Nov 21, 2024  
2023-2024 Quillen College of Medicine 
    
2023-2024 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 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 the Rural Primary Care Track (RPCT) option that is specially designed for students desiring to practice primary care in rural communities or work with underserved populations. The program places emphasis on healthcare disparities, social determinants of health and healthcare delivery in marginalized populations. During the first two years of medical school students participate in all basic science courses and learn communication skills, physical diagnosis, preventive medicine, public health, and epidemiology on-campus as part of their Doctoring curriculum and then have experiential learning in the rural communities and with other underserved patients throughout the region. The medical student will complete a community scholarly project as a part of the RPCT during the Doctoring course. As part of the third-year the medical student will spend twelve weeks in rural and underserved training sites where they will see patients and do a needs assessment of a community resulting in a scholarly presentation. The time commitment for RPCT does not exceed that of the general curriculum. During the twelve-week third year clerkship the student may spend weeknights in their community locations in housing provided at no cost.

RPCT has a teams-based approach locating students either in Mountain City or Rogersville, Tennessee, as their main clinical site. In these sites students will primarily work with physicians and nurse practitioners in clinics of the Rural Health Services Consortium. Both regional sites, each located one hour from campus, provide community and clinical experiences which are typical of our rural communities. In addition to these main sites students will have the opportunity to work in rural Veteran Affairs clinics, with The Health Wagon in SW Virginia, Rural Medical Services clinics, with homeless patients through Street Medicine, and in the ETSU family medicine residency programs. University vehicles are provided for student travel to the sites in the first two years.

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. 

Once the medical student is holding an acceptance to the Quillen College of Medicine they may apply to participate in the RPCT. The ideal candidate for the RPCT is the student who has an interest in rural or underserved populations and in becoming a primary care physician. However, any student desiring their clinical experience to have more of a focus on rural and underserved patients is encouraged to apply.

 

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. 

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 program. 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. For details: MD/MPH Dual Track Program (etsu.edu)

 

Dual MD/MBA Degree
The dual M.D./ M.B.A. degree program is an integrated program in partnership with the Department of Management and Marketing in the ETSU College of Business and Technology. Students in the Quillen College of Medicine can simultaneously pursue a master’s degree from the ETSU College of Business and Technology in addition to their medical degree, a dual track designed for students to gain business expertise. An MBA offers the opportunity to develop business acumen and leaderships skills to extend knowledge beyond patient care. Students become highly experienced physician leaders while acquiring tools to pursue management, administrative, and leadership roles. Graduates will enter the workforce ready to excel in medical or administrative positions. For details: Dual MD/MBA Degree Program (etsu.edu)

 

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

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 required 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

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 Seek and 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 in an appropriate and effective manner with patients, families, and the public, 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 helps others 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 “First Year” at Typical Curriculum and Course Designations 

 

M2 Requirements

Refer to “Second Year” at Typical Curriculum and Course Designations .​

 

M3 Requirements

Refer to “Third Year” at Typical Curriculum and Course Designations ​.

 

M4 Requirements

Refer to “Fourth Year” at Typical Curriculum and Course Designations ​.

 

Comprehensive Basic Science Exam

The Comprehensive Basic Science Examination (CBSE) produced by the National Board of Medical Examiners is administered to pre-clerkship students as a means of both program evaluation and individual student assessment. All pre-clerkship students will be required to take the CBSE or the Comprehensive Basic Science Self-Assessment (CBSSA):  first year students at the end of the first year and second year students at the end of the fall semester 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.

Comprehensive Clinical Science Exam

The Comprehensive Clinical Science Examination (CCSE) produced by the National Board of Medical Examiners is administered to fourth year students as a means of both program evaluation and individual student assessment. All students will be required to take the CCSE at the beginning of the fourth 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 2 preparation, these results will not be used for decisions related to grading or advancement in the curriculum.

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 step exams 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 basicto 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 ofclinical science essential for the provision of patient care under supervision and includes emphasis onhealth promotion and disease prevention.•Step 3 assesses whether you can apply medical knowledge and understanding of biomedicaland clinical science essential for the unsupervised practice of medicine, with emphasis on patientmanagement in ambulatory settings.” Step 3 is usually taken during residency.
Definition: * 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 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 Vice Dean for Academic Affairs (VDAA), 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 VDAA 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 VDAA with a study plan outline and 2) present the VDAA 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. Any student not receiving a passing score after their third attempt will be dismissed or permitted to withdraw from the Quillen College of Medicine.
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 Doctoring-Transition to Clinical Clerkship portion. Students are to take the Step 1 exam prior to April 1 to insure a score is received prior to the M3 Doctoring-Transition to Clerkship portion. Students who participated in the Transition to Clerkship course the prior year are expected to participate in the current course with their new class.

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 beforebeginning clinical requirements of the fourth year;
•Delayed Graduation date;
•Dismissal for not being able to complete the MD degree by the sixth graduation date followingtheir date of matriculation, including any leaves of absence.

Step 2 Exam:

Students are strongly encouraged to take Step 2 CK prior to beginning of or very early in their final clinical year. Students are expected to take Step 2 CK no later than September 1 of their final clinical year. Students participating in the NRMP who have not received a passing score on Step 2 CK 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 are permitted. Any student not receiving a passing score after their third attempt for the 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 Step 2 CK and sets rules for eligibility for the 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/nbme-licensure.php and https://www.etsu.edu/com/msec/resources/policies.php.

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
  • Nasogastric tube insertion
  • Pap smear
  • 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

Clinical Proficiency Competency Objective Structured Clinical Examination (OSCE) Graduation Requirements

An Objective Structured Clinical Examination (OSCE) is required at the beginning of the third year and fourth year at which time students must demonstrate clinical proficiency. A Formative Clinical Proficiency Competency (CPC) OSCE is required prior to beginning clinical clerkships, and a Summative Clinical Proficiency Competency (CPC) OSCE is required in the fourth year. The successful demonstration of proficiency is a requirement for graduation. The Office of Academic Affairs will be provided documentation of completion of the competency once it has been attained.

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 and do not replace other degree requirements.  Currently these electives include:  The Healer’s Art; Spanish for Medical Students; Global Healthcare: Perspectives and Practice; Global Healthcare: Disease Treatment and Prevention; and Substance Misuse and Addiction in Appalachia: Impacting the Community through a Vision of Change.  A full complement of electives is available to M4 students as they are preparing for their chosen specialty.