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The curriculum is structured to ensure all graduates meet the eleven educational goals outlined in the Johns Hopkins University School of Medicine's Mission and Medical Education Program Objectives. The standard M.D. program spans four academic years, labeled First through Fourth Years. Students may combine these requirements with graduate studies to earn a Master's or Ph.D. degree. Our Genes to Society curriculum features deep vertical and horizontal integration across all four years. Elective opportunities start in Quarter 4 of the Second Year, with course details available in departmental listings under Departments and Divisions, Centers, Institutes, and Subjects of Instruction. An annually updated elective book provides additional information. Exceptional students may pause their standard studies for one or more years to pursue specialized research. First Year students begin with four months of Foundations courses: Foundations of Human Anatomy, Scientific Foundations, Clinical Foundations, and Foundations in Public Health (covering Epidemiology, Ethics, and the Health Care System). These introduce core biomedical concepts including molecular biology, cell biology, biochemistry, anatomy, and social/behavioral sciences. Clinical Foundations initiates training in medical interviewing, physical diagnostics, and clinical reasoning. Upon enrollment, each student receives a college advisor (see Student Advising, page 77) who teaches Clinical Foundations and provides ongoing academic and career guidance throughout the program.