College of Medicine Degrees
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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 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. The Doctor of Medicine degree is offered in two tracks:
Generalist Track
The Generalist Track is the primary curriculum which enables students to acquire knowledge and skills necessary to practice in generalist disciplines such as family medicine, internal medicine, and pediatrics. Electives offer a wide range of opportunities for students to pursue their areas of interest in preparation for any career in medicine. By the conclusion of the four year curriculum students will be well prepared to begin the next stage of their training as resident physicians in their chosen specialty.
Rural Primary Care Track
The Quillen College of Medicine offers a unique Rural Primary Care Track option. 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. Most of these activities are components of the Doctoring I and II courses applied in rural communities. 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.
Medical students enroll in teams that study together 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, Ballad Johnson County Community Hospital, and other regional preceptor sites. The Rogersville, Hawkins County site includes family medicine and other primary care clinics and the Ballad 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.
During the third year Rural Track Clerkship students work one-on-one daily with primary care preceptors in their rural communities. An additional rural primary care experience is required during the fourth year. Many students have used this experience to enhance obstetrical skills, behavioral health and procedural skills in other rural locations in Tennessee. International rotations may also be available.
Limited to one-fifth 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.
NOTE: Due to COVID-19 Pandemic, clinical and hand-ons experiences for the Rural Primary Care Track are subject to change.
Dual MD/MPH Degree
The dual M.D./ M.P.H. degree program is an integrated program in partnership with the ETSU College of Public Health. 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 to help solve health problems on a large scale. Students in this dual track (M.D. / M.P.H.) 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. 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.
PhD Degree
The Ph.D. degree is offered through the School of Graduate Studies. The courses and research leading to the Ph.D. degree are conducted under the auspices of the Biomedical Science Graduate Program of the College of Medicine. Effective fall 2020, the program will offer the Ph.D. in Biomedical Science in the following new or revised concentrations: Cardiovascular Sciences; Cellular, Molecular and Chemical Biology; Immunology, Inflammation and Infectious Diseases; Neuroscience; and Pharmaceutical Sciences. More information about this program can be found at https://www.etsu.edu/com/grad/
All degrees are awarded by the East Tennessee State University Board of Trustees upon successfully completed requirements and certification of program faculty.
Curriculum for M.D. Candidates
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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-clerkship 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 spring graduation of the sixth year after matriculation. No more than a cumulative six (6) years is allowable for the completion of the entire curriculum.
Institutional Educational Objectives
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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 participate in implementing 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 any strengths, as well as limits, in knowledge, skills, and/or attitudes
3.2 Set learning and improvement goals
3.3 Identify personal gaps in knowledge, skills, and/or attitudes
3.4 Systematically analyze practice using quality improvement methods and identify changes with the goal of practice improvement
3.5 Incorporate feedback into daily practice
3.6 Locate, critically 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 Periodically review, analyze, and identify and apply 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 in an appropriate and effective manner 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 to benefit the patient
6.2 Coordinate patient care within the health care system
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 proposing 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 interprofessional teams to provide patient- and population-centered care that is safe, timely, efficient, effective, and equitable (see also 4.3)
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 in personal and professional situations
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
Refer to Typical Curriculum and Course Designations for additional information.
- BCHM-1315 Cellular and Molecular Medicine
- CBIO-1312 Cell & Tissue Biology
- MEDU-1322 Clinical Epidemiology and Biostatistics
- CSKL-1350 Doctoring I
- HGEN-1311 Genetics
- PSYH-1312 Lifespan Development
- ANTY-1314 Medical Human Gross Anatomy and Embryology
- PHSY-1322 Medical Physiology
- IDMD-1940 Rural Health Research and Practice (RPCT ONLY)
Refer to Typical Curriculum and Course Designations for additional information.
- NEUR-2321 Clinical Neuroscience
- CSKL-2350 Doctoring II
- PSYH-2312 Intro to Clinical Psychiatry
- MCRO-2321 Medical Microbiology & Immunology
- PHRM-2312 Medical Pharmacology
- PATH-2321 Pathology
- IDMD-2950 Rural Com Based Health Projects (RPCT ONLY)
Refer to Typical Curriculum and Course Designations for additional information.
- CSKL-3350 Doctoring II
- COMD-3051 Jr. Community Medicine Clerk (Generalist Track ONLY)
- FMED-3052 Jr. Family Medicine Clerkship (Generalist Track ONLY)
- IMED-3053 Jr. Internal Medicine Clerkship
- OBGY-3054 Jr. Obstetrics/Gynecology Clerkship
- MEDU-3011 Jr Clinical Experience
- PEDS-3055 Jr. Pediatrics Clerkship
- PSYH-3056 Jr. Psychiatry Clerkship
- SURG-3058 Jr. Surgery Clerkship
- RPCT-3059 Jr RPCT Primary Care Clerkship (RPCT ONLY)
Refer to Typical Curriculum and Course Designations for additional information.
- CSKL 4350 Doctoring IV
- 12 weeks of Selectives with one required four-week rotation in each of the following:
- Intensive/Critical Care
- Inpatient Subinternship
- Ambulatory Care
- 18 weeks of Electives-home and away
Comprehensive Basic Science Exam
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The Comprehensive Basic Science Examination (CBSE) produced by the National Board of Medical Examiners will be administered to 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 second year. 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.
United States Medical Licensing Examination (USMLE)
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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 medical student’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.
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 CK 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 2 CS uses standardized patients to test medical students and graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues.
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.
For the purpose of this policy, the fall semester consists of periods 1-4 of the six-week clerkships and periods 1-3 of the eight-week clerkships as denoted on the M3 academic calendar.
Students are responsible for being aware of USMLE reporting periods to insure a score is returned prior to defined dates. 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 .
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).
All students are expected to take the USMLE Step 1 exam prior to the start of the required M3 Transition to Clerkship course during the first clinical year. However, 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 one period of Special Studies for additional preparation time during period 1. These students will be enrolled in Special Studies in lieu of their scheduled period 1 clerkship. Eligible students must submit a written request for the delayed start of clerkships to the EAD for approval. Students approved for the delay and enrollment in Special Studies are expected to take the Step 1 exam by the end of period 1 and proceed to their scheduled period 2 clerkship. Those who do not take the exam by the end of period 1 will proceed to their scheduled period 2 clerkship or take a leave of absence. Students taking a leave of absence are to: 1) to provide the EAD with a study plan outline and 2) present the EAD with periodic reports of Comprehensive Basic Science Exam Self Assessments results indicating the student’s progress toward preparedness to sit for the exam. Students granted a leave of absence are required to complete the MD degree by the sixth graduation date following their date of matriculation, including any leaves of absence.
All students, including those on leave of absence for purposes other than a medical leave of absence, must take the USMLE Step 1 exam at least once prior to the end of 4th 6-week period/ 3rd 8-week period of the first clinical year (as denoted on the M3 academic calendar), depending on their clerkship schedule, in order to continue enrollment. Those students not meeting this requirement will be dismissed or permitted to withdraw from the Quillen College of Medicine.
Students who take the exam prior to period one and do not receive a passing score may be scheduled for one period of Special Studies to prepare for retaking the exam. Those who do not take the exam by the end of period of Special Studies will proceed to their next scheduled clerkship or take a leave of absence. Students are limited to one period of Special Studies before the end of 4th 6-week period/ 3rd 8-week period (as denoted on the M3 academic calendar), depending on their clerkship schedule. One additional period of enrollment in Special Studies during the remainder of the academic year is permitted, however, these two periods of Special Studies may not be taken consecutively.
Any student not receiving a passing score by the end of the last regularly scheduled clinical clerkship period as denoted on the M3 academic calendar of the spring semester of their first clinical year (the academic year in which the student was enrolled in at least one clinical clerkship) will be dismissed or permitted to withdraw from the Quillen College of Medicine. A maximum of three attempts to pass the Step 1 exam are permitted.
Students who take a leave of absence following the M2 year, including those enrolled in a dual-degree program, must have a passing USMLE Step 1 score prior to beginning of the required M3 Transition to Clinical Clerkship course. Students are responsible for being aware of USMLE reporting periods to insure a score is returned prior to the start date of the M3 Transition to Clerkship course.
Students granted a leave of absence are required to complete the MD degree by the sixth graduation date following their date of matriculation, including any leaves of absence.
Potential Consequences of delaying Step exams:
• Being placed on leave of absence
• Being ineligible to receive financial aid
• Delayed beginning final year. All required third year clerkships must be completed before beginning clinical requirements of the fourth year.
• Delayed Graduation date
• Dismissal for not being able to complete the MD degree by the sixth graduation date following their date of matriculation, including any leaves of absence.
Students are strongly encouraged to take both components of Step 2 prior to beginning of or very early in their final clinical year. Students are expected to take both components of Step 2 no later than September 1 of their final clinical year. Students participating in the NRMP who have not received a passing score on both Step 2 CK and Step 2 CS before the NRMP rank order deadline of their final clinical year will be subject to withdrawal from the NRMP. A maximum of three attempts to pass the Step 2 CK exam and three attempts to pass the Step 2 CS exam are permitted. Any student not receiving a passing score after their third attempt for either exam will be dismissed or permitted to withdraw from the Quillen College of Medicine.
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.
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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
- Nasogastric tube insertion
- Pap smear
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- Pelvic Exam
- Prostate exam
- Spirometry
- Stool Guaic testing
- Suturing
- Tube Thoracostomy
- Urine clean catch
- Urine dipstick test
- Venipuncture for laboratory studies
- DNA Vaginal Pathogen Probe
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OSCE Competency for Promotion to the Senior Year
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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:
- Assess the clinical skills learned during the pre-clinical years
- Assess how students integrate those clinical skills
- Provide formative and summative feedback to student on their clinical skills
- 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
- Prepare students for the format of the USMLE Step 2-Clinical Skills Exam
Students who are identified as having deficient performance will develop a remediation plan for implementation during the third year. Students will repeat the OSCE at the end of the third year and are required to pass for promotion to the fourth year.
Elective Course Offerings
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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. A full complement of electives is available to M4 students as they are preparing for their chosen specialty.
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