The first year curriculum consists of problem-based learning (a form of active learning that is student-centered rather than teacher-centered) with supplemental laboratory exercises, seminar discussions, and lectures. Students work through a set of cases, developing their skills in information and data gathering (history and physical examination), self-assessment to identify knowledge gaps, self-directed learning and resource utilization to fill the knowledge gaps (including other courses and lectures, books, journals, library, electronic databases, etc.), application of their new knowledge to clinical situations, and communication through group discussions, class participation, and written work. While the Clinical Medicine courses form the core of the curriculum, the other courses support this core by expanding upon it, enriching it, and providing specialized content. The students complete their basic science and clinical science work through the following courses:

In addition to a theoretical foundation provided by the basic science and clinical didactic courses students have learned special examinations and basic procedures such as:

The second year curriculum spans 12 months and is comprised of eight rotations in adult medicine, pediatrics, women’s healthcare, surgery, emergency medicine, behavioral medicine, medicine rotation and an elective. Emphasis is placed on developing a solid foundation for providing patient care under the supervision of a physician in a variety of primary care and specialty settings. Each rotation also emphasizes cultural sensitivity, understanding of health in relationship to the predominant culture, and the role of the health care provider in the setting.

In addition to the didactic and clinical courses, the Research Seminar courses provide an opportunity for the physician assistant student to complete a master’s project that contributes to the student’s knowledge and professional development, as well as to the profession.

The clinical year runs from August to August. This is the part of the program where we are asking for your institution's participation. We utilize various settings and do not expect that your facility will be able to take students on rotation in all areas in every time block. Rather, we are asking for your medical staff to precept when you are able and at the times that are convenient and mutually beneficial. The clinical rotations are designed to give students direct "hands-on" patient contact under the supervision of the clinic or staff clinicians. In addition to physicians, we strongly encourage the involvement of staff Physician Assistants and Nurse Practitioners in providing clinical instruction. The students are provided with professional liability coverage through the college. We ask that all training sites sign an affiliation agreement and a preceptor data form that formalizes the relationship between the college, the preceptor, and the site. We will provide you with the schedule for clinical rotations from which you can indicate those that are best for you and your staff.

The primary objective of the students during clinical rotations is to develop their clinical and patient management skills through supervised patient contact. The ideal situation would allow the student to:

1. Interview the patient and obtain the pertinent medical history
2. Perform the appropriate physical examination
3. Present his or her findings to the preceptor
4. Formulate a diagnosis and assessment with substantial input and teaching from the preceptor
5. Decide on a plan of therapy that integrates the student's level of knowledge with the preceptor's clinical experience
6. Write or dictate appropriate notes to be reviewed and countersigned by the preceptor

There are specific learning objectives and goals for each rotation. These goals and objectives have been developed with the input of practicing physicians and PAs and are provided to insure a uniform learning experience for all students. The student will be expected to work, on average, at least 40 hours per week at each rotation site. In addition, each rotation site may require that students participate in specific learning activities in addition to the patient care elements, such as taking call with the preceptor, attendance at Grand Rounds, conferences or lectures, assigned literature reviews, or presentations.

A second year physician assistant student will be prepared to perform a complete history and physical and have a rudimentary knowledge of how to present a patient. The speed and facility with which these tasks are met are a function of the number of previous rotations the student has completed. Students should show progress in applying these skills through the course of this rotation. They should be able to perform these tasks on the patients you assign to them, present the patient, and answer basic questions about the specific disease process.

With the preceptor's guidance, the student will build on his/her knowledge of each of these settings and is expected to gain valuable hands-on experience and expertise. Clearly, the primary duties of a preceptor are to impart medical knowledge, help the student refine clinical skills and serve as a clinical role model. Almost all preceptors assign students to specific patients. The students are then responsible for obtaining an appropriate complete or focused history and physical examination. They make an assessment, develop a differential diagnosis, construct a problem list, order and interpret diagnostic tests and recommend a treatment plan. Daily progress notes, preoperative notes, postoperative notes and discharge summaries should be written where applicable.

Additional preceptor responsibilities include:

1. Provide a physical location and adequate clinical space and provide or help to arrange a variety of patient encounters necessary for a learning experience for the student.
2. Provide at least 36 hours for the student to perform clinical activities in the practice site. During this time the preceptor or his/her designee must be available for supervision, consultation and teaching.
3. Supervise, demonstrate, teach and observe the student in clinical activities in order to develop the student's skills and to insure proper patient care.
4. Delegate gradually increasing levels of responsibility to the student for clinical assessment and management as the student's skills develop.
5. Schedule time to review objectives with the student in order to identify the problem areas and provide specific experiences for the student to resolve these problem areas (such as appropriate readings, etc.).
6. Allow the student to utilize the problem-oriented medical record system notation including problem lists, medication lists, and flow sheets in record keeping.
7. Participate in the evaluation of the student's clinical skills and didactic knowledge base through observation, supervision, teaching, and completing the formal final evaluation form.
8. Notify the Program promptly should any problems arise that would prevent the preceptor from accomplishing the above items or diminish the training experience for the student.

Physician assistant students are being educated to provide primary care services with the supervision of a physician. Insofar as possible, they should be assigned patients who have problems commonly seen in primary care settings. While patients may not present with these problems, many patients have primary care problems as part of their review of systems. A patient with an atypical presentation or a rare disease adds spice (and library time!) to any student's life, so they should be included as well.

While on clinical rotations, student activities have included giving formal presentations, attending formal presentations and demonstrations given by clinicians and participating in clinical rounds. In sites where medical students are present, group presentations, prepared by the medical students and physician assistant students serve to foster a team approach as well as promoting medical knowledge.