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The Medical Faculty of the University of Milano 1 Courses offered by the Faculty of Milan include most of the area of health care education. They include undergraduate “core” courses in Medicine and Surgery and Dentistry, as well as 20 3-year courses in the areas of direct care, rehabilitation, technical support, prevention, and medical biotechnology. In addition, are offered to graduate students : - 55 Specialization Schools —all the types recognized by the European Union — are active within the Faculty. A very large network of hospitals, covering most Lombardy, is organized around the Specialization Schools system . - 2 postgraduate courses: 1) Medical biotechnology and molecular medicine (40 students each year) includes the curricula in internal medicine, neurosciences, oncology issue engineering and transplants; 2) Infermieristica is aimed at preparing members of staff in charge of the organization and management of nursing services in hospitals and in health care structures. - 20 PhD programs are currently active within the Faculty. They cover basic sciences (such as cell and molecular biology, physiology, pharmacology) and pathophysiology areas (such as oncology or ageing): each program enrolls on average 5-10 postgraduate students each year. Some programs are run in collaboration with other Universities and involve non Italian teaching staff: an example is Advanced School In Molecular Medicine just started in collaboration with the “Federico II” University of Naples. Corso di Laurea specialistica in Medicina e Chirurgia 1. General description and aims The University course in Medicine and Surgery (Corso di Laurea specialistica in Medicina e Chirurgia) is open to students who have completed a five years high school cycle and have been awarded the corresponding degree. It lasts six years and requires 360 credits (credit of the the Italian university is a measure of the work, including personal study, that a student having an adequate initial background, is supposed to spend in order to acquire the knowledge, skills and attitudes defined by the educational rules of the course; it corresponds to 25 hours of student’s work, whose at least 50% must be allowed for personal study; a lower percentage of time can be dedicated to personal study in the case of training activities having a highly experimental or practical content ). At the end of the courses the degree “Laurea specialistica in Medicina e Chirurgia”, recognised within the European Union (EU) , is awarded. The Corso di Laurea is aimed at forming graduates possessing the working method, the culture and operational autonomy necessary to gain access to Scuole di specializzazione, to perform as surgeon in the different roles and to efficiently perform in continuing medical education. The training plan to reach the degree, besides the acquisition of essential theoretical knowledge of basic sciences and of physiopathology of diseases in man also provides for the acquisition of the ability of noticing and critically evaluating the state of health or disease of a subject; stimulating the attention direct as well to the behavioral aspects of illness, socioeconomical factors and ethical considerations that may impinge on medical management. The training plane also gives ables to clearly and kindly communicate with patients and their relatives. In order to help the student to reach these aims, the course provides also for training activities useful to acquire specific professional skills in the areas of internal medicine, general surgery, paediatrics, obstetrics and gynaecology, and medico-surgical specialities for 60 credits. 2 2. Admission to the Corso di Laurea specialistica Owing to the strongly professional character of the Corso di Laurea specialistica and in accordance to the indications of EU the number of students admitted to the course is planned each year depending by available teaching and hospital resources. In the last years, this number has been fixed at 300 places for European Union citizens and foreigners resident in Italy, plus 10 places reserved to non European Union citizens non resident in Italy. Candidates are selected through an admission test, that is the same in all Italian Public Universities and takes place on the same day (usually at the beginning of September) in the whole country. Information on the enrolment to the admission test can be obtained Programs of the test are defined by the Italian Ministry of Instruction, University and Research and can be found at the internet address: http://www.miur.it/ 3. Organization in teaching poles (Poli didattici) and teaching tracks (Linee di insegnamento) The Medicine and Surgery course includes 5 pre-clinical and 7 clinical semesters. The Corso di Laurea is organized in teaching poles , based on 3 groups of hospitals, each hosting a complete teaching course, and in teaching tracks (linee di insegnamento): each track is based on its own hospital facilities and students are enrolled in it from the beginning of the Course. Hospital structures available for the course in Medicine and Surgery include both general hospitals (5) and specialized structures (cardiological, oncological, orthopaedical, etc.). During the pre-clinical phase, students are divided in 4 classes (the “Central” pole includes two classes). During the clinical phase, the “Central” pole students are further divided in three classes, in order to offer the best student/hospital structure ratio.The overall students:teaching staff ratio is 5.To make sure that available hospital facilities are most efficiently used , teaching is based on the tutorial given to small group of students. The total average number of in-patients available for clinical practice to medical students is just above 2,450, giving an overall patient:student ratio of 2. Poles and tracks operating and available places in each track are the following: Pole Hospital and address Track Places Sacco-Vialba • Ospedale Luigi Sacco - Via G.B. Grassi, 74 Istituto Ortopedico Galeazzi A 80 San Paolo Ospedale San Paolo - Via Di Rudinì, 8 Istituto Oncologico Europeo Istituto Clinico Humanitas B 80 Centrale Ospedale Maggiore Policlinico - Via F. Sforza, 35 C and D 75+75 Istituti Clinici di Perfezionamento Istituto Gaetano Pini Istituto Cardiologico Monzino Ospedale San Donato Ospedale San Giuseppe A course takes place at the Vialba and S. Paolo Poles; for the Central Pole, courses of the first five terms are held at the facilities of “Città Studi”. An additional teaching track, open to a maximum of 30 students of the Central Pole (tracks C and D), is active at the S. Donato Hospital. This track begins on the second term of the third year when the clinical phase begins. 3 Finally, an experimental track, for a maximum of 20 voluntary students of the S. Paolo Pole (track B), is running at the Istituto Clinico Humanitas. This track, that begins at the second term of the third year, is based on innovating teaching methods, it includes an almost complete horizontal integration among courses of each term, clinical tutorial teaching at a tutor:student ratio of 1:1-1:2, problem based learning with small group discussions, seminars and a strong reduction of formal lectures (to see an example click here). Learning evaluation is performed through a single theoretical and practical examination covering all the objectives of the term. 4. Teaching plan Academic activities begin on the last week of September. Each academic year is divided in two terms, lasting approximately 13 weeks. Each term is followed by an exam session, lasting approximately 6 weeks; a third session, of three weeks, takes place in September. During the first and the second session are set at least two exam dates. For the first and the third session, an additional date is set respectively, immediately after Easter and at the beginning of November, During the examination sessions, teaching activities can not take place. 5. Teaching activities of the curriculum the Corso di Laurea specialistica The curriculum of the Corso di Laurea specialistica includes the following types of teaching activity: courses of the core curriculum: represent the compulsory part of the training program; they may last one or more terms, may be taught by one or more teachers having different competences, and include both formal lectures and non formal teaching (small groups discussing and solving problems, practical works, etc.); they end up with a single examination. 270 credits over the six years are devoted to these courses. professional training: practical activities personally performed by the students, in health care facilities under the supervision of a tutor, aimed at acquiring specific professional competences. Each student spends 60 credits over the six years course. electives: different learning activities (seminars, internships, field experiences, etc.) chosen by the students among several proposals offered by the Board of Professors or directly proposed by the student (by previous agreement of the Board of Professors). 15 credits over the six year course are provided for these activities. preparation of the degree thesis: practical research work performed by the student under the supervision of a teacher. A student must spend 15 credits in this work. 4 6. Teaching organisation of the Corso di Laurea specialistica in Medicina e Chirurgia The curriculum of the Corso di Laurea provides for 34 compulsory courses, each engaging the student for the number of credits indicated in brackets in the following table. Credits are awarded to the student when he passes the corresponding exam, independently of the obtained mark. Year I II 1st semester Human anatomy Introduction to Medicine (4) Histology and Embryology (7.5) Medical physics Chemistry and biochemical propaedeutics (6.5) Biological chemistry (12) Biology and genetics (11) English for science and medicine( 5) III General pathology and pathophysiology (12) Human physiology (18) Communication and relation in Medicine IV Semeiotics and systematics II (23) Medico-surgical specialities (6) Communication and relation in Medicine General diagnostics (4.5) V Clinical medicine General surgery Pathology Diseases of the nervous system (7.5) Medical pharmacology (9) Psychiatry and clinical psychology (5.5) Clinical medicine General surgery (17.5) Paediatrics (8) Pathology (7.5) VI 2nd semester Human anatomy (16) Biology and genetics Medical physics (6) Human physiology General pathology and pathophysiology Microbiology (6) Immunology and immunopathology (4) Semeiotics and systematics I (23) Statistics and evaluation of evidence in medicine (9) Communication and relation in Medicine General diagnostics Medical pharmacology Infectious diseases (6) Diagnostic imaging and radiation therapy (6) Dermatology (4.5) Public health (7.5) Communication and relation in Medicine (9.5) Clinical medicine General surgery Pathology Occupational medicine (6) Obstetrics and gynaecology (7) Orthopaedics and traumatology (6.5) Clinical medicine (26.5) Medico-surgical emergencies (8) Forensic medicine (4) Notes: the symbol after the name of a course indicates the end of the course and the corresponding examination; the symbol indicates that the course continues in the following term. 7. Compulsory attendance To be admitted to the corresponding examination, students must have attended at least 75% of formal and non formal teaching planned for each course. In case of courses spread over several terms, this provision applies to each term separately. Each teacher can choose how to verify student’s attendance. Students who have not complied with the obligation of attendance, are automatically enrolled as repeating students for the following academic year. 5 8. Propaedeutics and rules governing student progression In order to guarantee a progressive and balanced cultural growth of the student, the following propaedeutics and blocks are provided for. Propaedeutics Students must have passed the examination of: Histology Chemistry and biochemical propaedeutics, Medical physics, Introduction to medicine Human anatomy, Biochemistry, Biology and genetics Human physiology, General pathology and pathophysiology, Immunology and immunopathology, Microbiology Semeiotics and systematics I, Semeiotics and systematics II in order to be admitted to the examination of: Human anatomy Biology and genetics, Biochemistry Human physiology, General pathology and pathophysiology, Immunology and immunopathology Semeiotics and systematics I Semeiotics and systematics II Medico-surgical specialties Infectious diseases Dermatology Diagnostic imaging and radiation therapy Diseases of the nervous system Medical pharmacology Psychiatry and clinical psychology Occupational medicine Obstetrics and Gynaecology Orthopaedics and traumatology Paediatrics Pathology Medico-surgical emergencies Clinical medicine General surgery The order of the remaining examinations is left to the student’s choice. If the above rules concerning propaedeutics are respected, repeating students who did not pass the precedent examination (debt), can sit for exams at all dates fixed for other students; additional dates reserved to repeating students may be arranged , also during the term periods. Blocks First year Students who, at the 30th of September, have a debt of 20 or more credits are temporally enrolled as second year until the last exam date of the third session of examinations (first week of November). If by this date the debt remains, they are enrolled as 1st year repeating students for the whole following academic year. During this academic year students are not allowed to attend courses or training activities planned for following years, but can attend elective courses. 6 Second year Students who have, at the 30th of September, a debt of 25 or more credits are temporally enrolled as third year till the last exam date of the third session of examinations (first week of November). If by this date the debt remains, they are enrolled as 2nd year repeat students for the whole following academic year. During this academic year students are not allowed to attend courses or training activities planned for following years, but can attend elective courses. Third year Students who have, at the 30th of September, a debt of 30 or more credits are temporally enrolled as fourth year till the last exam date of the third session of examinations (first week of November). If by this date the debt remains, they are enrolled as 3rd year repeating students for the whole following academic year. During this academic year students are not allowed to attend courses or training activities planned for following years, but can attend elective courses. 9. Examinations Each course of the curriculum is followed by a single examination, which the student is individually evaluated in. Marks range is between 0 and 30, with laude. Examinations take place in periods free from other teaching activities (examination sessions). According to choices of the examining commissions, examinations may include written parts (quiz, questions with open answer) and/or practical tests, and/or oral colloquias. Oral examinations must be public; for written examinations the possibility of verifica most be provided for. During written examinations students are allowed to withdraw through the whole length of the examination; in case of oral examinations, withdrawal can take place before the recording of the result. The board of examiners must communicate to the student the result of the examination before recording it. Student can refuse the proposed evaluation and to withdraw. Once the result of an examination has been recorded, the examination cannot be repeated and the mark be can not be modified. In the first and in the second exam session must be set two examination dates, divided by at least three weeks; in the third, only a single date. If, in the first and/or in the second session, more than two dates are set, the period between the first and the last must last at least three weeks. Dates must be set at least with a 60 days notice. Each date must last long enough to allow all the students who have planned to sit for the examination in that date to do so. Provided that rules concerning attendance and propaedeutics are complied with, students can sit for an examination in any session, as from the session immediately following the end of the relevant course. A student who have failed an examination can repeat it in a subsequent date, after three or more weeks. There is no limit for the number of trials to pass an examination, but rules concerning propaedeutics, blocks, and credit obsolescence must be respected. For repeating students, as well as for sixth year students who have attended all the training activities planned by the curriculum, exam dates can be also set outside normal examination sessions. 10. Elective courses To be allowed to sit for the final examination, students must have spent 15 credits in attending training activities (elective courses) offered each year by the Board of Professors or submitted by the student to the approval of the Board of Professors. There are 4 different types of elective courses : - seminar courses, requiring additional study by the student; - experimental laboratory activities, requiring a a little time of additional study; - practical activities or experiences, requiring almost no additional study work; - internships in biological or clinical departments. 7 Electives courses require between 5 (0.2 credits) and 40 hours (1.6 credits), including personal study. Students can plan to spend as they like the 15 elective courses credits over the six years, but no more than 4.1 credits are acquired in each single year. 11. Programme of exchange Within the frame of European Union mobility programs (Socrates-Erasmus programme), students are allowed to spend at a University in a different EU country up to two terms, beginning from the second year. According to present rules, students willing to exploit this possibility must submit to the Socrates Commission of the course an application describing the work they are planning to perform at the foreign University (learning contract). Acceptance of the application is submitted to rules fixed by Socrates agreements. Training activities performed abroad are fully recognized as part of the curriculum and the corresponding credits are recognized according to the European Credit Transfer System (ECTS). Examinations passed at the foreign University are fully or partially recognized as if they were passed at the University of Milan. Marks recorded in different scales are transformed in the 0-30 scale according to the ECTS rules. Of course, during their stay abroad, students are exempted form attending training activities planned by the course in Milan. Remark: all the courses are taught in Italian: In future also English-language courses will be included into the programme. Italian language courses are organised (free of charge) for EU students in the Erasmus programme 12. Final examination To obtain the laurea specialistica, students, who have spent 270 credits in curricular courses, 15 credits in elective courses, 60 credits in professional training, for a total of 345 credits, must discuss a degree thesis To do it, students must have spent 15 credits in preparing thesis under the supervision of a tutor. Students interested in preparing their thesis in a Department or Institute of the Medical Faculty must submit to the Director of the Department or Institute a formal application including their curriculum. The Director, if working space is available, accepts the application and entrusts a teacher, possibly suggested by the student, with the responsibility of supervising him during the preparation of the thesis. This teacher, at the moment of the discussion of the thesis, will act as “Relatore”. Students planning to work for their thesis in non-University facilities must apply to the President of the Board of Professors, indicating where he is planning to work, the subject of the thesis, the name of the external tutor responsible of the supervision. This tutor, during the discussion of the thesis, will act as “Correlatore”. The President will entrust a Faculty member with the duty of supervising the work of the student and to act as “Relatore” when the thesis will be discussed. 13. Control of non-expiration of acquired credits Non-expiration of credits acquired by passing an examination must be verified nine years after they have been acquired. Non-obsolescence of acquired credits must therefore be verified in the following cases: a) students who have completed the attendance to all courses of the curriculum for more than three years; b) sixth-year students who have interrupted their enrolment for more than three academic years; c) sixth-year students who have been enrolled as repeating students for three or more years. Students can choose between two procedures for the control: a) an ad hoc Commission, including at least a teacher for each course of each term, globally verifies the non-expiration of the credits acquired with the courses of that term, on the basis of the examination programs set for the year which the control is performed in, possibly through a written examination; b) the normal examining commission for each of the examinations of a given term re-examins the students for the corresponding subject. 8 Corso di Laurea specialistica in Medical Biotechnology and Molecular Medicine 1. General description and aims The University course in Medical Biotechnology and Molecular Medicine is open to students who have been awarded the degree in Medical Biotechnology at the University of Milano or other degrees whose training plan is considered equivalent by the Faculty. The course lasts two years and provides for a total amount of 300 credits (CFU). The training plan provides for the acquisition of the essential theoretical knowledge of the relationship between function and structures of biomolecules and biosystems at cellular, tissue and whole body level in both physiologic and pathologic conditions; the comprehension of economic, ethic and forensic issues linked to medical biotechnology research. The course gives a basic knowledge of the main biotechnology tools and, the necessary biotechnological expertise that is acquired with a prolonged laboratory training. 2. Admission to the Corso di Laurea specialistica The number of students admitted to the course is planned each year depending by available teaching and laboratory resources. In the last years, this number has been fixed at 40 places for European Union citizens and foreigners resident in Italy, plus 5 places reserved to non European Union citizens non resident in Italy. Candidates are selected through an admission test, that usually takes place in October. The final admission will be based on the curriculum (20%) and on the admission test results (80%). 3. Teaching plan organization Academic activities begin on the first week of November. The teaching plan consists of a two common semesters and two semesters with teaching activities specific for each of four different curricula. Curricula include: Internal Medicine, Neurosciences, Oncology, Tissue Engineering and Transplants. Each semester is followed by an exam session, lasting approximately 6 weeks; a third session, of three weeks, takes place in September. During the first and the second session are set at least two exam dates. For the first and the third session, an additional date is set respectively, immediately after Easter and at the beginning of November, During the examination sessions, teaching activities can not take place. Since the beginning of the second semester, laboratory research activities will be personally performed by the students under the supervision of a tutor. Laboratory training is aimed at acquiring specific professional competences and to perform the experimental thesis to be discussed during the final exam. The choice of the laboratory will be performed on the basis of the programs proposed by laboratories participating to experimental training, cultural interests and curriculum studiorum of the student. 42 CFU will be provided over the whole period of this activity plus 6 CFU for the preparation and public discussion of experimental thesis. The organization of the courses of each semester is reported in the following tables. First Year-1st semester Course English Medical and molecular genetics Bioinformatics Cellular and Molecular Biology , Physiology and Pharmacology Morbid Anatomy Content Scientific English The course is organized in two modules. The topics covered by first module regard human genome organization (genes, pseudogenes, intervening sequences, duplications, repetitive sequences) and the regulation of gene expression in human cells. The second module regards the molecular mechanisms at the basis of Mendelian and complex human diseases and their diagnostic and counselling approaches. Informatics applied to biomedicine. This course is intended to introduce students to some of the many diverse and complementary paths by which modern cell scientists approach their research. The instructors will present current research from their own areas of expertise. Topics include: molecular structure and function of membranes, calcium imaging, patch-clamp techniques, optic, electronic and confocal microscopy and fluorescence techniques, cell fractionation, intracellular molecular trafficking, mechanisms of signal transduction and intracellular signalling, cell adhesion molecules and cell motility, polarity of the cells, genetics and genomics in development of new drugs. The course in Morbid Anatomy provides the general information pertaining a diagnostic CFU 3 5 2 6 1 9 laboratory of pathology and subsequently focuses on the modern application of biotechnology to human specimens. Specifically the course provides information on the use of human samples to obtain DNA and RNA suitable for the most common diagnostic technique. The course also provides basic information on mutation detection and gene expression evaluation, including modern quantitative techniques. Principles of storage and preservation of samples are discussed. Laboratory Practice Course Total CFU Laboratory practice of the fundamental biotechniques. 11 28 First Year-2nd semester Course Content CFU Physiopathology: from the cell to the clinics Molecular and cellular mechanisms at the basis of human pathologies. 5 Immunology The course on Immunology covers a selection of arguments of both innate and acquired immunity. Students are expected are requested to integrate basic notions on immunology on selected topics of fore front research activity. Arguments include pathogen recognition and killing, soluble mediators, antigen processing and presentation, lymphocyte activation and polarization, tumor immunology. A particular attention is dedicated to molecular and cellular aspects, as well as to methods and technologies of relevance. Reference to clinical implications is also provided. 2 Gene therapy and use of “biological” drugs for therapy 3 Management of a research laboratory Ethic principles of biotechnology applied to humans 2 2 Training in a research laboratory 18 Elements of gene and cell therapy and clinical pharmacology Management Bioethics Laboratory research training Total CFU 32 Second Year Common activities for all curricula Activity Content CFU Cellular Models Course of Experimental models in biotechnology The cell culture model: advantages, directions (instructions) and limits Primary cultures, cellular lines and immortalized cells Examples of cellular models Techniques to maintain cell cultures Techniques to check-up cell cultures Cell banks Animal Models Introduction to the animal models: drosophyla, zebrafish, xenopus, mouse Characteristics, advantages and disadvantages Stem cells ES: embryologic origin and potentiality Molecular strategies for genetic modification in knock-out mouse: Knock-in, Conditional knock-out; Transgenesis; ENU mutagenesis; Gene-trap. Animal models for pathology 2 Course of Technologies Basics of optics Electromagnetic spectrum. Atomic structure. Interaction of radiation with matter. Lenses (converging and diverging). The formation of images. Polarization. Detectors. CCD. Introduction to optical microscopy Objective and ocular. Numerical aperture. The condenser. Illumination techniques (bright field, dark field). Transmission microscopy. Phase contrast microscopy. Confocal microscopy. Manipulation techniques. Fluorescence techniques. Fluorescence and phosphorescence. Epifluorescence microscopy. Time resolved fluorescence techniques. FRET. Physical techniques for the measurement of ligand-receptor interactions 3 Physical 10 Evanescent-wave techniques: TIRF, surface plasmon resonance. TIRF microscopy Courses chosen by the students among different proposals offered each year by the Board of Professors or directly proposed by the student (by previous agreement of the Board of Professors). Electives Laboratory training Final exam Total CFU research 3 Training in a research laboratory 31 Thesis preparation and public discussion 6 60 Curriculum Neurosciences –1st semester Course Neurobiology Neural networks and artificial intelligence Psychology and Psychobiology Total CFU Content The course of Neurobiology is intended to offer an integrated view of the nervous system, from the cellular and molecular basis of neural excitability and synaptic transmission to the complex hierarchical organization of the brain. The molecular understanding at the cellular level is integrated to higher brain functions such as mechanisms of sensory perception, reflexes and motor function, learning, memory, and biorhythms. Students will be introduced to the insights, methods, and questions specific to the particular areas of research. Historical notes on the development of neural networks models and artificial intelligence concepts. Neuronal Models. Neural Netwoks Models. Learning by examples: the perceptron and the multilayer perceptron. Some applications The basis of experimental psychology and of behaviour CFU 5 1 1 7 Curriculum Neurosciences –2ndsemester Course Neuropsychopathology Imaging Diagnostics Biotechnological diagnostics Neuropsychopharmacolog y Total CFU Content Nervous system disease; psychiatric disease; genetic base of psychiatric disease. Modern techniques for in vivo non invasive imaging of human brain and methods for the preparation of biotechnology tools for imaging CFU 3 Application of biotechnology to the diagnosis of genetic and non genetic nervous pathologies 1 Mechanism of action of chemical and biotechnological drugs affecting the nervous system and their behavioural effects 3 1 8 Curriculum Internal Medicine –1st semester Course Molecular Epidemiology Biotechnological diagnostics I Total CFU Content The primary goal of the course is to introduce participants to the concepts and methods of molecular epidemiology that are relevant to studying the causes of complex human diseases. Class topics include: the theoretical advantages of biomarkers, criteria for evaluating potential markers, sample collection and storage, laboratory quality control considerations, issues in epidemiologic study design and analysis, and ethical/legal concerns. Basis of genetic epidemiology, including concepts of quantitative and qualitative traits, Hardy-Weinberg equilibrium and linkage disequilibrium, genetic risk models, methods for haplotype estimation. Study designs and methods will be illustrated with examples derived primarily from research and applications on cancer, infectious diseases, forensic medicine, and environmental health. CFU 3 Introduction and overview of forensic sciences. Basic concepts of the law of criminal procedure and rules of evidence as applied to forensic biology. Basic knowledge of proper collecting, and preserving physical evidence at the scene of crime. Genetic marker analysis and their applicability to forensic science. Evaluation of current developments in laboratory technology utilised to identify, analyse, and compare evidence in criminal, paternity testing and remains identification cases. Diagnostic setting of single disease and molecular diagnostics laboratory 5 8 11 Curriculum Internal Medicine –2nd semester Course Biotechnological diagnostics II Biotechnological therapy Total CFU Content Cytogenetic diagnostics and gene data banks management Gene therapy and biotechnology in fertility CFU 2,5 4,5 7 Curriculum Oncology –1st semester Course The neoplastic cell Epidemiology, prevention and statistics applied to oncology Tumor etiopathogenesis Diagnosis of cancer Content The cellular and molecular characteristic of neoplastic cells. Stem cells as target of tumor transformation. Analogy between stem cell and cancer cell. Tumor stem cells. Signaling pathways playing a role in development and deregulated in cancer: the hematopoietic system as example. Features of the tumor cell: genomic instability, genomic check point, DNA damage signaling and repair, telomeres, ploidy and cell fusion control, mitotic catastrophe); Cooperation between genomic instability and apoptosis resistance; anomalies in chromatin structure (methylation and acetylation). CFU 1 1 Genetics and cancer. Tumor agents. Viruses and cancer. Tumor immunology. The course is divided in three main fields: -radiochemistry of radiopharmaceuticals and the use of radiolabeled compounds and imaging techniques in the diagnosis, staging, follow-up and the study of tumors -circulating tumor markers: measurement, analysis, reliability and interpretation. -evaluation and study of minimal residual disease in onco-hematology (cytometry, molecular biology) and clinical application. Total CFU 3 2 7 Curriculum Oncology –2nd semester Course Elements of oncological treatment Innovative therapies in oncology Total CFU Content Elements of Surgical Oncology: clinical and surgical staging in oncology; choosing the surgical strategy after multidisciplinary evaluation; surgical aspects of primary and secondary prevention in Oncology; biotechnology application in Surgical Oncology. Elements of Radiotherapy in Oncology: radiosensitivity and radioresistance (definition and clinical impact); radiosensitivity modified through physics and chemistry (importance of combined treatments); dose fractionation (elements and impact on clinical practice); identifying target volumes through morphological and functional imaging; an optimal dose distribution can increase local control and / or reduce complications. Elements of Radiobiology and the use of radiodrugs: the treatment of thyroid disease; the treatment of bone metastases; cancer treatment with targeted radiotherapy; the treatment of lymphomas with radiolabelled monoclonal antibodies. Elements of Chemotherapy and pharmacological Targets: experimental drugs; toxicity of antiblastic drugs; drug resistance; chemotherapeutic drugs; biological treatments; genomic treatments; antiangiogenetic and antikinasic treatments. Palliative Care in Oncology: palliative care and pain treatment in advanced patients; biotechnological implications for palliative care. Selective chemotherapeutics, Hormone-therapy, biotherapy, Gene Therapy, Bone marrow Transplantation. CFU 4,5 3,5 8 Curriculum Engineering and Transplants –1st semester Course Immunolgy of organ transplantation Biological and clinical principles of organ injury and failure Content HLA locus, molecular mechanisms of graft rejection, pharmacologic immunosuppression of organ transplantation. Gross anatomy, structure and development of: heart, liver and kidney The pathological aspects of the complex scenario of organs failure are the math of debate of the other part of the course. Three main themes are developed: hearth failure, liver failure and kidney failure. These were chosen in order to facilitate the comprehension of the problem of organ transplantation, CFU 3 3 12 Experimental models of transplant In vitro mammalian cell culture Total CFU which, for these examples, is a concrete and real possibility. Among these issues the main disease are considered: left and right hearth failure, ischemic cardiopathy, valvular disease, liver cirrhosis, liver neoplasms and kidney cystic disease. Animal models of allotransplantation, xenotransplantation, bio-artificial and bio-mimetic structures, animal models of cell grafting, transgenic animals. Embryonal cells, somatic cells, pluripotent cells, differentiated cells. 2, 2 10 Curriculum Engineering and Transplants –2nd semester Course Legal principles and bioethics in transplantology and tissue engineering Stem cell manipulation and transplantation Tissue engineering Total CFU Content CFU Legislation of organ transplantation, bioethics of transplantology and tissue engineering, industrial features of transplantology and tissue engineering, legislation of animal experimentation. 1,5 Stem cells are increasingly used in human medicine. The main expectation is that targeted manipulation of these precursor cells will result in an efficient and reliable production of tissuespecific cells, which can be safely employed for therapeutic purposes. Main topics of this course are: Manipulation and in vitro culture of keratinocytes, chondrocytes and bone cells. Techniques developed to engineer the hematopoietic stem cell graft: these techniques include the removal of cells which cause graft-versus-host disease, the eradication of cells which might cause relapse, the expansion of donor cells when there is an inadequate cell dose, and the addition of selected cells to improve graft function. Source of mesenchymal stem cells for experimental and clinical applications as well as for tissue engineering. Dendritic cell generation for clinical application. Principles of gene-therapy Use of hematopoietic stem cells as therapeutic modalities for neurodegenerative diseases and the expanding role of stem cell transplants in cardiology. Organization of a “Cell-factory” Biocompatible and bioactive material; informatic models and scaffolds; management of a tissue engineering laboratory. 3,5 3 8 4. Compulsory attendance To be admitted to the corresponding examination, students must have attended at least 75% of formal and non formal teaching planned for each course. In case of courses spread over several terms, this provision applies to each term separately. Students who have not complied with the obligation of attendance, are automatically enrolled as repeating students for the following academic year. 5. Examinations Each course of the curriculum is followed by a single examination, which the student is individually evaluated in. Marks range is between 0 and 30, with laude. Examinations take place in periods free from other teaching activities (examination sessions). According to choices of the examining commissions, examinations may include written parts (quiz, questions with open answer) and/or oral colloquies. Examination dates must be set at least with a 60 days notice. Each date must last long enough to allow all the students who have planned to sit for the examination in that date to do so. 6. Programme of exchange Within the frame of European Union mobility programs (Socrates-Erasmus programme), students are allowed to spend a period at a University in a different EU country. According to present rules, students willing to exploit this possibility must submit to the Socrates Commission of the Faculty an application describing the work they are planning to perform at the foreign University (learning contract). Acceptance of the application is submitted to rules fixed by Socrates agreements. Training activities performed abroad are fully recognized as part of the curriculum and the corresponding credits are recognized according to the European Credit Transfer System (ECTS). Examinations passed at the foreign 13 University are fully or partially recognized as if they were passed at the University of Milan. Marks recorded in different scales are transformed in the 0-30 scale according to the ECTS rules. During their stay abroad, students are exempted from attending training activities planned by the course in Milan. Remark: all the courses are taught in Italian. In future also English-language courses will be included into the programme. Italian language courses are organised (free of charge) for EU students in the Erasmus programme 14 The Medical Faculty 3 year courses Courses Area of direct care Nursing Midwifery Area of rehabilitation Logopedy Occupational therapy* Orthoptic and opthalmological assistance Physiotherapy Podology Health and rehabilitation education Psychiatric rehabilitation students per year classes hospitals 535 50 10 2 10 2 25 30 15 1 1 1 1 1 1 90 20 50 3 1 1 3 1 - 25 1 1 * the sole Italian University course recognized by the Word Occupational Therapy Organisation Area of technical support Audiometry Audioprosthesis Cardiovascular reperfusion Dental hygiene Dietetics Laboratory tecnhicians Neurophysiopathology Radiology Area of prevention Health assistance Prevention in working places and enviroments 15 15 15 30 30 45 15 30 1 1 1 1 1 1 1 1 1 1 1 3 3 1 1 25 1 - 25 1 - 15 Medical Biotechnology 80 1 - 16