Medicine today is grow-
ing in its complexity, and
expectations of the 21
st
century physician far exceed
any other time in history.
Additionally, the demands
placed on the medical stu-
dent today in terms of time
and finances are beyond
what anyone would have
imagined 15 or 20 years ago.
We at NSU-COM are
considering the development of a curricular change that will develop
the high-quality physicians we currently produce with a more realis-
tic expectation of what must be accomplished to reach demanding
and rewarding goals of medicine’s future.
The challenge today in medical education is to present to the
student a balance of factual knowledge, the ability to discrimi-
nate, the skills for scientific inquiry and the usage of technology,
the coordination to perform procedures and techniques, and the
confidence to be a lifelong self-learner. These learning objec-
tives need to be done in an integrated program so the graduat-
ing physicians remain patient-centered and compassionate while
prepared to practice medicine throughout the 21
st
century. The
implementation of this curriculum will require a very difficult, but
necessary, critique of our current curriculum.
There are areas that need to be added, and areas that need to
be reexamined or possibly reduced, with respect to their content.
I have charged the Academic Curriculum Committee to begin an
evaluation by examining courses that can reasonably be decreased
without a reduction in the knowledge necessary to educate excel-
lent physicians. We are excited to embark upon the transformation.
A perfect example of the blend of traditional and new ways
of training physicians was reported by National Public Radio
(NPR) in a story broadcast on September 29. In the report, a
neurologist on rounds with a group of medical students was
teaching the strength of effective bedside clinical medicine. The
experience showed the benefits of laboratory and radiologic in-
Dean’s
Message
By Anthony J. Silvagni, D.O., Pharm.D., M.Sc., FACOFP dist., FACPP
2
Curricular Changes on the Horizon to
Meet 21
st
Century Demands
formation as a tool rather than a perfect solution in diagnosing
patients’ ailments. The adage that says the purpose of labora-
tory and radiologic information is to confirm and not make a
diagnosis holds true, even with today’s technology.
The case presented on NPR involved a woman with mus-
cular weakness. The neurologist was consulted to evaluate the
possibility she had suffered a stroke based on a CAT scan with
contrast. On examination, the neurologist asked the patient to
squeeze the bulb of a blood-pressure cuff 10 times. The physi-
cian then asked the students to monitor the test and determine
the patient’s rate of muscular fatigue during the examination. As
the students read the gauge, they noticed the patient’s muscle
fatigue increased and her strength decreased rapidly during the
last five compressions of the bulb. The neurologist then ex-
plained the medical basis for his bedside test and ordered a test
that confirmed myasthenia gravis instead of a stroke.
This case underlines our purpose as we examine the methods
of basic tenets and practices of training and combine them with
our new clinical approaches. We are adding to our curriculum,
including the principles of art observation to improve visual
diagnostic skills and cognition, the increased use of standard-
ized patient procedures, and the increased use of computerized
mannequins to improve skilled procedures prior to introduction
to the clinical environment.
We also realize we cannot continue to add courses without a
serious evaluation of what we are presently offering. The current
courses—along with more genetics, knowledge about genome
therapy, selection of pharmaceuticals based on DNA receptor
information, and other scientific breakthroughs—must also be
included in the assessment.
Choosing the correct content must go hand-in-hand with the
successful use of time. First- and second-year students currently
take full schedules of approximately 25 credits per semester,
along with the requisite quizzes and exams. As we seek to use
instruction time to the best advantage, we must create the most
innovative and successful curriculum to continue to be the lead-
ers we are in the education of 21
st
century physicians. We are
leaders—and leaders we will remain.
COM Outlook . Winter 2015
