DCS-PURCH 1&2 (part of FOM 1&2) provides a solid foundation in your first two years of medical school as you begin forming your professional identity as a doctor.
This mentored, skills-based curriculum develops the skills to interact with, examine, diagnose, treat, and educate patients about their diseases and their treatments.
It also emphasizes the impact of social determinants of health, social history, community influences, and resources, on disease processes.
It is taught by Brightwood Learning Community mentors and core DCS-PURCH faculty from Baystate Health with whom you will form long-term relationships throughout all four years of medical school.
DCS-PURCH Scope of Content
Year 1: Experiencing Patients and Their Communities (DCS-P 1)
Our 5-block curriculum focuses on patient-centered healthcare delivery.
- The Story—Discussion with members of our community on their experiences of illness and disease
- The Community—Visits to a local homeless shelter and jail to understand the impact of community on disease
- Healthcare Quality—Identify and impact healthcare disparities through a quality improvement lens
- The Patient—Discussions with a variety of patient populations, such as rural clinic, inner-city clinic, inpatients, military veterans
- The Diagnostician—An innovative clinical reasoning curriculum will be woven throughout all the teachings in the DCS1-PURCH course.
Year 2: Engaging with Patients and Clinicians in the Hospital (DCS-P 2)
This course focuses on building upon the interview and physical examination skills learned in your first year through a series of observed hospital-based patient interview experiences at Baystate Medical Center.
During this year you will participate in ten hospital sessions with patients who may have a variety of disease processes such as cardiac, pulmonary, gastrointestinal, and neurological conditions. You will take the interview, write up notes, observe peers, and make oral presentations.
Your Learning Community mentors will observe each medical interview and provide feedback on your interviewing and physical examination skills. From these experiences you will:
- Engage with patients during their time of hospitalization—Practice the key tenants of our program by listening to the patient’s story to learn about the course of their clinical illness and also explore the impact of social determinants of health on their health and recovery.
- Engage with members of the healthcare team—Experience firsthand our culture of delivering excellent patient-centered care, embracing education of our learners, and caring for one another in a welcoming, safe working environment.
- Build upon the quality improvement foundations learned in DCS-P 1—Identify the key quality measures that impact hospitalized patients and ensure these measures are being met to deliver safe, effective, and efficient patient care.
DCS-PURCH Educational Methods
DCS-PURCH has the same three educational components as at the main campus:
Small Group Sessions
Year 1
You will meet regularly with faculty facilitators to learn and practice skills in the core competencies, including the medical interview, clinical reasoning, teamwork, and presentation skills.
You will have extensive experience with patients from the community in both ambulatory and inpatient settings.
- Visiting and interviewing patients at a jail and a homeless shelter
- Meeting regularly with community faculty
- Participating in a poverty simulation exercise
- Experiencing first-hand food availability challenges in an urban environment
Year 2
Core educational session cover the topics of:
- Developing differential diagnoses
- Oral and written presentation skills
- Challenging interviews
- Working with medical interpreters
- Problem solving
Physical Diagnosis (PD)
This robust physical diagnosis curriculum includes both didactic and hands-on experiences, and coincides with your gross anatomy course.
Working under the direct observation of your Learning Community mentors, you will practice the skills of physical examination and get timely feedback to improve technique.
Sessions include:
- Introduction to general appearance and vital signs
- Physical examination of the heart and vascular
- Physical examination of the chest and breasts
- Physical examination of the abdomen
- Neurological examination
- Physical examination of the head, mouth, neck
- Arthroskeletal examination
- An integrated physical examination
Longitudinal Preceptorship Program (LPP)
The LPP is designed to provide you with the opportunity to experience the practice of medicine firsthand and begin to develop your identity as a physician.
During your first weeks of medical school you will be assigned a Longitudinal Preceptor with whom you will work for a year and a half. You will be placed in a clinical setting where you participate in clinical sessions with your preceptor—at first observing and then assisting hands-on with patient care.
You will gain experience:
- Interviewing and examining patients, and taking a medical history
- Dealing with different types of patient visits, including identifying preventive care practices, and appreciating the benefits of continuity of care
- Receiving feedback from physicians and patients
- Networking within the clinical system, and acting as part of an interprofessional healthcare team
You take part in eight sessions with your Core Preceptor and four sessions with a Rotating Preceptor. Preceptors come from variety of medical specialties, allowing you to experience a broad range of clinical settings, such as:
- Medicine
- Allergy/Immunology
- Cardiology
- Family Medicine
- Gastroenterology
- Geriatrics/Palliative Care
- Hospital Medicine
- Internal Medicine
- Nephrology
- Pulmonology
- Emergency Medicine
- Obstetrics/Gynecology
- Pathology
- Pediatrics
- Surgery
- Neurosurgery
- Otolaryngology
- Vascular Surgery
If you are a member of certain pathways at the main campus, you may have the opportunity to complete your Rotating LPP experiences in settings that align with those pathways. For example, students in the Rural Health Scholars Pathway may request to do a number of Rotating LPP sessions with a rural provider.
Integration with Other Courses
DCS1-PURCH's curriculum reinforces and integrates classroom learning in your FOM courses with your clinic-based sessions:
- Integration with the concepts of Genetics and Determinants of Health will emphasize the broad determinants of health including the roles of genetics, behavior, and social environment in health and disease.
- Principles covered in the Epidemiology-Biostatistics course underpin population health concepts.
DOH-PURCH 1&2 (part of FOM 1&2) lays the foundation for understanding the many complex and interrelated factors affecting the health of individuals and populations.
Scope of Content
DOH-PURCH builds upon the same curriculum content offered at the main campus.
Objectives include:
- Develop a fundamental understanding of the determinants of health
- Identify the relationships among community, culture, medical care systems, and the health of individuals and populations
- Identify the role of biostatistical and epidemiological principles in clinical diagnosis and treatment, population health, and evaluating outcomes of healthcare services
- Discuss and demonstrate the clinician’s role as advocate for the health of individuals and populations
- Describe and demonstrate the clinician’s role as one member of the interprofessional healthcare team
In addition, DOH-PURCH provides a robust interactive curriculum on biases, and explores how unconscious biases can impact the care delivered to patients.
Educational Methods
Year 1
classroom-based lecture and small group discussion
The same education components as at the main campus are used.
experiential learning opportunities
DOH-PURCH provides valuable additional opportunities that lend insight into social determinants of health. You will visit a jail and a homeless shelter, and meet with and interview patients.
PURCH students participate in the DOH Epidemiology-Biostatistics course at the main campus.
Year 2
Population Health Clerkship (PHC)
PHC provides you with a meaningful 2-week community-engaged experience to complement your preclinical coursework.
This is an immersive experience—you will partner with a community-based organization that provides services in communities within Baystate Health’s primary catchment areas—Franklin, Hampshire, and Hampden counties.
To provide a meaningful longitudinal community-based experience, partners are identified who can expand upon topics covered in Determinants of Health (DOH) or DCS1-P. Examples may include: food insecurity, transportation justice, and veteran’s health and housing.
PHC explores public health concepts such as, the effects of social determinants on the health of the population served by your community organization, how to examine populations as units of care, and how you might apply knowledge and understanding of community resources to advocate for your population of focus.
Embedded in a community organization, you will gain an understanding of how different health professionals and other local advocates work separately, and collaboratively, within their communities.
As part of your PHC field experience you will work with a community faculty preceptor and an academic faculty preceptor to:
- Collect, synthesize, and manipulate relevant population-level data
- Identify interprofessional teams of care available to a population
- Explore ways organizations can advocate for a population
- Apply your knowledge toward a meaningful service project in the community
Throughout the two weeks you will reflect on your experiences and encounters with community members, advocates, and other organizations or care systems that you collaborate with.
At the end of the PHC, you will present to UMMS-Baystate faculty, Baystate Health leadership, and community stakeholders, with the goal of recommending actionable strategies to advocate for your population of focus.
The Capstone Scholarship and Discovery Course is a mentored, student-driven, four-year-long scholarly experience on a topic you are passionate about in medicine.
In your first year, you work with your mentor in the Brightwood Learning Community to brainstorm ideas, scale the project, and connect you to potential advisors and resources to begin your capstone.
By the fall of your second year you must select a Capstone Advisor who will provide the expertise and additional support you need to complete your capstone.
How is Capstone Different for PURCH Students?
Because your CSD project is driven by you and based on your personal passions (as long as it's related to medicine and meets at least one of the core competencies) it provides an opportunity to make a more direct connection with the purpose of PURCH.
Throughout your four years in the PURCH track, you will gain a deeper understanding of the complex local and regional issues that impact the health of rural and urban populations in western Massachusetts. This valuable longitudinal perspective will help you develop a capstone project that addresses the health needs of our community.
Focusing your capstone in Baystate Health's communities gives you access to the creative and innovative work being done by our community partners and the change-makers in a diversity of fields who are working to transform the health, health care, and the overall well-being of community members in western Massachusetts.
In year 3, you will apply the knowledge and skills gained in your first two years under the supervision and guidance of our faculty. As an active member of a health care team in a hospital, community clinic, or physician office you will be taking on greater responsibility for direct patient care.
In the PURCH Track you have the option of completing the traditional required Core Clinical Experiences (CCE) or applying to PURCH's Longitudinal Integrated Clerkship (LIC) which focuses on the health care needs of rural under-served communities.
Required Clerkships
Clerkships are organized into three 16-week thematic blocks.
Care of the Adult
- Internal Medicine
Clerkship Director: Michael Picchioni, MD
- Neurology
Clerkship Director: Philip Hsu, MD
Care of the Family
- Family Medicine
Clerkship Director: Stephanie Silverman, MD
- Pediatrics
Clerkship Director: Harry Hoar III, MD
- Psychiatry
Clerkship Director: Sonia Riyaz, MD
Perioperative and Maternal Care
- Obstetrics/Gynecology
Clerkship Director: Halina Wiczyk, MD
- Surgery
Clerkship Director: Gladys Fernandez, MD
Flexible Clinical Experiences and Interstitials
You will have opportunities to participate in a variety of flexible clinical experiences throughout your third year.
Students and Baystate faculty have the ability to create a designer FCE (via UMMS website)—a novel, innovative educational experience to explore a passion, interest, or curiosity. This can be clinical or non-clinical (e.g. education, community service).
Interstitial curriculum is shared between the two campuses.
The Interstitial Curriculum will incorporate the “Becoming A Physician” curriculum, led by Learning Community Mentors, and will follow three main themes of: Advocacy, Professional Identity, and Teamwork. Many Interstitials will incorporate interprofessional learners, and will be facilitated by providers from a variety of departments.
More information about Core Clinical Experiences on the UMass Medical School website.
In year 3, you will have the option of enrolling in PURCH's Longitudinal Integrated Clerkship (LIC) based at Baystate Franklin Medical Center, a small rural community hospital in Greenfield.
The LIC accepts 4-6 students each year, and is geared to students who are seeking rural health experiences focused on the under-served small towns of rural Massachusetts.
Enrollment in the LIC is voluntary. If you do not participate in the LIC, your Core Clinical Experiences will be based at Baystate Medical Center, located in the urban under-served area of Springfield. They will follow the same format used at the main campus.
Read about Baystate Franklin and our other training sites.
Required Coursework
In year 4, your Emergency Clinical Problem Solver (ECPS) and Capstone Scholarship and Discovery (CSD) courses will be based primarily at the Baystate regional campus.
Your CSD and Advanced Biomedical and Translational Sciences (ABTS) projects must focus on a topic consistent with the goals and priorities of the PURCH Track.
Sub-internships and Electives
You may take your required subinternship and electives at either the Baystate regional campus or the main campus.
More information about Advanced Studies on the UMass Medical School website.