The M.D. Program Courses

Year One | Year Two | Year Three | Year Four | Electives

Curriculum Overview

Year One - During the 39 weeks of Year 1, the curriculum focuses on the theme of the normal structure and function of the human body. The important biomedical basic sciences are introduced by faculty from various basic science departments in the classical medical disciplines of human anatomy and embryology, histology, physiology, biochemistry, cell biology, microbiology, immunology, and pathology. A recently developed multidisciplinary course in neuroscience (combining elements of neuroanatomy and neurophysiology) has proven to be very successful, and a redesigned course covering the fundamental disciplines of biostatistics and epidemiology has been very popular. In conjunction with these fundamental or basic biomedical sciences, students begin their clinical studies with the course "On Doctoring", which extends over the first and second years, and introduces them to the science and art of caring for patients. A variety of elective courses is also offered.

Year Two - During the 38 weeks of Year 2, the major theme shifts to a study of pathophysiology--what goes wrong during disease. During this year, faculty from virtually every basic science and clinical department participate in the Scientific Basis of Medicine Program (SBM for short), which coordinates 14 separate courses. Each course in SBM focuses on a separate organ system or process, whereas courses in Year One focused on separate scientific disciplines. The required courses in Year Two include studying the cardiovascular system, the respiratory system, the nervous system, psychiatry, hematology, the endocrine system, the reproductive system, oncology, the gastrointestinal system, dermatology, connective tissue and bone, the renal system, and nutrition. Each of these SBM courses combines elements of physiology, pathophysiology, genetics, medicine, surgery, and pediatrics. Much of the material is taught in seminars, conferences, or problem-based learning tutorial groups. Course directors coordinate closely with year-long courses in pharmacology and On Doctoring. For example, during the SBM course in Neurology, On Doctoring is likely to cover the examination of the nervous sytem, while the Pharmacology course covers the antiseizure medications. Near the end of the year, an additional course in childhood health and development is also offered. At the end of the year, students take Step I of the USMLE series of examinations leading to licensure, and attend a 3-day orientation session leading up to Year 3.

Year Three - Year 3 builds on the skills and knowledge acquired during courses taken in Year 1 and Year 2. The required clerkships of Year 3 offer students the chance to experience the major broad specialty areas of clinical medicine (e.g. internal medicine, psychiatry, surgery, obstetrics and gynecology, pediatrics, and family medicine) in a variety of settings and communities, well in advance of the Year 4 process of making career and residency decisions. These 48 weeks of required clerkships are carried out both at the major medical facilities of the Dartmouth-Hitchcock Medical Center (Mary Hitchcock Memorial Hospital, VA Hospital, and Dartmouth-Hitchcock Clinic) and at a variety of affiliated hospitals and ambulatory sites, where patient populations and styles of practice differ widely. About one-third of the total time is spent training in ambulatory clinic facilties, while about two-thirds of the rotations take place in hospital settings.

Year Four - This final year of medical school offers each student the chance to complete several required clerkships, to begin to differentiate his or her clinical interests through a series of electives, to complete several outstanding courses designed to prepare our seniors for residency and for a career as a lifelong learner, and to work closely with a personal advisor to find the most appropriate postgraduate plan or residency slot. Along with required clerkships in Neurology and Women's Health and a subinternship of the student's choice, Year 4 students choose from a wealth of clinical and other electives offered on campus, across the U.S., and around the world. The DMS Medical Education Committee strongly encourages students to pursue at least one clinical experience in an off-campus setting. All seniors take excellent required courses titled "Health, Society, and the Physician," "Clinical Pharmacology and Therapeutics," "Advanced Medical Sciences," and "Advanced Cardiac Life Support."

Electives - During the four years of DMS, our curriculum offers a wide variety of electives, and flexibility which allows students to participate in research at various times in their medical education. Some students elect to try out basic science, clinical, or health services research as elective courses, as part of an expanded five-or six-year schedule, as part of a combined degree program, or during the summer after Year One. There is virtually no limit on the types of elective experiences that can be designed by a student, as long as an appropriate faculty sponsor is identified.

Curricular changes and improvement--The faculty at DMS are committed to updating our curriculum each year, and to finding ways to improve each course and clerkship every year. Students and faculty often work together to plan these changes and improvements. In recent years, we have strengthened our curriculum in areas such as primary care, human genetics, women's health, palliative and end-of-life care, geriatrics, and cultural competency. DMS is especially attractive to students who are excited about where medicine is headed, are stimulated by constructive change, and are willing to help the school move forward in its process of continuous improvement of its curriculum. These stimulating changes, combined with our traditions of close mentoring relationships between faculty and students, and cooperation between students while learning, make DMS a wonderful place to learn medicine!