A Disease-Based Approach to the Vertical and Horizontal Integration of a Medical Curriculum

As medical disciplines have become increasingly interdisciplinary and evidenced-based medicine is widely practiced, there is a need for curricula that reflect these changes. The newly revised LCME standards 1.1 Strategic Planning and Continuous Quality Improvement and 8.3 Curricular Design, Review, Revision/Content Monitoring require ongoing curricular review to assure accreditation compliancy. We have completed a comprehensive review of our curriculum and have moved from a discipline-based curriculum to that of one that focuses on a systems/disease-based model. The approach allows for a more horizontally integrated curriculum in the preclinical years, while the use of 115 distinct disease and eight themes creates a quality assurance mechanism that allows for tracking of vertical integration across the entire curriculum. The first step in the development of this quality assurance model was to establish and empower a newly formed integration subcommittee. This subcommittee was tasked with developing a model to review, track and improve the horizontal and vertical integration of the curriculum. Our integrated curriculum is now in its second year having completed the initial identification of gaps and redundancies through a process that relies on the mapping of diseases and themes throughout the courses. This ongoing review and evaluation process has created a dynamic quality assurance process that allows our faculty to address issues of both horizontal and vertical integration of our curriculum at the course level