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Improvement in USMLE scores at one institution after curriculum change to an integrated scientific curriculum.


UCSD School of Medicine underwent a complete curriculum change starting with entering year 2010. As part of the new curriculum, the school instituted a systems-based approach called the integrated scientific curriculum (ISC)9. The ISC has substantial small group activities, uses PBL extensively, and makes use of a "vertical" presentation of material. The grade of "honors" was completely removed from the preclinical curriculum in favor of true "pass-fail" grading. With an emphasis on mastering only essential material and reducing extraneous lectures, the ISC has less instruction in both lecture hours per day and number of weeks in class. This framework allowed several improvements over the previous curriculum. Dedicated USMLE Step I study time was increased from 5 to 6 weeks (with students free to schedule the exam anytime within that period). A one-week comprehensive, case-based basic science review was also added at the end of the second year prior to the dedicated study time. The first class to undertake the new curriculum took Step I earlier this year. This analysis reports effects of this intervention on USMLE scores when matched to MCAT scores.

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