Issues raised in this session:  There was a general consensus that integration of basic sciences and clinical medicine should occur throughout the medical school curriculum.  It was agreed that the primary objective of such integration is to promote clinical decision-making skills in medical students.  Ideally, longitudinal integration should bring clinical relevance to basic sciences and should strengthen basic science teaching in the clinical years.  The basic science educators in attendance used a variety of methods for promoting longitudinal integration of basic science and clinical courses.  Some of the strategies included case-based teaching of basic science concepts, the development of multidisciplinary, system-based courses, and utilization of clinical faculty in basic science courses.

The main focus of discussion was on methods for promoting integration of clinical medicine into basic science courses.  There was an active discussion regarding a variety of methods used to bring clinical relevance to basic science courses.  Potential effects of this integration on the basic science curriculum, e.g., time allotted for basic science instruction, faculty effort, etc. were discussed.  It was generally recognized that integration of clinical medicine into the basic science courses was beneficial in promoting student learning and providing clinical relevance of basic science concepts.  Dr. Ber described a successful clinical integration project which was designed to bridge pre-clinical basic sciences and the clinical clerkships. 

From our discussion, it was recognized that we have done a much better job at integrating clinical medicine into the basic science curriculum than we have in integrating basic science into the clinical curriculum.  Potential reasons for this included curricular density, rendering addition of basic science courses in the clinical years virtually impossible, and the relatively limited use of basic science concepts by primary care physicians in many aspects of routine practice.  However, it was recognized that basic science knowledge provides the foundation for the development of sound clinical decision-making skills.

There was a general consensus regarding the following issues: 

• Longitudinal integration of basic and clinical sciences promotes the development of clinical problem-solving skills. 
• Integration of basic sciences and clinical medicine should occur throughout the medical school curriculum.
• There are a variety of effective mechanisms through which this integration can occur.
• In general, basic science faculty have done an excellent job in integrating clinical medicine into basic science courses.
• Efforts to integrate basic sciences into the clinical curriculum have not been as successful.