UC Berkeley-UCSF Joint Medical Program

Presented by:Malia Paik-Nicely, MS3

CSU-Monterey Bay Mentorship Program

October 9, 2012

What do you want to be when you grow up?

Journey to Medical School

UCSF School of Medicine Research Paths

Traditional MD curriculum, MPH option between year 3 & 4 or following year 4

Medical Student Scientist Training Program, MSTP (MD/PhD)

Program in Medical Education for the Urban Underserved (PRIME-US)

UC Berkeley-UCSF Joint Medical Program, Master of Science/MD program

UC Berkeley-UCSF Joint Medical Program Mission

UC Berkeley-UCSF Joint Medical Program Mission

Train physician-leaders in the human, sociocultural, and bioethical contexts of health and disease

Commitment to exemplary education in the pre-clerkship medical sciences

Focus on cross-disciplinary research in the humanities, social & behavioral sciences and public health

Innovation in the design of medical education

JMP Program DesignJMP Program DesignFive year program of study for MS/MD

First 3 years on the UC Berkeley campusPre-clerkship Medical Curriculum

Masters Thesis

Clinical Skills and Introduction to Patient Care Curriculum

Matriculation to UCSF campus for 2 clerkship years with completion of MD

What is Problem-Based Learning (PBL)?

PBL serves to teach content by presenting students with real life situations similar to those they may encounter as a physician. The objectives of PBL are as follow:

Learn how to develop differential diagnoses Enhance critical thinking skills Enhance verbal and communication skills Work collaboratively with other professional and

disciplines Enhance researching skills, interpreting data, and

knowing where to get the right information.

It’s not about getting the right or wrong answer, it’s about learning how to approach a problem.

Traditional Medical CurriculumMedical School

Year 1 Year 2 Year 3 Year 4

In the hospitalIn the classroom

college residency

Biochemistry

Physiology

Behavioral Sciences

Pathophysiology

Anatomy

NeuroscienesEmbryology

Genetics

Year 1

Year 2

Problem-Based Learning (PBL)

Case 39:Diabetes

Case 112:Breast CA

Biochemistry

Physiology

Behavioral Sciences

Pathophysiology

Anatomy

Neurosciences

Embryology

Genetics

Year 1 Year 3

Uni

t 6

Year 2

Ready to try a case?!

You are a pre-medical student shadowing a physician at the Natividad Family Health Clinic. Mr. García, a 42 year-old male, is brought to the clinic by his wife who is concerned about his health. Mr.García complains of chest pain that has been occurring for the past year. He describes the pain as a burning sensation that is exacerbated when eating, bending over, and lying down.

STOP and take a few minutes – What are some conditions that cause chest pain?

Note: Try to come up with as much as possible no matter how off the wall you may think it is. Think about all the organ systems. Remember, there are no wrong answers

STOP and take a few minutes – What are some conditions that cause chest pain?

Note: Try to come up with as much as possible no matter how off the wall you may think it is. Think about all the organ systems. Remember, there are no wrong answers

Organ SystemsCardiovascular – heart attack (blockage of blood

flow to heart muscle)

Pulmonary – pulmonary embolism (blockage of blood flow to lung), pneumothorax (collapsed lung), cancer

Gastrointestinal – heartburn (GERD), gallbladder, esophageal irritation

Genitourinary – kidney infection, pelvic inflammatory disease (in women)

Musculoskeletal – intercostal muscle strain

Psychosomatic – anxiety attack

The patient describes feeling well outside of the chest pain. He exercises regularly 3 times a week and has not changed his diet nor daily activities. He is not taking any medications, although he says his chest pain is relieved with the aid of Tums. He denies fevers, chills, nausea, vomiting, and body aches. The patient has no known preexisting illnesses. Mr. García smokes 2 packs per week and drinks alcohol occasionally. His diet consists of fast food and “whatever his wife feels like cooking.” His father died of a heart attack at the age 43 and his mother is currently living with high blood pressure. Mr. García has two younger sisters who are both in good health.

STOP and take a few minutes – What part of the physical examination would you want to focus on? What tests should be performed to narrow differential?

Note: Not required to be specific, just general tests such as chest X-ray. Is there anything else you would like to know before performing the tests?

STOP and take a few minutes – What part of the physical examination would you want to focus on? What tests should be performed to narrow differential?

Note: Not required to be specific, just general tests such as chest X-ray. Is there anything else you would like to know before performing the tests?

PHYSICAL EXAM AND LAB WORKUP

PE Vitals: T 98.6 HR 76 P 16 BP 106/72 RR 18 General: WDWN male no acute distress Skin: normal turgor ENT: normal ears, mouth and nose, sinuses normal, normal tonsils Lung: Clear to auscultation and palpation bilaterally. Normal and symmetric breath sounds CV: regular rate and rhythm, normal S1/S2 Abdominal: Tenderness in epigastric area, no rebound/guarding, +BS, no HSM

Labs/Imaging Creatine phosphokinase 50 (32 – 150 U/L)

(A marker for myocardial infarctions. Concerned when elevated) Troponin Complex 0.2 (<0.4 ng/mL)

(Typically ordered along with CK for suspected heart attack. Concerned when elevated)

EKG: Normal Upper endoscopy: reveals peptic (esophageal) strictures

So what do you think his diagnosis is?

So what do you think his diagnosis is?

GERD!

Learning Issues

What are some other questions you might have that would help you better diagnose and/or treat the patient (what about treatment)?

What about lifestyle changes for the patient?

Is there anything that should or should not have been done in the case?

Getting into Med School:Take-Home Tips

Standard Approach: Take coursework seriously

Study study study

Volunteer

Research

Community Outreach

How to Stand Out: Get involved!

Pursue your passion!

Enjoy life

Leadership and Communication Skills

Don’t blend in

Questions?

I hope you enjoyed this session and I wish you all the best as you proceed

on this journey to become great health care

professionals!

ResourcesMD Application: https://www.aamc.org/students/

Medical School Admission Requirements (MSAR): https://www.aamc.org/students/applying/requirements/msar/

DO Application: www.aacom.org/

https://csumbpremed.wikispaces.com/

Future Directions for UCSF Mentors

What information/resources could future UCSF students do to help you?

How can we make the most out of this project?