Year 3 Transformation (Y3T)

Why Are We Doing This? Program Rationale

Curriculum reform is hard. Especially in a time of great demand and limited resources, change like this requires clear vision, enthusiastic faculty, and dedicated students. Why take on such a difficult task? SIUSOM and the Josiah Macy Foundation have agreed the evidence is overwhelming: Now is the time to build on the strengths and shore up the weaknesses of third-year clinical education in order to effectively and efficiently produce more competent, well-rounded physicians.

Basic Layout of the New Third Year

8 month-long core rotations in the following specialties:

  • Internal Medicine
  • Surgery
  • Psychiatry
  • Family and Community Medicine
  • Obstetrics/Gynecology
  • Pediatrics
  • Neurology
  • Emergency Medicine

The object of these 4-week-long clerkships is total immersion into a clinical setting. There will be no lectures or end-of-unit shelf exams to take students away from the clinical experience. Two overarching goals of this curriculum will be to socialize medical students into medicine and help students ‘find their people,’ i.e., choose a specialty to engage in for residency training and subsequent practice.

4 month PEP (Personalized Educational Plan) experience:

This period of time is planned by the student and his/her advisors, allowing complete flexibility for the needs of the individual student and his/her clinical learning. The goal of the PEP is provide significant individualization responsive to students’ developmental goals, including those in need of intensive remediation, those wishing to explore and/or acquire advanced skills in areas of their choosing, and for a small number of gifted students, graduation by the end of the third year of medical school.

Critical Clinical Competency (CCC) Curriculum

The CCC curriculum is an entirely online learning system, built in partnership with Parallel Consulting, LLC, that will begin in the first year of medical school and spiral through to the end of the third year. Each year, students will receive deliberate practice diagnosing and managing twelve chief complaints, listed below, working through 144 discrete diagnoses, a large percentage of those seen in ambulatory and acute care settings. This standardized curriculum will serve as the backbone of the new third year's immersive approach to clinical learning to ensure students graduate with the diagnostic and initial management competency expected of a general physician. Assessment of the CCCs will occur annually via a series of uncued, comprehensive standardized patient exams that will serve as summative evaluations of developing clinical reasoning skills.

The twelve chief complaints are:

  • Abdominal Pain
  • Chest Pain
  • Cough
  • Dizziness
  • Dyspnea
  • Edema
  • Fatigue
  • Fever
  • Headache
  • Low Back Pain
  • Mood Change
  • Vaginal Discharge or Bleeding

More Information: Executive Summary

Y3T Committees

Advisory Committee

  • Each subcommittee will be accountable to the Y3T advisory committee, who in return is accountable to the EPC.

4-Week Core Subcommittee

  • Develop and problem-solve the provision of a longitudinal “apprentice model” immersion clerkship experience with online delivery of necessary clinical information. The intention is for this subcommittee to work with a mirror departmental committee as well, so that information is freely available in both directions.  The subcommittee will need to develop a critical list of questions that must be answered/addressed, both within the committee itself or in the mirror subcommittees.  For example, What will the rotations look like?  How will faculty be recruited/assigned/trained?

PEP - Personalized Educational Plan (f/k/a 4-Month Deep Dive) Subcommittee

  • Develop and problem-solve the provision of a 4 month deep dive period that would allow for a longitudinally mentored, individually developed student curriculum for value-added clinical exposure in one or several specialties. The intention is for this subcommittee to work with a mirror departmental committee as well, so that information is freely available in both directions.  The subcommittee is responsible for creating the critical questions to be answered, such as “What interdisciplinary components will each Deep Dive need from other specialties?  How can Med Hum fit into the Deep Dive experience?  What about the student needing extensive remediation during this time?”

Assessment Subcommittee

  • Develop and problem-solve the provision of multiple assessment modalities and tools within the new curriculum delivery model.  Questions such as, “What evaluation components need to go into the 4-week clerkships? The Deep Dive experience?  How will honors be awarded (and if honors should be awarded)?”

Faculty Development Subcommittee

  • Develop and problem-solve the provision of faculty development for critical educational activities such as advising/mentoring, coaching, feedback, and working knowledge of identified crucial knowledge components and new assessment tools.  Questions such as: “What are the faculty development needs of the new mentor/advisor system?” ”How can we teach faculty to observe better and give better feedback to students (coaching/apprenticeship model?)” should be addressed.

Program Evaluation Subcommittee

  • Develop and problem-solve the provision of program assessment/outcome tools, efficacy measurements, program improvement and research.  Questions such as, “What measures will we use (pre and post implementation of the new curriculum) to know if the program has worked?” “What research questions should be asked/answered within this framework?” What permissions will we need (SCRIHS??) for this work?” will need to be addressed.