The year begins with an introduction to the principles of pharmacokinetics and pathological disease processes shared among organ systems. With this background, students enter an extensive, integrated Mechanisms of Disease module. The pathology, pathophysiology, and pharmacology of disease are approached in an organ-system-based, multidisciplinary manner centered around problem-solving. This instruction is fully coordinated with acquisition of clinical skills through the parallel Skills and Science of Doctoring module. The emphasis is on relating pathogenic mechanisms to the clinical manifestations of disease; introductory lectures are followed by precepted, small group discussions, seminars, and student-patient sessions.

The Skills and Science of Doctoring is a longitudinal, interdisciplinary module that spans the first two years of the curriculum. Within the first few weeks of medical school, students—in the very small precepted Patient Narrative unit—encounter patients and illness. Later in the first year and throughout the second year of training—in The Physician, Patient and Society I and II—they learn communication skills; grapple with questions of medical ethics, cultural diversity, disease prevention, and professionalism; and begin the development of clinical skills, including history-taking, physical examination, and evidence-based decision-making. These skills are reinforced and further developed during the Physical Diagnosis and Biostatistics, Epidemiology, and Preventive Medicine units.