'Medicine is not passive': Students reflect on changes to medical school curriculum

Students are learning to navigate the Translational Education at Carolina 2.0 curriculum, designed to enhance competency-based, active learning and clinical exposure, two years after the UNC School of Medicine launched the program. The class of 2027 has been the first to experience these changes. 

TEC 1.0, the previous curriculum, structured the first two years of medical school around three core components: Social and Health Systems, which covers social medicine; Patient Centered Care, which emphasizes clinical skills such as taking patient history and performing physical examinations; and Medical Sciences, which teaches foundational concepts tested on board exams. 

Traditionally, medical school professors lecture while students listen. Dr. Kathleen Barnhouse, UNC SOM assistant dean for the preclinical curriculum, said this approach wasn’t working, as student turnout and engagement with the curriculum were low.

“We talk[ed] to students, not with them,” she said about TEC 1.0. “And I think we have recognized that medicine is not passive at all.”

Barnhouse said the preclinical curriculum involves an emphasis on small-group and case-based learning. 

Ben Dosan and Sanjana Srinivasan, two first-year medical students, met each other in their case-based learning small group. Now, they are co-vice presidents of Curriculum Affairs for the UNC SOM student government.

“People feel a lot more comfortable being wrong and being willing to share their thoughts and opinions on whatever the subject matter may be at hand, without the fear of judgment,” Dosan said about the small groups in his Medical Sciences course. “It just helps facilitate learning and growth in general, because we all work and bounce ideas off of each other.”

Charlie Roethling, a fourth-year medical student and senior vice president of Education Development in the SOM student government, has worked as an assistant teacher for PCC classes. 

Roethling said that when he was a preclinical student, his case-based learning would involve self-study with homework and problem sets, but lacked the collaboration that current students have.

“At this stage of their learning, my students are so much more prepared and well equipped for all the next steps than I think I was at that stage,” Roethling said. “And I think it's by virtue of the fact that they've changed the curriculum up.”

Barnhouse said attendance is mandatory under the new curriculum. While Roethling said the attendance policy may not be preferred for some students, he said it ultimately would pay dividends. 

Srinivasan voiced similar sentiments. 

“I personally really like [the policy] because if I was staying at home or learning over Zoom, I wouldn't learn as efficiently as I currently am,” she said.

Dr. Catherine Coe, the assistant dean for the clinical curriculum, said there has been a national trend toward competency-based medical education, which focuses on diversity, telehealth, quality improvement and patient safety. The school is implementing these skills in its updated clinical curriculum, which will launch in March.

“We're definitely on the leading edge of the schools [that] embrace this notion of competency-based medical education, and are really trying to push our thinking in that space,” Coe said.

TEC 2.0 will also shorten third-year "core rotations" — pediatrics, psychiatry, OB-GYN, surgery and medicine — from 16 to eight weeks, allowing for more frequent check-ins to track student progress.

The fourth year focuses on career exploration and residency preparation, Coe said. Feedback from UNC SOM student government, as well as graduation exit surveys administered by the Association of American Medical Colleges have led to UNC reincorporating neurology into their required rotations. 

Srinivasan said the administration listens and incorporates as much student feedback as possible in curriculum updates. Roethling said student government members are given time and space to share their opinions in meetings. He said the administration holds their feedback in high regard, which is demonstrated through their actions.

“TEC 2.0 is specifically designed for students, not only to succeed, but not to fail,” Dosan said. “They have every countermeasure put in place to help us learn, help us grow.”

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