Duke‐NUS students concentrate on the basic sciences in their first year, covering four interdisciplinary basic science courses; Molecules and Cells, Normal Body, Brain and Behavior, and Body and Disease. The educational philosophy emphasizes active learning, in which classes are taught using TeamLEAD, a novel team-based learning methodology developed at Duke-NUS. Each course is conducted by teams of expert clinicians and basic scientists allowing the students an opportunity to gain first hand, up‐to‐date information. In addition, faculty members from Duke University visit to conduct some of the courses, sharing their knowledge and research experiences. The year begins with Foundations which lays the groundwork for the medical curriculum; while two longitudinal courses run parallel to the basic sciences courses. Practice Course provides a firm base in clinical skills, and Investigative Methods and Tools broadens students’ understanding the medical literature and basic statistics.
Most schools begin with an orientation, but Duke-NUS begins with a two and a half week “foundations course”. While there are some typical orientation activities such as registration and exploration of the school; the heart of the foundations program is preparing our students for the immersive experience of medical school and initiating them in our core values. This process – although brief in the long view -- builds a fundamental foundation to their professional development as future physicians.
We begin by explaining why we have chosen TeamLEAD as our learning method, exploring the importance of and building skills in peer evaluation and feedback, and introducing the effective use of electronic learning resources. Next, Duke Corporate Education provides a two-day workshop in teambuilding. Since our students will be in the same teams for the duration of the first pre-clinical year, it is critical that they understand the dynamics of teams as well as begin to work together effectively as a team immediately. We highlight the fact that the collaborative learning at Duke-NUS will be very different from anything the students have experienced before, and we discuss different strategies that will assist them in their teams. Through talks given by some of the outstanding medical and research leaders in Singapore, we introduce them to the value of leadership.
Foundations is completed by an intense, one-week introduction to the Practice Course, Duke-NUS skills of doctoring course. During the week, students begin their (life-long) practice of medicine –topics such as professionalism, health and illness, the patient’s perspective, non-verbal communication are covered through talks and small group sessions. The week culminates with students conducting their first patient interview with a “standardized patient.” Through this experience students understand firsthand how it feels to assume the role of healthcare provider and how much there is learn about patient care.
The experience is capped off with wisdom-sharing sessions from senior students and the ultimate induction into the profession of medicine – the White Coat Ceremony. (See Student Life for more information on the rest of Foundations.)
Molecules and Cells integrates biochemistry, genetics and cell biology. The biochemistry component focuses on the relationship between the structure and function of the major classes of macromolecules in the living systems. Important aspects of the metabolic interrelationships, control mechanisms, and the biochemical basis of human diseases are also discussed. The genetics component covers the molecular aspects of the human genome, the structure of complex genes, regulation of gene expression and experimental systems for genetic analysis. The cellular biology component focuses on properties of human cells. Normal activities, functions, and structural properties are introduced and disruptions in those properties are discussed in the context of human disease when appropriate. Fundamentally, the structure and function of cells and tissues of the body is taught in Molecules and Cells and forms the basis for the Normal Body and Body and Disease courses. While molecules and cells does not require students to have taken any prerequisite subjects, having a background in biochemistry and cell biology will be advantageous.
Following Molecules and Cells, Normal body trains medical students in clinically-oriented gross anatomy, micro-anatomy and physiology. The course teaches the component subjects in an integrated manner and is divided into modules related to specific sub-specialties in medicine and surgery. The course is taught by practicing senior clinicians, pathologists and radiologists who integrate the three subjects in a clinically relevant manner. The TeamLEAD learning methodology is complimented by gross anatomy dissection, physiology laboratory exercises and microanatomy classes. The main aim of this course is to provide students with a strong foundation in these pre-clinical sciences to enable them to develop into superior clinicians.
Brain and Behavior introduces students to clinical and basic neuroscience. The course has four interlocking components: First, laboratory sessions on clinical neuroanatomy teach the organization of the nervous system forming a basis for students to diagnose and understand the effects of neurological diseases and trauma. Next, a basic science component explores the fundamentals of the nerve cells and nerve cell circuits that underlie the function of neural systems. Later, the course moves on to investigate the behavioral components of neural function that underlie cognitive function and psychiatric disorders; this section also serves as an introduction to psychology and psychiatry topics. The final segment of the course is a series of clinical correlations during which students learn how to use their growing clinical and basic knowledge in the context of clinical cases based on real patients.
Body and Disease, the last course for the 1st year curriculum, teaches students the core concepts of pathology, pharmacology, immunology, and microbiology in preparation for their training in clinical medicine. The course is primarily delivered by a small core team of faculty that participates throughout the 20 weeks. In addition more than 40 invited Faculty come in for one or more sessions on topics within their area of expertise. The learning process is centered entirely around TeamLEAD, with the class time focused around review, discussion, and problem solving, and each session ends with a faculty member providing a summary. The TeamLEAD sessions integrate one or more of the four sciences with case scenarios and the process of clinical decision-making. The core concept is to use clinical problems faced by real patients to teach the four basic sciences. To further extend the learning process, each of the sciences conducts Labs or Tutorials that review the content from the TeamLEAD sessions, allowing the correction of any gaps, and the extension of core knowledge. Further, the last 2 weeks of the course are given over to 8 review sessions which cover all the first year material, as a way of integrating all the basic science issues with clinical decision-making, and as preparation for students’ transition to ward-based learning.
Practice Course 1 is a longitudinal skills course in which students learn the basic clinical skills of history taking, physical examination and professional behavior. In history taking, students acquire skills of effective doctor-patient communication through rapport building, effective listening, empathy, sensitivity, and respect. Students also learn the skills of physical examination in various organ systems which are essential in making a clinical diagnosis. The course is taught by a team of consultants and students have opportunities to interact with standardized patients and real patients. Ethics and professionalism are also emphasized in the course.
This year-long course is primarily designed to help medical students learn how to interpret the medical literature. The course is a combination of intuitive biostatistics and evidence based medicine. The focus is to help students grasp important concepts which they are likely to encounter in their professional careers, whilst helping them to develop search strategies to investigate infrequently encountered methods when needed. Ultimately, students learn how to be critical thinkers and objective interpreters of the medical literature.
Assessments in the first year include continuous assessments specific to each of the courses. Students are required to take one standardized exam at the end of the year: the Comprehensive Basic Science Exam (CBSE).
Contact email for Year 1: email@example.com