PA Curriculum

The course of study is 25 continuous months in length. Starting in January, the first year is dedicated almost exclusively to the foundations of medical science, pathophysiology of disease, and medical therapeutics. Students are introduced to various medical disciplines as well as the principles of physical diagnosis and provided several skill workshops designed to prepare them for the subsequent twelve months in clinical rotations.

Students can expect to spend six to eight hours a day in class the first year. Classes are based at the Health Sciences campus in Boston (Chinatown area), where students have easy access to library and study resources as well as faculty and PA Program staff. 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.

Please note that in addition to all university holidays, students will have breaks in April, August, and December.

During the second (clinical) year, a majority of students will travel within a 60-mile radius of Boston to clinical practice sites around eastern Massachusetts. They will have four- to five-week rotations in core clinical disciplines such as Internal Medicine, Pediatrics, Surgery, Emergency Medicine, Women’s Health, Behavioral Medicine, Family Medicine, and Orthopedics. Students are also permitted to choose one elective in a discipline of their choice after consulting with clinical faculty.

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 courses (130 credits) with a 3.0 cumulative GPA or better
  2. Successfully complete all Supervised Clinical Practice Experiences
  3. Pass a comprehensive written examination
  4. Pass the Objective Standardized Clinical Examination
  5. 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.

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.

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

  • 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 in the surrounding area. 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.

Per ARC-PA Accreditation Standards, Tufts University is responsible for the selection of clinical sites to which PA students will be assigned for clinical rotations.

Core rotations are expected to be taken in New England, but the elective can be in any state following selection and approval by Tufts. Students seeking to fulfill their clinical rotation at a new site outside of those previously selected by Tufts may do so by submitting a request for review and selection. 

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, take a final Comprehensive Exam, and attend various lectures and workshops to help prepare them for their national board exams and job searches.

Block 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.

  • Familiarizes students with problems encountered in an emergency room. Students are responsible for taking medical histories and performing physical examinations on acute as well as non-emergent patients and presenting these to the preceptor. When appropriate, students perform necessary diagnostic and therapeutic measures. Through clinical training and didactic sessions at the clinical site, students may also be exposed to the emergency management and treatment of such conditions as trauma, shock, burns, asthma, poisoning, allergic reactions, seizures, and respiratory failure.

  • Exposes students to a broad range of experiences 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 established diagnoses. In addition to routine health maintenance, students become familiar with common primary care and family medicine problems such as upper respiratory illness, orthopedic injuries, musculoskeletal complaints, hypertension, diabetes, and heart disease. Patient education, counseling, and integration with community services are other components of this rotation. Students may see patients in venues that include hospital ambulatory care clinics, private offices, family medicine practices, clinics and urgent care settings. This experience exposes students to broad aspects of ambulatory medical practice, emphasizing the patient as an individual and family member. Students will have exposure to caring for patients across a broad spectrum of ages. Students typically encounter such common medical problems as community acquired infections, musculoskeletal complaints, hypertension, diabetes, minor trauma, and heart disease. In addition to medical diagnosis and management, patient education, counseling, and integration of community services and arrangement of follow up care are major parts of this rotation. This part of the outpatient experience may be provided in a walk-in clinic or urgent care venue.

  • During this inpatient hospital rotation, students take and record medical histories and perform physical examinations. It offers students an opportunity to become familiar with the assessment and management of varied medical problems by attending medical rounds and conferences, performing diagnostic procedures, presenting case write-ups, recording progress notes, and working under the supervision of a physician. It emphasizes the skills of collecting, assessing, and presenting patient data for physician review; 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.

  • Students in this rotation participate in varied surgical patient care responsibilities, under the supervision of a surgical resident or staff surgeon. Emphasizes general surgery, though students may have some exposure to other surgical specialties and subspecialties. Students assist in surgical patients’ initial assessment, which includes obtaining accurate medical histories and performing physical examinations. As members of the surgical team, students 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. When possible, students attend surgical grand rounds and other surgically-oriented educational meetings.

  • Exposes students to varied mental health problems, in such settings as wards, clinics, and multiservice centers. Students are expected to perform mental status examinations and cognitive testing. Emphasizes recognizing various types of mental health problems that require referral to a specialist and managing problems that can be handled by the non-specialist. Assists students in furthering their understanding of effective patient interactions and the mental health components of health, disease, and disability.

  • Develops students’ familiarity with outpatient pediatric problems, in training clinics and private pediatric offices. Emphasizes caring for a child from birth through adolescence. Provides opportunities to take medical histories and perform pediatric physical examinations. Stresses diagnosing and managing common childhood illnesses and evaluating growth and development. Assists students in developing skills to counsel parents about immunizations, child visits, growth and development parameters, common psychosocial problems, nutrition, and accident and poisoning prevention. Students may also have the chance to learn how to administer immunizations and perform audio and visual screenings.

  • Enables students to become involved with obstetrical and gynecological services provided by teaching hospitals. Emphasizes pre- and postnatal care, monitoring labor, assisting in deliveries, and developing the necessary skills to deliver a child in an emergency situation. Provides opportunities to take obstetrical histories and perform obstetrical examinations. During this rotation, students are expected to learn how to assess and manage a variety of common gynecological problems and to counsel patients on family planning.

  • Exposes students to common orthopedic conditions/injuries in settings such as inpatient medicine floors, outpatient clinics, operating rooms, and other multiservice centers. Student will learn to diagnose common orthopedic conditions/injuries by examination and/or radiographic means. Students will gain exposure in performing musculoskeletal/joint examinations. Each student will develop skills to stabilize and treat common orthopedic injuries and distinguish among elective, non-emergent, and emergent scenarios. Students will also learn and practice techniques used to rehabilitate common orthopaedic conditions/injuries.

  • One block is a student-selected elective in a medical discipline that reflects the student’s intended career path. This provides exposure to an area of clinical medicine in which a student has particular interest. Students may choose additional experience in an area covered in required rotations or select a subspecialty, such as orthopedics, cardiology, cardiothoracic surgery, plastic reconstructive surgery, neonatology, infectious diseases, dermatology, gastroenterology, neurosurgery, critical care medicine, oncology, or geriatrics. Students will choose from existing clinical affiliations or by gaining approval from the Director of Clinical Education if it is a new clinical site.

  • 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 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 can choose to do a general medicine ambulatory rotation or a more specialized ambulatory care clinic.

  • During this Internal Medicine inpatient 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 offers students an opportunity to become familiar with the assessment and management of varied medical problems by attending medical rounds and conferences, performing diagnostic procedures, presenting case write-ups, recording progress notes, and working under the supervision of a physician. It emphasizes the skills of:

    • Collecting, assessing, and presenting patient data for physician review
    • Ordering appropriate laboratory and diagnostic studies
    • Counseling patients about therapeutic procedures
    • Helping to coordinate the contributions of other health professionals involved in management of the patient.

    As a selective, students can choose to do a general medicine in-patient rotation or a more specialized in-patient experience.