Components Of Internal Medicine Clerkship

Clinical assignments

Students are assigned to a clinical site for each month of the 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). Each student will be assigned to one month of ambulatory medicine.

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

Each student is required to submit 3 complete write-ups for evaluation by the end of the clerkship. For details of this requirement: See the document entitled "Required Write-ups Internal Medicine Clerkship".

Write-up Workshop

Students will be REQUIRED to attend a small-group session with a member of the Grades Committee during the third full week of the clerkship. A write-up must be submitted for review by the Grades Committee member one week prior to this session. In the small group session, the Grades Committee member will return the graded write-ups to individual students, offer "tips for success" in doing write-ups, provide general feedback about the write-ups he/she reviewed, and answer individual student questions about write-ups.

Reading

In order to complement daily patient care experiences, it is necessary to read pertinent chapters in an internal medicine textbook. Reading should be general (we suggest reading about topics covered in teaching sessions) and specific (about problems seen in the hospital or outpatient setting). References have been addressed previously. A copy of

Cecil's Essentials of Medicine...

Lectures/Conferences

A core curriculum is presented on Tuesdays from 1:00 pm to 3:00 pm and Thursdays from 1:00 pm to 3:30 pm, see core lecture schedule for details. The topics chosen follow the national curriculum for Internal Medicine clerkships. The national curriculum also serves as a guide for the developers of the NBME final exam. All presentations are case-based. Sessions will consist of supervised case-solving followed by review of the cases and related didactic material. Please fill out an evaluation sheet for each session. The House Staff lecture series and Departmental Grand Rounds (Thursdays, 8:30, WSK Alumni Auditorium) are also highly recommended.

Chief Resident Sessions

The VA inpatient students will meet with the VA Chief Resident on Wednesdays at 2:00 pm. UH inpatient students, on the first day of each rotation, will meet with the Chief Resident at 8:00 am in the 6th floor Medicine Library at University Hospital, Room 6141. VA inpatient students, on the first day of each rotation, will meet with the Chief Resident at 7:30 am in the VA 6th fl Resident Area.

Interdisciplinary Courses

Bioethics and Radiology are covered during the Internal Medicine clerkship, as part of a medical school-wide curriculum. Radiology will be integrated into the lecture series. 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 (50%), performance on the final written exam (25%), quality of write-ups (15%), attendance at Student Ambulatory Report (see Ambulatory orientation materials) (5%), and attendance at ACLS and EPEC courses (5%). 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.