Long held as the centerpiece of the School of Medicine's doctor of medicine program, the third year is also going under the knife as the rest of the curriculum gets a face-lift.
The most crucial element to third year changes is the requirement to complete a formal thesis, which will be independently graded and evaluated as rigorously as one submitted to a scholarly journal.
"We're not really changing much," said Dr. Debra Schwinn, professor of anesthesiology. "While it may seem like a change now, in the long run, these requirements will make it easier in the end."
The third year of medical school at Duke is unique in that it gives students the opportunity to pursue their academic interests and explore the research side of medicine.
"The third year really instills self-motivation and primes us to be leaders in medicine," said Ravi Karra, a third-year medical student who is involved in the curriculum development. "[This] is when we are given time to learn about various opportunities available to us and to do some soul-searching about the kind of doctors we want to be."
The vast range of research avenues and the fact that some students wrote manuscripts on the research they conducted during their third year while others did not made it difficult to objectively grade the students on their work. The changes to the third year are meant to eliminate this subjectivity and formalize the criteria for grading the students.
"All of the changes are meant to supplement the third year experience," Karra said. "The thesis adds some level of formality to the year and in many ways actually adds to the overall credibility of the third year."
Third-year students will choose from approximately 15 study tracks, covering medical issues ranging from typical laboratory research to the medical ethics surrounding genomics.
"There are plenty of options and pathways for what to write your thesis on," said Dr. Edward Buckley, associate dean of curriculum development. "Your choices are limited only by your imagination."
The whole structure of the thesis is designed to teach students the process of writing a scientific manuscript and will be graded on a number of criteria, placing an emphasis on how well the students integrate relevant literature on their topic with their findings.
"If you work in a lab for a summer internship, you're given a project like a technician. This is the next level," Schwinn said. "We want you to think like a scientist. We want to help you go through the process of writing a scientific paper. I think in the end, these are very positive changes."
The goal of the curriculum changes is to give medical students the skills they will need to be a physician in 2010, which involves offering more hands-on experience rather than class time.
"We are emphasizing information acquisition, not memorization," Buckley said. "There is no way to master the whole set, but physicians will need to be able to find where the answers are. This means you should spend less time in lectures and more time using what you need to know."
The medical school is currently developing survey tools in order to verify how useful a research-based third year has been to past School of Medicine graduates.
"We've had some evidence that graduates have benefited from their third-year experiences," Schwinn said. "The goal is to follow the students long term and prove that the third year works."
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