans Affairs Medical Center, the Regional Medical Center or Methodist University Hospital for the eight-week rotation. At the mid-point of the clerkship, each student will switch from one hospital assignment to another. Alternatively, students may rotate through Baptist Hospital in Nashville for four weeks of their rotation (Nashville MED4-3001/F). This clerkship also is offered in Knoxville (MED2-3001/F) and Chattanooga (MED3-3001/ F).

NEU1-3001/F - Core Clerkship in Neurology (7 credit hours). This four-week experience is offered in an eight-week rotation in concert with the Psychiatry Clerkship. The clinical sites for the clerkship are at Baptist Memorial Hospital, Methodist University Hospital, and the Veterans Affairs Medical Center. The major emphasis is on developing skills in neurological history taking and in the performance and interpretation of the neurologic examination. The clinical correlations of neurostructure and function taught in Neurosciences are expanded upon in the clinical setting. An exposure to the various categories of neurologic disorders and their pathophysiology is provided. The diagnostic approach to the patient stresses both anatomic and etiologic considerations. Neurology is a focal point for the dynamic advances in our understanding of the pathogenesis of disease and related new therapies. Currently, this clerkship is offered only in Memphis.

OBG1-3001/F - Core Clerkship in Obstetrics and Gynecology (14 credit hours). This required eight-week clerkship is designed to familiarize the student with female pelvic anatomy and the normal menstrual cycle. In addition, obstetric and gynecologic history taking and pelvic examination are taught, along with the normal physiology of pregnancy and care of the normal pregnant woman through the antepartum, int