Transcript Problem-Based Learning_MaliaP-N - CSUMBpremed

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
• Pursue passion
• Community
involvement
High School
College
• Pursue passion
• Good grades
• Pre-med classes
(optional)
• Make connections!!
• Volunteer/Intern
• Pursue passion
• Don’t be afraid to
take time off
• Post-Bac (optional)
• Get experience
Post-College
Application
Process
• Pursue passion
• Letters of
recommendation
• MCAT
• Personal statement
• Apply early
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
Train physician-leaders in the human, sociocultural, and
bioethical contexts of health and disease

Commitment to exemplary education in the preclerkship 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 Design
Five year program of study for MS/MD
First 3 years on the UC Berkeley campus
 Pre-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
Curriculum
Medical School
college
Year 1
Year 2
Year 3
In the
classroom
Year 4
residency
In the hospital
Year 1
Anatomy
Embryology
Biochemistry
Physiology
Genetics
Year 2
Pathophysiology
Behavioral Sciences
Neuroscienes
Problem-Based Learning (PBL)
Year 1
Case 112:
Breast CA
Year 2
Case 39:
Diabetes
Year 3
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
Organ Systems
 Cardiovascular – 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?
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?
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:
How to Stand Out:
 Take coursework seriously
 Get involved!
 Study study study
 Pursue your passion!
 Volunteer
 Enjoy life
 Research
 Leadership and
 Community Outreach
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!
Resources
 MD 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?