First Year

Overview

Duke Med’s first year curriculum is principally divided into two distinct sections with further subdivisions organized by organ systems and/or disease processes. The first semester addresses typical human physiology in a course called Human Structure and Function, while the second semester focuses primarily on disease pathology in Body and Disease. 

Alongside these courses, the curriculum also has two longitudinal classes:  Clinical Skills Foundations (CSF) and Cultural Determinants of Health and Health Disparities (CDHD) which take place weekly or biweekly though both the first and second years of medical school. The CSF course teaches students how to properly take a patient history, conduct a comprehensive physical exam, and practice using the electronic medical record in preparation for the clinical year through large group didactics and small group breakouts. In small groups, students practice interviewing standardized patient actors as well as patients in the hospital. CDHD addresses health disparities through a biopsychosocial lens to augment the clinical curriculum. There are biweekly large group sessions taught by experts in a given field followed by small group breakout sessions to discuss topics ranging from racial disparities, rural health, immigrant health, LGBTQIA+ health, ableism, and many more. The lessons learned from CDHD help to shape students into well-rounded, socially-conscious physicians. 

Duke’s first-year curriculum is administered via a combination of didactic sessions and Team-Based Learning (TBL) exercises. This approach builds upon foundational skills like teamwork, problem solving, conflict resolution, and others that are required for success in a team-based career like medicine. First-year medical students work with their TBL groups weekly to evaluate their learning, work through cases, and apply their knowledge with clinical correlates. 

Fall Semester: Human Structure and Function (HSF)

Approximately the first six weeks of HSF are devoted to biochemistry and biology as they relate to medicine with an emphasis on cancer and metabolism. This foundation is essential and serves as a transition during which students build upon the fundamentals learned in prerequisite courses. After this review through molecules, cells, and tissues, students focus on human physiology. This section of the course is divided roughly into two-week modules based on organ systems. Throughout HSF, students learn human anatomy in both the laboratory and lecture setting. Cadaveric dissection is utilized to augment lessons and will allow students the privilege of truly understanding human anatomy through the generosity of our donors. Students also attend regular histology lectures and labs to gain foundational knowledge of the human body on a microscopic scale using the digital microscope. 

The final three weeks of HSF, formerly a separate course called “Brain and Behavior,” comprise the neuroscience portion of the curriculum and take place after winter break. The course provides an incredibly comprehensive, in-depth foundation covering how the nervous system works and the basics of nervous system pathology. This portion of HSF utilizes a flipped classroom approach wherein students prepare before class with video tutorials and reading, then assess their knowledge in the classroom with a quiz and fully integrate the material in their Team-Based Learning groups by working through a real-world case application. Gross specimens will also be utilized to visualize nervous system pathology. This section of the curriculum is entirely focused on neuroscience and is historically reviewed as one of the best, most rewarding, albeit challenging, aspects of the MS1 curriculum. 

Spring Semester: Body and Disease

After students have gained a foundational understanding of typical anatomy, physiology, microanatomy, and the nervous system in HSF, students will explore immunology, microbiology, states of disease pathology, and begin to learn introductory clinical management, with a focus on pharmacology. The course begins with study of overarching themes such as autoimmune disorders, cancer, infectious processes in general, hemostasis, and inflammation to name a few. After these core concepts are established, the material is divided into organ systems. Content for each organ system covers pathology, pharmacology, microbiology, and immunology. Biweekly pathology labs taught by our incredible pathology attendings and residents integrate lecture materials with microscopic and gross pathology specimens. Weekly case discussions and clinical reasoning sessions incorporate the didactic lessons with patient cases as students grow in their ability to form a comprehensive differential diagnosis and provide treatment options. In addition, throughout Body and Disease students will also broaden their knowledge through engagement with hospital tumor boards, clinical simulations, and microbiology laboratories sessions, among other clinical opportunities.