Academic medical centers have four core missions and responsibilities: education, research, patient care, and community outreach. At the University of California at San Francisco, all four are carried out simultaneously, and, considered as individual efforts, each has been excellent.
In 2002, however, a closer look revealed a medical curriculum that was very conventional. Science courses, for example, were neither connected with each other nor with the practice of medicine; and the departmental residency programs were focused on the specialty needs of the department.
On the other hand, for many years the doctoral programs and organized research units had taken the form of umbrella programs (large programs that crossed department lines, and, in some cases, crossed school boundaries). The Cardiovascular Research Institute, for example, was trans-departmental, dealing with clinical medicine as well as basic science. The question arose, then, “Can the four core missions be integrated better?” The university’s response, as summarized by Yamamoto, is given below.
The integrative changes involve four new programs:
A new medical curriculum
The Clinical and Translational1 Science Institute
The Program in Quantitative Biology
The Institute for Molecular Medicine and the Graduate Program in Molecular Medicine
The new medical curriculum integrates basic, clinical, and social and behavioral sciences throughout the medical school’s four-year course of study. Students often work in small groups, and their instruction emphasizes problem solving and the relationships between research and clinical outcomes. The elective Pathways to Discovery feature of the program is designed to create a culture of inquiry, innovation, and discovery that will benefit all medical trainees. Pathways to Discovery brings together medical students and residents across department boundaries. Each of the pathways includes courses, research, and mentoring; and each pathway