Longitudinal Curricular Experiences

The Doctor of Medicine (M.D.) program aims to equip students with the knowledge, skills, and attitudes necessary to improve both health and future health care by engaging with patients longitudinally throughout their health care experience.

Longitudinal curricular experiences are integrated throughout the four-year curriculum to help students learn an assortment of skills required to improve population health.

The Duke Center for Interprofessional Education and Care is developing deliberate opportunities for health professions students in the School of Medicine (Doctor of Medicine, Physician Assistant, Doctor of Physical Therapy, Doctor of Occupational Therapy) and School of Nursing (bachelor, master, and doctoral programs) to engage in learning with, from, and about one another. Foundational coursework during MS1 will involve major co-located learning events and longitudinal small group engagement to prepare students for clinical learning on teams during MS2 and MS4. Duke graduates will be collaboration-ready physicians through participation in curricular, clinical, social, and service-learning activities.

The Cultural Determinants of Health and Health Disparities (CDHD) course in the Duke School of Medicine is the first required and interprofessional curriculum tasked with exploring health disparities and the impact of socio-cultural influences on a broad spectrum of health outcomes observed in Durham, NC, and beyond.

This required course began for first-year medical students in the fall of 2017. In 2019, the course was expanded to include first-year Doctor of Physical Therapy students as well as second-year M.D. students.

CDHD content is intended to enhance student education by promoting discourse about current and future patients, providers, and peers. Students will be invited to share views/opinions while simultaneously gaining insights into how to promote health equity and culturally appropriate medical care. Engaging audiovisual presentations, small group discussions, self-reflection exercises, and case-based learning activities will be used throughout the year.

The curriculum is organized to introduce learners to health disparities, structural competency, and the impact of implicit associations/bias on patient care and peer interactions. The course draws upon the expertise of various thought leaders including faculty, patients, providers/clinicians, activists, and scholars across Duke Health. Specific session topics include, but are not limited to: Race, Racism, and Racial/Ethnic Disparities; Marginalized Sexual and Gender Identities; Immigrant Health; Rural Health; and Ableism.

In the second year of the course, the CDHD content is matched to the clinical clerkship and led by clinician educators in each individual specialty.

Course Directors:

Kenyon Railey, MD, and Victoria Parente, MD

The Leadership Education and Development (LEAD) Curriculum was developed as an integrated curriculum for all Duke medical students that spans the four years of Doctor of Medicine (M.D.) education, teaching emotional intelligence, integrity, teamwork, selfless service, and critical thinking.

The first two years (Foundations and Experiential) of the LEAD program includes lectures, workshops, clinical skills foundations, team-based learning (TBL) activities, and the Cultural Determinants and Healthcare Disparities (CDHD) curriculum. The third and fourth years (Electives and Capstone) provide students with opportunities to practice newly acquired skills through a variety of active leadership roles, to include being a student facilitator for the LEAD program. 

Course Director

Dean Taylor, MD 

Associate Course Directors

Cecily Peterson, MD and Joe Doty, PhD

Assistant Course Directors

Tony Fuller, MD; Adia Ross, MD; Fatima Syed, MD; Chan Park, MD

Clinical Skills Foundation 1 and 2 are longitudinal course throughout the first two years. In year 1, CSF1 meets 4 hours/week for the entire year and focuses on the doctor/patient relationships, communications, interviewing, physical exam and basic counseling skills. The course includes a physical exam intensive in February. CSF3 continues to work in all aspects of the physician-patient relationship. Working together in the same small groups from Year 1, students will reflect on their experiences on the clinical rotations and apply topics such as ethics, spirituality, pain management, professionalism, and end-of-life issues. Students develop skills in advanced patient communication techniques. 

The Innovations Sciences thread seeks to integrate topics that prepare medical students to lead transformations in health care within the Patient FIRST curriculum. These concept areas will augment the biomedical and clinical sciences and introduce medical students to skills and ideas equipping them to become leaders in evidence-based clinical medicine, clinical research, basic science research, population health, health systems science and data science as their careers progress.   

The topics encapsulated in the Innovations Sciences thread affect all areas of modern medicine. The underlying goal in aligning these concepts is to allow expansion of learning objectives throughout the entire Patient FIRST curriculum beginning early in the MS1 year. With such early exposure, students will have additional knowledge and skills to apply during their MS3 experience and beyond.   

Innovations Sciences content will be interspersed throughout the Patient FIRST curriculum as stand-alone didactics; incorporated case and discussion points during Symptom-Based Biomedical Framework, Clinical Skills Foundation, and Clinical Determinants of Health and Disease sessions; and practical and interactive modules during the MS3 experience. Interprofessional faculty experts are drawn from across the School of Medicine and University, including clinical departments, the Department of Population Health Sciences, MMCi program, Design Health, and Duke Institute for Health Innovation.