Oct 03, 2024  
2018-2019 Quillen College of Medicine 
    
2018-2019 Quillen College of Medicine [ARCHIVED CATALOG]

Academic Degrees and Curricula



College of Medicine Degrees

The Quillen College of Medicine offers three degrees: the Doctor of Medicine degree (M.D.); a combined Doctor of Medicine/Master of Public Health degree (M.D./M.P.H.); and the Doctor of Philosophy degree in Biomedical Science (Ph.D.).

The Ph.D. is offered through the School of Graduate Studies. The courses and research leading to the Ph.D. are conducted under the auspices of the basic science faculty of the College of Medicine. More information about this program can be found at https://www.etsu.edu/com/grad/.

The dual M.D./M.P.H. degree program is a five-year integrated program in partnership with the ETSU College of Public Health (see MD/MPH Dual Track Program; https://www.etsu.edu/com/sa/admissions/mdmph.php). 

All degrees are awarded by the East Tennessee State University Board of Trustees upon successfully completed requirements and certification of program faculty.

Requirements for the Degree Doctor of Medicine

The doctor of medicine degree is conferred upon students who have satisfactorily completed not less than the equivalent of four years of study in the medical sciences. All courses and clerkships, required and elective, must be completed with a passing grade. In order to receive the degree, a minimum of the final two years of study must be completed as a student at the Quillen College of Medicine. Assessment of student performance is in both cognitive and noncognitive realms (Student Assessment System ).

Curriculum for M.D. Candidates

Curriculum information will continue to be revised as ongoing curriculum changes take place. These changes may be implemented for the period covered by this catalog.

The Quillen College of Medicine curriculum, typically occurring over four years, consists of science courses basic to medicine and courses in applied clinical medicine. The first two years of the curriculum (pre-clinical phase) emphasize the foundational scientific information needed to become a competent physician and its clinical relevance while introducing early clinical skills. Clinical skills such as communications and physical examination are introduced in the first- year and built upon with clinical experiences over the remainder of the curriculum. Beyond scientific knowledge the curriculum instills professional values in developing physicians. Throughout the curriculum efforts are made to integrate and reinforce concepts. By the conclusion of the four year curriculum students will be well prepared to begin the next stage of their training as resident physicians.

Students are to successfully complete the required curriculum by June 15 of the sixth year after matriculation; the first two years of the curriculum must be completed within three years of the initial matriculation date.  No more than a cumulative six (6) years is allowable for the completion of the entire curriculum.  

Institutional Educational Objectives

The curriculum is designed to assist students in gaining the fundamental information, attitudes, skills, and practice principles required to enter residency training while encouraging the lifelong acquisition of knowledge and skills needed to advance the practice of medicine. Consistent with this institutional purpose, the Medical Student Education Committee has adopted the following educational objectives.These objectives are achieved through course and clerkship offerings with specific goals and objectives as well as through involvement in an environment that continually demonstrates by example.

https://www.etsu.edu/com/msec/institutionaleducationalobjectives.php 

1. Patient Care

Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

1.1 Perform all medical, diagnostic, and surgical procedures considered essential for the area of practice
1.2 Gather essential and accurate information about patients and their conditions through history-taking, physical examination, and the use of laboratory data, imaging, and other tests
1.3 Organize and prioritize responsibilities to provide care that is safe, effective, and efficient
1.4 Interpret laboratory data, imaging studies, and other tests required for the area of practice
1.5 Make informed decisions about diagnostic and therapeutic interventions based on patient
information and preferences, up-to-date scientific evidence, and clinical judgment
1.6 Develop and carry out patient management plans
1.7 Counsel and educate patients and their families to empower them to participate in their care and enable shared decision-making
1.8 Provide appropriate referral of patients including ensuring continuity of care throughout transitions between providers or settings, and following up on patient progress and outcomes
1.9 Provide health care services to patients, families, and communities aimed at preventing health problems or maintaining health
1.10 Provide appropriate role modeling

2. Knowledge for Practice

Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care

2.1 Demonstrate an investigatory and analytic approach to clinical situations
2.2 Apply established and emerging bio-physical scientific principles fundamental to health care for patients and populations
2.3 Apply established and emerging principles of clinical sciences to diagnostic and therapeutic decision-making, clinical problem-solving, and other aspects of evidence-based health care
2.4 Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations
2.5 Apply principles of social-behavioral sciences to provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care seeking, care compliance, and barriers to and attitudes toward care

3. Practice-Based Learning and Improvement

Demonstrate the ability to investigate and evaluate one’s care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning

3.1 Identify strengths, deficiencies, and limits in one’s knowledge and expertise
3.2 Set learning and improvement goals
3.3 Identify and perform learning activities that address one’s gaps in knowledge, skills, and/or attitudes
3.4 Systematically analyze practice using quality improvement methods, and implement changes with the goal of practice improvement
3.5 Incorporate feedback into daily practice
3.6 Locate, appraise, and assimilate evidence from scientific studies related to patients’ health problems
3.7 Use information technology to optimize learning
3.8 Participate in the education of patients, families, students, trainees, peers, and other health professionals
3.9 Obtain and utilize information about individual patients, populations of patients, or communities from which patients are drawn to improve care
3.10 Continually identify, analyze, and implement new knowledge, guidelines, standards, technologies, products, or services that have been demonstrated to improve outcomes

4. Interpersonal and Communication Skills

Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals

4.1 Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds
4.2 Communicate effectively with colleagues within one’s profession or specialty, other health professionals, and health related agencies (see also 7.3)
4.3 Work effectively with others as a member or leader of a health care team or other professional group (see also 7.4)
4.4 Act in a consultative role to other health professionals
4.5 Maintain comprehensive, timely, and legible medical records
4.6 Demonstrate sensitivity, honesty, and compassion in difficult conversations, including those about death, end of life, adverse events, bad news, disclosure of errors, and other sensitive topics
4.7 Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions

5. Professionalism

Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles

5.1 Demonstrate compassion, integrity, and respect for others
5.2 Demonstrate responsiveness to patient needs that supersedes self-interest
5.3 Demonstrate respect for patient privacy and autonomy
5.4 Demonstrate accountability to patients, society, and the profession
5.5 Demonstrate sensitivity and responsiveness to a diverse patient population,  including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
5.6 Demonstrate a commitment to ethical principles pertaining to provision or withholding of care, confidentiality, informed consent, and business practices, including compliance with relevant laws, policies, and regulations

6. Systems-Based Practice

Demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care

6.1 Work effectively in various health care delivery settings and systems relevant to one’s clinical specialty
6.2 Coordinate patient care within the health care system relevant to one’s clinical specialty
6.3 Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population-based care
6.4 Advocate for quality patient care and optimal patient care systems
6.5 Participate in identifying system errors and implementing potential systems solutions
6.6 Perform administrative and practice management responsibilities commensurate with one’s role, abilities, and qualifications

7. Interprofessional Collaboration

Demonstrate the ability to engage in an interprofessional team in a manner that optimizes safe, effective patient- and population-centered care

7.1 Work with other health professionals to establish and maintain a climate of mutual respect, dignity, diversity, ethical integrity, and trust
7.2 Use the knowledge of one’s own role and the roles of other health professionals to appropriately assess and address the health care needs of the patients and populations served
7.3 Communicate with other health professionals in a responsive and responsible manner that supports the maintenance of health and the treatment of disease in individual patients and populations
7.4 Participate in different team roles to establish, develop, and continuously enhance interprofessional teams to provide patient- and population-centered care that is safe, timely, efficient, effective, and equitable

8. Personal and Professional Development

Demonstrate the qualities required to sustain lifelong personal and professional growth

8.1 Develop the ability to use self-awareness of knowledge, skills, and emotional limitations to engage in appropriate help-seeking behaviors
8.2 Demonstrate healthy coping mechanisms to respond to stress
8.3 Manage conflict between personal and professional responsibilities
8.4 Practice flexibility and maturity in adjusting to change with the capacity to alter one’s behavior
8.5 Demonstrate trustworthiness that makes colleagues feel secure when one is responsible for the care of patients
8.6 Provide leadership skills that enhance team functioning, the learning environment, and/or the health care delivery system
8.7 Demonstrate self-confidence that puts patients, families, and members of the health care team at ease
8.8 Recognize that ambiguity is part of clinical health care and respond by utilizing appropriate resources in dealing with uncertainty

M1 Requirements

Refer to Typical Curriculum and Course Designations   for additional information.

  • ANTY-1314 Medical Human Gross Anatomy and Embryology
  • BCHM-1315 Cellular and Molecular Medicine
  • CBIO-1312 Cell & Tissue Biology
  • CSKL-1350 Doctoring I
  • HGEN-1311 Genetics
  • MEDU-1322 Clinical Epidemiology and Biostatistics
  • PHSY-1322 Medical Physiology
  • PSYH-1312 Lifespan Development
  • IDMD-1940 Rural Health Research and Practice (RPCT ONLY)

Elective Course Offerings

Several electives are available to students in all four years of the curriculum.  In general these are optional enrichment electives which are taken as a Pass/Fail elective, but do not replace other degree requirements.  Currently these electives include: The Healer’s Art, Spanish for Medical Students, Global Healthcare: Perspective & Practice, Global Healthcare: Disease Treatment & Prevention; Substance Abuse and Addiction in Appalachia, Holocaust Whispers: Lessons in Resilience, and Interprofessional End of Life Care.

Comprehensive Basic Science Exam

The Comprehensive Basic Science Examination (CBSE) produced by the National Board of Medical Examiners will be administered to first- and second-year students as a means of both program evaluation and individual student assessment.  All students will be required to take the CBSE at the end of the first and second years.  Aggregate data will be used by the Medical Student Education Committee for program evaluation. Individual student data will be primarily used for student self-assessment. While results of this examination may be used to advise students regarding their personal progress in mastering foundational concepts and for USMLE Step 1 preparation, these results will not be used for decisions related to grading or advancement in the curriculum.

M2 Requirements

Refer to Typical Curriculum and Course Designations ​  for additional information.

  • CSKL-2350 Doctoring II
  • MCRO-2321 Medical Microbiology & Immunology
  • NEUR-2321 Clinical Neuroscience
  • PATH-2321 Pathology
  • PHRM-2312 Medical Pharmacology
  • PSYH-2312 Intro to Clinical Psychiatry
  • IDMD-2950 Rural Com Based Health Projects (RPCT ONLY)

United States Medical Licensing Examination (USMLE)

The United States Medical Licensing Examination® (USMLE®) is a three-step examination for medical licensure in the United States and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®).

The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care.

All students are required to take USMLE Step 1 before the beginning of the third year curriculum. As a requirement for graduation, students must pass Step 1 and both components of USMLE Step 2, Clinical Knowledge (CK) and Clinical Skills (CS).  

Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy.

Step 2 assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention

Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 is usually taken during residency.

Students are responsible for the timely application and payment of all fees and expenses related to the examinations. Information and application forms are available online at http://www.usmle.org . Students are required to prepare for and complete the Step 1 exam prior to the beginning of the required Transitions to Clerkship course at the beginning of the junior year.  

Exceptions to this requirement may occur. Based on a detailed review of prior academic performance by the Executive Associate Dean for Academic and Faculty Affairs (EAD), some students may be identified as eligible to delay taking the exam, preceded by a period of special studies preparation time. Eligible students who choose to delay taking the exam must submit a written request for the delay, accompanied by a study plan outline to the EAD for review and approval. Students approved for the delay will be required to submit periodic progress reports to the EAD. These students are expected to take Step 1 by the end of Period 1 of their junior year.

In the event any student fails USMLE Step 1 on their first attempt, the following principles will guide modifying the student’s schedule to prepare for a successful retake of the exam and to complete at least two clerkship periods by the end of the fall semester.

  1. Students already in a clerkship when they receive a failing score will generally be expected to complete the current clerkship before taking the next clerkship period off as special studies preparation time to prepare to retake the exam by the end of that clerkship period. No more than two clerkship periods in the fall semester may be permitted for special studies. These periods of special studies cannot to be taken consecutively.
  2. For periods of special study students must submit a written study plan to the EAD for review and approval. Students will submit periodic progress reports.
  3. Students without a passing score by the beginning of Period 5 may elect to continue with up to two additional periods of special studies or begin a Leave of Absence until a passing score is achieved. Once a passing score is achieved students may resume their third year curriculum with the next available clerkship period.
  4. All required third year clerkships must be completed before beginning clinical requirements of the fourth year.

Students are strongly encouraged to take both components of Step 2 prior to beginning of or very early in their fourth year. Both components of Step 2 must be passed before a student can graduate. The National Board of Medical Examiners (NBME) determines the passing score for each exam and sets rules for eligibility for each exam. This body also sets all policy regarding repeats of any step of the exam and the frequency of any repeats. Both passing scores and rules regarding repeats change occasionally and all students should be familiar with current policy. This information is available through the USMLE website at www.usmle.org.

For more information, please refer to https://www.etsu.edu/com/acadaffairs/studentinfo/nbme/default.php and https://www.etsu.edu/com/msec/resources/policies.php.

OSCE Competency for Promotion to the Senior Year

Prior to beginning the third year of the curriculum, all students are required to take the Clinical Proficiency Competency Objective Structured Clinical Examination (OSCE).  The purpose of this competency is to:

  1. Assess the clinical skills learned during the pre-clinical years
  2. Assess how students integrate those clinical skills
  3. Provide formative and summative feedback to student on their clinical skills
  4. Establish both readiness to proceed into the clinical years and guidance to students how best to focus their ongoing clinical training in the clinical years
  5. Prepare students for the format of the USMLE Step 2-Clinical Skills Exam

M3 Requirements

Refer to Typical Curriculum and Course Designations ​  for additional information.

  • COMD-3051 Jr. Community Medicine Clerk (Traditional ONLY)
  • FMED-3052 Family Medicine Clerkship (Traditional ONLY)
  • GMED-3000 Transitions to Clinical Clerkships
  • IMED-3053 Jr. Internal Medicine Clerkship
  • MEDU-3011 Jr Clinical Experience
  • MEDU-3314 Career Exploration III
  • OBGY-3054 Obstetrics/Gynecology Clerkship
  • PEDS-3055 Pediatrics Clerkship
  • PSYH-3056 Psychiatry Clerkship
  • SURG-3058 Jr. Surgery Clerkship
  • RPCT-3059 Jr RPCT Primary Care Clerkship (RPCT ONLY)

Required Clinical Skills

 

All QCOM students are required to satisfactorily demonstrate (perform and interpret results) the following clinical skills as a requirement for graduation (must be completed by the end of the third year; can be accomplished on any clerkship): 

  • Arterial puncture
  • Aseptic technique
  • Bacterial culture
  • EKG
  • Foley catheter insertion
  • Glucose test finger-stick
  • GTA training
  • Injections-intramuscular and subcutaneous
  • KOH prep
  • Nasogastric tube insertion
  • Pap smear
  • Prostate exam
  • Spirometry
  • Stool Guaic testing
  • Suturing
  • Tube Thoracostomy
  • Urine clean catch
  • Urine dipstick test
  • Venipuncture for laboratory studies
  • Wet mount

M4 Requirements

Refer to Typical Curriculum and Course Designations ​ for additional information.

  • GMED-4501 Keystone Course
  • RPCT-4310 RPCT Selective in a Primary Care Specialty in an Underserved Area
  • Various Electives and Selectives

Rural Primary Care Track (RPCT)

The Quillen College of Medicine offers a unique Rural Primary Care Track option. Limited to one-quarter of each entering medical school class, students must apply to participate in the Rural Track. Those students who are accepted have opportunities to work with patients and families early in their curriculum and gain experience in rural issues and community health more than in traditional medical school courses.

Medical students enroll in teams that study together over two years in one of two rural communities. The Mountain City, Johnson County site includes a family medicine center, nurse practitioner clinic, one of the country’s first rural critical access hospitals, Johnson County Community Hospital, and other regional preceptor sites. The Rogersville, Hawkins County site includes family medicine and other primary care clinics and the Hawkins County Memorial Hospital. Both regional sites, each located one hour from campus, provide community and clinical experiences which are typical of this region’s rural communities. University vehicles are provided for student travel to the sites in the first two years.

The Rural Primary Care Track is designed for students who are considering practice in a rural community or as a primary care physician. The program places emphasis on learning core clinical and professional leadership skills in a rural community primary care setting. Students participate in all basic science courses on campus and learn communication skills, physical diagnosis, preventive medicine, public health, and epidemiology through early clinical community-based experiences. Students devote one day a week to these activities in a rural area during the first two years of the medical school curriculum. The instruction is student-oriented and experiential, involving limited didactic instruction supplemented with experience with patients and community-based activities. Medical students participate in community-based participatory research and community projects sections. During the third year Rural Track Clerkship students work one-on-one daily with primary care preceptors. An additional rural primary care experience is organized by the student during the fourth year with site selection made by the clerkship director and student. Many students have used this experience to enhance obstetrical skills, behavioral health and procedural skills in other rural locations in Tennessee, all across the country and internationally.

MD/MPH Dual Track Program

Students in the Quillen College of Medicine can simultaneously pursue a master’s degree from the ETSU College of Public Health in addition to their medical degree, a dual track designed to provide future physicians a broad perspective that could help solve health problems on a large scale. Students in this dual track, called the MD/MPH program, will devote one year to the master’s program in public health before returning for a final year at the College of Medicine.

This is an ideal choice for physicians who want to pursue a career in academic medicine, public health, or public health leadership at the local, state or federal level. Students wishing to pursue this program must apply and be accepted to both the MD and MPH programs individually as prescribed by the individual units. To aid in this, agreement has been reached between the two colleges involved allowing an interested applicant to use the AMCAS application as the primary application for both programs. However, the completion of a graduate school application is also required. The School of Graduate Studies will accept MCAT scores in lieu of the GRE for this combined program. Complete information on this process is available on the ETSU and College of Medicine website.

On acceptance and enrollment, students will enroll simultaneously in both College of Medicine and College of Public Health courses for portions of their enrollment. Tuition will be charged at the medical school rate for the first three years of the program, at the graduate school rate for the fourth year of the program and again at the medical school rate for the fifth year. Students will receive credit for certain courses occurring in the medical curriculum for graduate school purposes and for certain courses taken under the graduate school for medical school purposes. Portions of the senior year of medical school will provide students latitude to complete field experience and electives pertaining to both degrees.