ASCEND includes three major phases: the Pre-Clerkship Phase, the Clerkship Phase, and the Integration and Transitions Phase.

Pre-Clerkship Phase

The Pre-Clerkship Phase of ASCEND supplies students with foundational knowledge in basic sciences through early clinical exposure and collaborative learning sessions. At 17 months, the Pre-Clerkship starts with acclimation and immersion sessions and progresses through a series of foundational blocks that cover core scientific principles. This is followed by organ systems-based modules that leverage a mix of didactics, workshops, and lab activities.A typical week includes ample flexibility, allowing students to explore their own passions.

It culminates with the Periodic Assessment of Knowledge and Skills (PEAKS 1) assessment, as well as preparation for the USMLE Step 1 Licensure Examinations.

Clerkship Phase

The 13-month Clerkship Phase features core clerkships in various medical fields, focusing first on acute and emergent patient care, followed by a phase dedicated to chronic disease management, health maintenance, and preventive health.

Each clerkship offers immersive experiences for our MD students. This includes real-time patient care, diagnostic skills, and inter-professional collaboration. After every six-week rotation, the Clerkship Phase also includes Coaching, Advising, Mentoring, and Preparation (CAMP) weeks that provide periods for reflection, mentorship, and self-care. This approach integrates clinical experience with guidance and wellness, ensuring continuous professional development. Elective opportunities allow students to explore areas of clinical interest further. The Clerkship Phase concludes with assigned PEAKS 2 assessment weeks, which are aimed at evaluating student competencies and readiness for the Integration and Transitions Phase.

Integration and Transitions Phase

The Integration and Transitions Phase of ASCEND spans 15 months and represents the final segment of medical education at Icahn Mount Sinai. Focused on preparing students for post-graduate training, it includes a two-month Chronic Care clerkship along with other advanced clinical experiences, as well as faculty-mentored scholarly projects.

The Pre-Clerkship Phase of ASCEND builds the foundational knowledge in basic sciences through collaborative sessions and early clinical exposures. Starting with acclimation and immersion sessions, it progresses through a foundations block covering core scientific principles, followed by organ systems-based modules using a mix of didactics, workshops, and lab activities. The Practice of Medicine effectively integrates this theoretical knowledge with practical clinical skills. This phase emphasizes active learning in small groups, guided by faculty facilitators. It culminates with the Periodic Assessment of Knowledge and Skills (PEAKS) One assessment, preparation of students for the United States Medical Licensing Examination (USMLE) Step One Examinations and the subsequent Clerkship Phase, while also embedding The Inquiry (THINQ) curriculum to develop critical inquiry skills.

BaseCamp

Phase One begins with BaseCamp, a week-long module designed to facilitate and acclimate students. It provides opportunities for students to orient themselves to Icahn Mount Sinai as well as to the myriad of processes, procedures, and activities supporting their journey and ensuring their success. It also provides opportunities for students to familiarize themselves with curricular activities, instructional methodologies, and assessment formats.

Foundations Block

BaseCamp is followed by the five-month Foundations block, immersing students in the prerequisite core sciences critical that equip them to engage with the integrated, systems-based modules that follow. The following modules will cover key foundational principles:

• Molecular, Cellular and Genomic Foundations: Focuses on the fundamental aspects of molecular biology, cellular physiology, and genetics. Covers molecular mechanisms, cellular functions, and the impact of genomics in medicine.
• Anatomy: This module provides a comprehensive understanding of human anatomy, exploring the structure and organization of the body's systems. Emphasizes spatial relationships, functional anatomy, and clinical correlations. 
• Immunology and Microbiology: Examines the principles of microbiology and the immune system. Includes the study of pathogens, infectious diseases, and the body's defense mechanisms against infections.
• Pathology: Centers on the study of diseases, their causes, processes, development, and consequences. Integrates knowledge of anatomical changes with the underlying molecular and cellular disruptions leading to disease.

Integrated Systems-Based Content Modules

The modules in the Foundations block are followed by a sequence of integrated pathophysiology systems-based modules. Integrated within each system-module are relevant content in anatomy, physiology embryology, and histopathology.

• Neuroscience: This module equips students with knowledge from basic to advanced neurosciences, including neural dysfunction and neurological disease states, ensuring a comprehensive understanding of neural science.
• Behavioral Science: This module provides insights into psychopathology, human behavior patterns, and their impact on health, exploring the complexities of human behavior.
• Hematology: This module introduces students to the study of blood, its diseases, and the organs involved in its production, covering essential aspects of hematology.
• Pulmonary Medicine: This module delivers a deep understanding of the pulmonary system, from basic anatomy to complex respiratory conditions.
• Cardiology: This module provides students with a robust understanding of the cardiovascular system, emphasizing its anatomy, physiology, and common pathologies.
• Endocrinology: This module imparts knowledge about the endocrine system, its functions, and related disorders, focusing on the glands and hormones.
• Gastroenterology: This module provides comprehensive insights into the digestive system, its physiology, and associated diseases.
• Genitourinary, Sexual, and Reproductive Health: This module equips students with comprehensive knowledge of human reproduction, covering both male and female aspects.
• Renal: This module furnishes insights into the renal system, emphasizing its anatomy, function, and prevalent disorders, ensuring a thorough understanding of renal health.
• Musculoskeletal: This module educates students about musculoskeletal and rheumatologic diseases and treatments, covering essential aspects of this medical field.

Practice of Medicine and Clinical Competency Mentoring Program

The Practice of Medicine module, spanning the entire phase, is designed to enhance proficiency in patient assessment, history taking, physical examinations, communication, and ethical decision-making—all crucial for medical practice. Through weekly workshops, simulated encounters, and reflective practices, it prepares students for clinical rotations by focusing on professionalism, patient-centered communication, and clinical reasoning. The module also introduces students to their Clinical Competency Mentors, who provide direct observation and feedback, enriching the learning experience with early clinical exposures in various settings, embodying a comprehensive "whole patient" approach.

The Inquiry (THINQ) Curriculum

The Inquiry (THINQ) curriculum is a program structured around the four areas of curricular concentration: Scientific and Scholarly Discovery; Advocacy, Social Justice and Anti-Oppression; Healthcare Delivery Science; and Leadership and Professional Identity Formation. Conducted as monthly three-hour sessions over the entire phase, THINQ allows students to dive deep into their professional interests, augmenting the core curriculum with specialized knowledge and career exploration. It also emphasizes the development of inquiry methods and critical thinking, essential for crafting scholarly proposals that address complex health care and community challenges.

Periodic Assessment of Knowledge and Skills (PEAKS) One

At the end of the Pre-Clerkship Phase, students complete a series of assessments that measure achievement of Phase One level program objectives. This one-week Periodic Assessment of Knowledge and Skills (PEAKS) assesses knowledge and skills related to the acquisition of basic science concepts and their practical applications in clinical scenarios they are likely to encounter in the Clerkship Phase. Practical demonstration of clinical skills are also assessed in preparation for Phase Two.

Weekly Independent Learning Half-Days

Independent Learning half-days in the weekly curricular template are designed to provide students with time and resources to review materials, reinforce learning, and prepare for upcoming ASCEND sessions. These blocks support the development of self-directed learning skills by allowing students to engage in activities, either individually or in small groups. The structure of these blocks is flexible, accommodating personal commitments and professional development pursuits such as clinical shadowing or research activities.

Dedicated Study Period for USMLE Step One Licensure Examinations

The ASCEND curriculum preserves the dedicated study period for the United States Medical Licensing Examination (USMLE) Step One prior to the start of Phase Two training. Students utilize this six-week dedicated period to prepare and sit for Step One. Successful completion of Step One is a graduation requirement at Icahn Mount Sinai.

The Clerkship Phase has a biphasic curricular framework with acute and emergent clinical experiences during the first 12 months, followed by a two-month clerkship in the Integration and Transitions Phase (Phase Three) dedicated to chronic disease management and the development of skills promoting healthy living and disease prevention. The phase also provides the opportunity for students to present and disseminate their scholarly product. Core clerkships in Clerkship Phase include:

• Emergency Medicine (Four Weeks): Students will engage in the high-paced environment of emergency care, developing skills in rapid diagnostics, emergency interventions, and acute patient management, including real-time patient triaging and emergency procedures.
• Inpatient Medicine (Six Weeks): This clerkship immerses students in inpatient care, equipping them to manage hospitalized patients with a focus on diagnosis, treatment planning, and inter-professional collaboration, directly engaging with patients.
• Neurology (Four Weeks): Building on earlier neuroscience studies, this clerkship delves into diagnosing and managing neurological disorders, covering conditions from migraines to strokes through clinical assessments and patient management.
• Obstetrics-Gynecology (Six Weeks): Students gain comprehensive exposure to reproductive health, engaging in prenatal care, childbirth, postpartum management, and gynecological care, enhancing their understanding through hands-on experiences.
• Palliative Medicine (Two Weeks): Focused on end-of-life care, this clerkship develops students' abilities in pain management and ethical considerations, offering insights into providing compassionate care to terminally ill patients.
• Pediatrics (Six Weeks): This clerkship covers child health care from neonatal stages to adolescence, emphasizing growth assessments, immunizations, and management of common pediatric conditions through direct patient interactions.
• Psychiatry (Six Weeks): Students explore mental health, developing skills in diagnosing, managing therapeutic interactions, and understanding a broad spectrum of psychiatric conditions, enhanced by direct patient care and therapeutic engagements.
• Surgery-Anesthesiology (Six Weeks): Introducing students to surgical procedures and anesthesiology, this clerkship covers the entire surgical process from pre- to post-operative care, including principles of anesthesia and patient safety, with practical experiences in surgeries and patient management.

Coaching, Advising, Mentoring, and Preparation (CAMP) Weeks

Serving as a pivotal juncture in the Clerkship Phase, CAMP Weeks follow each six-week clinical rotation block, providing students with a dedicated period for reflection, mentorship, and self-care. These structured intervals allow students to consolidate their clinical experiences with guidance from clinical competency mentors and faculty advisors. CAMP facilitates a critical evaluation of performance, discussion of challenges, and celebration of successes. It promotes continuous professional development and well-being, ensuring students are recharged and equipped with actionable strategies for their subsequent clinical rotations.

Periodic Assessment of Knowledge and Skills (PEAKS) Two

As the Clerkship Phase concludes, students undergo another series of assessments to evaluate their achievement of the Phase Two program objectives. This one-week Periodic Assessment of Knowledge and Skills (PEAKS) evaluates students' acquisition of clinical knowledge and their ability to apply it to patient scenarios encountered during the Clerkship Phase. Additionally, the PEAK assessment includes practical demonstrations of clinical skills, preparing students for Phase Three, the Integration and Transitions Phase.

Our expanded Integration and Transitions Phase offers clinical rotations designed to further hone advanced clinical skills related to semi-independent and team-based patient care. This phase is also a period of individualized differentiation through the exploration of areas of interest via internal and extramural electives and focused sessions related to areas of scholarly concentration.

Chronic Care Clerkship

This eight-week clerkship focuses on managing chronic conditions such as diabetes and cardiovascular diseases. Students learn to develop comprehensive care strategies that incorporate patient education, nutrition, and lifestyle changes. The program emphasizes interdisciplinary approaches, patient education, and preventive care, aiming to equip students with the skills to create long-term, sustainable management plans within the context of patients' everyday lives.

Acting Internships

Medical students in the Integration and Transitions Phase select one of our mandatory four-week acting internships. Acting internships in the fields of Medicine, Pediatrics, Emergency Medicine, General Surgery, or one of six surgical subspecialties (Urology; Ear, Nose, and Throat; Plastic Surgery; Orthopedics; Neurosurgery; or Vascular Surgery) are available. These acting internships emphasize the acquisition of advanced clinical skills in both independent and team-based patient care.

Transition to Residency

This two-week capstone course prepares fourth-year medical students for a successful transition to the next phases of their careers: internships and residency. Specialty-specific, hands-on, and active learning activities focus on patient care, as well as self-care skills.

Area of Concentration

In Phase Three, medical students continue the scholarly project they have started in Phase One. The Medical Student Research Office provides guideposts to ensure timely completion. The scholarly project must align with the student’s selected area of concentration and/or selected specialty. Medical students present their scholarly projects through a dedicated day for dissemination during the latter part of Phase Three.

Periodic Assessment of Knowledge and Skills (PEAKS) Three

At the end of the Integration and Transitions Phase, students complete a series of capstone assessments that measure achievement of the medical education program objectives. This one-week assessment serves as the graduation capstone. It assesses the achievement of basic science, clinical knowledge, and practical application to patient scenarios a student has encountered throughout their time at Icahn Mount Sinai. Practical demonstration of clinical skills is required for the successful transition to internship and residency.

The ASCEND curriculum is firmly rooted in principles of comprehensive assessment, continuous learning, and robust student support, with the overarching goal of developing well-rounded medical professionals. It emphasizes in-depth, fair evaluation and fosters academic resilience by integrating diverse formative and summative assessments across all three phases.

Early phases focus on foundational knowledge and skills, using real-time feedback and adaptive learning modules, which pave the way for more advanced studies. In the later clinical phases, the curriculum employs a criterion-referenced grading system, specifically designed to mitigate biases in evaluating competencies. This system not only assesses academic performance but also closely examines clinical application and decision-making skills. Additionally, the curriculum offers targeted support mechanisms to assist students facing academic challenges. These features ensure that the ASCEND curriculum evaluates and significantly enhances student learning, preparing graduates for the dynamic and complex nature of health care practice.

For the past few years, the Curriculum Redesign Initiative Committee has been working to redesign the Icahn Mount Sinai MD Program curriculum. ASCEND embodies our ongoing efforts across four major focus areas:

1. Providing a curricular framework that minimizes extraneous cognitive load. ASCEND achieves this through more effective content delivery, as well as increased flexibility for students to engage with content materials. Through early and continuous clinical experiences, ASCEND contextualizes biomedical, social, and health systems science.
   
   
2. Designing curricular content that promotes the “whole patient” perspective. This includes patient signs, symptoms, goals, values, and lived experiences. To maximize student learning in this approach, ASCEND integrates key information and experiences throughout all phases of the curriculum.
   
   
3. Delivering more frequent learner assessment and feedback opportunities. ASCEND features new mechanisms to track learner progression, and further enhances student preparation through simulation, standardized patients, and additional interactive experiences.
   
   
4. Elevating student and faculty well-being through expanded support resources. ASCEND includes more opportunities for students to individualize their path into medicine, extends faculty and staff development resources, and works to achieve equity in Icahn Mount Sinai’s learning environment.

The Curriculum Redesign Initiative Committee offers a full list of guiding principles for the focus areas listed above.

Since the inception of the redesign initiative, the Curriculum Redesign Initiative Committee has collaborated closely with stakeholders throughout Icahn Mount Sinai. The aim is to ensure comprehensive representation and to launch ASCEND in a manner that genuinely benefits the entire academic community. To facilitate this, dedicated committees were formed early in the process, tasked with guiding the development, execution, and enhancement of ASCEND.

ASCEND Steering Committee Members

The Steering Committee consisting of deans, chairs, and senior leaders, guides the overall direction and strategic decisions for the curriculum redesign, ensuring alignment with Icahn Mount Sinai’s goals.

ASCEND Framework Committee Members

The Framework Committee focuses on establishing the structural foundation of the new curriculum, including its core principles and educational strategies.

ASCEND Content Committee Members

The Content Committee is comprised of three Working Groups for each phase of the curriculum. Together these are responsible for defining the specific knowledge areas, skills, and competencies that the curriculum will cover in all of its phases, ensuring relevance and comprehensiveness.

Phase 1 Working Group

Phase 2 Working Group

Phase 3 Working Group

ASCEND Learner Assessment Committee Members

The Learner Assessment Committee develops and implements evaluation methods to accurately measure student progress, achievements, and readiness for clinical practice.

ASCEND Student Support Committee Members

The Student Support Committee proactively aims to provide comprehensive support services and resources to students, enhancing their educational experience and well-being throughout the curriculum transition.

Educator Support Committee Members

ASCEND Curricular Leadership

ASCEND is managed by the Office of Curricular Affairs and bolstered by extensive curricular leadership throughout all phases, ensuring a comprehensive and responsive educational experience.