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A 21st Century Approach to Medical Education
The School of Medicine´s new curriculum emphasizes personalized care.

blank David Nichols
David Nichols shows off the new $54 million Armstrong Medical Education Building.

When Johns Hopkins leaders first started talking about a new curriculum, they began with a clean slate and a pointed question: How will medicine be practiced 10 years from now?

That was six years ago. Today, as the class of 2013 becomes the first to experience the new medical school curriculum, leaders find that things have changed much as they anticipated.

The federal government is talking seriously about national health insurance. The patient population is increasingly international and diversified. " We´re preparing our students to take care of malaria or dengue fever just as much as the common cold or influenza," says David Nichols, vice dean for education. And the explosion of scientific knowledge has not let up. "Since the volume of information is so great, we have to create a way for students to organize and think about and apply that information to patients."

That way of teaching, novel in the United States according to Nichols, is called the Genes to Society curriculum. "It takes an approach rooted in systems biology to understanding all levels of the human being—from genes, molecules, cells and organs on one end to the familial, community, societal and environmental components at the other end," explains Nichols. "The Genes to Society curriculum integrates all these various factors that explain why patients present to a physician the way they do.

This approach specifically rejects the notion that patients are normal or abnormal. "The old, traditional curriculum spent a year teaching ´normal´ human biology," says Nichols. "We´re saying now that no one is ´normal.´ Everyone is on some kind of continuum, and we need to understand why they´re presenting the way they do at any given moment in time."

The overhaul of the curriculum has been a herculean effort involving hundreds of faculty as well as students, administrators, former patients and even people in industry. That its philosophy is unique is fitting, given that 100 years ago Hopkins created the educational model that became the template for 20th century American medical schools.

A central theme of Genes to Society is the integration of basic and clinical sciences throughout the entire four-year curriculum, not a new idea but one that was never completely realized during Hopkins´ last curriculum revision in 1991.

The newly opened Anne and Michael Armstrong Medical Education Building was specifically designed around the new curriculum. The 100,000-square-foot, four-story structure, which cost roughly $54 million, features various learning settings ranging from a 70-person instructional studio and two large lecture halls to flexible lab space and study areas for smaller groups.

Digital communication technologies were factored into the design. Students have virtual microscopy tools composed of high-resolution monitors and displays showing multiple images housed on centralized servers. Large screens at the end of each dissection table provide students with digital reference tools. The building also is adjacent to the recently opened Simulation Center, allowing medical students to learn and practice key clinical procedures on plastic mannequins and robots before performing them on patients.

Already the medical students have been divided into four "colleges" named after legendary Hopkins individuals—Daniel Nathans, Florence Sabin, Helen Taussig and Vivien Thomas—to encourage more meaningful mentoring relationships and social events. The colleges and their respective areas have been designed to blend teaching and learning with a sense of camaraderie and community. Each college has its own suite of rooms where students can gather informally and where individualized and small-group teaching can also take place.

Still, students will be getting out of the classroom "pretty much from the moment they get here," says Nichols. "They´re going to do a clinical skills course right at the beginning of medical school, and they´ll be assigned to their own clinic and see patients after the first six months."

– From staff reports



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