Although it is not the intent or purpose of this initial report to spell out the details of a curriculum, it did seem advisable to map out the broad outlines of a program that we think would be workable. Undoubtedly other specific arrangements might serve the purpose equally well. [Our proposal can be summarized as follows]:
1. In the first year a coordinated course on cell and organ biology, taught primarily by the Biological Sciences Council, would constitute the major experience. This would be supplemented by Clinics designed to indicate the Importance of cell biology to clinical medicine. The students will make their first contacts with patients through instruction in interviewing.
2. The second year will be devoted to the major course in human biology. This will be a coordinated teaching exercise, conducted by the Biological Sciences and the Clinical Sciences. Blocks of time will be devoted to the major organ systems and normal function and structure will be presented as well as the abnormal. This will be supplemented by instruction in the Behavioral and Social Sciences and in the Clinical Sciences. The latter will now constitute case-taking with exphasis on the skills of history-taking, and the physical examination.
3. The third year will be devoted mainly to the Major Clinical Experience. This will be taught on the wards and in the clinics of the hospitals. It will be taught with emphasis on the whole patient rather than the approach of the specialist. Seminars presented by the Biological Sciences. The Behavioral and Social Sciences will provide instruction throughout the year, hopefully at the hospitals.
4. The fourth year will be devoted to elective courses offered in all divisions, taught by departments and chosen by students according to their interests and needs from a catalog with the help of their faculty advisors. Throughout the preceding three years, at least one-third of the teaching time will also be devoted to elective courses.
The role of the elective courses will be quite different from what it is currently. They will now become an integral part of the curriculum. They will provide at one time both the experience in depth required for attainment of scholarly attitudes and simultaneously give the desired flexibility to the curriculum. There would be three kinds of offerings in the electives:
a. Subjects not otherwise considered in the core curriculum.
b. Subjects considered in the core curriculum but now offered in greater depth and detail.
c. Opportunities for supervised but independent research.
There may be established some pre-requisites for certain of the electives. Thus it would seem reasonable that electives open to the first year class would be available to all upper classmen but the reverse situation need not apply.
The Electives
Students would pick their elective subjects from a catalog with the assistance of faculty advisors who will oversee the general program for each student and assure that balance consistent with the aims of the students is preserved. It is anticipated that most students will attain the M.D. degree having concentrated in clinical areas but it will also be possible to specialize in clinical areas such as medical genetics, medical anthropology, administrative medicine and so forth. It is considered that one elective for the fourth year might be an internship in an approved teaching hospital for selected students.
It is thought that this admixture of required core curriculum and electives will allow all students to be nourished by that material which should be common to all recipients of the degree of Doctor of Medicine and still allow flexibility to accommodate different backgrounds, aptitudes and goals. Essential opportunities to explore in depth will also be provided.
The advantages accruing to the faculty from this admixture of required core curriculum and electives should also not be overlooked. It is hoped that this mixture will provide more than a safety valve for those members of a distinguished faculty who may suffer frustrations by their participation in a coordinated program of teaching. These same faculty willhave complete freedom of action and expression in the elective offerings they provide. Opportunity for scholarship and distinction in teaching will be fostered with the likelihood that more great teachers will develop in this system. Our present block and coordinated teaching is so geared to an accepted urgency to teach everything to every student that it permits little opportunity for development by the faculty of presentations with distinctive personality and philosophy. An occasional lecture here, seminar there, does not engender the kind of teaching experience which brings the students to sit at the feet of the scholar, nor does it stimulate the teacher to mull over, reconsider his facts and premises, view his special area from all sides and interrelate his cherished intellectual offspring with other currents of contemporary thinking. In short, our present system does not provide those features which can make teaching the greatest of all educational experiences for the teacher. In the