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The Stanford Primary Care Associate Program curriculum is based on principles of adult learning and community based education. After the first fall quarter of didactic education, students learn in clinical sites in their home communities for three weeks/month and attend classes on campus one week/month. (Quarters 2 - 5, San Diego satellite students have approximately one class week/quarter in San Diego ). This curriculum design allows students to immediately apply didactic content in clinical practice. The accelerated 16-month curriculum works well for students with considerable prior health care experience.
The didactic curriculum is structured on a body system model and is iterative in nature. During the 1 st fall quarter, each body system is covered. The 1 st fall quarter provides a solid foundation of basic medical sciences, clinical medicine lectures, pharmacotherapeutics, information literacy, pediatric development, history taking/communication skills, physical exam skills, critical thinking skills and cultural medicine.
In subsequent quarters, body systems are revisited to provide more complex content. For example in Cardiovascular 1 week (week 6, in October), the following cardiac topics are included: hypertension, angina, and CHF. Cardiovascular 2 week, (week 13, in January), includes MI, valvular disorders and carditis. During Emergency Medicine week (week 17, in July), students learn arrhythmias, review cardiac medications and take ACLS. Lecture weeks are included for the following specialty areas:
- Emergency Medicine
- Surgery
- Geriatrics
- Psychiatry
- Pediatrics
- Obstetrics & Gynecology
Unlike most PA programs, the Stanford program has two comprehensive courses each quarter (one didactic course and one clinical course), instead of a series of smaller topic/content-related courses. The exception is the 1 st fall quarter, which begins with a separate 3-week course, Directed Studies in Primary Care Medicine. This course consists of one week of basic medical sciences and two weeks of history taking and physical diagnosis of each body system, including a review of pertinent anatomy and physiology.
Following the opening 3-week course, the 1 st quarter and each subsequent quarter contains one didactic and one clinical course.
The table below lists the courses and units by quarter:
|
Didactic Courses |
Course # |
units |
Clinical Courses |
Course # |
units |
1 st Fall Quarter |
Directed Studies in Primary Care Med |
190Z |
2 |
Family Medicine Clinical |
080P |
5 |
|
Family Medicine Didactic |
080 |
14 |
|
|
|
2 nd Quarter |
Family Medicine Didactic |
081 |
8 |
Family Medicine Clinical |
081P |
8 |
3 rd Quarter |
Family Medicine Didactic |
082 |
8 |
Family Medicine Clinical |
082P |
9 |
4 th Quarter |
Family Medicine Didactic |
083 |
6 |
Family Medicine Clinical |
083P |
9 |
5 th Quarter |
Family Medicine Didactic |
084 |
8 |
Family Medicine Clinical |
084P |
9 |
The didactic courses include
- basic medical sciences (anatomy, physiology, pathophysiology and genetics)
- clinical medicine lectures
- pharmacotherapeutics
- information literacy/evidence based medicine
- pediatric development
The clinical courses include
- supervised clinical practice (starting in the 2 nd quarter)
- behavioral medicine
- clinical skills (physical diagnosis)
- clinical problem solving seminars
- cultural medicine
- professional issues (health policy, professional practice issues and medical ethics).
Although all these curricular threads, except supervised clinical practice, are delivered in the classroom through lecture/discussion/seminar, the content is included in the clinical courses. This content is considered appropriate for the clinical courses because most of it is taught in small groups that focus on application of knowledge and clinical skill-building.
The two courses/quarter design has the following advantages:
- Each course includes several curricular threads, which are inter-related
- Content can be sequenced when it is most appropriate, rather than being limited to a consistent weekly schedule
- As medical knowledge develops, new topics and/or changes in content can be easily added, without the burden of developing new courses
