SCHOOL

Why Apply to Trinity?

Ready to Apply?

Curriculum

The Foundations of Medicine Program

Title of Course	Credit Hours
Term 1
Introduction to Clinical Medicine I	1 hour
Biochemistry & Genetics I	4 hours
Gross Anatomy I	4 hours
Microanatomy I	4 hours
Physiology I	4 hours
Total:	17 hours
Term 2
Introduction to Clinical Medicine II	1 hour
Biochemistry, Genetics & Molecular Biology II	3 hours
Gross Anatomy/Microanatomy II	3 hours
Physiology II	3 hours
Neurosciences	3 hours
Total:	13 hours
Term 3
Microbiology/Immunology	3 hour
Pathology I	4 hours
Medical Pharmacology I	3 hours
Behavioral Science	4 hours
Introduction to Clinical Medicine III	1 hours
Total:	15 hours
Term 4
Microbiology/Immunology	3 hour
Pathology II: Systemic & Clinical	4 hours
Pharmacology II	3 hours
Introduction to Clinical Medicine lV	5 hours
Total:	15 hours
Term 5
Basis of Diseases	12 hours
Clinical Therapeutics	3 hours
Introduction to Clinical Medicine V	1 hours
Total:	15 hours

Foundations of Medicine Course Descriptions

Terms 1 and 2

ANAT 111: Developmental and Microscopic Anatomy (4 credits)

ANAT 121: Developmental and Microscopic Anatomy (3 credits)

Provides a comprehensive review of human microscopic anatomy, consisting of the cell and basic forms of tissues. The microstructure of each organ and organ system is studied in a systematic approach, with emphasis on function. Ultra-structure and function of major tissues and organs are presented didactically. In addition, a brief review of the principles of development from gametogenesis to the fourth week of embryonic development is provided. Mechanisms of teratogenesis are briefly discussed, and congenital malformations are presented where they illustrate mechanisms of normal development. Clinical relevance is emphasized through case-based sessions.

ANAT 112: Gross Anatomy (4 credits)

ANAT 122: Gross Anatomy (3 credits)

Studies gross structure, as well as normal and abnormal development of all organs and systems of the human body, with an emphasis on function. To enhance understanding of this subject, an Anatomical Learning Resource Center (LRC) is in place at Trinity. The LRC incorporates computer-based individual learning and other audiovisual aids, such as videotaped dissections, laser disc programs including imaging modalities, including Slice of Life, Adam and anatomical models. The integration with physiology in a systembased approach, along with clinical correlation and physical examination of the various systems, provides students with the knowledge of traditional anatomical relationships, with functional and clinical relevance. Laboratory work includes the study of both prosections and dissections of cadavers.

BIOC 111: Biochemistry and Genetics I (4 credits)

BIOC 112: Biochemistry and Genetics II (3 credits)

Introduces the basic aspects of biochemistry and genetics. Molecular genetics is a major part of this course. Molecular genetics is followed by the study of major types of genetic disease, including chromosome aberrations and single-gene disorders. Several specialized topics are included, which complement material taught in physiology, histology and neuroscience courses. These include hormonal signaling cascades, cytogenetics and neurotransmitters. Mitochondrial oxidation and carbohydrate metabolism are the only metabolic pathways covered in the first semester course. The course also focuses on metabolism, which includes nutrition, treatments of vitamins and minerals, and nutrition-related metabolic disorders. The genetics track continues with multifactorial inheritance, population genetics and assisted reproduction. More specialized topics include cell cycle control, the molecular causes of cancer, genetic imprinting and human reproductive cloning.

PHYS 113: Medical Physiology I (4 credits)

PHYS 123: Medical Physiology II (3 credits)

Enables students to acquire a sound understanding of the mechanisms upon which life depends, through an integrated study of the body’s control systems. Most disease conditions of the body result from abnormal functioning of one or more of the basic control systems. The effective practice of medicine depends on the future physician’s knowledge of these regulatory mechanisms. This objective is achieved through lectures, case-based discussions, problem-solving sessions and one-on-one meetings. At the end of two semesters, the students will have an understanding of not only each major organ system, but of how these organ systems integrate to maintain normal body function (homeostasis).

NEUR 125: Neuroscience (3 credits)

Integrates both the anatomy and physiology of the nervous system. The principles that underlie the anatomical structures of each system are correlated with its physiology and relevant clinical applications, including behavioral aspects. Emphasis is placed on the function of the nervous system in health and sickness. Modern principles of neuronal circuits and synaptic transmission also are introduced. Laboratory instruction includes detailed brain examination and exposure to neuro-imaging modalities, vision and principles of neurological examinations.

Semesters 3 and 4

MICR 231: Microbiology and Immunology I (3 credits)

MICR 241: Microbiology and Immunology II (3 credits)

Presents the basic concepts and applications of immunity: microbial ultrastructure; physiology and genetics; general infectious cycles of bacteria, viruses, fungi, protozoa and helminthes; and the public health methods that underlie the host-parasite relationships, diagnostic methods, and therapeutic and preventive modalities required for the infectious diseases seen in the primary health care clinic. Term 4 covers infectious diseases using the integrated organ systems approach begun in Term 3. Within each system block, the microbiology material will start with the normal flora within the different body niches of the system, the infectious diseases damaging that system of the body and the agents causing the infection. Essential information for each infection will include major symptoms, basics of the infectious agent, and the epidemiology (including demographics, pathogenesis, basic laboratory diagnosis and treatment).

PATH 232: Pathology I/General (4 credits)

PATH 242: Pathology II/Systemic and Clinical (4 credits)

This is substantially the study of general pathology with the addition of hematology. The goal is to bridge the gap between pure basic science and the disease processes related to clinical medicine. Prepares students for the initiation into patient care. Combines morphologic and functional changes to determine mechanisms of pathologic processes. Actual disease states are reflected from the viewpoint of pathogenesis, gross and microscopic alterations, and are contrasted with normal structures. Subject amplification is accomplished by the addition of case studies.

The course sequence is:

cell degeneration and adaptations;
inflammation and repair;
hemodynamic disorders, thrombosis and shock;
general disorders;
diseases of immunity;
neoplasia;
environment and nutrition;
hematology;
diseases of infancy and childhood; and
infectious diseases.

Integrated with microbiology, pharmacology and behavioral science, Path II takes a systemic approach to the study of disease. Within each system, the basic gross and microscopic changes associated with each disease are stressed, but the courses also allow for a review of normal anatomy, pathophysiology and the clinical aspects of disease. Taught in blocks that include cardiovascular and respiratory systems, gastrointestinal and hepatobiliary systems, urinary and reproductive systems; and endocrine, skin, musculoskeletal and nervous systems. Highly integrated with microbiology, pharmacology and introductory clinical medicine courses taught in Term 4. Students have the opportunity to review the workings of a modern hospital laboratory and assist at autopsies at a local hospital.

PHM 234: Medical Pharmacology I (3 credits)

PHM 244: Medical Pharmacology II (3 credits)

Studies the effects of drugs on living organisms. Emphasis is placed on the basic mechanisms of action and major indications of drugs used in medical practice. Provides an introduction to general principles of pharmacology (drug metabolism, pharmacokinetics and drug-receptor interactions), autonomic pharmacology, drugs that modulate inflammatory and immune responses and anti-infective agents. The presentation of the anti-infective agents complements the infectious agents presented in microbiology and pathology. Faculty presentations are supplemented with online materials such as quizzes, a drug database and demonstrations of drug action on a human-patient simulator. Pharmacology II continues Pharm I; however, pharmacology appears as a component of the organ-based blocks in the fourth semester curriculum, integrating clinical medicine, microbiology, pathology and pharmacology. Material is provided through faculty presentations, computer-based resources and demonstrations of drug action using a human-patient simulator.

BEH 233: Behavioral Sciences (4 credits)

Stresses the complex relationship between psychological make-up and experience on one hand and disease manifestation on the other. It is designed to develop the knowledge and insights required for a practicing physician’s understanding of the patient’s emotional responses to illness and stress. The basics of recognizing organic and functional psychological disturbances are described. Sexual dysfunction, bereavement, suicide and socio-pathological disorders receive detailed attention. Workshops on realistic clinical problems are an integral part of this course. Learning to communicate effectively with patients and colleagues is stressed. Biostatistics is included, and emphasis is placed on practice interviews and data collection through the use of professional patients.

CLM 115: Introduction to Clinical Medicine I (1 credit)

CLM 125: Introduction to Clinical Medicine II (1 credit)

CLM 211: Introduction to Clinical Medicine III (1 credit)

CLM 241: Introduction to Clinical Medicine IV (5 credits)

Gives students the skills that they will need when they begin their clinical rotations. These skills include interviewing, physical examination, interpretation of common clinical investigations, presentation skills, searching and evaluating medical literature and clinical reasoning. Comprises lectures, physical diagnosis labs, half-day hospital attachments throughout the semester, and assignments in local clinics and laboratories.

The goals of the Clinical Medicine curriculum are as follows:

Provide training in fundamental clinical skills through patient contact, under close supervision.
Provide students with a broad overview of medical practice so that they understand the interrelationships between different levels of practice and various areas of specialization.
Present an opportunity to assess areas of medical practice in which students might want to specialize upon graduation.
Prepare students to function effectively in and to gain the most from graduate medical education.

Term 5

CLM 351: Basis of Disease (12 credits)

The “Basis of Diseases” course comprehensively integrates and builds upon the basic sciences previously learned in the “Foundations of Medicine” course. The objective of the course is to further the successful transition of the student from the basic sciences into the introductory stages of clinical medicine, preparing them for clinical clerkships and a life of learning in the “healing arts”. The course commences with an organ systems approach which includes: Cardiology, Pulmonology, Digestive Diseases, Nephrology, and Neurology. This is followed by the systemic diseases and individual clinical specialties so as to allow the student to acquire skills in critical analysis of problems with integration of information to develop a well founded clinical hypothesis and a sound differential diagnosis. The course is closely integrated with clinical therapeutics and advanced clinical skills so as to further develop the major core clinical competencies necessary for mastering the foundations of a successful practice of medicine. The students will continue to gain integrated experience in collecting and relating patient information both orally and in appropriate written formats. The methodologies used to achieve these goals for the student will include: didactic lectures; clinical case discussions; small group sessions; Problem Based Learning (PBL) sessions; journal clubs; and clinical rotations linked with grand rounds and chief of service rounds lead primarily by Visiting Faculty who are accomplished physicians in their respective fields.

CLM 351: Introduction to Clinical Medicine V (1 credit)

The Introduction to Clinical Medicine V (ICM) segment builds on previously acquired basic science knowledge and clinical skills. ICM prepares students for a successful transition to clinical clerkships through additional patient contact in the context of a teaching hospital. Emphasis is place on improving techniques of the physical examination and diagnostic skills. Critical thinking will be refined to strengthen each student’s ability to formulate rational clinical hypotheses and differential diagnoses. By the end of the courses, students will be able to demonstrate their improved criticalthinking skills, their fund of knowledge on mechanisms of disease processes and their clinical acumen, by making cogent written and oral presentations in a patient-care setting. Finally, a full review of the Foundations of Medicine program and formal preparation to sit for the USMLE Step 1 are incorporated into this Advanced Introduction to Clinical Medicine course.”

Clinical Clerkships

Students are eligible to enter clinical clerkships in specific fields after passing the USMLE Step 1. Students are required to take 48 weeks of clinical core clerkships and 27 weeks of electives. The core clerkships in medicine, surgery, pediatrics, family medicine, obstetrics/gynecology and psychiatry are the basic areas of medical practice about which all physicians need to be knowledgeable. They are included in the curriculum of every medical school. Participation in these clerkships also provides students with an understanding of the various specializations in medicine.

Internal Medicine
In this clerkship, students learn the steps necessary for proper diagnosis and treatment of patients they see. Students learn how to take complete medical, personal and family histories in order to do a diagnostic “work up” and develop a plan for managing a patient’s care. They participate in clinical conferences, where they learn to report their findings and conclusions logically and succinctly.

Surgery
In the surgery clerkship, students learn about conditions that require surgical intervention and have opportunities to observe how surgical patients are managed. In the process, they become familiar with policies and procedures followed in the operating room. Opportunities will be provided for direct practice of simple procedures such as suturing, debridement and wound care. Students will be expected to observe and assist during various procedures in the operating room and participate in follow-up and treatment of the post-surgical patient, as well as ambulatory practice settings.

Pediatrics
In this clerkship, students acquire an understanding of the principles of family medicine and how they apply in community practice. Emphasis is placed on continuous and comprehensive health care for people of both sexes and all ages within the context of their families, social groups and communities. Particular attention is paid to the diagnosis and treatment of common medical problems and to health maintenance, ambulatory care and continuity of care.

Obstetrics/Gynecology
During this clerkship, students learn about the changes that take place during pregnancy, labor, delivery and the post-partum period, both normal and pathologic. They also become familiar with diagnosis and treatment of major gynecological diseases and various methods of family planning.

Psychiatry
In this clerkship, students become familiar with the major categories of mental disorder, including diagnosis and some methods of therapy. In the process, they learn how to take a psychiatric history and to evaluate a person’s mental state.

Electives
The additional 27 weeks are spent in elective clerkships. These must include eight additional weeks in medicine, which may be spent in general medicine or in medical subspecialties; and four additional weeks of surgery, which may be spent in general surgery or in surgical subspecialties.

Hospital Affiliates
During Semesters 6 through 10, students will participate in clerkships on medical campuses in the United States.

Some students may choose to take electives at other locations — for example, in a state where they may wish to eventually practice medicine, at a particular hospital with a strong program in a desired elective or at a hospital being considered for residency training. This option gives the student the added advantage of having completed a rotation onsite and gained knowledge of key physicians and residents prior to applying for residency. Approval by Trinity’s Dean of Clinical Sciences will be required. Our geographical focus in these early years will be in America’s northeast, Mid-Atlantic, and the southern states. As recruitment at Trinity grows more national and international in scope, additional affiliate hospitals/medical programs will be sought in the country’s midwest, southwest, far west and the southeast areas.

Trinity’s key commitment to students is that all clerkships — required and elective — will be conducted in the United States at hospitals with ACGME approved clerkships.

Graduation

The Doctor of Medicine (MD) degree is awarded upon successful completion of the Foundations of Medicine curriculum, the Clinical Sciences Clerkships and the USMLE Step 1, USMLE Step 2 (CK) and (CS). The entire program consists of 10 fifteen (15) week semesters (150 weeks).

The foundations of medicine program and the Advanced Introduction to Clinical Medicine will be conducted at the Trinity School of Medicine campus in Kingstown, St. Vincent & the Grenadines. The 75 weeks of Clinical Clerkships will be offered at ACGME approved clerkships in teaching hospitals affiliated with Trinity.

Residency Training

Graduating students will register for the National Residency Match Program (NRMP) which is a paired choice system for matching applicants to available residencies that takes place every March. Students train in a residency program for two to five years during which time they sit for the USMLE Step 3. Upon completion of their residency (fellowship) and passing USMLE Step 3, candidate physicians are prepared for licensure.