Family Medicine Clerkship – 6 weeks

During the 6-week Family Medicine Clerkship the students will attend to patients, under the direct supervision of a primary care family practitioner. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences:

• 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 see patients in the inpatient and ambulatory settings. As part of the requirement, students will complete a 2-week subspecialty rotation of their choice. This subspecialty rotation can be completed during the 3rd or 4th year. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences are:

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)

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. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences are:

• 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/n obstetrician/gynecologist. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences are:

• 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 a pediatrician. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences are:

Psychiatry Clerkship – 4 weeks

During the 4-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. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences are:

• 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 Internal Medicine Clerkship the students will see patients in the inpatient and ambulatory settings. As part of the requirement, students will complete a 2-week subspecialty rotation of their choice. This subspecialty rotation can be completed during the 3rd or 4th year. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences are:

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

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 an emergency medicine physician. Participation in the patient’s history, physical exam, differential diagnosis and therapeutic plan will be expected. The required clinical experiences are:

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)

Extended Clinical Experience – 2 weeks

This required two-week course will be required in the M3 year and will complement and expand on the clinical experiences of the M3 clerkships. The course will include a variety of topics including review of radiology concepts in plain radiography, computed tomography and ultrasounds, an overview of Advanced Cardiac Life Support concepts and protocols as well as time spent in the simulation lab practicing different procedures, which may include lumbar puncture, central line placement or thoracotomy. Finally, students will be completing their required M3 OSCE in this course:

• Student will obtain a basic understanding of plain radiography, computed tomography and ultrasounds including clinical indications, technique and basic interpretation
• Student will obtain a basic understanding of ACLS and driving concepts behind resuscitation in the setting of cardiac arrest
• Students will have the opportunity to run a mock code as well as act as a supporting team member during a mock code
• Students will have hands-on experience with procedures offered in the simulation lab and/or EMR simulated exercises
• Students will obtain a basic understanding of indications, patient consent, technique and complications of variable clinical procedures
• Students will complete their required M3 OSCE