Clinical Anatomy

Dr. Ernest April

Director

Office: P&S 10-420
Phone: Ext. 5-5631
Email: ewa1@columbia.edu

Dr. Angela Lignelli-Dipple

Radiology
 
Office: MHB3-111
Phone: ext. 5-2511
Email: al270@columbia.edu

We define Clinical Anatomy as that which pertains specifically to the practice of contemporary medicine. An essential pre clinical subject, Clinical Anatomy enables student physicians to acquire the fund of anatomic knowledge necessary for the practice of medicine and the knowledgeable discussion of findings or problems with consulting colleagues. Lectures introduce each laboratory topic, explain conceptual relationships between structure and function, and emphasize important subtleties between the normal and aberrant. The dissection laboratory affords a different and stimulating learning experience. Here small-group preceptor discussions focus the laboratory experience and provide informative interactions with faculty. Appropriate computer-assisted tutorials, developed by our faculty, enhance learning as well as facilitate review. Weekly correlation clinics or radiographic anatomy sessions exemplify anatomic application in the practice of medicine. We emphasize understanding, not memorization.  By course end, student physicians are able to analyze, synthesize and apply clinically relevant anatomical information - goals and skills essential for physical examination as well as proper diagnosis, appropriate therapy and accurate prognosis in patient care.

Clinical Practice I

Dr. Delphine Taylor

Course Director

Office: P&S 3-401
Phone: Ext. 5-0344
Email: dst4@columbia.edu

Dr. Michael J. Devlin

Associate Course Director

Office: 1051 Riverside Dr., Unit 116
Phone: (212) 543-5748
Email: mjd5@columbia.edu

The goal of Clinical Practice is to introduce students to the knowledge, skills and attitudes necessary to translate scientific knowledge into the clinical care of individual patients, and to guide students in their own life transition into the role of the physician. The course includes clinical clerkships, lectures and small groups.

In the first semester, students acquire basic knowledge and skills in medical interviewing, and practice these skills on actors playing patients. In the second semester students learn how to approach the medical literature with a basic understanding of epidemiology and biostatistics. Students also learn about health policy and economics, focusing on what impact the system has on patient access to care and the ability to provide effective care. Lastly, students learn about health promotion and disease prevention, and practice skills in counseling for behavior change. Special lectures devoted to cultural competence and the ethical dimensions of medical care are scheduled throughout the year. Small group sessions provide opportunities to integrate the didactic parts of the curriculum with clinical experiences in clerkships, and also serve as a forum for exploring issues relating to professional development and medical ethics.

Human Development

Dr. Cathy Mendelsohn

Course Director

Office: BB 1502 or 1514,
Phone: Ext. 5-1591, 5-7941
Email: clm20@columbia.edu

The goal of this course is to introduce students to the principles of human embryology, from conception to birth. This should provide a basis for understanding human anatomy, genes that regulate developmental processes and the molecular basis of birth defects. Topics will include the formation of the basic body plan, the origin and division of body cavities, the role of the placenta, early organogenesis, the maturation of organ and sensory systems, and an introduction to molecular mechanisms that orchestrate development.

Neural Science

 

Dr. Daniel Goldberg

Course Director
Office: PH 7 West
Phone: Ext. 5-1673
Email: djg5@columbia.edu

You will learn the fundamentals of neural science: structures, pathways and mechanisms subserving sensory, motor and higher cognitive functions, how information is transmitted along and between neurons, and symptomatology and etiology of neurological and behavioral disorders. These basics will be enriched with recent information derived from cellular and molecular biological approaches so as to give you an appreciation of the extraordinary potential being developed for the understanding and treatment of disorders of the nervous system and of the techniques by which this potential will be realized. Instruction is by a mix of basic science and clinical lectures, anatomy labs, and research demonstrations.

 

Psychiatric Medicine I

Dr. Janis Cutler

Course Director
Office: PI 1st Floor, 1303-E
Phone: 543-5552, 543-5556
Email: cutlerj@pi.cpmc.columbia.edu

Dr. Kelli Harding

Assistant Course Director
Office:  PI, 1st Floor, 1303-D
Phone:  543-6801
Email:  kjh2104@columbia.edu

The course consists of lectures and small groups for discussion and interviewing patients. The goals of the course are for students to understand the concepts of depression and psychosis and the psychiatric syndromes that affect mood and thought, including Schizophrenia and Bipolar Disorder.

Science Basic to the Practice of Medicine and Dentistry

Pictured Left to right: Dr. Marc Dickstein, Dr. Michael Gershon and Dr. Patrice Spitalnik

Dr. Marc Dickstein, Course Director

Office: BB 15-1516
Phone: Ext. 5-1857
Email: mld2@columbia.edu

Dr. Michael Gershon, Course Director

Office: P&S 12-513
Phone: Ext. x5-3447
Email: mdg4@columbia.edu

Dr. Patrice Spitalnik

Section Head, Histology
Office: P&S 14-426
Phone: Ext. x2-2911
Email: pfs2101@columbia.edu

Science Basic to the Practice of Medicine provides students with an understanding of fundamental molecular and cellular biology and systems physiology. The course is divided into the following sections:

• Tissues of the body
• Cardiovascular system
• Pulmonary and Renal systems
• GI system
• Metabolism
• Endocrine and Reproductive systems.

In each of these blocks, the knowledge of the structure and function of cells will form the basis for understanding the structure and function of the systems of the body. Emphasis is placed on using this knowledge and understanding to solve clinical and scientific problems.

The course is comprised of a series of core lectures, histology labs, and small group sessions. Lectures explain and highlight important concepts and principles, put material into clinical and historical contexts, and provide a sense of the direction in which a field is moving. Histology labs provide an opportunity for students to learn how the structure of cells, tissues, and organs enable these structures to fulfill their particular functions. Professor’s Rounds, Journal Club, Workshops, and the Case-Based Learning Series represent opportunities for students and faculty to interact in a relatively small groups during which time critical thinking is stressed and application of the core material to either clinical medicine or basic science research are stressed.

Pathophysiology I & II

Dr. Thomas Garrett (pictured)

Course Director
Office: BB15-1516
Phone: Ext. 24116
Email: tjg1@columbia.edu

Dr. Jay Lefkowitch

Associate Course
Director for Pathology
Office: PH 15W-1574
Phone: Ext. 57381
Email: jhl3@columbia.edu

Ms. Betty Carroll

Course Coordinator
Phone: Ext. 59306
Email: ec11@columbia.edu

The Pathophysiology course runs in both semesters of second year.

Pathophysiology I is composed of five sections: Molecular and Cellular Pathology, Immunology, Microbiology/Infectious Diseases, Parasitology and Neuropathology. Each section has an examination for which the student receives a numerical grade. A final grade for the semester is calculated using a weighted average since the sections have significantly different durations.

Pathophysiology II is composed of seven sections: Cardiology, Pulmonary Diseases, Endocrinology, Gastroenterology, Renal Diseases, Oncology, and Hematology.

Each section has an examination for which the student receives a numerical grade. A final grade for the semester is calculated using a straight average for the seven sections since all have a similar duration.

No final examination is held in either semester. However, all students must demonstrate that they have mastered the core competency in all twelve sections. Students who do not demonstrate core competency on an examination will be required to do a make up examination at the discretion of the Second Year Faculty Committee.

Foundations of Clinical Medicine

Dr. Deepthiman Gowda

Course Director
Office: BB 15-1516
Phone: 212-305-2451
Email: dg381@columbia.edu

Dr. Mary Johanna Fink

Associate Course Director
Office: Farrell Clinic, 610 West 158th St.
Phone:  212-544-1880
Email:  mjf2103@columbia.edu

Foundations of Clinical Medicine was determined by asking the question, ‘what clinical skills and knowledge does the P&S student need to confidently enter the Major Clinical Year?' The course, which runs from October to May of the second year, will primarily be taught in Preceptor Groups comprised of four students and one faculty member. The first section of the courseis an intensive training inthenormal physical exam and will take place at Preceptor sites and at CUMC-based physical exam tutorials.

The student will thenwork with hospitalized patients at their Preceptor sites to learn to obtain both complete and hypothesis-driven medical histories and physical exams. The student will learn toorganize histories, physical exams, and laboratory and imaging data into effective write-ups and oral case presentations.  Students will also take turns leading cases in theirPreceptor Groups. Thecases, which will correlate with contentin the Pathophysiology course, will introduce students to clinical reasoning, hypothesis-driven history taking and physical examination, and an application of the concepts ofclinical epidemiology to decision-making.

Clinical Practice II

Dr. Delphine Taylor

Course Director

Office: P&S 3-401
Phone: Ext. 5-0344
Email: dst4@columbia.edu

Dr. Michael J. Devlin

Associate Course Director

Office: 1051 Riverside Dr., Unit 116
Phone: (212) 543-5748
Email: mjd5@columbia.edu

Building on the experiences of first year, Clinical Practice II continues to emphasize the communication skills needed to become an effective and empathic clinician. The first semester focuses on improving interviewing and listening skills geared toward particular clinical situations. To complement material learned in pathophysiology, pharmacology and psychiatry and physical diagnosis, Clinical Practice workshops provide a hands-on approach to addressing substance abuse, chronic pain and disability, and adherence to medical therapy. Students also practice talking to patients and families about bad news and end-of-life issues. In the second semester, Clinical Practice small groups provide students a format to discuss concerns about caring for patients and practice core skills as they transition to the clinical years.

Narrative Medicine Seminar Series

In the second semester, students will participate in the Narrative Medicine Seminar Series, a series of graduate-level small-group seminars in the humanities taught by P&S faculty and faculty from the Morningside campus. Students may choose among seminars in literature, creative writing, history, visual arts, photography, philosophy, and religious studies. Some of the seminars offered in previous years include, The Philosophy of Death, Faith in the Study of Practice of Medicine, Women’s Illness Narratives, Medical Student as a Writer, Fiction Workshop, Photography, Life Drawing, Mindfulness-Based Stress Reduction, and Attending to Movies. For a description of seminars offered previously, go to the Program in Narrative Medicine website at www.narrativemedicine.org/ or CP2 website at www.columbia.edu/itc/hs/medical/cp2

Students may elect to fulfill this requirement instead by enrolling in a main campus course in the humanities in the fall or spring. Course listings on the main campus are available in the Registrar’s office in Black Building or online and must be approved in advance. For more information, contact seminar series director Rita Charon at rac5@columbia.edu

Pharmacology

Dr. Penelope A. Boyden

Course Director

Office: P&S 7-464
Phone: 5-7907
Email: pab4@columbia.edu

The subject of the Pharmacology course is the effects of drugs and chemicals on physiological processes particularly in conditions of disease. Both basic mechanisms of therapeutic and toxic drug actions as well as practical aspects of drug administration to patients are the topics of the lectures and conferences. The course also teaches the vocabulary and concepts necessary for the use of drug therapy in the clinical years of medical school as well as for future practice.

Psychiatric Medicine II

Dr. Janis Cutler

Course Director

Office: PI 1st Floor, 1303-E
Phone: 543-5552, 543-5556
Email: cutlerj@pi.cpmc.columbia.edu

Dr. Kelli Harding

Assistant Course Director

Office:  PI 1st Floor, 1303-D
Phone:  543-6801
Email:  kjh2104@columbia.edu

Skills and knowledge will be built upon those acquired in the first year. Major psychiatric disorders to be discussed will include Anxiety Disorders and Personality Disorders. Normal child and adult psychological development will also be presented. Principles of psychiatric treatment will be introduced. Psychiatric patients will be interviewed in small groups.

Electives In The First Two Years

This section describes electives that are offered to first and second year students through the Dean’s Office. These are in addition to the required clinical selectives of the Clinical Practice I course. Students may also choose to participate in the following clinical electives:

Metropolitan Alumni Clinical Elective

A major objective of this elective is to help first and second year medical students get a better understanding of a particular specialty by spending an afternoon in a clinical setting with a P&S alumnus. The list includes physicians in 29 different specialties ranging from Anesthesiology to Vascular Surgery.

The Role of the Unsung Hero

Objective: To observe an anesthesiologist at work in the O.R. and in patient care.
One student every Saturday and Sunday morning will come in at 7 A.M. and report to the attending on call that day. He/she will have the opportunity to follow that attending, observe surgery from the anesthesiologist’s point of view and interact with residents and patients.

Introduction to Basic Surgical Skills

Objective: To introduce first year students to the basic tools and techniques of surgery.
Two hour small group mid-winter sessions with instruction on suturing, tying knots, and stapling wounds.  E-mail Doris Leddy at DL642@columbia.edu

Introduction to Laparoscopic Surgery and Endoscopy

Objective: To introduce second year students to the "surgical learning lab" using simulation equipment.
Two hour small group late-winter sessions with the opportunity to gain familiarity with the use of virtual instruments, real instruments, and simulated patients.   E-mail Doris Leddy at DL642@columbia.edu

Major Clinical Groups & Sections

The class is divided into 10 groups of approximately 15 students per group. Each of the 10 groups rotates through all clerkships at different times throughout the third year, based on the rotation schedule you chose.

All students will experience the clerkships below:

• Medicine (5 weeks Presbyterian, 5 weeks affiliated hospital)
• Neurology (5 weeks)
• Ob/Gyn (5 weeks)
• Pediatrics (5 weeks)
• Primary Care (5 weeks)
• Psychiatry (5 weeks)
• Subspecialties I (one week of each of the following):
• Neurosurgery
• Ophthalmology
• Otolaryngology
• Anesthesiology
• Vacation
• Subspecialties II
• Urology 2 weeks
• Orthopedics 2 weeks
• Vacation 1 week
• Surgery (5 weeks)

Selecting a Section

Students group themselves into teams of 1 to 4 students per team. Student groups are randomly assigned a number by the Registrar’s Office. The teams with the best (i.e., lowest) lottery numbers have first chance at signing up for the Group (1 through 10). Those with the higher (worse) numbers may find themselves closed out of a more popular section. There is no “best” rotation schedule. Advice is to schedule your preferred rotation in January.

Rotating Through the Affiliates

Each student in a given section is assured of doing the same rotations at the same time as the other members of that section. They may not be assigned to the same preceptor groups, or even to the same hospital. During their Major Clinical Year students can be assigned as follows:

Medicine

All students are assigned to New York-Presbyterian for 5 weeks. The other 5 weeks are spent at one of the following: Harlem, St. Luke’s, Roosevelt, Stamford or the Allen Pavilion.

Pediatrics

Students are assigned to one of the following: New York-Presbyterian or Harlem Hospital.

Obstetrics/Gynecology

All students spend the full five weeks of clerkship at New York-Presbyterian, St. Luke’s/Roosevelt Hospital, or Stamford Hospital.

Primary Care

Sites for the five-week clerkship are: Bassett HealthCare (Cooperstown, NY), The Tulley Center (Stamford, CT), Stamford Hospital (Stamford, CT), Harlem Hospital Center, St. Luke’s/Roosevelt, New York-Presbyterian Hospital, the Bronx VA, NH-Dartmouth —Concord, or Indian Health Service sites in Arizona and New Mexico.

Neurology

Students are assigned either to the Neurological Institute or Harlem Hospital Center.

Psychiatry

All didactic courses are taught at the Psychiatric Institute. Students are assigned for all or most of their clinical work to St. Luke’s, Roosevelt, Creedmoor Psychiatric Center, or the New York State Psychiatric Institute.

Subspecialties I

Otolaryngology, Neurosurgery and Anesthesiology are taught at New York-Presbyterian. Ophthalmology is taught at the Eye Institute.

Surgery

All students are assigned to either New York-Presbyterian, Allen Pavilion, Bassett, or St. Luke’s-Roosevelt Hospital.

Subspecialties II

Urology is taught at New York-Presbyterian. Orthopedics is taught at New York-Presbyterian or St. Luke’s/Roosevelt Hospital Center.

Course Directors and Clerkship Descriptions

About the Fourth Year

While the fourth year is generally elective in nature, it is expected that certain requirements will be met - the first being the completion of at least one intensive advanced clinical clerkship, or equivalent, which will demonstrate the student’s ability safely to care, by themselves, for acutely ill patients 24 hours a day. The second requirement is the completion of one of three “Return to the Classroom” selective months, with lecture/seminar format, which emphasize the foundation of medical knowledge and the critical appraisal of data rather than the day-to-day aspects of patient management. The required “Return to the Classroom” month focuses on one of 3 areas (Clinical Pathology, Pathophysiology, or Pharmacology) and also includes weekly Clinical Practice (CP4) sessions and twice weekly sessions in Biomedical Informatics. The Clinical Practice sessions foster collegial discussion of challenges facing physicians and medicine today. The Biomedical Informatics sessions focus on both concepts and practical skills that will prepare graduating students for the role of informatics in their future clinical careers.

During the third year, the student begins a series of decisions which culminates in a choice of a particular residency program for postgraduate education. During March and April of their third year, the students plan their fourth year elective curriculum. To make the best choices, the students must consider where their interests lie and then decide what to study, at which institution, and at which point in the year.

To help the students become aware of the decisions to be made and the options available, the Senior Associate Dean for Student Affairs (x5-3806) provides information in the form of memoranda and meetings throughout the year. Advisory Deans also provide numerous opportunities for students to meet with and learn about different residencies. At the same time, the student is supported by the class ahead as well as the Dean’s Office.

All fourth year students are required to take the United States Medical Licensing Examination (USMLE II - Clinical Knowledge and Clinical Skills) no later than November 30, 2009. Passing Clinical Knowledge is required of all students for graduation from P&S.

Phone/web registrations are scheduled for April, July, October, and February for fourth year students.

• December of their third year, students meet with the Senior Associate Dean for Student Affairs and with faculty from P&S affiliates for a planning session about the fourth year and discussion of the various elective opportunities.
• In January the Senior Associate Dean commences meetings with each student individually to review their academic achievements and discuss plans for fourth year and residency applications.
• In February, there are a series of meetings at which fourth year students advise the third years on how to plan their elective schedules.
• In April of the third year, students begin the process of telephone/internet registration for fourth-year electives.
• In May, the Senior Associate Dean for Student Affairs meets with the entire class to go over the residency application process step by step.
• In June, students meet in a series of small-group discussion sessions with individual clinical department chairmen and senior faculty in the various specialties in which they may be interested.
• To help students with their decision-making, the P&S elective catalog is available on-line: Web address: (http://cpmcnet.columbia.edu/dept/ps/electives)
• Brochures from residency programs throughout the country are available in the Dean’s Office, as well as evaluations by students who have visited them in previous years.

By the start of their fourth year, all students are involved in registering for the National Residency Matching Program (N.R.M.P.), requesting letters of recommendation from the faculty, and researching on-line programs that might fit their needs. At a meeting with the Senior Associate Dean for Student Affairs, the student selects a faculty advisor in the field of medicine in which the student is interested in pursuing a career. With the help of the advisor, the students identify residency programs they may be interested in and follow the necessary procedures for applying.

Most interviewing for residency programs is done during December and January. By the third week in February, the various programs and applicants across the country have ranked each other in order of preference and submitted their rank order lists to the National Residency Matching Program. Each applicant is then matched to the most preferred program on their rank order list that offers him/her a position, and each program matches the most preferred candidates who accept its offer of a position. The final match is announced on Match Day in March of the fourth year.

Clinical Practice IV

Constance Park, M.D., Ph.D.

Course Director

Email: cmp4@columbia.edu

In Clinical Practice IV students return to the classroom for weekly discussions during their Back to the Classroom Selective. Goals of this course are 1.) To provide an opportunity for students to reflect on their profession, their goals, and their training while considering the mission of medicine and what it means to them as individuals. 2.) To encourage habits of open communication between colleagues as they work together to identify and address contemporary challenges in medicine throughout their careers. 3.) To explore major challenges facing medicine today. The four sessions are:

• Challenges and Strategies in Disease Prevention: Life style changes, cardiovascular disease, and stroke.
• Our Changing Health Care System: Economics, Organization and Ethical Challenges.
• The Physician and Patients near Death: Loss and grief, healing and curing, what can be done when nothing can be done.
• Selective Topics with attention to self-care. These include Physical Therapy, Pain Management, Human Rights, Economics, Nutrition, and Topics in Complementary and Alternative Therapeutics.

Clinical Months

Students are required to complete a total of eight electives. Five of the eight electives must be clinical and five must be completed at Columbia and/or its affiliated hospitals. All students must have one sub-internship/advanced clinical clerkship and one “Return to the Classroom” selective. No more than two months of electives in a particular specialty are permitted.

Research

Students interested in research may spend two or more months on a research project. As recipient of a National Institutes of Health award to encourage student research, P&S is able to offer a number of funded Research Fellowships to fourth year students undertaking a research project. Research programs now underway in P&S are described in Chapter 12.

Electives at P&S

The College of Physicians and Surgeons, through its affiliated hospitals (Bassett HealthCare, Harlem, Helen Hayes, New York-Presbyterian, Stamford and St. Luke’s-Roosevelt) offers in its Elective Catalog over 300 electives, covering an extraordinary range of areas in both research and clinical medicine.

Web address: http://cpmcnet.columbia.edu/dept/ps/electives

Preceptorships

An elective that has grown in popularity with P&S students is the preceptorship, a resurgence of the old apprentice system, whereby a student selects a preceptor in a given field and stays with that person throughout the working day and night, for an entire month. Currently more than four out of every five fourth year students select preceptorships for one or more months. Most of these preceptorships, some 150 months, are in clinical medicine; however, as many as 60 fourth year student-months are spent in research preceptorships.

Fellowship in Urban Medicine and Immigrant Health

Focusing on Manhattan’s lower east side, this fellowship, established by the Center for the Study of Society and Medicine at P&S, is designed to help future physicians understand the unique health care plight of immigrants; it encourages them to pursue careers in Primary Care.

Extramural Programs

Students may spend three months at extramural programs, that is, at Institutions not affiliated with the College of Physicians and Surgeons. Each year, approximately three out of every four P&S students take one or more electives away - at other U.S. medical schools and in countries throughout the world.

International Exchange Programs

The following is a list of international medical schools that have formal exchange programs with the College of Physicians and Surgeons at Columbia University.

Country	Institution	Web Site
Armenia	Yerevan State Medical University	http://www.ysmu.am
Australia	Flinders University of South Australia University of Sydney	http://www.flinders.edu.au http://www.medfac.usyd.edu.au
Chile	Clinica Indisa	http://www.indisa.cl
China	Fudan University Guangzhou Medical College Peking University Health Sciences Center	http://www.fudan.edu.cn http://www.gzhmc.edu.cn email: donzhe@mail.bjmu.edu.cn
France	University of Marseille University of Paris (MICEFA) American Hospital in Paris	http://www.timone.univ-mrs.fr/medecine/index.html http://micefa.org/american/programme/medicine.html http://http://www.ahpf.org
Germany	Heidelberg University	http://www.med.uni-hd.de/studiendekanat
Ireland	Royal College of Surgeons in Ireland Trinity College	http://www.rcsi.ie/medical_school/student_electives http://www.tcd.ie
Israel	Ben Gurion University of the Negev	http://cpmcnet.columbia.edu/dept/bgcu-md
Italy	University of Padova	http://www.unipd.it
Japan	Keio University Tokyo Women’s Medical University	http://www.med.keio.ac.jp/index.html http://www.twmu.edu.ac.jp
Korea	Hallym University Seoul National University	http://www.hallym.ac.kr/main.htm http://plaza.snu.ac.kr/~bklife/english/e_index.html
Lebanon	American University of Beirut	http://www.aub.edu.lb
Romania	University of Bucharest	http://www.unibuc.ro/en/main_desprenoi_en
South Africa	University of the Witwatersrand	http://www.wits.ac.za
Spain	Universidad de Navarra	http://www.unav.es/admision/titulaciones/doctorados.html
Sweden	Göteborg University	http://www.gu.se
Thailand	Chiang Mai University	http://http://www.grad.cmu.ac.th
United Kingdom	St. Bartholomew’s and London School of Medicine & Dentistry University of Edinburgh, Faculty of Medicine	http://www.mds.qmw.ac.uk http://www.ed.ac.uk
Venezuela	University of Zulia, Maracaibo	http://www.arg.luz.ve