Pre-clinical Education

This course is offered over two semesters and presents the observable structure, function, and clinical manifestations of the human body through lectures and cadaver dissection laboratories. Human Anatomy and Embryology integrates the systems of the body with anatomical regions, embryological development, and diagnostic imaging. The course emphasizes anatomical knowledge that relates to the practice of osteopathic medicine. The lectures of the first semester emphasize developmental, functional and clinical anatomy of the limbs, thorax, abdomen, pelvis and perineum, while those of the second semester emphasize the head and neck. The laboratories offer a challenging series of dissection exercises that promote discovery-based learning in a digital and hands on environment.

This course is offered over two semesters and presents the observable structure, function, and clinical manifestations of the human body through lectures and cadaver dissection laboratories. Human Anatomy and Embryology integrates the systems of the body with anatomical regions, embryological development, and diagnostic imaging. The course emphasizes anatomical knowledge that relates to the practice of osteopathic medicine. The lectures of the first semester emphasize developmental, functional and clinical anatomy of the limbs, thorax, abdomen, pelvis and perineum, while those of the second semester emphasize the head and neck. The laboratories offer a challenging series of dissection exercises that promote discovery-based learning in a digital and hands on environment.

General pathology introduces the student to the nature and causes of disease. This course emphasizes the importance of integrating the molecular and cellular basis of disease with the associated structural changes in cells and tissues. Areas covered in this course include cellular adaptation, injury, and death, inflammation and repair, neoplasia, environmental and nutritional disease, immunopathology, and introduction to laboratory medicine.

The course begins with a description of histological techniques. This will also help the student to understand the study of the ultrastructure (fine structure) of the cell. Once this has been completed the student will study of the basic tissue types (i.e. epithelial, muscle, nervous, connective tissue, cartilage and bone), and then the various organ systems (i.e. endocrine, digestive, cardiovascular, hematologic, lymphoid, integument, respiratory system, urinary system, and male and female reproductive systems).

This course is intended to provide the student with insight into the foundations of pathogenesis and treatment of microbial-induced diseases of the human body. The course begins by examining in detail the basic mechanisms by which the immune system functions in protecting against human disease. The basic principles of microbial pathogenesis will then be described along with the characteristic features of the major types of microbial pathogens.

The Introduction to Cultural Competence in Healthcare course will expose students to challenges in understanding cultural diversity as an important factor which may potentiate or inhibit the success of a caregiver in a community such as Harlem or Middletown. The Course Director and invited guests from the community will present cases, history and observations to create awareness and sensitivity to these issues. Students will then explore the issues in an effort to identify the important features which can lead to successful interactions leading to effective patient management. This process will be conducted in an open forum with all classmates participating at will. Students will also cover healthcare policy and how it improves or hinders access to care for all. This course will further deepen the students understanding of inter-professional education via a group project.

Biochemistry emphasizes the clinical relevance of the basic principles and phenomena which define how the human body works at the molecular level. Throughout the course, diseases related to biochemical disorders will be emphasized with the aid of weekly clinical vignettes. Topics include protein structure, enzyme kinetics, metabolic pathways and basic nutrition, emphasizing their medical importance. A basic understanding of these issues lays the groundwork for making insightful diagnoses of disease states and managing the treatment of illnesses effectively. The goal of this course is to emphasize the relevance of biochemistry in a clinical context.

Medical Genetics emphasizes the importance of Genetics in Medicine. Throughout the course, diseases related to molecular and genetic disorders will be emphasized together with the aid of weekly clinical vignettes. The first half of the course deals with the fundamental molecular biology topics and their medical applications such as human genome structure, DNA, RNA, protein synthesis, regulation of gene expression, and tools in genomic and molecular medicine. The second half of the course stresses genetics topics including a discussion of cancer genetics, genetic inheritance, pedigrees and probabilities, population genetics, pharmacogenomics, prenatal diagnosis and screening and concludes with the current approaches to the treatment of genetic diseases. The goal of this course is to understand the basic molecular biology and emphasize the relevance of genetics in a clinical context.

This course is designed to introduce the student to the normal anatomy and function of the central nervous system. This comprehensive course covers basic neuroanatomy and neurophysiology in both a lecture and laboratory format. The course builds on the students’ knowledge of neural structure and function to encompass complex brain activities such as sleep, learning and memory, emotion, language, and cognition.

These courses are designed to introduce and develop the history, philosophy, and principles and skills of osteopathic health care. The course is offered throughout the four semesters of Phase I and Phase II. Emphasis is on the sequential development of the palpatory diagnostic and therapeutic skills of osteopathic manipulative medicine. Recognizing the contribution of the musculoskeletal system to health and disease, the course integrates the osteopathic Philosophy with patient care. The courses will teach osteopathic approaches to problem-solving and patient management, incorporating multiple osteopathic manipulative techniques as appropriate, including: muscle energy, fascial release, high-velocity/low-amplitude, counter strain, articulatory techniques, osteopathy in the cranial fields and other course content areas.

These courses are designed to introduce and develop the history, philosophy, and principles and skills of osteopathic health care. The course is offered throughout the four semesters of Phase I and Phase II. Emphasis is on the sequential development of the palpatory diagnostic and therapeutic skills of osteopathic manipulative medicine. Recognizing the contribution of the musculoskeletal system to health and disease, the course integrates the osteopathic philosophy with patient care. The courses will teach osteopathic approaches to problem-solving and patient management, incorporating multiple osteopathic manipulative techniques as appropriate, including: muscle energy, fascial release, high-velocity/low-amplitude, counter strain, articulatory techniques, osteopathy in the cranial fields and other course content areas.

The goal of these courses is to prepare students to be able to perform appropriate, high-quality medical history and physical examinations. Students will obtain proficiency in acknowledging the patient, interviewing to obtain a thorough and pertinent history, understanding the use of screening versus focused exams, using basic diagnostic equipment, skillfully performing a physical examination, integrating the structural exam into the classical "visceral" exam, and documenting the examination findings.

This course will also introduce the student to the clinical system modules which include head, ears, eyes, nose and throat system.

The goal of these courses is to prepare students to be able to perform appropriate, high-quality medical history and physical examinations. Students will obtain proficiency in acknowledging the patient, interviewing to obtain a thorough and pertinent history, understanding the use of screening versus focused exams, using basic diagnostic equipment, skillfully performing a physical examination, integrating the structural exam into the classical "visceral" exam, and documenting the examination findings.

This course will also introduce the student to the clinical system modules which include head, ears, eyes, nose and throat system.

Physiology consists of lectures and clinical correlates covering the classical concepts of vertebrate physiology, with emphasis on the function of normal tissues in humans. Specific topics related to neurophysiology, cardiovascular, respiratory, renal, gastrointestinal, endocrine, exercise, and sexual physiology are presented. This course will also develop the student to understand basic pharmacology and the kinetics of drugs and disease.

Physiology consists of lectures and clinical correlates covering the classical concepts of vertebrate physiology, with emphasis on the function of normal tissues in humans. Specific topics related to neurophysiology, cardiovascular, respiratory, renal, gastrointestinal, endocrine, exercise, and sexual physiology are presented. This course will also develop the student to understand basic pharmacology and the kinetics of drugs and disease.

While many people claim to be professional or to act in professional ways, there is a growing demand for moral behavior amongst professionals. This course will provide a values-based approach to ethical professionalism and provide a method of thinking about and dealing with ethical issues that will be encountered in the education, work and medical environments. Essentially, the course will provide a discussion of what professionalism is and what it means to constantly and consistently act professionally. We will focus on an in-depth analysis of the ethical principles that are fundamental to any professional: integrity, respect for persons, justice, compassion, beneficence and nonmaleficence, and responsibility. In addition, the course will focus on some of the ethical and moral issues facing people in the profession of medicine. Lastly, students will be informed of expected behaviors for their clinical rotation years.

The Professionalism and Medical Ethics course will focus primarily on three of the core osteopathic principles: patient care, interpersonal and communication skills, and professionalism. Through a hearty discussion of the obligations of the physician-patient relationship and identification of tools to enhance empathy the student will begin to embody traits necessary for successful patient care. This course also allows students to discuss difficult and sometimes controversial topics in a safe environment improving their ability to relate to others with differing views and to improve their verbal communication skills. Furthermore, students will gain insight into the impact health literacy plays in ethical conflict. They will have an opportunity to practice distilling complex medical information into lay-person terms when discussing ethical concerns and possible outcomes. Professionalism will be part of every session with the bioethical principles, as well as awareness of cultural differences, being applied consistent throughout the course to the cases presented. Assessment and feedback relating to the mastery of these competencies will be provided informally during class discussion and formally via a written assignment and a board style multiple choice exam at the end of the term.

This course will introduce the student to clinical medicine by allowing them an opportunity to shadow doctors in the field. The student will be able to choose from several physicians and healthcare practices to observe and develop an understanding of Touro’s mission.

This course is a continuation of primary care from the first year. Each organ system is presented beginning with a review of the pertinent basic science concepts. Pathophysiology and clinical manifestations of diseases affecting each system are presented along with appropriate diagnostic and treatment modalities. Pathology, medical microbiology and immunology, and pharmacology course presentations are integrated with clinical systems lectures, as described previously. The systems are:

• Cardiovascular
• Pulmonary
• Gastrointestinal
• Renal and Genitourinary
• Endocrinology
• Dermatology
• Rheumatology & Immunology
• Neuromuscularskeletal
• OB/GYN
• Hematology/Oncology
• Special Topics

The Early Clinical Experience: Introduction to Doctoring Part I and 2 is a two semester course which is taught using a variety of formats including large group interactive sessions, small group case based learning sessions and OSCE encounters. In this course, students will work with faculty in both large and small group sessions designed to allow students to practice the following skills: osteopathic patient history taking, physical exam techniques, and the development of a differential diagnosis using clinical reasoning, utilization of evidence based medicine, the professional verbal case presentation and patient note documentation. The cases presented in this course correlate with the concepts taught in the Clinical Systems course and follow the second year module schedule. In addition, the clinical content will place emphasis on primary care medicine as it relates to prevention of disease through appropriate health care maintenance and the management and treatment of acute and chronic disease. During the ECE course, students will participate in a series of Objective Structured Clinical Examinations (OSCEs) as part of their summative and formative evaluation. Students are primarily graded across three domains: history and physical examination skills, humanistic skills, and documentation skills.

These courses build upon the Basic Science Foundations of Infection and Immunity course provided in the first year. Clinical microbiology and immunology is taught in a systems-based approach intended to provide the osteopathic medical student with insight into the epidemiology, pathogenesis, clinical manifestations, and treatment of microbial-induced diseases of the human body. Individual groups of pathogens and the diseases that they cause are presented. How the immune system causes disease and how it can be used as a diagnostic and therapeutic tool is also examined. Laboratory sessions are designed to provide hands-on understanding of immunological and microbiological principles and methods.

The use of medical simulation is a highly effective method to enhance learning, improve patient care, decrease medical errors and improve patient safety. In this hands-on course, simulation will be utilized to provide students with opportunities to gain exposure to patient care, critical thinking, clinical decision making, communication and procedural skills. Students will work with a variety of simulators (including low, mid and high fidelity simulators, task trainers and cadavers). This is a one semester course is offered to second year osteopathic medical students.

Students will be assigned to take the course in either the Fall or the Spring semester.

These courses are a continuation of the development of the basic philosophy and principles of osteopathic health care. Emphasis is on the sequential development of palpatory diagnostic and therapeutic skills of osteopathic manipulative medicine.

These courses consist of comprehensive lectures and clinical correlations which present general principles of pharmacodynamics and pharmacokinetics, followed by a systematic investigation into the pharmacological agents based on drug group classification. The major emphasis is on the clinically significant aspects of therapeutic effects, toxic effects, and the metabolism of drugs. Receptor concepts among various drug groups will be discussed. Upon completion of the course, students are expected to understand appropriate pharmacological treatment for disease processes involving the major systems.

This course covers a variety of topics including: an overview of public health and health care delivery systems; an introduction to evidence-based medicine; epidemiology; definitions and applications in prevention and control of communicable and chronic diseases; biostatistics and hypothesis testing; definitions and appropriate uses; major public health issues for families, children, and older adults; managed care; and legal and ethical aspects of medical and public health practices.

The objective of these courses is to provide a sound foundation for the understanding of the etiology, diagnosis, progression, and appearance of human disease processes. The courses describe these conditions from the molecular to the organismal levels. The first phase addresses the fundamental principles common to all disease processes, and continues to examine each major organ system in a logical and thorough fashion, with emphasis on the clinical manifestations of each disease condition. Cell injury and death, inflammation, repair and adaptive processes, hemodynamic alterations, neoplasia, chemical and physical injuries, and infectious disease processes are discussed in great detail. A weekly laboratory session enhances the understanding of the morphologic alterations in diseased tissues, as well as promote diagnostic skills at the gross and microscopic levels. Projected material, as well as human tissue specimens in whole and glass slide formats, are included in the laboratory experience.

This course covers a variety of topics in basic behavioral medicine and psychiatry, including but not limited to; the psychiatric interview, emotional reactions to illness, anxiety disorders, mood disorders, sexual disorders, child and adolescent development and psychopathology, suicide, violence, including domestic violence, personality disorders, somatoform and factitious disorders, legal and ethical issues, and addiction medicine.

This course is a continuation of primary care from the first year. Each organ system is presented beginning with a review of the pertinent basic science concepts. Pathophysiology and clinical manifestations of diseases affecting each system are presented along with appropriate diagnostic and treatment modalities. Pathology, medical microbiology and immunology, and pharmacology course presentations are integrated with clinical systems lectures, as described previously. The systems are:

• Cardiovascular
• Pulmonary
• Gastrointestinal
• Renal and Genitourinary
• Endocrinology
• Dermatology
• Rheumatology & Immunology
• Neuromuscularskeletal
• OB/GYN
• Hematology/Oncology
• Special Topics

The Early Clinical Experience: Introduction to Doctoring Part I and 2 is a two semester course which is taught using a variety of formats including large group interactive sessions, small group case based learning sessions and OSCE encounters. In this course, students will work with faculty in both large and small group sessions designed to allow students to practice the following skills: osteopathic patient history taking, physical exam techniques, and the development of a differential diagnosis using clinical reasoning, utilization of evidence based medicine, the professional verbal case presentation and patient note documentation. The cases presented in this course correlate with the concepts taught in the Clinical Systems course and follow the second year module schedule. In addition, the clinical content will place emphasis on primary care medicine as it relates to prevention of disease through appropriate health care maintenance and the management and treatment of acute and chronic disease. During the ECE course, students will participate in a series of Objective Structured Clinical Examinations (OSCEs) as part of their summative and formative evaluation. Students are primarily graded across three domains: history and physical examination skills, humanistic skills, and documentation skills.

This is the final course that students encounter before entering the clinical years. As such, the course is designed to present and review areas of immediate importance to the primary care physician, ranging from medico-legal considerations to emergency room care, routine office care, and subsequent care. It is also an introduction to the general routine of the clinic or hospital setting and the responsibilities and expectations of the medical student in those settings.

These courses build upon the Basic Science Foundations of Infection and Immunity course provided in the first year. Clinical microbiology and immunology is taught in a systems-based approach intended to provide the osteopathic medical student with insight into the epidemiology, pathogenesis, clinical manifestations, and treatment of microbial-induced diseases of the human body. Individual groups of pathogens and the diseases that they cause are presented. How the immune system causes disease and how it can be used as a diagnostic and therapeutic tool is also examined. Laboratory sessions are designed to provide hands-on understanding of immunological and microbiological principles and methods.

These courses are a continuation of the development of the basic philosophy and principles of osteopathic health care. Emphasis is on the sequential development of palpatory diagnostic and therapeutic skills of osteopathic manipulative medicine.

These courses consist of comprehensive lectures and clinical correlations which present general principles of pharmacodynamics and pharmacokinetics, followed by a systematic investigation into the pharmacological agents based on drug group classification. The major emphasis is on the clinically significant aspects of therapeutic effects, toxic effects, and the metabolism of drugs. Receptor concepts among various drug groups will be discussed. Upon completion of the course, students are expected to understand appropriate pharmacological treatment for disease processes involving the major systems.

The objective of these courses is to provide a sound foundation for the understanding of the etiology, diagnosis, progression, and appearance of human disease processes. The courses describe these conditions from the molecular to the organismal levels. The first phase addresses the fundamental principles common to all disease processes, and continues to examine each major organ system in a logical and thorough fashion, with emphasis on the clinical manifestations of each disease condition. Cell injury and death, inflammation, repair and adaptive processes, hemodynamic alterations, neoplasia, chemical and physical injuries, and infectious disease processes are discussed in great detail. A weekly laboratory session enhances the understanding of the morphologic alterations in diseased tissues, as well as promote diagnostic skills at the gross and microscopic levels. Projected material, as well as human tissue specimens in whole and glass slide formats, are included in the laboratory experience.