Phase B - Clinical Clerkships

The clerkship curriculum begins in the third year of medical education and is 46 weeks long. Clerkship rotations are a time for students to reinforce their first two years of medical training and apply their knowledge to patients in outpatient and inpatient settings.

Prior to each clerkship, students will return to the College of Medicine for clerkship-specific didactics. These sessions include readings and discussions on wellness, determinants of health, and health promotion. Clinical faculty in the respective disciplines will guide the discussions and assess the students based on participation and weekly audience-response quizzes. Included in the didactics are important aspects of preventative, acute, chronic, continuing, rehabilitative, and end-of-life care.


Clerkship Total Week Inpatient Outpatient
Family Medicine 6 0 6
Internal Medicine 8 4 4
Neurology 4 2 2
Obstetrics/Gynecology 6 3 3
Pediatrics 6 3 3
Psychiatry 4 2 2
Surgery 8 4 4
Emergency Medicine 4 0 4

Health System Affiliations

The clinics and hospitals of our health system affiliations provide clinical clerkships and training in multiple medical specialties to our students.

By having access to these community healthcare facilities, medical students are exposed to diverse patient populations with differing severities of illness and all under the supervision of faculty physicians.

 

Kaiser Permanente of Northern California (over 900 beds and 1,400 physicians)

  • Kaiser North Valley
  • Kaiser South Sacramento
  • Kaiser Roseville

Dignity Health System (over 1,000 beds and 2,100 physicians)

  • Mercy General
  • Mercy San Juan
  • Methodist
  • Woodland Memorial

To augment experiences in psychiatry, CNU is affiliated with the psychiatric hospitals Heritage Oaks (125 beds) and Sierra Vista (120 beds).


Family Medicine Clerkship – 6 weeks

During the 6 week Family Medicine Clerkship the students will be expected to spend six weeks in a Family Medicine setting, under the direct supervision of a primary care family practitioner. The following clinical conditions will be expected to be seen by the students and they will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the core clinical conditions listed:

  • Sexual dysfunction (may be male or female, may be encountered during family medicine, internal medicine, or psychiatry clerkships)
  • Lesbian, gay, bisexual or transgender patient (may be encountered during family medicine or internal medicine – this is not to be considered a clinical condition, but a critical encounter to ensure awareness and sensitivity to issues specific to this population)
  • Back pain
  • Cough/URI/viral syndrome
  • Depression/anxiety
  • Diabetes and its complications
  • Dyslipidemia
  • Dysuria/hematuria/stones/UTI
  • Hypertension
  • Allergy/sinus problems
  • Musculoskeletal complaint (i.e. arthritis, arthralgia, muscle strain, fracture)
  • Preventive care/health promotion/counseling
  • Skin problems (i.e. cellulitis, rash)
  • Scrotal mass/pain (may be encountered during internal medicine, pediatric, surgery or emergency medicine clerkships)
  • Thyroid dysfunction
  • Women’s health wellness

Students will also be expected to successfully complete the following procedures:

  • Breast examination (mastery, may be completed during the OB/GYN clerkship)
  • Finger Stick Glucose (mastery, may be completed during the internal medicine or pediatric clerkships)
  • IM injection (participate/(mastery), may be completed during the pediatric clerkship)
  • PPD placement (participate/(mastery))
  • Urine dipstick with interpretation (participate/(mastery), may be completed during the OB/GYN or pediatric clerkships)

Internal Medicine Clerkship - 8 weeks

During the 8 week Internal Medicine Clerkship the students will be expected to spend four week on an internal medicine hospital ward rotation (inpatient) and four weeks on an ambulatory (outpatient) setting, both under the direct supervision of an internist. The following clinical conditions will be expected to be seen by the students and they will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the core clinical conditions listed:

Students will also be expected to successfully complete the following procedures:

  • Airway Management (observe/participate, may be completed during surgery, OB/GYN, or emergency medicine clerkship)
  • CPR/ET tube placement (mastery, may be completed during surgery clerkship)
  • Arterial blood gas (observe, may be completed during surgery clerkship)
  • EKG placement and interpretation (mastery)
  • Abdominal Ultrasound (observe/participate, may be completed during surgery or OB/GYN clerkships)
  • Fingerstick glucose (mastery, may be completed during Family Medicine clerkship)
  • Foley catheter placement (mastery, may be completed during emergency medicine or surgery clerkship)
  • Nasogastric tube placement (mastery, may be completed during surgery clerkship)
  • Peripheral I.V. placement (mastery, may be completed during any clerkship)
  • Rectal exam (participate, may be completed during surgery, OB/GYN, or emergency medicine clerkships)
  • Venipuncture (participate/mastery, may be completed during any clerkship)

Neurology Clerkship – 4 weeks

During the 4 week Neurology rotation the students will be expected to spend two weeks in an inpatient neurology ward and two weeks in an outpatient/ambulatory clinic, both under the direct supervision of a neurologist. The following clinical conditions will be expected to be seen by the students and they will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the core clinical conditions listed:

  • Alcohol/substance abuse
  • Altered mental status/coma
  • Chronic pain
  • Dizziness/syncope
  • Headache
  • Movement disorder/Parkinson’s disease
  • Multiple sclerosis
  • Nervous system tumors
  • Neuropathy
  • Neuropharmacology
  • Seizure/epilepsy
  • Stroke

Students will also be expected to successfully complete the following procedures:

  • Lumbar puncture (participate/mastery, may be completed during the emergency medicine clerkship)

Obstetrics/Gynecology – 6 weeks

During the 6 week OB/GYN rotation the students will be expected to spend three weeks in an inpatient/delivery/surgical setting and three weeks in an outpatient OB/GYN clinic, both under the direct supervision of a obstetrician/gynecologist. The following clinical conditions will be expected to be seen by the students and they will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the core clinical conditions listed:

  • Sexual dysfunction (may be male or female, may be encountered during family medicine, or internal medicine clerkships)
  • Lesbian, gay, bisexual or transgender patient (may be encountered during family medicine or internal medicine – this is not to be considered a clinical condition, but a critical encounter to ensure awareness and sensitivity to issues specific to this population)
  • Abnormal PAP smear
  • Breast pain/mass/nipple discharge
  • C-section
  • Contraception/reproductive options
  • Infertility
  • Domestic violence/Sexual abuse
  • Labor/delivery (normal and complicated)
  • GU malignancy
  • Hysterectomy
  • Menopause
  • Menstrual abnormalities/abnormal genital tract bleeding
  • Puerperium (normal) and (abnormal)
  • Pelvic mass (non-pregnant)
  • Pelvic pain (acute/chronic)
  • Pregnancy (complicated/high risk)
  • Hypertension or diabetes in pregnancy
  • Pregnancy (normal), 1st trimester; 2nd trimester
  • Pregnancy loss
  • Sexually transmitted disease, including screening
  • Vaginal discharge
  • Infant delivery

Students will also be expected to successfully complete the following procedures:

  • Breast exam (mastery, may be completed during the family medicine clerkship)
  • Mammogram (observe)
  • Abdominal or Vaginal Ultrasound (observe/participate, may be completed during the surgery or emergency medicine clerkship)
  • Delivery of an infant (observe/participate, uncomplicated vaginal delivery)
  • Cervix biopsy or surgical procedure (observe)
  • Papanicolaou smear (mastery)
  • Pelvic examination (mastery)
  • Peripheral I.V. placement and removal (participate/mastery), may be completed on any clerkship
  • Rectal exam (participate, may be completed during the internal medicine, surgery, or emergency medicine clerkships)
  • Urine dipstick interpretation (participate/mastery)

Pediatrics Clerkship – 6 weeks

During the Pediatric Clerkship the students will be expected to spend three weeks on a pediatric hospital ward rotation (inpatient) and three weeks in an ambulatory (outpatient) setting, both under the direct supervision of an pediatrician. The following clinical conditions will be expected to be seen by the students and they will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the core clinical conditions listed:


Psychiatry Clerkship – 4 weeks

During the 6 week Psychiatry Clerkship the students will be expected to spend three weeks on an inpatient psychiatric setting and three weeks in an ambulatory (outpatient) setting, both under the direct supervision of a psychiatrist. The following clinical conditions will be expected to be seen by the students and they will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the core clinical conditions listed:

  • Alcohol/substance abuse
  • Altered mental status/coma
  • Anxiety conditions (one of the following: GAD, panic attacks, phobias, PTSD, OCD)
  • Bipolar disorder
  • Chronic pain
  • Depression
  • Delirium/dementia
  • Headache
  • Personality disorder
  • Suicidal ideation/attempt
  • Psychosis or schizophrenia spectrum disorders

Surgery Clerkship – 8 weeks

During the 8 week Surgery Clerkship, students will be expected to spend four weeks on an inpatient surgery rotation and four weeks on ambulatory (outpatient) surgery clinic setting, both under the direct supervision of a surgeon. The following clinical conditions will be expected to be seen and the students will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the following core clinical conditions listed:

Students will also be expected to successfully complete the following procedures:

  • Airway management (observe/participate, may be completed during internal medicine, OB/GYN, or emergency medicine clerkships)
  • Peripheral IV placement (participate/mastery), may be completed during any clerkship
  • Arterial blood gas (observe, may be completed during internal medicine or pediatric clerkships)
  • Chest tube placement (observe, may be completed during emergency medicine clerkship)
  • CPR/ET intubation (mastery, may be completed during internal medicine clerkship)
  • Abdominal Ultrasound (observe/participate, may be completed during internal medicine, or OB/GYN clerkships)
  • Foley catheter placement and removal (mastery, may be completed during emergency medicine or internal medicine clerkships)
  • Nasogastric/feeding tube placement and removal (mastery – may be completed on internal medicine rotation)
  • Rectal exam (mastery, may be completed during internal medicine, OB/GYN, or emergency medicine clerkships)
  • Skin Suturing (mastery, may be completed during emergency medicine clerkship)
  • Venipuncture (mastery, may be completed during any clerkship)

Students will be expected to observe or participate in and understand the indications for the following core surgical procedures

  • Inguinal/abdominal hernia repair
  • Anorectal procedures
  • Laparoscopic procedures (e.g., appendectomy, cholecystectomy)
  • Laparotomy
  • Incision and drainage
  • Wound care

Emergency Medicine – 4 weeks

During the 4 week Emergency Medicine rotation the students will be expected to spend four weeks in an emergency department, both under the direct supervision of a emergency medicine physician. The following clinical conditions will be expected to be seen by the students and they will be expected to analyze these conditions using the schemes and process worksheets studied in Phase A. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected for the core clinical conditions listed:

Students will also be expected to successfully complete the following procedures:

  • Airway Management (observe/participate, may be completed during internal medicine, surgery, or OB/GYN clerkships)
  • Chest tube placement (observe, may be completed during surgery clerkship)
  • CPR/ET intubation (mastery, may be completed during internal medicine or surgery clerkship)
  • EKG placement and interpretation (mastery, may be completed during the internal medicine clerkship)
  • Abdominal Ultrasound (observe/participate, may be completed during the surgery, internal medicine, or OB/GYN clerkships)
  • Foley placement and removal (observe/mastery, may be completed during the internal medicine or surgery clerkships)
  • Peripheral IV placement (participate/mastery, may be completed during any clerkship)
  • Rectal exam (participate, may be completed during the internal medicine, OB/GYN, or surgery clerkships)
  • Lumbar puncture (participate/mastery, may be completed during the neurology clerkship)
  • Skin suturing (participate/mastery, may be completed during the surgery clerkship)
  • Urine dipstick (participate/mastery, may be completed during the family medicine, OB/GYN, or pediatric clerkships)
  • Venipuncture (participate/mastery, may be completed during any clerkship)