2012/2013 FOURTH YEAR 
CORE CLERKSHIPS

FOURTH YEAR CURRICULAR REQUIREMENTS

Members of the Class of 2013 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 Friday, February 17.

 

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 general 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 attending physician and resident where applicable. Students will provide care to no more than 6 patients at a time, and are encouraged to take a self-directed approach to their education, push their limits in a supportive environment in preparation of internship. On-call duties will resemble those of interns at their hospital.  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

        1 students per month

·         University–Hospitalist Team

        2 students per month

·         University –  ICU
        3 students per month

·         Methodist – Ward Medicine
        4 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, as it risks being counterproductive to their performance in the clinical venue and on the standardized exam.  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's experience in the University Hospital’s ICU setting risks being counterproductive, 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 examination, taking into consideration not only the patient's 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 Oncourse 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 Oncourse 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:

Indianapolis- Methodist Hospital, St. Francis Hospital, St. Vincent Hospital, Wishard Hospital, IU Heath Universtiy Hospital, IUH West Hospital, IUH North Hospital

Bloomington- Bloomington Hospital (Longitudinal Clerkship)

Terre Haute- Reid Hospital

Northwest-Methodist-Gary Hospital

South Bend- Elkhart General Hopsital

 

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 Oncourse 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

 

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 US 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 have the opportunity to demonstrate the Level III Competency in Effective Communication by doing an oral presentation in class and then preparing a 2-3 page paper based on the presentation. Students can achieve the Life Long Learning Competency by preparing a digital case using specific guidelines. 

 

Grading: 40% on the mid-term, and 60% on the final examination.