MD in Medicine

Patient Based Learning

First and Second Years

Years one and two consist of four nine-week blocks. Each block has two components: basic science/patient-based Learning (BSci/PBL) and introduction to patient care (IPC).


In this component, students work through one authentic clinical case each week in small groups with a faculty facilitator. The facilitator is not a content expert, but rather guides the group as they work through the case seeking a diagnosis and patient care plan. BSci/PBL cases guide learning and the application of basic science concepts in clinical scenarios. A few basic lectures and laboratory experiences teach concepts that supplement the cases. BSci/PBL features about ten hours of patient-based learning with about ten hours of traditional teaching such as lectures each week.


Themes change with each block and focus on clinical skills, including history taking and physical examination, psychosocial issues and increasing the students' understanding of epidemiology, diagnostic tests and psychopathology. The primary learning strategies also emphasize small-group learning with supporting lectures and laboratory experiences.

ACE (Ambulatory Care Experience)

ACE is required during blocks two through four of the first year and is elective during the second year. During the ACE experience, each student spends a half-day twice a month with a role-model faculty or community physician-preceptor.

Advanced Physical Diagnosis (APD)

APD is required during the second year. Students are assigned to a clinician mentor for the entire academic year. Times and frequency of meetings are at the discretion of the faculty member and the students; however, it is recommended that they meet at least twice each month. The emphasis of this APD experience is on history and physical exam skills and clinical reasoning. Successful completion of APD is required for advancing to the core clerkships.

Contemplating Medicine Patients, Self and Society (COMPASS)

This is a longitudinal small group course. Faculty facilitated small group sessions occur throughout all four years; addressing topics related to professional formation. 

Independent Learning

Two half days each week are protected time for independent or student-directed learning; no faculty-initiated activities may be scheduled.

M1 - Blocks 1, 2, 3, 4

MED_ID 5041Structure and Function of the Human Body I6
MED_ID 5042Interviewing3
MED_ID 5043Structure and Function of the Human Body II6
MED_ID 5044Physical Examination3
MED_ID 5045Structure and Function of the Human Body III6
MED_ID 5046Psychosocial Aspects of Medicine3
MED_ID 5047Structure and Functions of the Human Body IV6
MED_ID 5048Clinical Epidemiology and Preventive Medicine3
MED_ID 5051Ambulatory Clinical Experience I1

M2 - Blocks 5, 6, 7, 8

MED_ID 5551Pathophysiology I6
MED_ID 5552Diagnostic Tests and Medical Decisions3
MED_ID 5553Pathophysiology II6
MED_ID 5554Psychopathology and Behavioral Medicine3
MED_ID 5555Pathophysiology III6
MED_ID 5556Clinical Practicum3
MED_ID 5557Pathophysiology IV6
MED_ID 5558Physician as a Person3
MED_ID 5561Advanced Physical Diagnosis I1

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Year three includes seven clerkships in family medicine, internal medicine, neurology, obstetrics and gynecology, pediatrics, psychiatry, and surgery. The neurology clerkship is four weeks long, the psychiatry clerkship is six weeks, and all others are eight weeks. Six of the seven core clerkships are required to be taken in the third year with one clerkship being deferred to the fourth year. During these core clerkships, students learn the fundamentals of good patient care, and faculty assesses student competencies. Clerkships must be supervised by Columbia-based School of Medicine faculty or community faculty appointed through the School of Medicine. Students may take up to three clerkships at designated community sites as part of the MU Rural Track Clerkship Program.

Child Health Clerkship -  CH_HTH 6000

Students have the opportunity to learn about common illnesses and abnormalities in children. Emphasis also is placed on the importance of preventive and developmental aspects of child care. Lectures and case presentations correlate with the clinical experiences.

Family and Community Medicine Clerkship -  F_C_MD 6001

Core learning experiences take place in ambulatory clinic settings. Students work with experienced clinicians and senior residents, spending time in University teaching practices, and in community-based practices. Students also may spend time seeing patients in emergency room, hospital, or nursing home settings, and taking call with residents and practicing physicians. A high volume of patients of all ages with a wide range of problems is encountered. Many patients will have undifferentiated problems.

Internal Medicine Clerkship -  IN_MED 6002

Students spend eight weeks on the internal medicine inpatient service at University Hospital and Harry S. Truman Veterans Hospital, where they learn to care for adult patients with acute and chronic illnesses. Teaching emphasizes the principles of differential diagnosis and problem solving, as well as the integration of basic science information into the art of patient care. Students also gain clinical experience in medical interviewing and physical examination.

Obstetrics/Gynecology Clerkship -  OB_GYN 6004

Students rotate on the obstetric service, the gynecology service, and the gynecologic oncology service, seeing a broad range of patients in both inpatient and outpatient settings. In addition, they attend lectures and interactive case presentations.

Neurology Clerkship -  NEUROL 6003

Students see patients with neurological disorders in the outpatient clinics, in hospital settings, and on consultation services.

Psychiatry Clerkship -  PSCHTY 6005

Students see patients with psychiatric disorders in the outpatient clinics, in hospital settings, and on consultation services.

Surgery Clerkship - SURGRY 6006

Emphasis is placed on the diagnosis and treatment of disorders requiring surgical intervention. Each student has a faculty mentor-advisor, attends faculty discussion sessions that cover objectives in the required textbooks, and takes call under the supervision of surgical residents. Students are assigned patients from all surgical specialties, participate in pre-operative examinations and evaluations, assist during surgical procedures, and follow the post-operative management process.

Patient-Centered Care Objective Structured Clinical Evaluation (PCC-OSCE)

A PCC-OSCE will be administered at the end of the third year to assess students' ability to provide patient-centered care. Successful completion is required for graduation.  

Contemplating Medicine Patients, Self and Society (COMPASS)

This is a longitudinal small-group course. Faculty-facilitated small-group sessions occur throughout all four years, addressing topics related to professional formation. 

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The fourth year consists of two one-month advanced clinical selectives (sub-internships) in the core disciplines, four one-month general electives, one two-week general elective, and a one-month advanced biomedical science (ABS) course. One of the advanced selectives must be in a surgical area and one must be in a medical area. A minimum of four courses (including one advanced selective) must be taken under the supervision of Columbia-based School of Medicine faculty. Many students will have completed the two-week elective requirement during the third year, coupled with the psychiatry clerkship. Students may have completed one of the four-week general elective requirements if they took the neurology clerkship during the third year.

The fourth year consists of two groups of advanced selectives and general electives.

Advanced Clinical Selectives

Two advanced clinical selectives from the core disciplines of child health, family medicine, internal medicine, neurology, obstetrics and gynecology, psychiatry and surgery are required. Each selective is four weeks long. One must be in a surgical area and one must be in a medical area. Advanced clinical selectives build on the knowledge and skills acquired during third-year core clerkships. Students are expected to assume more responsibility for patient care than in the core blocks.

Advanced Biomedical Sciences Selectives

The advanced biomedical science selectives revisit the biomedical sciences in the context of a patient, disease, diagnosis or problem. Four options are available. Students may:

  • Search and analyze literature, integrate and evaluate data, produce a paper or presentation
  • Conduct original research with mentors from the basic or clinical sciences
  • Attend a series of graduate-level lectures and discussions of current literature
  • Function as co-tutors for PBL, attend tutor preparation sessions and write a PBL case

General Electives

Eighteen weeks of general electives are required. Off-site experiences are available but must be approved by the appropriate department.

For more information on fourth year course offerings, please refer to the Clinical Rotation Catalog. This catalog contains descriptions of all clinical rotations offered at the University of Missouri - Columbia School of Medicine, as well as information concerning enrollment for rotations.

Contemplating Medicine Patients, Self and Society (COMPASS)

This is a longitudinal small group course. Faculty facilitated small group sessions occur throughout all four years; addressing topics related to professional formation. Fourth year students complete a required COMPASS capstone assignment.

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