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Upstate Medical university Case Study

Overview of the Medical Literature Curriculum (MLC)


Goals & Philosophy of the Program

The MLC is a series of courses whose main goal is to engage students in the authentic discussion of medicine as represented in the medical literature. The courses run in parallel with the standard curriculum and are designed to promote integration of clinical reasoning and basic science throughout the medical school experience.

            MLC-1 (first year students): Case studies for integration of basic and clinical science
            MLC-2 (second year students): Pathophysiologic mechanisms of disease
            MLC-3 (fourth year students): Current biomedical research

The pre-clerkship courses (MLC-1 and MLC-2) balance and highlight the relevance of the basic science courses through study of published cases. Students become conversant in the language and logic of medicine as expert clinical problem solving is modeled for them in “clinical problem solving” or “case records from the Massachusetts General Hospital” articles from the New England Journal of Medicine. Students are instructed to study the cases with the overall objective “to understand and be able to explain the underlying mechanisms of what happens to the patient and the rationale for what is done or discussed by the authors.”  This usually requires extensive background investigation of the meaning of clinical findings, disease categories and pathophysiology, and drug indications and mechanisms of action. In the second year (MLC-2), supplemental articles that expand upon mechanisms of disease relevant to the case readings are increasingly introduced into assignments.

MLC-3 is taken in the 4th year after the students have had significant clinical experiences in the clerkships and aims to bring the scientific basis of medicine back into focus by studying primary clinical and translational research papers.

The mechanics of all of the courses are similar:

  • Independent study of the assigned paper
  • “Open notes” quiz prior to class session to assure preparedness for discussion
  • Class discussion with faculty experts in the area of interest
  • Written assignments aligning with course objectives
    • For MLC-1 and MLC-2, the usual assignment is to generate a pathophysiologic hypothesis explaining the mechanisms of disease in the assigned case
    • For MLC-3, the assignments are aligned with AAMC objectives referenced in the new LCME standard for accreditation regarding exposure of students to medical research:
      • Knowledge of the basic science and clinical issues relevant to the readings
      • Ability to assess and critique the research presented, demonstrating a scientific attitude and knowledge of the scientific method
      • Ability to translate the research into lay language appropriate for communication with patients
      • Ability to appropriately apply the findings to clinical problems
      • Ability to suggest further research questions stemming from the study results
      • Awareness of ethical issues in scientific investigation (e.g., conflicts of interest, patient safety, informed consent).