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C21 Transforms the Face of Medical Education

New Approach to Medical Education at NYU School of Medicine Changes How Medical Science Is Taught and Students Learn to Care for Patients

When NYU School of Medicine’s class of 2014 arrives on campus this week, they will be the first to experience its new Curriculum for the 21st Century (C21), one of the biggest changes to medical education since the medical school system was created 100 years ago. 

“We believe medical education is at a crossroads today and a fundamental restructuring of medical education is needed in response to changing scientific, social, and economic circumstances and dramatic changes in the health care delivery system,” said Robert I. Grossman, MD, dean and CEO at NYU Langone Medical Center. “C21 is our answer for driving medical education to the next level of excellence and to better prepare outstanding physicians for the 21st Century.”

Historically, medical education was an apprenticeship in which students worked closely with a physician to care for patients. Uniform standards for medical school education were not in place until 1910 when The Carnegie Foundation for the Advancement of Teaching issued the Flexner Report, a comprehensive survey of medical education. The report recommended that medical curriculum be divided into two strict halves, with basic science taught in the first two years and clinical skills provided in the second half. The report had a dominant impact on the education of medical students for over half a century as most schools modeled their curriculum along the lines recommended in the report. However, because students did not have patient contact until the clinical years, they often had a limited understanding for both the scientific and clinical underpinnings of a disease.

C21 will change the historic approach of teaching by introducing medical students to specific areas of medicine, or “pillars,” on their very first day to foster student knowledge both through a study of the scientific underpinnings of a disease and, at the same time, through direct patient care–from the basic sciences to bedside application and back again.

“The advantage of merging the classroom study of science with the clinical experience is that it gives students a context for their book learning,” said Steven Abramson, MD, vice dean for education, faculty, and academic affairs, and responsible for overseeing the new curriculum’s development. “By providing our students with a context for their basic science, they can immediately see the scientific implications for the patient from a clinical standpoint.” Dr. Abramson also explained that by exposing medical students to direct patient care beginning the first day of school, they enhance their skills to create positive and strong physician/patient relationships down the line.

Four pillars will be introduced to the incoming class this fall, including diabetes, atherosclerosis, tuberculosis and colon cancer, and students will see patients with these diseases on their very first day. Each pillar was chosen for its far-reaching complexity involving many fields of medicine and nursing from molecules, cells, organs to the full range of clinical practice, to ethics, society, and death. In addition to a disease’s developmental, cellular, and molecular biology, pillars will cover genetics, nutrition, epidemiology, imaging, informatics, preventive health, biomedical ethics, health disparities and cultural competencies among different populations.

In addition to enabling a connection between the information students learn in their classes and its application to real patient care simultaneously throughout their education, combining the classroom and clinical experience may also enable students to graduate in less than four years or with a dual degree.

Additionally, because medical students have diverse learning styles, it was important to change the curriculum to be learner-centered. For this reason C21 leverages technology through computer-assisted instruction and simulation including online learning modules, including WISE-MD, an innovative, computerized surgical education tool, and even a Virtual Microscope that will allow students to never look through a physical microscope during their four years of medical school.

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