“From our earliest conversations, Dean Minor was focused on the future possibilities of a new curriculum,” Utz said. “He could see the need for a uniquely Stanford balance between scientific investigation and superlative clinical training, and helped to ensure it became a reality.”
Preetha Basaviah, MD, clinical professor of medicine and assistant dean for pre-clerkship education, and Bernstein co-chair the committee charged with implementing the Discovery Curriculum. Basaviah spent a decade as one of the directors of the Practice of Medicine course, which began in 2003 and now makes up about 40 percent of the medical student curriculum. “Preparing students for clinical care is a top priority of the School of Medicine,” Basaviah said. “We’ve kept a continued focus on clinical excellence with longitudinal mentorship that includes advancing communication and clinical skills as well as professionalism.”
A few of the new classes in the Discovery Curriculum began during the 2017-18 academic year. Now, the curriculum is fully implemented. It includes several restructured courses and some entirely new ones, along with an option to split the second year of medical school into two years to give students large blocks of free time for research during the second and third years of school.
Among the new courses is the Pharmacologic Treatment of Disease, led by Kobilka. His participation, not only as a designer of the curriculum but as one of its teachers, is notable. “Usually Nobel Prize winners are off doing other things and not teaching in medical schools,” Utz said. “But ours are here on campus. They’re vocal. They’re in front of the students and deeply involved.”
Time, and funding, for discovery
Not all students will choose to split their second-year coursework over two years. But those who do will have a variety of options for using the unscheduled time, and will pay the same tuition for five years that they would have for four.
Berg said that although some will choose to do research, many of the MD students he interviewed during the redesign efforts expressed a wish to take classes on the university’s main campus and possibly earn a master’s degree. Other students may opt to split the curriculum for other purposes — parenting a new baby, training for the Olympics, writing a novel or just slowing down the pace of learning. The advantage of the split curriculum is that students can start a research project during the spring or summer quarter of their first year and have sufficient time to continue it for the next two years. This type of extended scholarly experience had not been possible in the previous curriculum.
What we want our students to do is not to emulate us, but to eclipse us.
“We are luckily a medical school in the middle of a major university campus,” Gesundheit said. “The opportunities for dual training for interdisciplinary work are enormous.”
Opportunities for financial support are available to students who add a sixth year to earn a newly offered master’s degree in biomedical investigation. A new $2.5 million grant from the Burroughs Wellcome Fund and other funding sources could pay for that additional full year of research, as well as the two years of clinical rotations, for up to five students each year.
“The six years spent in completing the MD-MS training is shorter and less costly than the seven to eight years used to obtain the MD-PhD. Those two features increase the likelihood the student will elect an investigative career,” Berg said.
‘Feasible and worthwhile’
Students who began medical school in the fall of 2017 — now starting their second year — are the first to have the option to split their second-year coursework into two years.
“I jumped at this opportunity,” said Joshua Guild, a second-year student who is researching how alveoli — the tiny air sacs that serve as the site of gas exchange in the lungs — are repaired by stem cells after injury. “The faculty here have done an amazing job of introducing additional flexibility in the curriculum to make an opportunity such as this both feasible and worthwhile.”
Guild’s classmate, William Shi, sees the chance to split his second year as a “sneak preview” into his future career as a physician-scientist. “I plan to spend this time conducting research, working to advocate for my classmates and patients, and taking care of my personal wellness,” he said.
Students who are the first to take part in the Discovery Curriculum know that their feedback will be an important part of refining and perfecting the new program. “I’m apprehensive about being the first cohort to split the curriculum,” said second-year student Areli Valencia, who is using the extra time to work towards a master’s in bioinformatics and continue his research. “But I’m also excited because I’m able to design my own path.”
For students, embarking on such a novel curriculum may feel like a big change, but innovation is precisely the point. “We’re persuading students to do the unusual, to be the pioneers,” Berg said. “We built it, now we want people to come and be a part of it.”
Students can still opt for the traditional four-year clinical MD degree at Stanford, but for those looking to change the face of medicine, from discovering new treatments to designing better health care systems, the Discovery Curriculum provides a foundation and pathway.
“What we want our students to do is not to emulate us,” Gesundheit said, “but to eclipse us. We want them to gain skills and leadership, knowledge — whatever they need — to become the academicians and the thought leaders, the change agents for the future.”