February 3, 2023

Some important teaching updates involving Pioneer Curriculum – December 2022

The Duke School of Medicine is in the midst of making some major changes to their curriculum and to the schedules for medical students in their clinical years. They are calling the new curriculum Pioneer.


In the past, medical students have rotated through various specialties in a “siloed” fashion, whereby students might complete 8 weeks on inpatient rotations on surgery followed by another 8 weeks on an internal medicine service.  Beginning in August 2023, medical students at Duke will experience longitudinal components to their education.  Their clinical years will be divided into three 16-weeklong trimesters.  During one of those trimesters, the students will rotate through various outpatient sites.


During the longitudinal trimester, the students will rotate through internal medicine, pediatrics, and urgent care one half day per week for each of the 16 weeks of the trimester. The students will still spend some time in hospital in during their other two trimesters.  Students in family medicine will spend a full day at a clinic site each week.  The students won’t be doing any inpatient work in family medicine which is why there is some extra outpatient time in this field.


As you might imagine, the leadership team from the School of Medicine very much wishes to place many medical students into our clinic settings.  While they want to place 4 students weekly into urgent care and 5 into pediatric sites, the numbers are less clear for the other specialties.  At the moment, it is anticipated that there will be between 10-20 medical students who are assigned to our internal medicine sites.


Most importantly, there will likely be close to 35 students who will need to be placed into our family medicine sites each trimester, because we are anticipating that DPC will provide instruction to a total of about 90-110 students per academic year.


We are hoping that most of these medical students can be paired individually with providers who are experienced clinicians comfortable with teaching.  Clearly, the specialty where we will need the greatest number of providers is in Family Medicine.  There will still be some small number of students who are assigned to a clinic as a whole and whose teaching is shared by multiple providers.  But the majority of the assignments will be individual ones because we believe that provides the best educational opportunities for the students.


Of course, we still have major commitments to the Duke NP and PA programs, and we don’t intend to change or alter those commitments.

Additionally, we will continue to welcome first and third-year medical students, and our APP fellows into our clinics.


Overall, its estimated that the new Pioneer curriculum will increase the number of yearly learners in our clinics by about 5%.  Again, these changes will first be noticeable in the early fall of next year.


In response to these demands and changes, we are working to create a new Clinician Educator Track within Duke Primary Care.  You will hear much more about this track in the very near future.


As always, if you have any questions or concerns about any of these changes, please reach out to me so we can discuss them in more detail.