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Carver College of Medicine

Professional Program (M.D.)

Doctor of Medicine

The Carver College of Medicine accepts 148 first-year students annually into its four-year course of study leading to the Doctor of Medicine (M.D.).

First and Second Years: Basic Medical Sciences and Clinical Foundations

The first three semesters present a core of sciences basic to the study of medicine and introduce students to the foundations of clinical practice.

FIRST SEMESTER

099:163 Medical Biochemistry presents concepts concerning structures of biological macromolecules, cellular metabolism, elements of human nutrition, molecular biology and genetics, and extra- and intracellular signaling mechanisms. It uses clinical examples to illustrate how alterations in these molecules and pathways can lead to pathological conditions.

060:103 Medical Gross Human Anatomy includes complete dissection of the human body with a regional focus that emphasizes relationships to the living system. Clinically relevant areas of radiologic imaging, surface anatomy, embryology, and clinical correlations complement the dissection experience. Students acquire anatomical knowledge through lectures, small group work, and independent activities.

050:120 Medical Cell Biology presents concepts concerning the structure and function of the cell and its organelles at the molecular level. The course consists of basic science lectures and clinical correlations and relates basic cell biological concepts to the understanding and treatment of human disease.

070:110 Medical Genetics is integrated with ongoing classes in anatomy, biochemistry, and cell biology. It provides an overview of clinical and medical genetics, with particular emphasis on recent changes that affect clinical practice with respect to common diseases that have a genetic component.

050:162 Foundations of Clinical Practice I is the first semester of a sequential four-semester course that introduces clinical skills students need in order to become practicing primary care physicians.

The five major goals for students over the four-semester course are to develop knowledge, attitudes, and skills that are necessary for:

• maturation into a competent and confident clinician;
• maintaining a lifelong process of learning the practice of medicine;
• application of relevant basic science and clinical concepts and other scientific advances to the practice of medicine;
• application of the principles of health promotion and disease prevention to the practice of medicine; and
• increasing awareness of the ethical and social context in which medicine is practiced.

Through large group lectures, small case-based learning groups, and small-group skill building sessions, students focus on communication in the doctor-patient relationship, accessing and managing medical information, and applying basic principles of evidence-based medicine and medical ethics.

SECOND SEMESTER

060:234 Medical Neuroscience is a course for medical students, physical therapy students, and graduate students in the basic medical or related sciences. Through lectures, clinical correlate presentations, laboratories, and small group discussion sessions, the course emphasizes the interdisciplinary and integrated study of the human central nervous system. Its faculty is drawn from basic science and clinical departments.

148:251 Principles of Medical Immunology is offered by the interdisciplinary Immunology Program. Its goals are to teach basic components and mechanisms of the immune response as well as medical principles of normal and abnormal immunity. The course consists of lectures by Immunology Program faculty and small group case analysis sessions.

050:240 Human Organ Systems is an interdepartmental course that presents the normal structure (histology) and function (physiology) of human organ systems in a coordinated and integrated organ systems approach. The course is designed to emphasize structure/function relationships by integrating the microscopic anatomic and physiologic function of normal human organ systems. The course's faculty includes members of basic science departments and clinical departments.

050:163 Foundations of Clinical Practice II is the second semester of a sequential, four-semester course that introduces clinical skills students need in order to become practicing primary care physicians (see 050:162 for overall course goals). In this semester, students continue to work toward course goals through small case-based learning groups, large-group lectures, and small-group skill acquisition sessions. They also are introduced to clinical medicine in a shadowing experience with health care providers. Principles of doctor-patient communication are reinforced and performance of the components of the general physical examination are taught and practiced. Multiculturalism, preventive medicine, and the social context of medicine are included.

THIRD SEMESTER

071:105 Pharmacology for Health Sciences: Medical introduces basic principles of drug action and drug disposition through discussion of mechanisms of action, therapeutic uses, and side effects for a wide variety of commonly used medications. Lectures integrate knowledge from related scientific disciplines, including biochemistry, microbiology, pathology, and physiology. Students acquire knowledge of rationale and basis for appropriate selection of medications in clinical situations and an understanding of the basis for common drug-drug interactions and adverse drug reactions.

061:103 Principles of Infectious Diseases presents a comprehensive approach to the microbiology of infectious diseases, covering infectious agents at both the organismic and molecular levels. The molecular aspects of pathogenesis are presented as the basis for present and future preventive and therapeutic measures. The laboratory includes hands-on experiments ranging from principles of aseptic technique to the most modern molecular aspects of diagnostic microbiology.

069:205 Medical Pathology I starts with general principles of disease: cell injury, inflammation, immune mechanisms, neoplasia, and hemodynamic disorders, followed by etiology, pathogenesis, epidemiology, and major clinical and morphologic manifestations of disease by organ systems. The course combines lecture information, small group analytic skills, and observation of current laboratory procedures.

050:164 Foundations of Clinical Practice III is the third semester of a sequential, four-semester course that introduces clinical skills students need in order to become practicing primary care physicians (see 050:162 Foundations of Clinical Practice I for overall course goals). This semester continues the knowledge, attitude, and skill acquisition begun in the preceding two semesters. Students continue to learn through small patient-centered learning groups as well as lecture and clinical skill-building small groups. Content areas include human sexuality, biomedical ethics, and problem-specific medical history and physical exams. Students begin to apply clinical history taking and physical exam skills learned in preceding semesters by taking complete histories and performing physical exams on simulated and real patients.

Some elective courses are available to students during the first and second years. These normally carry 1 or 2 s.h. of credit. Topics include areas not specifically covered in the regular curriculum and areas related to medical practice and the role of the physician. Course offerings vary from year to year, but typical subject areas are global health issues, U.S. health care systems, and community health outreach.

FOURTH SEMESTER

069:206 Medical Pathology II is a continuation of  069:205 Medical Pathology I.

050:183 Healthcare Ethics, Law, and Policy introduces M.D. and physician assistant students to health care ethics, law, and policy. Students learn to appreciate the inseparable relationship between medicine and ethics, recognize key ethical obligations and challenges common in medical practice, identify sources of ethical value commonly used in ethical reasoning, and apply a systematic approach to clinical ethical reasoning. They learn fundamental legal doctrines and theories that relate to business and professional aspects of the law pertaining to health care delivery. They also develop an understanding of the relationship and contrasts between ethics and law in medical practice, and they gain familiarity with the ways in which health policy influences medical practice.

050:165 Foundations of Clinical Practice IV ICD is the final course in the foundation series. The fourth semester is devoted primarily to this major interdisciplinary course, which includes participation by a large proportion of the faculty and is vital in providing students with the tools for a lifetime of patient care.

Mornings are devoted to intensive review of the diagnostic and therapeutic aspects of organ-system-based clinical medicine. The reviews are presented by teams of specialty and subspecialty clinicians. Students spend afternoons acquiring and practicing the clinician's skills in history taking and physical examination and in learning specialized exams. Small group learning and clinical case conferences take place throughout.

Each student is evaluated individually during the semester. Evaluations include the student's approach to the patient, accuracy of history and physical examination, precision in communicating gathered data, ability to synthesize available data into a realistic differential diagnosis, and ability to apply the process of problem-based learning to the understanding of patient-based problems. Cognitive knowledge of topics covered in the morning lecture and small group sessions is assessed through computer-based multiple-choice examinations. Students who need further work receive guidance and assistance.

All M.D. students are required to pass Step 1 of the United States Medical Licensing Examination before they may be promoted to the third year of the curriculum.

Third and Fourth Years: Clinical Training

The clinical courses take place during the last two years of the medical curriculum. In order to qualify for graduation with the M.D., students must complete satisfactorily a total of 81 weeks of courses during the two clinical years: 69 weeks of required courses and 12 weeks of electives. Course distribution is 49 weeks in the first clinical year and 32 weeks in the second.

Clinical Beginnings (050:170), a required, 1 s.h. course, follows the first two years and precedes the start of clinical clerkships in the third year. Clinical Beginnings helps students make the transition between the first and the second years of the curriculum by emphasizing the "four Cs": Clinical reasoning and reflection; the core Competencies (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communications skills, professionalism, and systems-based practice); interdisciplinary Collaboration and teamwork; and Critical appraisal of the literature and lifelong learning.

The required clerkships are as follows.

Eight core clerkships: internal medicine, obstetrics and gynecology, pediatrics, psychiatry, surgery, outpatient internal medicine, community-based primary care, and family practice preceptorship; each course includes a mix of inpatient and outpatient activities, introduces the student to a specific discipline or to the practice of medicine in the community, and presents the opportunity to develop and practice clinical skills.

Required subspecialty clerkships: anesthesia, dermatology, neurology, ophthalmology, orthopaedics, otolaryngology, radiology, and urology, and courses in laboratory medicine and electrocardiography.

Advanced clerkships: subinternship, in which the student assumes responsibility for managing patients in a variety of approved medical disciplines, supervised by a senior resident and a faculty physician; emergency room or intensive care rotation.

Three electives: electives chosen from clerkships listed in the course book distributed by the Carver College of Medicine.

FIRST CLINICAL YEAR COURSE REQUIREMENTS

All medical students must complete satisfactorily 49 weeks of courses, including 050:170 Clinical Beginnings (one week), 40 weeks of core clerkships, and 8 weeks of courses chosen from the required subspecialty clerkships.

SECOND CLINICAL YEAR COURSE REQUIREMENTS

All medical students must complete satisfactorily 32 weeks of clerkships chosen from those not completed in the first clinical year, including the required subspecialty clerkships and electives.

Primary venues for clinical training of medical students are the University of Iowa Hospitals and Clinics, the Iowa City Veterans Affairs Medical Center, and the Des Moines Area Medical Education Consortium Inc.. Students also participate in the family practice preceptorship and the community-based primary care clerkship, which are off-campus rotations. Other courses may be assigned to off-campus sites, as well.

Admission to the M.D. Program

The Carver College of Medicine participates in the American Medical College Application Service (AMCAS), a nonprofit centralized application processing service for applicants to U.S. medical schools. AMCAS applications are available for completion in May of the year preceding the beginning of the class for which application is being made. Prospective students are urged to apply as early as possible. The deadline for AMCAS submission is November 1.

Secondary applications are forwarded to applicants whose AMCAS applications pass a review conducted by the college. A $60 fee must accompany the secondary application from all applicants.

Admitted applicants must have an official transcript from each college they have attended sent to the University's Office of Admissions.

Technical Standards for Admission and Retention

The Carver College of Medicine seeks students who will serve the needs of society best, and it strives to graduate skilled and effective physicians. To achieve these goals, it applies the following principles and technical standards to candidates for admission and to continuing students.

PRINCIPLES

Technical standards refer to criteria that go beyond academic requirements for admission and are essential to meeting the academic requirements of the M.D. program.

Applicants to the Carver College of Medicine and students continuing in the college, with or without disabilities, are expected to meet the same requirements.

Matriculation and continuation in the college assume a certain level of cognitive and technical skill. Medical students with disabilities are held to the same fundamental standards as their nondisabled peers. Although not all students should be expected to gain the same level of proficiency with all technical skills, some skills are so essential that mastery must be achieved, with the assistance of reasonable accommodations where necessary.

Reasonable accommodations are provided to assist in learning, performing, and satisfying the technical standards.

Every reasonable attempt is made to facilitate the progress of students, providing that such efforts do not compromise collegiate standards or interfere with the rights of other students and patients.

TECHNICAL STANDARDS

Applicants for admission to the Carver College of Medicine and continuing students must possess the capability to complete the entire medical curriculum and be granted the degree. To this end, they must complete all courses in the curriculum successfully. In order to acquire the knowledge and skills to function in a broad variety of clinical situations and to provide a wide spectrum of patient care, M.D. students must have abilities and skills in five areas, including observation; communication; motor skills; intellectual, conceptual, integrative, and quantitative abilities; and behavioral and social attributes.

Technological compensation can be made for some disabilities in certain areas, but each student must meet the essential technical standards in such a way that he or she is able to perform in a reasonably independent manner. The use of a trained intermediary is not acceptable in many clinical situations, because it implies that the student's judgment must be mediated by someone else's power of selection and observation.

Observation: Students must have the functional ability to observe demonstrations and experiments in the basic sciences and must have sufficient use of the senses necessary to perform a physical examination.

Communication: Students must be able to relate reasonably to patients and establish sensitive, professional relationships with patients, colleagues, and staff. They are expected to communicate the results of the history and examination to the patient and to their colleagues with accuracy, clarity, and efficiency.

Motor: Students are expected to participate in basic diagnostic and therapeutic maneuvers and procedures. Those who cannot perform these activities independently should be able to understand and direct the methodology involved in such activities.

Intellectual, conceptual, integrative, and quantitative abilities: Students must be able to learn to analyze, synthesize, solve problems, and reach reasonable diagnostic and therapeutic judgments. Students are expected to be able to display good judgment in the assessment and treatment of patients. They must be able to learn to respond with prompt and appropriate action in emergency situations.

Behavioral and social attributes: Students are expected to be able to accept criticism and respond with appropriate modification of their behavior. Students also are expected to possess the perseverance, diligence, and consistency necessary to complete the M.D. curriculum and enter the independent practice of medicine in a reasonable period of time. They must demonstrate professional and ethical demeanor and behavior in all dealings with peers, faculty, staff, and patients.

Cultural Competency:  Medical students must be able to communicate with and care for persons whose culture, sexual orientation or religious beliefs are different from their own. They must be able to perform a complete history and physical exam on any patient regardless of the student's and patient's race, religion, ethnicity, socioeconomic status, gender, age or sexual preference. Similarly, students must be able to interact professionally with colleagues and other healthcare professionals without regard to race, religion, ethnicity, socioeconomic status, gender, age or sexual preference.

Applicants who may not meet these standards are encouraged to contact the college's admissions office.

Admission Requirements

Applicants for admission to the Carver College of Medicine must have a baccalaureate degree; or they must be enrolled in a baccalaureate degree program, have earned at least 94 s.h. of credit or the equivalent, and expect to receive their degree before enrolling in the Carver College of Medicine. They must have earned college credit in the following courses.

Physics: a complete introductory course (one year), including lab instruction.

Mathematics: college algebra and trigonometry; applicants who completed college algebra and trigonometry in high school must take a course in advanced college mathematics or in statistics.

Chemistry: a minimum of one complete introductory course in organic chemistry (one year), ordinarily following a complete introductory course in modern general chemical principles, each with the appropriate laboratories.

Biological sciences: a complete introductory course in the principles of biology, or zoology and botany (one year), each with the appropriate laboratories; and an advanced biology course (one semester or quarter); recommended advanced biology courses include biochemistry, molecular and cell biology, human physiology, genetics, and microbiology.

English: two courses (including composition and literature); the requirement may be waived if the applicant's school has an integrated writing requirement in courses across its curriculum.

Social and behavioral sciences, and humanities: four courses; because writing skills are important in the study and practice of medicine, prospective applicants are encouraged to fulfill this requirement with courses that include a writing component; recommended courses include behavioral psychology, foreign language, and other courses that encourage appreciation for diversity and cultural competency.

Fulfillment of these requirements does not guarantee admission to the Carver College of Medicine. The college's admissions committee selects applicants who appear to be best qualified to study and practice medicine.

Applicants must have a cumulative g.p.a. of at least 2.50 for all college work. Applicants should have taken the required science courses for a grade rather than electing pass/fail grading.

Preference is given to Iowa residents with high scholastic standing. Consideration also is given to outstanding nonresidents.

Applicants are required to take the Medical College Admission Test (MCAT) no earlier than five years before and no later than September of the year of application. MCAT registration is available on the AAMC web site (http://www.aamc.org).

Personal interviews are part of the admission process. Candidates invited for an interview are contacted by the admissions committee.

An external criminal background check is performed for all admitted students at the time of admission.

Applicants accepted on or before February 15 must submit an advance payment of $50 by March 1. Applicants accepted after February 15 must submit the $50 payment within two weeks after they receive notification of acceptance. The advance payment is credited toward tuition and fees.

All students who enter the Carver College of Medicine are required to comply with the pre-entrance and annual health screening program developed by the University's Student Health Service in cooperation with University of Iowa Hospitals and Clinics.

All registered Carver College of Medicine students are required to maintain health insurance (or an equivalent care plan) that satisfies minimum standards of coverage. Insurance coverage must be maintained continuously throughout each year of attendance at The University of Iowa.

Financial Support

The Carver College of Medicine's philosophy is that no student should be denied a medical education due to a lack of financial resources. Admissions decisions at the Carver College of Medicine are made without consideration of financial need. Therefore, the Carver College of Medicine financial aid staff actively seeks financial aid sources so every student interested in a medical education can finance that education.

Financial assistance is provided by the Carver College of Medicine primarily on the basis of demonstrated financial need. Although a limited number of collegiate or institutional grants are available for the most economically disadvantaged students, most aid is in the form of loans. Examples of federal loan programs are the Federal Direct Stafford/Ford Student Loan, the Federal Direct Unsubsidized Stafford/Ford Student Loan, the Federal Perkins Loan, and the Primary Care Loan (PCL). Students also may qualify for Federal Direct Grad PLUS Loans or private loans to supplement their financial aid package.

In addition, the college supports scholarship and loan programs through permanent endowments and/or contributions from alumni and friends of the Carver College of Medicine. These funds are administered by the college's financial aid office and are awarded as a part of a student's total financial aid package. Funds to support short-term emergency loans are available for students with immediate financial need.

A small number of Dean's Scholarships are awarded by the college's admissions office to highly qualified candidates on the basis of their academic excellence, leadership abilities, and their potential to enrich the college. Dean's Scholarships are included in the recipient's overall financial aid package.

To learn more about financial aid, contact the Carver College of Medicine Office of Student Affairs and Curriculum financial services department.

Academic Rules and Procedures

Student Promotion

The Carver College of Medicine has established promotion policies and procedures to ensure that each of its graduates has adequate skills, knowledge, judgment, ethical standards and personal integrity to assume the responsibilities of a medical doctor. The student promotions committee, made up of seven faculty members and two students, performs these duties with the cooperation, advice, and judgment of course directors, faculty members, students, and administrators.

The committee recommends specific actions to be taken when a student's skills, knowledge, judgment, or ethical behavior is in any way considered consistently marginal or unsatisfactory. Possible recommendations include dismissal of the student from the college; suspension for a specified period of time; requiring the student to repeat all or any part of the curriculum on academic probation; and allowing the student to continue on academic probation with a full or partial course load. The committee's recommendations are forwarded for action to the executive dean of the Carver College of Medicine.

Medical students have the right to appeal a promotion decision. They must submit the appeal in writing to the Carver College of Medicine's executive dean within five days of notification of the decision. Appeals are considered by the Appeals Committee, made up of faculty representatives of the Medical Council and the Executive Committee, a medical student, a lay member, and the associate dean for student affairs (ex officio). Students may request an opportunity to appear before the Appeals Committee to make a statement and answer questions. The committee then makes its recommendation to the college's dean, who is the final authority.

Specific information about student promotion policies and procedures is available from the Office of Student Affairs and Curriculum and is online in the Medical Student Handbook. See Office of Student Affairs and Curriculum/Student Handbook on the college's web site.

Leaves of Absence, Withdrawal, Reinstatement

The Carver College of Medicine has established policies regarding leaves of absence, dropping courses, withdrawal from the college, and reinstatement to the college. Information about each of these policies is available at the college's Office of Student Affairs and Curriculum and is published annually in the Medical Student Handbook.

Disputes and Complaints

Student complaints concerning actions of faculty members or departments are pursued first through mechanisms established in the Carver College of Medicine. These procedures allow the greatest flexibility for all concerned in resolving a conflict. They are intended for situations such as grading disputes, alleged academic dishonesty, alleged dishonesty during a clinical rotation, alleged unethical or unprofessional conduct, and perceived discrimination or harassment.

Complaints regarding sexual harassment are handled confidentially in accordance with University policy and procedures; see the University's Policy on Sexual Harassment.

For information about the established informal mechanisms, contact the Office of Student Affairs and Curriculum or see the Medical Student Handbook.