OXBRIDGE MEDICINE

Course structure
Pre-clinical
Yea
r
Cambridge Oxford
1
Body organization
Physiology
Pharmacology
Biochemistry
Medical genetics
Body organization
Homeostasis
Molecules in medical
science
Cell biology and scientific
basis of medicine
2
Integratie body
systems
!erous system
Pathology and
microbiology
Medical "sychology
Biology of disease
Mechanism of drug action
!eurobiology and human
behaior
Human re"roduction
#
!euroscience
$enes and
deelo"ment
Molecular medicine
Cardioascular
"hysiology
%es"iratory
"hysiology
Infection and immunity
&ignaling in health
and disease
Pathology
Physiology
History and ethics
'lectie sub(ects
Molecular cell biology
The Molecular Cell Biology (MCB) course concentrates on:
The integration of biological systems (systems biology)
Techniques used to study molecular and classical genetics, cell biology, metabolic pathways
and the assembly of macromolecules and their complexes
The role of nucleic acids as information sources to direct cellular processes either directly
or in future generations.
Cellular energetics
Metabolic pathways and inter-conversions of molecules within system
Principles of inter and intra cellular communication
to introduce students to the concepts of "life", its evolution and the basic building blocs of
living organisms!
to explore the rise of multi-cellularity and need for cells to communicate
to consider the "# structure of the cell and its nucleus in the context of inter- and intracellular
communication.
to introduce the basic components and biochemistry of signaling pathways
to outline the examples of signaling pathways form transmembrane receptors to genes in the
nucleus
Books recommended:
Biochemistry Berg, Stryer ( Freeman)
Biochemistry Voet, D. and Voet, (John Wiley & Sons).
Biochemistry and Molecular Biology Elliott (!"ord #ni$ersity %ress).
Molecular &ell Biology ('odish, Freeman.
Molecular Biology o" the &ell (l)erts. *arland
+e!t)oo, o" Biochemistry -ith &linical &orrelations .De$lin
Essential &ell Biology (l)erts. *arland.
.ntroduction to *enetic (nalysis *ri""iths. Freeman.
*enes /. 'e-in. Jones and Bartlett.
Modern *enetic analysis 0 *ri""iths, *el)art, 'e-ontin, Miller
1uman Molecular *enetics 0 Strachan & 2ead.
*enetics, (nalysis o" *enes and *enomes (3th Edition) (4556) 1artl and Jones, Jones
and Bartlett
'ehninger %rinci7les o" Biochemistry (8th Edition) (4559). :elson & &o! (Freeman)
Functional Biochemistry in 1ealth and Disease (45;5). 'each. (John Wiley & Sons).
Meta)olism at a *lance (;<<6). Sal-ay, J. *. (Blac,-ell Scienti"ic).
Bioenergetics at a *lance (;<<8) 1arris, D.(. (Blac,-ell Scienti"ic)
M&B0 cell biology 'ecture contents=
$. Life begins with cells (proaryote and euaryote differences)
%. Cell compartmentalization (importance &hy it is not a bag of molecules but can have
specialised functions and channels of communication with each other)
!" Cell organization and mo#ement
$" Modes of cell di#ision
%" &ntegrating cells into tissues
'" (pecialized cells"
'. Multicellularity and communication (Pros and cons of multicellularity. (oing from single cells to
multiple cells during evolution and during embryonic development. The conservation of molecules
and processes. The need for inter- and intracellular communication for physiological and genetic
responses. )ontrol of cell division and differentiation. Pathologies associated with abberant
communication e.g. cancer, inflammation, diabetes, etc.)
*. Cell structure and compartmentalisation in )u*aryotic cells (The membrane as a barrier.
+imple treatment of different models for membrane structure. Topological considerations,
cytoplasmic surfaces and luminal-outer surfaces. Transcription and translation and insertion of
membrane proteins in the endoplasmic reticulum and passage to cell surface. .ndocytosis.)
/. +iochemistry of receptors and intracellular signal transduction ((i) 0inases, Phosphate from
1TP transferred to proteins and to lipids. Protein an dlipid phosphorylation as a principle means of
intracellular communication. Phosphorlyation of serine, theonine, and tyrosine residues.
)onservation of inases. 2ore recent evolution of tyrosine inases associated with multicellularity
and development. &hat phosphorylation does, alters conformation and forms binding sites for other
proteins.(ii) 1denyl cyclases, c12P from 1TP
(iii) 1TPases and (TPases, Phosphate from 1TP liberated to perform wor e.g. ion transport.
+odium-potassium 1TPase.)
$3. ,eceptor acti#ation and coupling with intracellular signalling cascades e#ents at the
membrane (.xtracellular ligands and cell surface receptors! subtypes, synthesis, insertion,
orientation, receptor tyrosine inases and how they function. #iscovery of src tyrosine inase,
4omology domians +4$, %, " etc. 5eceptor activation and coupling to intracellular signalling events
via protein-protein interaction )
$$. (tructure of the nucleus and the nuclear membrane ()ompartmentalisation within the nucleus.
6asic structure of a euaryotic gene and upstream elements, transcription and processing. (enes
are controlled through regulatory cascades, many involving protein phosphorylation. Programmes
and adaptive gene regulation. Primary and secondary responses.)
$%. (ignalling across membranes to specific genes" ()onnecting receptors at the cell membrane to
genes in the nucleus, examples of the types of mechanisms involved in signalling to and controlling
genes. )onservation of basic mechanisms from yeast to higher organisms. Translocation of inases
and-or transcription factors into the nucleus.
M&B0genetics 'ecture contents=
Classical and molecular genetics
$. -./ and gene function (.xperimental evidence that identified #71 as the genetic material.
4ow structure of #71 helps to explain how it is able to encode genetic information, replicate
and engage in recombination.)
%. -./ replication (2eselson-+tahl experiment demonstrating the semi-conservative replication
of #71. Properties of #71 polymerases. 8rgani9ation of the replication for : 8a9ai
fragments. 8ther proteins involved in #71 replication, e.g. #71 helicase, primase,
topoisomerase. 5eplication origins and their organi9ation in proaryotic and euaryotic
genomes. ;ses of #71 polymerases in the P)5 techni<ue.)
". 0enetic analysis in bacteria (.vidence for recombination in bacteria. = plasmid and
con>ugation. ?ntegration of = episome and properties of 4fr strains. ?nterrupted mating
experiment. =@ plasmids and sexduction. Aysogenic mode of phage lambda infection and
speciali9ed transduction. ;ses of plasmids and phage genomes in recombinant #71
technology. 5estriction en9ymes and #71 ligase. (ene libraries.)
B. 1sing mutations to analyze genes (Ceasts (+accharomyces cerevisiae and
+chi9osaccharomyces pombe) as examples of genetically amenable organisms. ?solating
mutants. #esigning mutant screens. 1nalysis of yeast mutants by complementation analysis.
;sing meiotic recombination in yeast to map gene locations. ?solation of yeast genes by
transforming yeast mutants with gene libraries and selecting by complementation.)
D. 0enetic code (4ow genetic code was deciphered. ?nsight from genetic experiments. ;se of in
vitro system for protein synthesis with synthetic m571s. Triplet binding assay. 6asic features of
genetic code table. 7onsense mutations and their suppression. Third-position wobble and ability
of single t571s to decode more than one codon. #eviations from the EuniversalE genetic code.)
F. Transcription and protein synthesis (2echanism of transcription. Promoter and terminator
sites. +ubunit structure of 571 polymerase. =actors needed for translation. 5ibosome structure.
t571 charging by aminoacyl t571 synthetases. +teps in protein synthesis, initiation, elongation
and termination.)
'. 0ene regulation in bacteria the lac operon (8verview of gene regulatory mechanisms.
=eatures of transcription regulation in bacteria. Aac operon model. (enetic evidence for
repressor and operator. (enetic and biochemical evidence for lac operon model. 5egulation of
lac operon by )1P.)
*. )u*aryotic genome organization ((enome organisation. &e now have a large amount of
whole genome se<uence data to analyse. This is a revolution in biological nowledge, and we
are now maing spectacular advances in our understanding of how genomes wor. The ma>or
point of this lecture is to emphasi9e the amount of #71 in genomes which does not code for
proteins. &hat does it doGor is it really >ust >un #71H)
/. Transcriptional regulation in eu*aroytes (Transcriptional regulation in euaryotes. 1ll the
cells in our body contain the same #71, but do not express the same proteins. 8f crucial
importance in biology is the fact that genes can be switched on and off. ?n euaryotes, the basal
transcriptional machinery, 571 pol ?? and its associates cannot usually activate transcription on
its own. Transcription factors are re<uired to activate (or repress) genes with due regard to time
and space. 4ow the pacaging of #71 itself plays crucial roles in regulating transcription)
23" Chromatin structure and gene e4pression
$$. 5ost-transcriptional regulation in eu*aryotes (Post-transcriptional regulation in euaryotes.
.ven after the decision has been made to initiate transcription of a particular gene, there are
many different mechanisms by which gene expression can be controlled, and we will survey
these in the order they may happen, with regard to specific examples. +uch mechanisms
include anti-termination mechanisms, controls acting over m571 processing and export to the
cytoplasm, controls over m571 stability and localisation, and finally regulation of translation)
$%. )4tra-chromosomal genetics in eu*aryotes (#id you now that organelles such as
mitochondria and chloroplasts have genomes of their own, separate from the nuclear genome
of a cellH &hat sort of #71 is in these genomesH &hat proteins are encoded by organelle
genomesH 4ow are these genomes transmitted when a cell divides or an organism reproducesH
1nd what was the origin of these organellesH)
$". ,ecombinant -./ & 0ene isolation (6asic methods of #71 manipulation. 4ow #71 can be
cleaved at specific sites and how cut #71 can be re>oined. 4ow genes can be isolated through
conventional library construction and screening. )onstruction of both c#71 and genomic
libaries. #71 amplification by the polymerase chain reaction (P)5).)
$B. ,ecombinant -./ && Characterization of cloned genes (?n this lecture we will examine how
cloned #71 is used to determine gene se<uence data and to determine gene copy number in
the genome. &e will also investigate how cloned genes can be used to analy9e both m571 and
protein accumulation patterns within an organism.)
2%" ,ecombinant -./ &&& genome sequencing programs
$F. ,ecombinant -./ &6 &ntroduction to +ioinformatics (6ioinformatics involves the computer-
based analysis of ever expanding biological datasets. ?t incorporates database development for
the storage and user-guided retrieval of data, and the development of statistical tools and
computer algorithms that analyse and determine the relationships between biological datasets.)
$'. The structure and function of #71, and its role in transmitting genetic information! #71
replication! mutations and their use in analysing genes! simple microbial genetics and gene
regulation! gene structure and regulation in euaryotic organisms! some aspects of genetic
engineering including #71 se<uencing and genome analysis.

M&B0metabolism 'ecture contents=
The aims of this course are to explain:
the principles of metabolic pathways;
the inter-relationship between the various pathways;
the mechanism of regulation of pathways.
how foods are broken down to produce energy;
how the degradation and synthesis of glycogen is regulated;
the breakdown of glucose and other monsaccharides;
the experiments that led to the discovery of the citric acid cycle and its functions;
the regulation of the synthesis and degradation of fatty acids and ketone bodies;
how amino acids are degraded and urea produced.
1. Metabolic pathways. Definition/nature of a metabolic pathway. Principal chemical
reactions (hydrations/dehydrations, condensations, redox reactions). G
o
and G
changes in pathways. Stepwise nature of catabolism/anabolism.
2. Glycolysis. The pathway of anaerobic glycolysis from glucose/glycogen and its role in
ATP generation in muscle. Regulatory aspects of glycolysis regulation of phospho-
fructokinase in heart muscle. The fate of glycolytic NADH.
3. Aerobic breakdown of glucose. Oxidation of pyruvate. Tricarboxylic acid
cycle. Evidence for TCA cycle. Generation of reduced NAD and FAD. Importance of
decarboxylation reactions, and their energetics.
4. Oxidative phosphorylation (1) Oxidation of NADH, succinate and fatty acids by the
respiratory chain. Redox potentials and biological electron carriers. Ubiquinone as
mobile electron carrier. Oxidation of cytoplasmic NADH. Generation of proton
electrochemical gradient by respiratory chain, and use of this by ATP
synthase. Coupling of electron transfer to ATP synthesis. P/O ratios. Uncoupling in
mitochondria artificial uncouplers and possible physiological role.
5. Breakdown of fats. Digestion of triglyceride. Lipoproteins & transfer of fatty acids
around the body. Transfer of fatty acids into the mitochondrion. oxidation of fatty
acids to acetyl CoA. Degradation of odd chain length fatty acids and unsaturated fatty
acids. Lipidaemias.
6. Fat synthesis. Synthesis of fatty acids from acetyl CoA. Role of malonyl CoA. The
fatty acid synthase complex. Role of compartmentation in
biosynthesis/degradation. Synthesis of triglyceride in adipose tissue.
7. Generation of reducing equivalents NADH and NADPH different roles and
compartmentation. Generation of cytoplasmic NADPH pentose phosphate pathway
& malate-pyruvate system. Redox state of cytoplasm and mitochondrion role of
glutathione.
8. Amino acid metabolism Principles of amino acid degradation in
mammals. Transamination and glutamate dehydrogenase. Ornithine cycle. Urea
and excretion of nitrogen. Roles of folic acid derivatives. Amino acid metabolism and
breakdown of keto acids derived from transamination
9. Glycogenolysis Glycogen structure. Glycogen breakdown and its link to
glycolysis. Glycogen synthesis. Coordinate regulation of glycolysis with glycogen
breakdown and synthesis. Role of hormonal regulation. Roles of muscle and liver
glycogen. Glycogen storage diseases.
10. Gluconeogenesis. Synthesis of glucose in the liver. Source of carbon
skeletons. Synthetic and degradative pathways in same cell compartment futile
cycles. Inability of animals to convert acetate to glucose. The glyoxylate cycle in
plants and bacteria.
11. Integration of metabolism Muscle, liver and adipose tissue in energy storage and
utilisation. Hormonal and other regulation. Maintenance of blood glucose. Formation
of ketone bodies in starvation. Metabolism of fructose, galactose and mannose in the
liver.
12. Photosynthesis Photochemical reaction centres. Generation of oxygen and reducing
power. Chemiosmotic generation of ATP in chloroplasts.The dark reactions of
photosynthesis. Rubisco. The Calvin cycle and relationship to Pentose Phosphate
Pathway. C4 pathways.
HARVARD MEDICAL SCHOOL - Course Requirements
1. Biology
The required 1-year biology course should be devoted to genetics and cell biology and should
emphasize human biology (signal transduction, basic pharmacologic principles,
homeostasis and feedback, an introduction to hormone receptors, neuronal
signaling, and immunology). Because biology is the most elegant expression of chemistry, physics, and
mathematics, computational skills that tie these previously separate disciplines together should be emphasized.
The focus on genetics should include nucleic acid structure and function, genetic recombination, and
mechanisms of gene expression in eukaryotic and prokaryotic cells, the study of cell biology should include
subcellular organization, differentiation, cellular metabolic function, energy transfer, structure-function
relationships, reproduction, and membrane properties. Preparation in biology should place more of an
emphasis on human biology and on principles of systems biology.
2. Chemistry
Students should be exposed to general chemistry, organic chemistry, and biochemistry especially
protein structure and function).
physical and inorganic chemistry such as bonding, molecular structure, chemical reactivity, equilibrium,
energetics, and thermodynamics. 3. Physics
In the area of physics, students should be well prepared in biologically relevant areas of mechanics, kinetics,
thermodynamics, the properties of matter (quantum theory) and wave theory, electricity and magnetism,
and optics.
4. Laboratory Experience-hypothesis driven exercises
5. Computational Skills/Mathematics
Computational skills are required for contemporary scientific literacy. Although the calculus of derivatives
and integration represents important concepts for the precise, quantifiable understanding of
dynamic physiological processes and systems, , given the importance of statistics for
understanding the literature of science and medicine,
6. Analytical and writing skills/Expository Writing
Creative, complex, and compelling discoveries in medicine, as in other fields,
involve grappling with good questions borne from close-reading analyses and
careful observations. analytical and advanced expository writing
skills Specific skills students may be expected to master and apply to the fields of medicine and scientific
inquiry include the following:
a. Writing logically and with clarity and style about important questions across disciplines.
b. Articulating persuasively, both on paper and in oral presentations, focused, sophisticated, and credible thesis
arguments.
c. Appreciating the methodologies that particular disciplines apply for understanding and communicating results
effectively.
d. Approaching evidence with probity and intellectual independence.
e. Using source material appropriately with scrupulous and rigorous attribution.
8. Additional Requirements for the HST Program
In addition to all the above requirements, the HST curriculum requires that students be comfortable with upper-
level mathematics (through differential equations and linear algebra),
biochemistry, and molecular biology. This is usually demonstrated through upper level course
work, but other approaches may satisfy these requirements. In addition, one year of calculus-
based physics in college is required.
Other Recommendations
extracurricular experiences and activities that prepare candidates to understand
human behavior, to appreciate societal structure and function, and to achieve cultural awareness provide valuable
preparation for the study and practice medicine. Courses in literature, languages, the arts, humanities, and the
social sciences (e.g., psychology, sociology, anthropology, and ethics) are encouraged. Honors
courses and independent study or research are encouraged, because they permit a student to explore an area
of knowledge in depth and provide a scholarly experience that will facilitate a lifelong habit of self-education.
)undamentals of Medicine Course %e*uirements
Year I
I!+,1-. /he Molecular and Cellular Basis of Medicine
I!+,,-. Human $enetics
I!+,2-. Integrated Human Physiology
Year II
I!+,+-. Human &ystems
I!+#1-. Human 0eelo"ment
P&+..M-1 Psycho"athology 2 Introduction to Clinical Psychiatry
Year I
H/.1. Human 3natomy
H/.#. Pathology
H/14. Molecular Biology and $enetics
H/1+, Immunology
H/154 Human Biochemistry and Metabolic 0iseases
H/16. Introduction Biostatistics and '"idemiology
H/.4. 'ndocrinology
H/.6. Cardioascular Patho"hysiology
H/1.. %es"iratory Patho"hysiology
H/11. %enal Patho"hysiology
&ocial Medicine
Year II
H/.5. Mechanisms of Microbial Pathogenesis
H/.+. Human %e"roductie Biology
H/12. $astroenterology
H/1#. Introduction to !eurosciences
H/.2. Musculos7eletal Patho"hysiology
H/.8. Hematology
H/1,. Princi"les of Pharmacology
First Year
Anatomy: Human Anatomy and Development
Biochemistry*
Biological Basis of Behavior
Cell Biology: Cell Biology and Histology*
Child and Adolescent Development
Genetics: Human Genetics
History of Medicine
Immunobiology eurobiology: !tructural and "unctional #rgani$ation of the Human ervous
!ystem
%hysiology: Medical %hysiology*
%athology: %athological Basis of Human Disease
Second Year
focuses on abnormal human biology&
CAM: Complimentary and Alternative Medicine: 'hat %hysicians eed to (no)
*pidemiology + %ublic Health
History of Medicine
Microbiology: Medical Microbiology and Infectious Diseases
%athology: %athological Basis of Human Disease , -utorials
%harmacology: Mechanisms of Drug Action
Mechanisms of Disease Course: #rgans.!ystems /a0a 1-he Modules23:
o Cardiovascular Module
o Clinical eurosciences Module
o Clinical !cience of %sychiatry Module
o Dermatology Module
o Digestive Diseases Module
o *ndocrine Module
o Hematology Module
o Musculo,!0eletal !ystem Module
o #ncology Module
o #phthalmology Module
o 4enal Module
o 4eproductive Medicine Module
o 4espiratory Module
0%9$ 0I&CO:'%Y
C3!C'% BIO;O$Y
P3/HO;O$Y
IMM9!O;$Y
!'9%O;O$Y
0':';OPM'!/3; BIO;O$Y
PHY&IO;O$Y 3!0 3!3/OMY
Know the fundamental principles:
Governing the assembly and function of macromolecules.
Underlying gene expression in bacteria and eukaryotes.
Of cell physiology and histology.
Of human metabolism.
Of genetics.
Underlying pharmacology.
Of pathobiology.
Begin to make the connections between basic scientific
information and clinical medicine.