Ethics in the Medical Curriculum at LAU: How we do it. Kamal F Badr, MD, Founding Dean

Clinical Sciences Basic Medical Sciences General Science courses

Med 4 Clinical Science Years 1 4 Basic Science Med 1

1. Basic and Clinical Sciences 2. Clinical Skills / Competence 3. Professional and Behavioral 4. Population Health and Social Medicine

Competencies Med 4 Bs/Cs Theme Clinical Skills Med 1 Professional & Behavioral Curriculum Content Public Health

OVERALL OBJECTIVES OF THE MEDICAL CURRICULUM Professional and Behavioral Theme Discuss the basics of normal human development and range of behavior at each stage of the life cycle. Communicate with patients and their families courteously and provide appropriate counseling, while demonstrating respect for their beliefs, views, and privacy. Communicate professionally, clearly, and concisely with all categories of healthcare workers in all areas and all media. Apply behavioral competencies in structured awareness and skilled action for effective negotiation and communication Manage conflict and emotions, and lead problem solving in both short-term and long-term working relationships Use ethical principles in all healthcare-related decisionmaking particularly where this may involve disadvantaged members of society. Recognize one s limits of knowledge and abilities and seek help in a timely manner. Demonstrate competence in the use of information technology in clinical practice and medical research. Engage in continuous self-evaluation and continuous medical education and take responsibility for one s professional development.

Ethics in the Medical Curriculum at LAU: -Is NOT a one-shot episode delivered as a short course or assignment once or twice during the four years of medical education -Is NOT intended to enable students just to answer the ethics questions on USMLE

Ethics in the Medical Curriculum at LAU: -IS integral to the School s Mission: To create a new physician, one who is superbly trained in the skills of medicine, but who believes deeply that a physician is, above all, a merciful healer.

Ethics in the Medical Curriculum at LAU: -IS delivered through the four years of medical training as a continuous thread of an integrated curriculum: Med I and II: Foundations of Medicine Block and in each organ system module

1 Sept 11 Dec 14 Dec 5 Feb 8 Feb 9 April 12 April 21 May 24 May 25 June 28 June 9 July 12 July 16 July Med I Foundation Block 15 Wks Hematology & Immunology 6 Wks Endocrine & Reproductive 9 Wks Renal 6 Wks Musculoskeletal 5 Wks Revision 2 Wks Examination 1 Wks 1 Sept 15 Oct 18 Oct 3 Dec 6 Dec 28 Jan 31 Jan 15 April 18 April 1 May 2 May 6 May Med II Pulmonary 6 Wks Cardiovascular 7 Wks Gastrointestinal 7 Wks Central Nervous System, Peripheral Nervous System, Sensory System 11 Wks Revision 2 Wks Examination 1 Wk * Communication Skills Session 1: Saturday October 31 and Sunday November 1, 2009 * Communication Skills Session 2: Saturday February 27 and Sunday February 28, 2010

Time Monday Tuesday Sep 1, 09 Wednesday Sep 2, 09 Thursday Sep 3, 09 Friday Sep 4, 09 08:00 08:50 09:00 09:50 WELCOME FROM THE PRESIDENT AND THE DEAN SDL MULTIDISCIPLINARY Medical Education The PBL Process (ID# 1003) Histology Lab Introduction to Histology and Microscopy: How to Make Visible the Invisible (ID# 1006) Pathology Introduction to Pathology (ID# 1009) Pharmacology Introduction to Medical Pharmacology and Therapeutics (ID# 1010) 09:50 10:10 BREAK 10:10 11:00 MULTIDISCIPLINARY Medical Education Introduction to Integration and Foundations of Medicine (ID# 1001) BECOMING A DOCTOR Clinical Skills Lab Clinical behavior: Good Habits for a Lifetime Practice (ID# 1011) Social Medicine Introduction to Social Medicine (ID# 1015) Biochemistry Introduction to Biochemistry and Cell Structure (ID# 1007) 11:10 12:00 Library Orientation Library catalog (OPAC) and ZPortal Library Orientation Medical Online Databases and Library Services Microbiology and Immunology Introduction to Microbiology and Immunology (ID# 1008) 12:00 01:00 LUNCH BREAK 01:00 01:50 MULTIDISCIPLINARY Medical Education Introduction to Learning Topics & Self-Directed Learning (SDL) (ID# 1002) BECOMING A DOCTOR Medical Ethics Who Needs Ethics? (ID# 1012) Population Health Introduction to Public Health (ID# 1014) MULTIDISCIPLINAR Y Medical Education Assessment (ID# 1004) 02:00 02:50 Anatomy Introduction to Anatomical Concepts (ID# 1005) Library Orientation Medical Online databases, e-books and e/print journal finder Behavioral Sciences Introduction to Behavioral & Social Sciences as Applied to Medicine SDL

08: 00 08: 50 Anatomy & Relationship of Thorax, Heart & Mediastinum (ID# 1017) The Cell The Functional Unit of the Body I (ID# 1022) Spinal Cord Basics (ID# 1019) Histology Epithelial Specializations & Cell Junctions (ID# 1024) 09: 00 09: 50 Cell structures and functions Biochemistry Cell Structure (ID# 1025) SDL Cell structures and functions Histology The Cell The Functional Unit of the Body II (ID# 1023) SDL Cell structures and functions Genetics Genes (ID# 1032) 09: 50 10: 10 BREAK 10: 10 11: 00 Anatomy Lab Dissection of Thoracic Wall and Pectoral Region. (ID# 1016) Anatomy Lab Dissection of the Pleural Cavity. Removal of the Heart & Lung (ID# 1018) 00 (ID# 1016) Heart & Lung BECOMING A DOCTOR Medical Ethics Introduction to Philosophical Bioethics (ID# 1035) Anatomy Lab Dissection of the Heart & Lung (ID# 1020) Genetics Developmental genetics (ID#1033) 11: 10 12: 00 SDL Cell structures and functions Biochemistry Protein Folding in Health & Disease (ID# 1027) 12: 00 01: 00 LUNCH BREAK 01: 00 01: 50 Cell structures and functions Physiology Biological Membranes, Solutes and Solutions, Pt 1 (ID# 1028) Cell structures and functions Biochemistry Protein Structure (ID# 1026) Cell structures and functions Physiology Biological Membranes, Solutes and Solutions, Pt 2 (ID# 1029) Cell structures and functions Physiology Biological Membranes, Solutes and Solutions, Pt 3 Cell structures and functions Genetics The Human Genome (ID# 1034)

Ethics in the Medical Curriculum at LAU: -IS delivered through the four years of medical training as a continuous thread of an integrated curriculum: Med III and IV: Afternoon Tutorials: - Integrated clinical topics + competencies in business/ finance in Medicine, - Physician interaction with pharmaceutical industries. - Conflict resolution - Critical Incident Reports

! " " # Med III 14 Wks 12 Wks 4 Wks 12 Wks Internal Medicine 2 Wks Medical ER General Surgery 2 Wks Orthopedic 2 Wks Surgical ER Electives Mixed Block 3 Radiology/Nuclear Medicine 3 Primary care/family Medicine 3 Geriatrics 3 Infectious Diseases Afternoons = integrated clinical topics + competencies in business/ finance in Medicine, Physician interaction with pharmaceutical industries, conflict resolution, Critical Incident Reports E X A M S Med IV 12 Wks 12 Wks 8 Wks 4 Wks 8 Wks OBGYN Pediatrics 4 Wks Neonatology 8 Wks Pediatrics 4 Psychiatry 4 Neurology/Neurosci ences Electives Mixed Block 2 ENT 2 Ophthalmology 2 Urology 2 Dermatology E X A M S

What will be the attributes of the LAUMS medical graduate? The LAU graduate would have learned the following Educational Competencies (Based on Institute of Medicine of the National Academies of Sciences, Engineering, and Medicine, and the National Research Council, USA, Health Profession Education: A bridge to Quality, 2003). Provide patient-centered care Employ evidence-based practice Utilize informatics Apply quality improvement Work in interdisciplinary teams

What will be the attributes of the LAUMS medical graduate? (II) 1. Competencies in Humane Medicine. To develop the depth of character and the insight into human nature required of the well-rounded humane physician, LAU has developed major curricular requirements in the competencies of social medicine. 2. Competency in the Business of Medicine. In collaboration with the LAU School of Business, and to safeguard the dignity of the profession, curricular offerings addressing aspects of finance and business which impact medical practice will be required at LAUMS. 3. Competency in professional interactions with the pharmaceutical industry. In collaboration with the LAU School of Pharmacy, LAUMS will require of its graduates to be well versed, self-confident, and ethically transparent in their professional interactions with the pharmaceutical industry, and with emerging global therapeutic and healing trends and technologies. 4. Competencies in Continuing Education, Self-Monitoring, and Self- Improvement: The pre-clinical and clinical curriculum prepares students to meet the changing science and practice of medicine as life long learners through fostering of self-direction, critical thinking, self-assessment and performance improvement.

$ Objectives: Promote reflective thinking and deep learning Prepare students to deal with ethical and Professional dilemmas Self awareness and introspection Balance between personal and professional values Counterbalance negative effects of the hidden curriculum with reflective group process.

$ May relate to issues of : Communication Knowledge Treatment Culture Relationships Emotions Beliefs

Ethics in the Medical Curriculum at LAU: -IS integral to the School s Mission - IS delivered through the four years of medical training as a continuous thread of an integrated curriculum -IS delivered most effectively through the Hidden Curriculum : We require of our Faculty and Staff to demonstrate the principles of ethical medicine in their words and their actions.

Zeinat Hijazi, M.B.B.ch., DCH, MRCP, FRCP, MRCPCH, FRCPCH Professor of Pediatrics Assistant Dean for Medical Education School of Medicine Dr. Hijazi is a Professor of Pediatrics. She obtained her medical degree (M.B.B.ch) from Cairo University Medical School, followed by training in Britain (UK). Dr. Hijazi obtained a Diploma in Child Health (DCH) and MRCP degrees from the Royal College of Physicians and Surgeons in the UK, and became a member and a fellow of the UK Royal College of Pediatrics and Child Health (MRCRCH, FRCPCH). After 11 years of pediatric practice in the UK, Dr. Hijazi joined the Medical School at Kuwait University as Assistant Professor in Pediatrics and was promoted to Associate then Full Professor. She was appointed Chairperson of the Department of Pediatrics in Clemenceau Medical Center, and joined the Faculty at LAU as Assistant Dean for Medical Education in September 2007.Dr. Hijazi has a long standing interest in medical education. As chairperson of the Department of Pediatrics, she introduced major changes in the teaching program with greater emphasis on patient centered learning. Her accomplishments in Pediatrics led to her active involvement in the implementation of a new case-triggered curriculum in Kuwait. In addition, Dr. Hijazi has been an MRCP examiner for the Royal College of Pediatrics and Child Health since 1996. Dr. Hijazi has published extensively on issues relating to medical education, as well as on diseases of children, particularly childhood asthma and respiratory infections.

Social Medicine: Mona Haidar, MD, MPH