Components Of Internal Medicine Clerkship

Clinical Assignments

Students are assigned to a clinical site 3 times for two week rotations 12-week clerkship. Specific expectations at each site (attending, rounds, call schedule, etc.) will be outlined on the first day. (see separate note in folder re. computer orientation at the VA).

Patient Care

Third year students should carry 2 -4 (no more than 5) patients at a time. Students should follow closely all aspects of each patient's care, and should be up-to-date on the patient's clinical status, lab data, medications, etc. For ambulatory rotations, patient care responsibilities will vary according to the site and preceptor(s).

Student Call

Students will follow call schedule of their team. Students are not expected to take call during the last week of the clerkship (Monday through Friday).

Attending Rounds

The attending physician should meet with the students alone a minimum of twice per week, and will meet with the entire team at least three times a week. Students may be asked to present cases, prepare presentations on specific topics, and are expected to participate actively in discussions.

Patient Write-ups and SOAP Notes

Each student is required to submit 1 complete write-up for evaluation by the end of the clerkship and a portfolio of a minimum of twelve (maximum of 24) team assessed write-ups and SOAP notes comprised of six H&Ps and six SOAPs; six must be assessed by the attending, and six by the residents. However, the more you turn in, the better because it shows the assessors how hard you are working and could have a favorable effect on your overall, final write-up grade.

Lectures/Conferences

A limited amount of lectures will be given by the Clerkship Director on Tuesdays from 1:00 pm to 3:00 pm, see schedule for details. The House Staff lecture series (12:15 WSK 103) and Departmental Grand Rounds (Thursdays, 7:15 am, WSK Alumni Auditorium) are also highly recommended.

Chief Resident Sessions

Outpatient students will meet with one of the three Medicine Chief Residents on Thursday at 10:00 am - these sessions will most focus on ECG interpretation and understanding. Also to note - VA inpatient students will meet with the VA Chief Resident on Wednesdays at 2:00 pm.

Interdisciplinary Courses

Bioethics are covered during the Internal Medicine clerkship, as part of a medical school-wide curriculum. Bioethics is a separate course, which is held throughout the school year on a monthly basis. You will follow your Bioethics schedule for dates/times/locations of these classes, which will take precedence over the Internal Medicine clerkship.

Evaluation

Final grades are determined by the departmental grades committee, and include clinical evaluations by faculty and house officers (25%), performance on the final written exam (25%), quality of write-ups (20%), ECG quiz (10%). Submission of all required write-ups, satisfactory clinical performance, and a passing score on write-ups and the written exam are required to pass. For a grade of Honors, performance should be outstanding in all areas of evaluation and test score must be at or above the five-year class mean. For a grade of High Pass, performance must be superior in all areas of evaluation and test score must be at or above 67. Test score must be 62, to earn a grade of Pass. Each component of the course must be successfully completed in order to pass the clerkship. In accordance with College of Medicine requirements, the Internal Medicine clerkship aims to assign approximately 15-20% Honors, another 20-25% High Pass (for no more than 40% Honors and High Pass grades), and 60-65% Pass grades over the course of an academic year.

Ongoing Feedback/Support

Students should initiate a meeting for feedback with the attending physician and the senior resident halfway through, and again near the end of, each four-week rotation. The clerkship director(s) will meet with each student mid-way through the clerkship to discuss any aspect of grading/evaluation a student wishes to cover. There is a mid-rotation practice exam (does not count toward final grade) designed to give students an idea what format the test will take, to allow them to assess their knowledge base, and to plan study strategy for the rest of clerkship.