2011/2012
FOURTH YEAR
CORE CLERKSHIPS
FOURTH YEAR CURRICULAR REQUIREMENTS
Members of the Class of
2012 are required to successfully complete seven months of elective study as
well as the following three core clerkships:
Students should submit their preferences for the three core
clerkships using the on-line form in Angel. Click on the "Fourth Year
Clerkship Preferencing" option. Preferences must be submitted by Monday,
February 14.
Internal Medicine Sub-Internship
This core rotation is designed to
prepare students for internship by providing a rigorous clinical experience
that closely resembles the internship year. Students are assigned to inpatient Medicine
teams that care for patients in a medical intensive care unit or the ward
setting. Students are given primary patient care responsibilities with a
closely guided experience in clinical decision-making of diagnostic and
therapeutic management of typical medical conditions related to internal
medicine. Close supervision is provided by the team’s Internal Medicine
resident and attending physician. Students will provide care to no more than 6
patients at a time and may take overnight calls with the team to admit new
patients and cover their own patients. Overnight call experiences are evolving
with new duty hour rules for interns, but some experience with the resident may
be included. The primary method of
teaching is active participation in patient care activities with daily
teaching attending rounds. Daily conferences and morning reports along with
Web-based case modules will provide complementary educational venues. The
course is a one month rotation with an average of one day off per week, and
in accordance with school policy, vacations and interviews are not allowed
during this rotation.
Students will have the opportunity
to achieve Level 3 in the Effective Communications competency (Competency I)
while on this rotation.
Objectives:
Students
will demonstrate competence in the following areas:
Students will apply the above
competencies along with their clinical knowledge & skills to learn how to
manage patients with the 17 common clinical scenarios as outlined in the course
syllabus. Students will gain knowledge of these and other common medical
conditions.
The following sites/services comprise the clerkship.
All sites/services are available in all months:
·
Wishard
– Ward Medicine with open PICU (Progressive ICU)
7 students per month
·
Wishard
– ICU
2 students per month
·
VA
– Ward Medicine
5
students per month
·
VA
– ICU
2
students per month
·
University
– ICU
3 students per month
·
Methodist
– Ward Medicine
3 students per month
·
St.
Vincent’s – Ward Medicine
4 students
per month
·
St.
Vincent’s – ICU
4 students
per month
PLEASE
NOTE: The
inherent nature of the ICU setting requires a much higher level of clinical
abilities and acumen from clinicians. This is especially true of the ICU
at University Hospital where the most complex patients from all over the state
are referred for tertiary/specialized care. Therefore, medical students
who did not receive a final grade of High Pass or Honors during their Junior
Medicine Clerkship are strongly advised to avoid choosing the University
Hospital’s ICU rotation for their sub-internship. Due to the lottery
scheduling system to accommodate such a large class size, special exceptions
can be made for certain students who did not meet the above criteria—but this
will be at the Clerkship Director’s discretion after careful review of the
student’s academic records, i.e., if a student is deemed to be unqualified for
the University Hospital’s ICU setting, he/she will be reassigned to a ward
rotation.
Emergency Medicine
Availability:
All months except May
Clerkship Director: Butch
Humbert, MD
Assistant Clerkship Director: Bart Besinger, MD
Clerkship Coordinator: Jim Graber
Course Objective: The
student will learn the fundamental approach to caring for the undifferentiated
patient with urgent or emergent conditions. The student will be required to
identify the patient's problem with a focused history and physical taking into
consideration not only the medical condition but also the psychosocial aspects
of the problem. The student will implement solutions to these problems under
the direct supervision of the Emergency Medicine faculty. The student will also
learn to consider unexpected circumstances that arise in the emergency
department. Students taking this course will have the opportunity to achieve
Level III in Competency VIII: Problem Solving, or Competency V: Self-Awareness,
Self-Care, and Personal Growth.
Course Description and Requirements:
Introduction to Clinical Emergency
Medicine:
The first three working days of the month will follow a structured
format of both lectures and workshops to provide the student with the tools
necessary to perform their clinical responsibilities. Objectives for the
clerkship are posted on the Angel site.
Student Responsibilities:
·
Attendance
is mandatory at the initial 3-day lecture series. In
addition, completion of the required online didactic material, simulation
experiences and small group sessions are mandatory.
·
Students
are scheduled to work fifteen nine-hour shifts (or the equivalent) during their
rotation. Those shifts are divided between the day, evening, and night shifts.
The schedule will be posted on the EM Angel site and distributed at the
beginning of the month or as they become available. Any requests should be
directed to the Clerkship Coordinator by the first of the month prior to the
beginning of the rotation. We will attempt to honor reasonable requests.
·
During the
clinical shifts, the student will be the patient's primary caregiver. He/She will be responsible for evaluating the patient and
with the faculty or senior resident's guidance will develop and implement a
focused diagnostic and treatment plan.
Students are supervised by BC/BE Emergency Physicians during their
shifts.
·
Students
will perform procedures on their patients as needed, including but not limited
to suturing, arterial puncture and/or line placement, central venous access,
and airway management. Procedures are performed under the direction and at the
discretion of your supervising physician.
They are also expected to interpret radiographs and ECGs used in the
care of their patients.
Sites available for clinical activity:
|
|
Methodist |
St.
Francis |
St.
Vincent |
Wishard |
University |
|
Annual
Visits |
107,000 |
75,000 |
70,000 |
105,000 |
14,000 |
|
Pediatric
Pts. |
18% |
20% |
10% |
4% |
1% |
|
%
admitted |
20% |
20% |
26% |
14% |
30% |
|
Admits
to ICU |
24% |
8% |
10% |
20% |
20% |
Methodist Hospital-
10 students/month
EM residency training site, Level 1 trauma center, community based tertiary
St. Francis
Hospital - 2-4 students/month
Community-based
St. Vincent
Hospital - 6-8 students/month
Community-based, Level 2 trauma center
Wishard Hospital-
10 students/month
EM Residency Training Site, Level 1 trauma center
University Hospital- 2
students/month
Tertiary Care Research Hospital with concentration in Oncology
A site coordinator that assists with
implementation of the clinical activities is available at all sites. Students
will preference a clinical site. Attempts to honor site preferences will be
made.
Grading: The grade in this rotation will be comprised primarily
of the shift evaluations completed after each shift by the faculty. The
remainder of the grade will be determined by the end of rotation quiz, and
participation and attendance in required activities.
Level 3 Competency:
Problem-Solving (Competency VIII) can be achieved by satisfactory
completion of a case presentation and discussion that is turned into the ECMS
Web site. The written summary needs to demonstrate the student’s advanced
problem solving skills involved in the case. Please see the EM Clerkship Angel
Web site for details on the competency experience including an example of a
well-written summary.
Self-Awareness, Self-Care, and Personal Growth (Competency V) can be achieved
by writing and submitting a portfolio project that centers on a student’s
written reflection regarding an experience they had during their Emergency
Medicine Clerkship. The intent is to have the student share how the experience
affected their personal growth and development to become a professional
physician. Please see the EM Clerkship Angel Web site for details on the
competency experience including an example of a well-written portfolio.
Radiology
Availability: All months except December
Clerkship Director: Richard B.
Gunderman, MD, PhD, MPH
Course
Description: Radiology
has revolutionized the practice of medicine, by allowing physicians and
patients to peer inside the living human body without cutting it open. It is
vital that every physician understand the enormous diagnostic and therapeutic
potential of radiology and be equipped to make effective use of it in their
practice. This month-long clerkship provides formal lectures, interactive
sessions, hands-on clinical experiences, and Web-based learning opportunities.
Students have limited after hours duties and every student functions not
only as a learner but also a teacher.
Level 3
Competencies: Students
work in groups to complete presentations and have the opportunity to
demonstrate the Level III Competency in Effective Communication by preparing a
2-3 page paper.
Grading: 20% on student presentations, 35% on the
mid-term, and 45% on the final examination.