PA Curriculum

The program spans 25 continuous months, beginning in January, with the first year focusing on foundational medical science, disease pathophysiology, and therapeutics. Students explore various medical disciplines and principles of physical diagnosis, preparing for subsequent clinical rotations through skill workshops. In addition to all university holidays, students will have breaks in April, August, and December.

During the first year, students typically spend six to eight hours daily in classes at the Health Sciences campus in Boston’s Chinatown area. This location provides convenient access to library resources, faculty, and PA Program staff, facilitating a conducive learning environment.

NOTE: Due to the demanding curriculum and full-time clinical rotations, it is strongly recommended that students do not work during their time in the PA program.

In the clinical year, students will be placed at clinical practice sites across Massachusetts and New England (most sites are within a 60-mile radius of Boston). Students may also be assigned to rotations in Portland, Maine; Portsmouth, New Hampshire; or Cape Cod for which housing may be provided. During clinicals, students engage in four- to five-week rotations in core disciplines, including Internal Medicine, Pediatrics, Surgery, Emergency Medicine, OB/GYN, Behavioral Medicine, Family Medicine, and Orthopedics. Additionally, students have the opportunity to do a deeper dive to complement their family medicine and internal medicine rotations by completing a more selective rotation in these respective areas. There is also an opportunity to choose one elective in their preferred discipline.

NOTE: Clinical sites and preceptors are assigned by the program, students are not responsible for finding their own.

All students must successfully complete the following to meet the program's graduation requirements and earn their degree of Master of Medical Science:

  1. Pass all didactic courses with a minimum of a B-
  2. Maintain a cumulative GPA of 3.0 or better
  3. Successfully complete all Supervised Clinical Practice Experiences
  4. Pass a comprehensive written examination
  5. Pass the Objective Standardized Clinical Examination
  6. Demonstrate professional conduct throughout the entire program

First Year: Didactic Course Sequence

Every effort is made to provide an organized, progressive flow of information for our students. Anatomy and Physiology subjects are presented so that the course work parallels that which is presented in Internal Medicine and other subjects.

Semester 1

  • This course teaches the structure and function of the human body. Utilizing lectures, discussion, models, and cadavers, students will have a structural introduction to the organ systems of the thorax, abdomen, and pelvis. Upon completion of the course, students will be able to identify normal anatomical structures, recognize abnormal anatomy, and determine the clinical implications of pathologic anatomy.

  • This course will focus on immunology, infectious diseases, and the hematology system. The pathophysiology, presentation, diagnosis, treatment, and prevention of diseases involving these topics will be discussed.

  • Focusing upon the principles of pharmacologic action, classification, and drug uses, this will be an introduction into clinical use of medications for various disease states. Emphasis will be placed upon indications, contraindications, bioavailability, drug interactions, dose response, side effects, and adverse reactions.

  • This course offers students an introduction to psychiatric disease, its classification of disease states, an in-depth look at common psychiatric illnesses seen in general medical practice and emergency practice settings. Topics such as psychotherapy, psychoanalysis, pharmacological intervention, substance abuse and addiction, domestic and child abuse will be discussed also.

  • The history of the Physician Assistant profession will be discussed. Topics such as the role of the PA in the US health care system, scope of practice, professional and legal restrictions, national board certification, and state licensure will be addressed. Interdisciplinary dynamics, PA-supervisor relationships, practice management and ownership, federal and private insurers, billing, public policy trends, medical ethics, hospital credentialing, continuing medical education, and medical malpractice will be covered.

  • Using traditional lectures, simulated and standardized patients, and small student group interactions, students will be introduced to the basics of history taking and complete physical examination. Development of interviewing techniques and examination skills will be emphasized.

  • This course will review basic principles of normal physiology including central nervous, cardiovascular, pulmonary, gastrointestinal, endocrines, renal, and reproductive systems of the human body. Tracking anatomy, pharmacologic, and internal medicine topics in other courses, these lectures are meant to serve as a foundation of information.

  • This course offers first year physician assistant students in-depth training in a wide variety of clinically related subjects including Public Health, Medical Genetics, Dermatology, Otolaryngology and Ophthalmology. The pathophysiology, clinical presentation, diagnosis, treatment, and prevention of diseases involving these topics will be discussed. Clinical case discussions and a simulated patient experience will be utilized to build the students' critical thinking skills.

  • Students will be taught the basics of human nutritional needs as well as alterations of these demands during various clinical scenarios and disease states.

Semester 2

  • Continuing Part 1, this course will focus upon the musculoskeletal and head and neck structure of the human body utilizing lectures, discussion, and cadavers. Clinical correlation through case studies will be emphasized.

  • This course will focus on diseases of the cardiovascular, pulmonary, and endocrine systems. The pathophysiology, presentation, diagnosis, treatment, and prevention of diseases involving these topics will be discussed.

  • Continuation of Pharmacology I

  • The course focuses on the basic surgical concepts needed for the PA to function in primary care settings as well as major surgical areas. The course emphasizes surgical concepts, topics and surgical technique as well as attention to examination of the acute abdomen, surgical diagnosis and treatment of common surgical conditions including obstructive, infective, and neoplastic diseases of the gastrointestinal tract, cardiothoracic diseases, trauma, and the vascular system. Risk assessment, wound healing, pre and postoperative care will also be addressed.

  • The spectrum of female reproduction, conception, fetal growth and development, prenatal and antenatal care, and reproductive endocrinology will be covered. Students will be given an introduction to the anatomy of the female genitourinary tract as well as gynecologic oncology, its natural course, diagnosis, and treatment. Cardiovascular disease in women will be addressed, as will gynecologic infections and sexual assault diagnosis and management. Emphasis will be placed upon history taking, gynecologic examination, counseling, testing, and disease prevention.

  • Students will continue to learn interview and examination techniques and build upon Physical Diagnosis I. Instructors will assist students in honing their interviewing and examination skills through focused examinations and varying interviewing techniques. Compilation of patent data in written form and oral presentation of patients’ medical history and examination results will be emphasized. Some instruction may take place in external clinical sites.

  • This course is an elementary introduction to electrocardiography. Students will learn the basics of electrical impulses generated by the heart's electrical conduction system and the manifestation of these impulses on paper charts and ECG monitors. Students will learn to identify conduction abnormalities, heart blocks, ischemic and infarction changes as generated on ECGs. They will learn to calculate heart rates, axis deviations, and chamber hypertrophy.

  • This course is a continuation of Primary Care I and offers first year physician assistant students in-depth training in a wide variety of clinically related subjects, including common cardiovascular disorders, respiratory disorders and endocrinologic disorders encountered in the primary care setting. The pathophysiology, clinical presentation, diagnosis, treatment, and prevention of diseases involving these topics will be discussed. Clinical case discussions and a simulated patient experience will be utilized to build the students' critical thinking skills.

  • Radiologic safety, imaging modalities, indications, contraindications, benefits and risks of use of X-ray diagnosis will be covered. Assessment of common X-rays used in primary care and emergency medicine will be addressed. Students will be taught to recognize common radiologic abnormalities. Other diagnostic tools such as ultrasonography, MRI, CT scanning, and nuclear medicine scans will be introduced.

  • This course provides fundamental instruction in the diagnosis and management of both common and life-threatening patient presentations to the emergency department.

Semester 3

  • This course introduces the core concepts of evidence-based medicine and life-long learning, and clinical decision-making. These concepts include the process of evidence-based medicine, the interpretation of research results, and clinical reasoning based on an understanding of clinical epidemiology concepts, and the need for self-management of one's clinical knowledge.

  • This course will focus on diseases of the gastrointestinal, rheumatologic, and renal systems. The pathophysiology, presentation, diagnosis, treatment, and prevention of diseases involving these topics will be discussed.

  • This course explores all aspects of diseases and conditions of bones and joints. Emphasis will be placed on the orthopedic examination in conditions such as fracture, dislocation, ligament, tendon, and muscular conditions. Joint aspiration, immobilization, splinting, and casting will be addressed in supplementary workshops.

  • Students will be introduced to hemodynamic derangements in multiorgan system failure patients, including shock, trauma, cardiac arrest, acid-base and electrolyte management, and nutritional support. Other topics covered include ventilator management, invasive procedures, and diagnostic methods used in ICU care.

  • Students will be introduced to process of aging as it affects the human body and mind. Atypical presentations of common acute and chronic diseases as they are seen in older populations will be addressed as will the challenges of managing various and concomitant disease states. Pharmacologic therapy in older patients, Alzheimer’s disease, dementia, patient compliance issues, and end-of-life care will be discussed as well.

  • This course for physician assistants focuses upon common bedside procedures performed in clinical situations. Procedures taught range from vital sign taking and phlebotomy to invasive procedures such as thoracentesis and central line placement. Using peer practicums (phlebotomy and venipuncture) and simulation models for more invasive procedures, key concepts and techniques will be taught.

  • This course is a continuation of Primary Care I and II and offers first year physician assistant students in-depth training in a wide variety of clinically related subjects including common oral health conditions, gastrointestinal and genitourinary disorders encountered in the primary care setting. The pathophysiology, clinical presentation, diagnosis, treatment, and prevention of diseases involving these topics will be discussed. In addition, there will be a focus on health maintenance/preventative medicine. Clinical case discussions and a simulated patient experience will be utilized to build the students' critical thinking skills.

  • This course will present neuroanatomy and neurophysiology as they relate to clinical assessment and management of various disease states. History taking, physical examination and diagnostic imaging techniques will be discussed as they apply to neurological disease and trauma. In addition to lectures, small student group sessions will allow students to practice neurological examination techniques. Both the complete neurological examination as well as problem-focused neurological examinations will be discussed. The signs, symptoms and pathophysiology of neurologic diseases commonly encountered in Primary Care and Emergency Medicine will be covered as well as diagnostic testing modalities, radiographic imaging and laboratory tests utilized for diagnostic purposes.

  • Normal child growth and development will be emphasized as well as diagnosis and management of common childhood diseases and infections. Also discussed will be immunizations and medications used in pediatric practice, their indications, contraindications, and dosage in relation to specific disorders. Pediatric respiratory emergencies, injuries, cancer and hematologic disorders, and child abuse will be covered.

  • Acute and chronic recovery from disease and injury will be covered as it applies to physician assistant practice. Implications of and indications for rehabilitative services, levels of care required, specific interventions and therapies will be discussed.

Second Year

Supervised Clinical Practice Experiences

Students spend the second year rotating through assigned medical disciplines and one elective rotation. These rotations will take place at various clinical sites throughout New England. Students are under the direct supervision of their clinical preceptor and will follow the preceptor's work schedule (possible nights and/or weekends). There are three scheduled breaks throughout the clinical year. All additional breaks and holidays during this year will correspond with the schedule of the student's clinical preceptor.

The Tufts PA Program has affiliation agreements with over 120 different clinical sites, the majority of which are within 60 miles of downtown Boston. These include major teaching hospitals in and around the city, community hospitals in suburban and rural areas, neighborhood health clinics, and private practices. Through 4-5-week long rotation blocks, our students are given multiple opportunities to experience health care in many different types of settings and medical disciplines in culturally diverse areas.

Core rotations are expected to be taken in New England, but students may request a selective or elective rotation be taken in another state at a new site. Students may submit a formal request to the Director of Clinical Education who will review the site and its practitioners to ensure they meet program standards. Only after these standards are met and a new affiliation agreement is enacted by both parties, may a student be granted approval for their rotation.

Some of our current clinical sites include:

Coursework

In addition to clinical rotation responsibilities, students are "called-back" to campus once a month to complete End-of-Rotation Exams. At this time, students also review additional coursework needed to prepare them for clinical practice, national board examinations, and present their Capstone projects. The Capstone project is an individual effort on a medical topic chosen by the student. This graded project requires considerable effort, including library research and clinical insight, culminating in a poster presentation to PA students, faculty, and staff.

  • The purpose of the Capstone Project is to foster a clinically-relevant, scholarly activity in a mentored environment. The project serves as the culminating experience for graduate education in physician assistant studies and must be completed prior to the awarding of the MMS degree. Building upon prior clinical experiences, the program curriculum, and specific student interests, the Capstone Project gives students greater insight into healthcare-related issues, such as specific medical conditions, specific therapies, specific diagnostic tests, clinical practice guidelines, healthcare delivery systems, or patient education challenges. The deliverable for the Capstone Project is an 8-10 page paper (excluding references) and accompanying poster presentation that substantiates or refutes a clinical hypothesis through integrating an existing body of knowledge.

  • Preparation for Clinical Practice includes a wide variety of clinical and practice-related lectures for second-year students in an effort to prepare them for future clinical practice.

    It also provides formative and summative academic events as part of the concluding curriculum and milestones of the PA curriculum. Students will present selected case studies from actual patient experiences during their clinical experiences. These presentations will be real cases the student has encountered, including\ medical histories and physical findings, details of the diagnostic workup, differential diagnoses, treatments, and actual outcomes. Students will conclude with a discussion of the disease process and address any questions from the audience of fellow students and principal faculty. These presentations provide students with presentation experience, training in consolidating clinical cases into teaching objects, and an opportunity to address challenging clinical questions from peers.

    The two formative PACKRAT Examinations provide detailed content feedback for individual students as well as class performance benchmarked against the national cohort taking the examinations. Similarly, summative examinations such as the Comprehensive Examination and OSCE offer similar content feedback on student performance as well as performance as a cohort. Utilizing these results to pinpoint content or performance deficiencies, Principal Faculty will produce a customized board review lecture series designed to address cohort deficiencies in preparation for clinical practice and the national board examination (PANCE).

    The OSCE results will also permit faculty to identify procedural and skill deficiencies in students and allow for individualized remediation sessions during the final weeks of the curriculum.

    Using the feedback from the OSCEs, Formative and Summative examinations, the final 4 weeks of the curriculum will be structured to include focused lectures on specific medical topics.

The Final Month

The final month of the second year is a culmination of all the work students have completed throughout their second year. Students present their Capstone projects in a poster session and attend various lectures and workshops to help prepare them for their national board exams and job searches.

Rotation Course Descriptions

Below are descriptions of the supervised clinical practice experiences in the second year of the curriculum. Each block is four to five weeks in length.

  • The Emergency Medicine Supervised Clinical Practical Experience (SCPE) exposes students to a broad range of experiences and patient populations in the emergency room for acutely ill patients. Students will hone their skills in triage; learning to recognize and manage patients that need immediate care. They will learn to prioritize care for conditions which are less urgent. Students will be responsible for taking medical histories and performing physical examinations on acute as well as emergent patients and presenting these to the medical preceptor. When appropriate, students will perform necessary diagnostic and therapeutic measures.

  • The Family Medicine Supervised Clinical Practical Experience (SCPE) exposes students to a broad range of experiences and patient populations that emphasize the patient as an individual and family member. Students are involved in the initial and ongoing assessment of patients in all age groups as well as management of individuals with new and established diagnoses. Emphasis is placed on evaluation, management, health promotion, and preventative medicine. Students are expected to be involved in the care of acute, chronic and preventative visits.

  • The Inpatient Internal Medicine Supervised Clinical Practical Experience (SCPE) offers students an opportunity to become familiar with the assessment and management of varied medical problems that result in admission to the hospital. Students will attend medical rounds, perform diagnostic procedures, present case write-ups, record progress notes, and assist with discharge planning. It emphasizes the skills of collecting, assessing, and presenting patient data; ordering appropriate laboratory and diagnostic studies; counseling patients about therapeutic procedures; and helping to coordinate the contributions of other health professionals involved in management of the patient.

  • The Surgery Supervised Clinical Practical Experience (SCPE) exposes students to varied surgical patient care responsibilities with emphasis on general surgery, though students may have some exposure to surgical specialties and subspecialties. Students assist in surgical patients' preoperative initial assessment, which includes obtaining accurate medical histories and performing physical examinations. They also participate in preoperative management, including patient education and procedures necessary to prepare patients for surgery.  Students assist surgeons in the operating room and have an opportunity to become familiar with operating room procedures and equipment. Students are also involved in patients' postoperative evaluation and management. 

  • The Behavioral Medicine Supervised Clinical Practical Experience (SCPE) is designed to provide an understanding of the behavioral components of health, disease and disability. Through exposure to patients presenting with a broad spectrum of psychiatric disorders, students will develop history taking and mental status examination skills, classification skills utilizing DSM IV TR criteria, be exposed to and evaluate different treatment modalities for varying presentations. The student will enhance their ability to recognize and categorize psychiatric disturbances and techniques of early intervention and psychiatric referral. Students are expected to be involved in the care of acute and chronic visits.

  • The Pediatric Supervised Clinical Practical Experience (SCPE) is designed to develop the students' familiarity with pediatric medicine.  The rotation will emphasize caring for a child from birth through adolescence. Students are provided opportunities to take medical histories and perform pediatric physical examinations. The focus will be on diagnosing and managing common childhood illnesses and evaluation of growth and development.  Students will work on developing skills to counsel families about immunizations, child visits, growth and development parameters, common psychosocial problems, nutrition, and accident and poisoning prevention.

  • The OB-GYN (Women’s health) Supervised Clinical Practical Experience (SCPE) allows students to participate in all aspects of OB-GYN care, including acute, preventive, chronic, and emergent situations.  Students will be exposed to prenatal, labor and delivery, and postpartum care.  Also, students will care for women across the lifespan, including menarche, infertility, menstrual conditions, benign and malignant gynecologic conditions, menopause and postmenopausal situations.

  • The Orthopedics Supervised Clinical Practical Experience (SCPE) Offers students an opportunity to care for injured and infirm patients in a variety of settings including, rehabilitation centers, and convalescent facilities, and exposes the student to issues of caring for patients with sub-acute but in many cases, multiple problems complicated by advanced age, post-acute event recovery issues, and complex social and economic problems commonly seen in this population. Students will also receive exposure to common musculoskeletal injuries from a broad range of etiologies.

  • This elective supervised clinical practice experience is designed to provide the student with the knowledge and skills in an area of interest. Students will gain an understanding of the variety of problems encountered in a medical or surgical sub-specialty discipline. The understanding of the varied medical and/or surgical sub-specialty problems is accomplished through history taking, physical exam, interpretation of diagnostic testing, and the development of a plan for each presenting problem including pharmacologic and non-pharmacologic management. In addition to gaining clinical skills specific to the specialty of the rotation, the student will also continue to develop skills in medical problem solving and patient management. Elective rotation sites are chosen based on practice characteristics that are important for the PA student within this rotation. These may include practice location, patient populations, and availability of specific experiences and procedures.

  • The Ambulatory/ Outpatient selective supervised clinical practice offers students the ability to spend additional time in an outpatient medical clinic and is meant to compliment the family medicine rotation. Students are involved in the initial and ongoing assessment of patients as well as management of individuals with established diagnoses. Students may see patients in venues that include hospital ambulatory care clinics, private offices, family medicine practices, clinics and urgent care settings. As a selective, students may be placed in general medicine ambulatory rotations or a more specialized ambulatory care clinic.

  • During this Inpatient Medicine supervised clinical practice experience (SCPE), students will be exposed to patients presenting with acute and chronic illness requiring admission to the hospital setting. Students will elicit and record medical histories, perform physical examinations, and be involved in the management of the admitted patient. This SCPE is meant to complement the inpatient internal medicine core rotation by offering students additional time learning how to care for admitted patients. As a selective, students may be placed in a general inpatient medicine rotation or a more specialized in-patient experience.