Module Information

In the past 50 years, rapid advances in medical research have revolutionized clinical medicine. Discoveries in fundamental science continue to pave the way for changes in diagnosis and treatment of disease. We will examine and evaluate these developments, seeking to understand their scientific, clinical, social, and ethical importance, in an active and collaborative learning environment.

Learning Outcomes

1.    Students will use material from primary research, experimental data and case studies to develop intellectual curiosity, knowledge, attitudes and skills necessary to examine, analyze and critically evaluate biomedical research. This will be done in an active, discursive format that allows students to research, generate arguments, and articulate decisions.

2.  Students will develop a better understanding of scientific method, critical thinking, and scientific communication. They will gain skills in evaluating research outcomes and will understand how information generated through basic research influences clinical diagnosis and treatment and, how science and medicine interact with society.

3.    Students will develop strong teamwork skills. This is important because healthcare professional work in teams, including doctors, nurses, physiotherapists, pharmacists etc. As such, the ability to communicate ideas clearly and to work with others is important.

4.    Each student will demonstrate the ability to analyse and evaluate developments in a biomedical area of their interest, and will develop attitudes of inquiry, rational and critical thinking, through a written assignment of a project proposal and the presentation of their proposed research project through a poster presentation, at the end of the module.

Teaching Modes

TeamLEAD (Team Based Learning)

Duke-NUS uses TeamLEAD (Learn, Engage, Apply, Develop) as their educational structure, and we will adopt the same. TeamLEAD is a form of collaborative team based learning that employs a sequence of pre-class preparation, in class individual work, group work, immediate feedback and class-wide discussion. It focuses on giving students the opportunity to use course concepts to solve problems.
Consequences of Team Based Learning:

  • The teacher shifts from being a “sage on stage” to a “guide at side”.
  • Course goals shift from knowing to applying.
  • Students shift from passive to active.
  • Responsibility for learning shifts from instructor to student. Students are accountable to their teams and for their own individual learning.

The structure of a TeamLEAD class is different from lecture classes and most seminar classes as well. Students must complete the assigned pre-readings prior to class.

Here is an outline of the structure of ensuing classes:

1.    Individual Readiness Assessment (10 minutes) – brief quiz on readings
2.    Group Readiness Assessment (10 minutes) – quiz taken again in groups
3.    Discussion and Debate (30 minutes) – cross-group discussion
4.    Summary and Conclusions (5 minutes)
5.    Application Activities – These include scenario-based discussions, debates, and other group exercises
For many of the application activities, we will use the 4S’s for effective group tasks:

1.    Significance – Problem, case or question that is relevant and significant
2.    Same problem – Groups work on the same problem or scenario
3.    Specific choice – Groups have to make a specific choice and argue for it
4.    Simultaneous report – When possible, choices should be reported simultaneously


A.    Readiness Assessments

In the first session, students will be introduced to the essence of TeamLEAD by taking part in a short quiz in the following sequence:

1.    Reading assignment (posted before class)
2.    Individual Readiness Assessment test on the reading
3.    Group Readiness Assessment test on the reading
4.    Simultaneous reporting of answers and class discussion

The above sequence will be repeated in every session where there is a Readiness Assessment (RA) test. Students are expected to complete the weekly reading assignments before coming to an RA session. Each session will begin straightaway with the RA, and this means students will not be given extra time to complete the readings in class.

There are a total of 8 RAs in this module, covering the following topics:

Genomic Medicine (1 session)

Recent technological advances like next generation genome sequencing make it possible to identify genetic causes of human diseases in the clinic. This course is designed to introduce the students to the concept of recent technological advancements like next generation sequencing in gaining momentum for personalized medicine. We will discuss how such technologies help us gain valuable knowledge for disease stratification, medicine and biomedical research. We will also discuss the social and ethical issues dealing with the use of genetic information.

Cancer and Stem Cell Biology (2 sessions)
This course is designed to introduce the students to the basic concepts of cancer biology and train them to apply these concepts in designing experiments that could aid the development of novel and better therapies to treat cancers. The hallmarks of cancer comprise six biological capabilities acquired during the multistep development of human tumors. We will discuss how these hallmarks constitute an organizing principle for rationalizing the complexities of neoplastic disease. They include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. Underlying these hallmarks are inflammation and genome instability that generate genetic diversity and fosters multiple hallmark functions. We will also discuss how two emerging hallmarks, reprogramming of energy metabolism and evading immune destruction, are critical to cancer progression. In addition to cancer cells, tumors exhibit another dimension of complexity: they contain a repertoire of recruited, ostensibly normal cells that contribute to the acquisition of hallmark traits by creating the “tumor microenvironment”. Recognition of the widespread applicability of these concepts will increasingly affect the development of new means to treat human cancer. In addition, students will also study the profound and multifaceted influences of stem cell research in both science and medicine. The characterization of stem cells (both normal and cancer stem cells) and targeting them for cancer therapy or regenerative medicine will be discussed.

Metabolic Disorders (1 session)

This course is designed to introduce the students the concept of metabolic disorders focusing on type 2 diabetes and factors that influence the development and complications of this disease. Students will be introduced to the biochemical and physiological basis of metabolic disorders and factors that influence the development of these diseases. The progress and pitfalls of current biomedical research to better understand and combat such chronic life threatening conditions, will be discussed. The students will be introduced to an overall view of glucose and lipid metabolism in the context of insulin resistance, diabetes and metabolic syndrome. We will explore the outcomes of the disruption in metabolic processes with a focus on body physiology and organs related to glucose and lipid metabolism. We will debate on possible causes of insulin resistance and metabolic syndrome, including obesity and lifestyle patterns. Students will explore possible mechanisms that result in these disease states, for example, the accumulation of toxic lipid metabolites in muscle, liver, pancreas and arterial tissues. We will discuss current therapies and lifestyle changes to combat these chronic illnesses. Through these sessions, students will be introduced to current challenging problems that remain to be solved in order to develop more effective therapeutic approaches.

Emerging Infectious Diseases (2 sessions)

This course is designed to introduce students to the basic concepts of virology. Students will learn to apply these concepts to design experiments that aid the development of novel methodologies to improve the diagnosis, detection or treatment of infectious diseases. Emerging infectious diseases (EIDs) are considered to be among today’s major challenges to medical science, global health, and human development. Rapid changes associated with globalization and development, especially environmental change and the ease of transport, are mixing people, domestic animals, wildlife, plants, and associated pathogens, at unprecedented frequencies and combinations. Recent outbreaks of Ebola virus, H1N1, H5N1, SARS, and Nipah virus have cost numerous lives and heavily impacted regional and national economies and students discuss their emergence and consequences. Students will also discuss how to detect and define EIDs, especially novel pathogens. Of central importance in all of these scenarios is the convergence of pathogens, hosts, and vectors resulting in increased EID interactions and spill-over at human-natural interfaces. As 75% of recognized EIDs either once were, or currently are, zoonotic - that is, transmissible between animals and humans, students will be introduced to the concept of the epidemiological triad and how spatial-temporal convergence can serve to amplify or dampen transmission. Throughout these classes, students will be introduced to the concept of One Health and how we can mitigate EID outbreaks with surveillance, therapeutics and vaccinations.

Neuroscience (2 sessions)

Students will be introduced to how the brain works, the current methods and techniques employed to study it, its abnormal function in disease and mental disorders, and the medical, legal, and societal consequences of individual differences in brain function. We will explore the basics of the nervous system, and discuss the use of mouse models and functional magnetic resonance imaging in the study of common mental diseases and disorders. These health issues include stroke, schizophrenia, depression, Parkinson's disease, and Alzheimer's disease. In-class exercises include interpreting experimental data and reasoning out the relationship between brain structure and function through comparative anatomy. Such exercises help students to understand the complex human brain at multiple levels, ranging from chemical signalling in nerve cells to gross organization. They also link the properties of the brain to the behaviours it supports and how disruptions to the system can lead to disease states. We will also focus on individual differences in brain function. For example, we will discuss the use of neuroimaging in medical and legal contexts, such as attempts to determine which individuals will develop dementia or to identify psychopaths. Students will explore the links between genetics, the nervous system, and behaviour, again considering the societal implications of such relationships (e.g. a “warrior gene” predicting aggressive behaviour). Through these explorations, students will gain an appreciation for the difficulty of defining “abnormal behaviour” and the variety in neural and mental function. Such lessons are valuable both for understanding neuroscience, and for better appreciating how scientific inferences are made and how these inferences affect medicine and society.

B.    Project Proposal

Students will complete a project proposal as a group, and will learn how to critique proposals written by their peers. Thereafter, students will present their project proposals in the form of scientific posters. They will get to present twice – the first will be a closed-door (and graded) session, where students present their posters in electronic version and get instant feedback from the instructors in class; the second will be a public defense (and ungraded) session, where students present their posters in printed version to a wider audience that comprises of Duke-NUS faculty members, medical students and research staff.

C.    Field Trips 

There are 2 field trips in this module, one at Duke-NUS and the other at Singapore General Hospital (SGH). The Duke-NUS field trip will comprise of a guided tour of the research facilities at the school, followed by hands-on clinical workshops facilitated by senior MD students. The SGH field trip will comprise of a guided tour of the research and educational facilities at The Academia, and the SGH Museum.