Syllabus - Medical Microbiology and Infectious Diseases

IA. Overview:

The Medical Microbiology and Infectious Disease Course is designed to give the prospective physician an understanding of the basic biology of microbial pathogens and the mechanisms by which they cause disease. The course will also give the prospective physician knowledge of the signs and symptoms of major infectious diseases and practice in developing differential diagnoses and fundamentals of treatment and prevention for these diseases. The course will run from September 14, 2007 through December 7, 2007, with the final cumulative exam (National Board Subject Exam) on December 14.

The course is composed of the following:

1. Lectures and clinical correlations in virology

2. Lectures and clinical correlations in bacteriology

3. Lectures and clinical correlations in mycology & parasitology

4. Computer exercises:
    a.  "Bugs" program, a self instructional computer program utilizing patient cases, is designed to integrate virology, bacteriology, mycology, and parasitology and to give the student practice in recognizing the signs and symptoms of and developing differential diagnoses for specific infectious diseases (http://www.mgm.ufl.edu/~gulig/mmid/bugs).
    b.  The Virtual Microbiology Lab (www.mgm.ufl.edu/~gulig/mmid/mmid-lab).

5. Small group discussions:
    a.  Three student-directed "Current Topics in Microbiology", in which students read original medical research literature.
    b.  Five Infectious Disease faculty-led "Clinical Microbiological Conferences".

Faculty:

Course Director
Paul A. Gulig, Ph.D.
392-0050, R1-250
gulig@ufl.edu

Basic Science Lecturers
Richard C. Condit, Ph.D.
Virology Director
392-3128, R2-208
e-mail address: condit@mgm.ufl.edu

David Bloom, Ph.D.
Current Topics Director
392-8520, R2-291
dbloom@mgm.ufl.edu

Shouguang Jin, Ph.D.
392-8323, R1-293
sjin@mgm.ufl.edu

Division of Infectious Diseases Chief
Frederick Southwick, M.D.
392-2928, R2-124A
southfs@medicine.ufl.edu

(Other clinical faculty are linked on the schedule)

Educational Philosophy

We believe that by understanding the basic structure and biology of pathogenic microorganisms and the principles of microbial pathogenesis, students will be able to better prevent, diagnose, and treat infectious diseases.  We believe that students learn best and teachers teach best in an atmosphere of mutual respect and caring.  Moreover, student interest should be nurtured and encouraged by acquainting students with the underlying scientific principles through a variety of teaching modalities, many of which originate with patient problems.  Lastly, we hope to foster, by example, the qualities of curiosity, industry, and compassion.

IB. Learning Objectives:

Our goal is to help students become skillful and caring physicians with the knowledge and compassion to prevent, diagnose, and treat infectious diseases.

1.  Medical knowledge:
     A.  Core Discipline Competencies and Objectives: The student will acquire a foundation in the biology of bacteria, viruses, fungi, and parasites that will serve as a basis for his/her continuing understanding of infectious diseases, including any new diseases that may arise.

  1. At the end of the course the student will be able to demonstrate knowledge of the basic structure, physiology, and genetics of bacteria, viruses, fungi, and parasites; the student will also be able to correlate the structure, physiology and genetics of these microorganisms to the pathogenesis of the diseases they cause.
  2. The student will understand basic laboratory procedures used in the diagnosis of microbial diseases and will have the opportunity to perform some of the procedures.
  3. The student will be able to demonstrate knowledge of the pathogenesis of major infectious diseases, including their causative agents, epidemiology, and virulence mechanisms.
  4. The student will be able to demonstrate knowledge of the signs and symptoms of major diseases caused by infectious microorganisms.
  5. The student will have practice in developing differential diagnoses for major infectious diseases.
  6. The student will demonstrate knowledge of the principals of antimicrobial function. (Note: It is not our mission or intent to provide the specifics of usage of antibacterial and antiviral agents; the students will later be able to understand the specifics of antibiotic usage utilizing the frame work of knowledge they will gain in this course).
  7. The student will be able to demonstrate knowledge of the prevention, diagnosis, and treatment of major infectious diseases.
  8. In the CMC's (Clinical Microbiological Conferences) students will discuss with physicians diseases of the respiratory tract, endocarditis, central nervous system, gastrointestinal tract, and genitourinary tract.
  9. In the BUGS computer cases, the students will have practice diagnosing diseases of the respiratory tract, genitourinary tract, gastrointestinal tract, and nervous system in addition to endocarditis, wound infections, zoonotic infections, viral infections, and parasitic (worm and unicellular eukaryotic) infections.

    Instruction methods for core discipline competencies: We will use a variety of methods, including textbooks, lectures, clinical correlations, small group sessions, the "BUGS" computer program, and other on-line resources and exercises.

    Evaluation methods for core discipline competencies: All evaluation is done by multiple choice, short answer and short essay exams

     B.  Problem Solving:  Clinical Microbiology Conferences.  In CMCs students meet with Infectious Diseases clinical faculty and discuss cases.  Students will be assessed for their preparation and participation during the CMC.

2.  Practice Based Learning Competencies:
   
    A.  Physician Scholar Competency: Current Topics in Microbiology. Students will analyze the quality and implications of medical literature. They must attend, present a component of one of three topics, and participate effectively in the current topics to satisfy this competency.
 

3.  Professionalism: The student's evaluation for this competency will be based on the student's honesty and integrity, respectfulness, and compassion. This will be evaluated at each and every contact students have with faculty.

Schedule of Activities for a Typical Week:

The structured time during a typical week would likely include 5-10 lectures or clinical correlations, 1-2 small groups, and 4-6 (on average) self-instructional computer cases. The work load for Bugs cases is heavier some weeks than others, so students are advised to work ahead on these if possible.  Learning from the cases is NOT dependent on having previously studied the subject matter. Lectures and clinical correlations are all in rooms C1-15 and C1-17 unless otherwise noted.

Lectures:
The lectures will deal with the biology of human pathogens and mechanisms of pathogenesis. They are divided into three sections:

  1. virology
  2. bacteriology
  3. mycology and parasitology

Clinical Correlations:
These are lectures given by clinicians discussing the clinical aspects of diseases caused by viruses, bacteria, fungi, or parasites.

Small Group Sessions:
Current Topics In Microbiology (CTIM) and Clinical Microbiological Conferences (CMC).

The CTIM are student discussions about some aspect of microbiology, while the CMC's are meetings of small groups of students with a physician to discuss selected infectious diseases.

BUGS computer cases (http://www.mgm.ufl.edu/~gulig/mmid/bugs):
This is a self-instructional, interactive program composed of 50 clinical cases. The case histories have interspersed multiple choice questions (MCQ's) for "guided discovery" of the case resolution and for learning the principles of basic microbiology, pathogenesis, and diagnosis of infectious diseases.

Cases may be done at anytime, but the most appropriate schedule in included on the course web page and schedule. The textbooks and other appropropriate resources should be used to answer the MCQ's associated with the cases. Feedback is provided after both correct and incorrect responses to the MCQ's, and is an integral part of the learning process.

Please note that the cases do not always directly correspond to lecture material, but simulate the real life situation in which patients present with disease caused by an unknown spectrum of agents.  Thus students may encounter organisms in the cases that they have not yet been exposed to in lectures.  Students should consider these references as primers for material they will learn about later.  Some students may find it beneficial to spend some time learning about such organisms at the time they first appear.  Other students may wish to just register the fact that these organisms exist and wait to learn about them later. However, again, please note that learning from the cases is NOT dependent on having previously studied the subject matter.

The BUGS Cases Assignments are listed and linked on the course schedule.

Textbook Recommendations and Requirements:

We require that students purchase the two listed texts for reference and instruction. Students have also found the Levinson and Jawetz review to be very helpful and we do recommend it to students, but it is not required. Another book a lot of students like is Microbiology Made Ridiculously Simple, but it is not recommended by the faculty.

Textbooks (required):
Schaechter's Mechanisms of Microbial Disease, Fourth Edition.  Purchase of this book enables online access to its content.  There will be required self-study from the text, and questions regarding factual material directly from the text will initially be directed to the text.

Infectious Diseases in 30 Days by F.S. Southwick, McGraw-Hill, 2003.  The Clinical Microbiology Conferences are based on material in this book, as are several clinical correlation lectures.  Preparatory online assignments and class electronic quizzes are based on pre-reading this text for specific lectures.

Reviews (recommended):
Examination & Board Reviews: Medical Microbiology & Immunology, by Levinson and Jawetz (Appleton and Lange)

IC1. Student Performance Criteria

Summative Evaluation: There are three exams and a final exam. The final exam will be composed of two parts: 1) the NBME Microbiology Subject Exam and 2) a shorter exam made up of our own questions on the last module’s material. The exams are largely multiple choice but also contain some short answer and essay questions.  A portion of each exam is cumulative.  Although it is not easy to translate electronic cases to paper cases, we will try to ask some questions like those associated with the computer cases on all exams. Students are responsible for all lectures, clinical correlations, assigned reading, labs, and small group sessions.  Students are also responsible for the "Bugs" computer cases as assigned and other assigned on-line reading and exercises. Our broad medical knowledge objective is that the student will acquire a foundation in the biology of bacteria, viruses, fungi, and parasites that will serve as a basis for his/her continuing understanding of infectious diseases, including any new diseases that may arise.  Multiple choice (MCQ) and short answer questions are appropriate for this, while essay questions probe students’ understanding of disease and diagnostic skills. The specific objectives are given in bold type below together with the method of testing them.

At the end of the course the student will be able to demonstrate knowledge of the basic structure, physiology, and genetics of bacteria, viruses, fungi, and parasites; the student will also be able to correlate the structure, physiology and genetics of these microorganisms to the pathogenesis of the diseases they cause. This is tested by multiple choice (MCQ) and short answer questions.

The student will understand simple laboratory procedures used in the diagnosis of microbial diseases and will have the opportunity to perform some of the procedures.  We do not require that the student be able to perform the diagnostic tests, so to examine their understanding of the diagnostic tests MCQ’s and short answer questions are appropriate.  Some questions would ask what tests would be appropriate in certain clinical situations, injecting a “real world” aspect to the question.

The student will be able to demonstrate knowledge of the pathogenesis of major infectious diseases, including their causative agents, epidemiology, and virulence mechanisms. This is tested by multiple choice (MCQ) and short answer questions. Questions are often couched in clinical scenarios.

The student will be able to demonstrate knowledge of the signs and symptoms of major diseases caused by infectious microorganisms and will have practice in developing differential diagnoses for major infectious diseases. To test this objective students are given signs and symptoms and asked to diagnose the disease. Questions are either MCQ or short answer or short essay as is appropriate. In the essay questions, students must give a differential diagnosis and they are graded on their clinical reasoning by their CMC leaders who are clinicians.

The student will demonstrate knowledge of the principals of antimicrobial function. This is tested by multiple choice (MCQ) and short answer questions.

The student will be able to demonstrate knowledge of the prevention, diagnosis, and treatment of major infectious diseases. This is tested by multiple choice (MCQ) and short answer questions.

Exam Schedule

TEST DATE % of Grade  
Exam I: Virology October 12 25%  
Exam II: Bacteriology 1 November 1 22.5%  
Exam III: Bacteriology 2 December 1 22.5%  
Exam IV: Mycology and Parasitology December 14 10%  
Final Exam: NBME Subject December 14 20%  

Grades:

Grades in the course will be determined as follows: The grades on the USMLE Exam will be normalized.

PERCENTAGE LETTER GRADE
92 and above A
84 - 91.99 B
75 - 83.99 C
70 - 74.99 D
69.99 and below F

Pluses are discretionary. Anyone with a grade below 75 on ANY exam will be required to consult with Dr. Gulig to formulate a plan for improved performance.

Competency Evaluation (PDF)

IC2. Feedback to Students

Formative Evaluation: It is our intent to keep students informed of their progress and help them achieve their desired level of competency. This is called, in educational vernacular, formative evaluation and remediation.  Every 2 weeks or so, students will be given "quizzes" so that they may evaluate their progress.  These should be taken as if they are to be graded, however, they will not count toward a grade.  After each exam, answers will be posted and wrong answers explained.  If students still have questions as to why a certain answer is wrong they may contact the course director or any faculty member.  Protracted arguments regarding grades will, however, be considered unprofessional.  In addition to analysis of current exams, many old exams are posted on the web site so that the student may continually assess his/her knowledge. Grades on exams given up to the final NBME subject exam will let the student know, within a half a grade, what his/her final grade will be, providing he/she works toward the shelf exam with the same effort as the other exams.  All challenges to exam grades must be completed within three days of the posting of the grades and keys.  No changes will be made to earlier exams at the end of the course.

ID. Administrative Policies:

Class Attendance: While we advise attendance at all classes, we believe mature students know best what helps them learn.

Make-up Exams or Other Work: Permission must be obtained PRIOR to any exam to miss that exam. If exams are missed without permission, the student may receive a zero on those exams. Excused exams due to unavoidable absences, may be made up after the class has taken the exam. There is no mechanism to make up missed CTIM's or CMC's.

Class Demeanor: We expect no one will receive cell phone calls during class except in the case of dire emergencies.  We expect students to be punctual and quiet so as not to disturb other students.

Class Room Accommodations: "Students requesting classroom accommodation should contact Robyn Sheppard, Chair of the Americans with Disabilities Act assessment committee for the College of Medicine, 392-4569."

Honesty Policy:

All students must agree to the following:
"I understand that the University of Florida expects its students to be honest in all of their academic work. I agree to adhere to this commitment to academic honesty and understand that my failure to comply with this commitment may result in disciplinary action, up to and including expulsion from the University." [From University of Florida Rule 6C1-4]