PREREQUISITES AND PLACEMENT IN THE CURRICULUM: Completion of Year Two; Year Three

PURPOSE:
The Family Medicine clerkship is a required primary care ambulatory rotation. The clerkship teaches the knowledge, attitudes, and skills necessary to provide continuing, comprehensive and preventive care to individuals and families who represent a broad spectrum of ages and cultures in the outpatient setting.

COMPETENCIES:
During the six-week clerkship, students will increase their ability to:

1. Diagnose and manage common acute and chronic ambulatory problems in a well-reasoned manner
2. Provide comprehensive patient care with a family and community perspective
3. Recognize and address personal knowledge, skill, and/or reasoning gaps that arise during patient encounters
4. Behave in a professional and ethical manner.

INSTRUCTIONAL FEATURES:

Students spend approximately 1 and ½ days per week at the UIC Department of Family Medicine where they:

1. Work in small groups on typical family medicine problems
2. Participate in workshops designed to enhance particular skills

Students spend the remainder of the clerkship in a clinical practice site where they are supervised by Family Medicine attending physicians and residents.

ASSESSMENT:

Students’ clinical performance is evaluated by faculty members using Department’s Clerkship Evaluation form. Students are also required to pass a Family Medicine multiple-choice national examination and may be required, as well, to complete locally developed clinical performance assessments.

Updated: 11/15/22

PREREQUISITES AND PLACEMENT IN THE CURRICULUM:
Completion of M2 Year; Year Three

PURPOSE:
The basic Internal Medicine clerkship is designed to expose students to the comprehensive approach to adult patients with nonsurgical disease. The emphasis is on perfecting the fundamental skills of data collection, clinical reasoning, and understanding of pathophysiological processes. The experience is patient-centered, supplemented with didactic presentations and student readings appropriate to the care of their own patients. In their first exposure to Internal Medicine as a discipline, students simulate the role of a trained internist under the close supervision of resident trainees and faculty members.

GOALS:
The Department of Internal Medicine will provide an educational experience for clinical clerks offering graduated supervised responsibility for patient care in the area of general internal medicine.  During the clerkship each student will gain an awareness of the knowledge, skills, values and attitudes that internists strive to acquire and maintain throughout their professional lives. Students will have graduated, supervised responsibility for patient care, learning to integrate clinical knowledge with practical experience. During the course of the clerkship, the students will gain competencies in 8 core areas: Patient care, medical knowledge, interpersonal and communication skills, professionalism, practice based learning and improvement and systems based practice, interprofessional collaboration and personal and professional development.

OBJECTIVES:
At the end of the clerkship, the student should be able to demonstrate competencies in each of the competency domains as outlined below:

Medical Knowledge:

• Explain the pathophysiology of each of the diagnoses or clinical conditions as outlined by the AAIM Core Medicine Clerkship Curriculum Guide.
• Describe how biomedical, ethical, and psychosocial-behavioral factors apply to the clinical presentation of the disease in their patients
• List the indications, contraindications and benefits of the following common procedures: ABGs, thoracentesis, paracentesis, and lumbar puncture
• Describe the indications for the following tests: complete blood count, comprehensive metabolic panel, coagulation studies, chest Xray, abdominal x-rays, EKG, PFTs, and interpret results of these tests for their patients

Patient Care:

• Obtain an accurate, pertinent history from all appropriate available sources, perform a thorough and accurate physical examination, and record all findings in a complete and well-organized manner. (EPA: 1 and 5)
• Perform and record a thorough physical examination, and review the physical findings with the faculty
• Based on history and physical examination findings as well as any laboratory or diagnostic tests done, develop an appropriately prioritized and detailed problem list for each patient
• Utilize clinical reasoning to develop appropriate differential diagnoses to assess the patients’ problems. (EPA 2)
• Select a working diagnosis and formulate a diagnostic and therapeutic plan for their patient(s) based on gathered clinical information and laboratory data. (EPA: 2 and 3)

Interpersonal and Communication Skills:

• Document and deliver oral case presentations on new admissions (full H&P) and document and present daily progress notes (SOAP notes) that are generally accurate, concise, organized, and complete. (EPA: 5 and 6)
• Communicate with patients and their families in a clear, respectful manner, responding to verbal and non-verbal cues.
• Demonstrate respect and courtesy when communicating with all members of the health care team, including staff, nurses, residents and faculty
• Describe the key components of informed consent, and when, applicable, participate in obtaining informed consent prior to performing procedures in their patients. (EPA 11)
• Demonstrate ability to actively engage with patients, families and other members of the health care team to coordinate care. (EPA 9)
• Demonstrate ability to discuss management plan with their patient and explain pathophysiology to them without using medical jargon

Professionalism:

• Discuss how psychosocial, educational, economic and religious backgrounds of patients may underlie their diverse belief systems, and demonstrate this understanding in the approach to the management of individual patients
• Demonstrate sensitivity to, and an understanding of, the ethical dimensions of patient care, and demonstrate this sensitivity in the approach to the management of individual patients
• Develop professional relationship based on trust, mutual-respect, empathy and conscientiousness with patients, peers and other health care members at all times
• Demonstrate ability to work hard, accept patient responsibility and respond appropriately to feedback provided
• Demonstrate respect, compassion, integrity, and honesty at all times

Practice Based Learning and Improvement:

• Develop and research clinical questions that arise during patient care and management, using evidence-based resources. (EPA 7)
• Demonstrate critical reading skills by analyzing selected journal articles, and identify characteristics of effective medical articles. (EPA 7)
• Choose pertinent issues related to the care of their patients and research them independently. (EPA 7)

System Based Practice:

• Participate, whenever possible, in coordination of care and in the provision of continuity of care including transfer and discharge.
• With supervision, students should begin to learn how to identify system failures and contribute to a culture of safety and improvement (EPA13)

Interprofessional Collaboration:

• Describe the roles of other health care professionals in the care of patients in internal medicine.
• Collaborate with other health professionals to establish and maintain a climate of mutual respect, dignity, diversity, ethical integrity, and trust. (EPA-9)

Personal and Professional Development:

• Develop the ability to use self-awareness of knowledge, skills, and emotional limitations to engage in appropriate help-seeking behaviors
• Demonstrate healthy coping mechanisms to respond to stress
• Manage conflict between personal and professional responsibilities
• Practice flexibility and maturity in adjusting to change with the capacity to alter one’s behavior
• Demonstrate trustworthiness that makes colleagues feel secure when one is responsible for the care of patients
• Recognize that ambiguity is part of clinical health care and respond by utilizing appropriate resources in dealing with uncertainty

Third Year Role & Responsibilities

1. Patient Care Responsibilities (EPA: 1, 2, 3, 5, 6, 7, 9, 13)
   • Obtain a thorough history and physical exam at the time of patient admission
   • Write & present full H&P(s) on new admissions
   • Write & present daily progress notes (SOAP notes) on the patients they are followingPre-round on assigned patients & follow-up on tests and consultation notes and updates
   • If feasible, accompany patients to tests (e.g., colonoscopy, stress test, etc.)
   • Participate in family meetings and multidisciplinary rounds
   • Participate in sign-out rounds
   • Actively practice EBM & Read and bring in articles or other educational materials related to your own or team patients.
   • Assist interns and senior residents with the care of any patient with supervision commensurate with their level of training and particular skill i.e., calling a consultant about a case.
   • Ask for feedback about write-ups, presentations, participation, etc. consistently and especially at midpoint
   • Communicate collaboratively and effectively with nursing, pharmacy staff, social workers, patient’s outpatient physicians, inpatient consultants and other staff members to enhance patient care.
   • Students may perform, under supervision, procedures on their patients commensurate with their level of training (e.g., BLS, EKG placement, venipuncture, insertion of an i.v.). (EPA 12)
2. Call Responsibilities:
   • The students are expected to be on call with their team for the duration of the call.
   • Students will work with their teams on weekends, and on average will get 1 day off per week (at the discretion of the team). These (off days) are typically weekend days, unless the team is on or post call. Days off for special circumstances must be requested in advance with the Clerkship Director and Coordinator. Days off may be required to be made up at the discretion of the Clerkship and Site Director.  The supervising resident, attending and team must also be notified in advance.
   • Students should not exceed work hour rules set by UI COM.
   • Students should respond to the blue alerts/Code Blue as part of the code team.
3. Floor Responsibilities:
   • Students are expected to participate in pre-rounds and sign-outs and follow patients with their intern –M3s may admit 2-3 new patients a week (no >2 on a given call day) and follow 3-5 patients daily depending on complexity.
   • Students are expected to pre-round on their patients and follow up on (and inform the team) all test results and consultant recommendations
   • Students are expected to write daily notes (SOAP notes) on their assigned patients
   • The students are expected to participate with the medical team in the “sign-out” of patients at the end of the day
   • Students are not expected to write discharge summaries, but may practice if desired.
   • Students should try to contact the PCP at discharge with the supervision of their residents to inform them of the follow-up plans.
   • Students should try to participate in family meetings, end of life and code discussions, and emergent bedside management of their patients when needed and discharge planning.
4. Mandatory Requirements
   • Students are expected to attend all mandatory student didactics/meetings as assigned by the Clerkship director
   • Students must complete:
     • IM Patient Log form (BenWare)
     • 4 direct observation Forms (formerly Mini-CEX)
     • Assigned Aquifer Cases
     • Formative SP exam
     • Other assignments designated by the clerkship directors
   • Students must complete a Mid-term Evaluation/Feedback meeting
   • Students should complete Qualtrics surveys & Evaluation of Clerkship

UI COM Student Work Hour Policy

• The maximum number of required hours at clinical sites (hospital, clinic, nursing home, etc.) should not exceed 80 hours per week.
• There should be no required consecutive call.
• Night call should be assigned no more than an average of every fourth day (Q4) over the duration of the experience.
• Night call should not be required the day before administration of the end of clerkship examination.
• Students should have an average of at least one day (24 hours) each week free of clinical responsibilities (including lectures, seminars, clinic, and rounds).
• Any time off including getting off early on scheduled work days must be approved by the Clerkship office/Director.

The above restrictions do not include independent study time apart from clinical duties or optional activities in which the student voluntarily participates.

The Association of American Medical Colleges (AAMC) 13 Core EPAs

• EPA 1: Gather a history and perform a physical examination
• EPA 2: Prioritize a differential diagnosis following a clinical encounter
• EPA : Recommend and interpret common diagnostic and screening tests
• EPA 4: Enter and discuss orders and prescriptions
• EPA 5: Document a clinical encounter in the patient record
• EPA 6: Provide an oral presentation of a clinical encounter
• EPA 7: Form clinical questions and retrieve evidence to advance patient care
• EPA 8: Give or receive a patient handover to transition care responsibility
• EPA 9: Collaborate as a member of an interprofessional team
• EPA 10: Recognize a patient requiring urgent or emergent care and initiate evaluation and management
• EPA 11: Obtain informed consent for tests and/or procedures
• EPA 12: Perform general procedures of a physician
• EPA 13: Identify system failures and contribute to a culture of safety and improvement

IMPORTANT:
All students will be placed at our academic sites: UIH or VA for at least ½ the rotation.  Additionally, some students will be placed at our community sites (St. Francis Hospital, St. Joseph of Chicago Hospital, Weiss Memorial Hospital, Lutheran General Hospital, Advocate Christ Hospital, and Illinois Masonic Hospital) or on an IM subspecialty ward at UIH (cardiology or oncology).  Students will have call and weekend responsibilities. In general, students will get 1 day off per week at the discretion of their team (generally a Saturday or Sunday depending on the call schedule).

ASSESSMENT:
Written clinical evaluations from residents and attending physicians, and a clerkship examination given at the end of the rotation.

Updated: 04/19/2022

PREREQUISITES AND PLACEMENT IN THE CURRICULUM:
Must be a current third or fourth year student.

REQUIREMENTS:
Be aware that paperwork for the VA paperwork is needed 6 weeks in advance.  Students are not allowed to start their rotation at Jesse Brown VA Medical Center without it.

PURPOSE:
Student clerks spend four weeks on the Neurology Service at the Jesse Brown VA Medical Center (JBVA) or the University of Illinois at Chicago Medical Center (UICMC).   Paperwork must be completed 6 weeks in advance at JBVA, please see forms section of the website: Clinical Site Compliance Requirements & Forms

Students must be present for orientation on the first Monday of the Clerkship.  Unexcused absence from orientation will require rescheduling of the Clerkship.  Each medical student will be allowed no more than 2 days in the rotation for excused absences.  All absences must be cleared by the Clerkship Director no later than 4 weeks prior to the start of the Clerkship.  Students will be assigned to one resident and one faculty member. If any students are interested in Neuro ICU rotation that option is available.

COMPETENCIES:
In the process of completing this course students acquire the following competencies:

• Become proficient with a basic neurological examination.
• Increase knowledge and skills in performing a more comprehensive examination.
• Learn and apply the principles of neurological localization to clinical diagnosis.
• Know the major categories and cardinal manifestations of neurological diseases.
• Be able to recognize common neurological emergencies.
• Be familiar with major modes of neurological therapy.

INSTRUCTIONAL FEATURES:
The clerkship has a four-week structure with an orientation at the beginning, and a final exam at the end of the clerkship. Students will be provided with the learning objectives and the basic neurology course on blackboard.

ASSESSMENT:
The NBME exam will be scheduled the last Friday of your rotation. The final course grade is based on the clinical assessment from your supervising preceptors (neurology attendings with input from the neurology fellows and residents) and your NBME score (2/3 of grade clinical evaluations and 1/3 NBME exam).

Updated:  01/05/23

PREREQUISITES AND PLACEMENT IN THE CURRICULUM:
Completion of M2 Year, Year Three

PURPOSE:
The overall objective oh the Third Year Clerkship in Obstetrics and Gynecology is that students acquire and apply the basic information and master the basic skills needed by all physicians who provide care for women.  Further, students will be exposed to a variety of patients with obstetric and gynecologic problems; including normal and high-risk pregnancies, pregnancy wastage and infertility, gynecologic endocrine abnormalities, infections, psychosomatic, and neoplastic problems.  Students will also encounter patients who desire contraceptive advice or have problems in the psychosexual sphere.  Students spend three weeks on synecology ambulatory and surgical services, evaluating patients in general gynecology, gynecologic oncology, family planning, and endocrine clinics.  During the three weeks on the obstetrical services, students rotate on prenatal clinics, labor and delivery, and antepartum/postpartum wards.  These are subject to change as the clerkship is revised; also, there may be some site variations.

COMPETENCIES:
Within the context of human reproduction and the various physiological and psychosocial aspects of health and disease, students will demonstrate ability to:

1. Obtain and record a gynecologic and sexual history, as well as an obstetrical history
2. Perform a pelvic examination satisfactorily
3. Perform and interpret a breast examination
4. Evaluate a patient’s pain and therapy
5. Assess the status of a woman in labor.

INSTRUCTIONAL FEATURES:
Students rotate onto three wards – labor and delivery, antepartum /postpartum , and gynecology. Patients are seen in ambulatory sites in the clinics: antepartum, gynecology, gynecologic oncology, reproductive/endocrine, and family planning. Students have a variety of didactic sessions to attend including subspecialty seminars, core lectures, visiting faculty lectures and seminars, grand rounds and teaching rounds. Students are encouraged to present patients to attendings and senior residents. Students also participate in the pelvic teaching associates program where they develop their breast and pelvic examination skills on women who are trained to act as patient models. This allows review of skills and methods prior to examinations of patients.

ASSESSMENT:
Performance is evaluated by residents and faculty members using the College of Medicine Clerkship Evaluation Form, by means of clinical pathophysiology/management cases as well as through direct observation during clinical activities. Student’s cognitive knowledge base is assessed through the National Board of Medical Examiners multiple choice examination in Obstetrics/Gynecology.

Updated: 6/20/19

PREREQUISITES AND PLACEMENT IN THE CURRICULUM:
Completion of Year Two; Year Three

PURPOSE:
The clerkship provides extensive clinical experience with diseases of infants, children, and adolescents, as w ell as with normal infants and children. Patients are seen in a variety of clinical settings, including the newborn nursery, the pediatrics inpatient units, and a variety of outpatient settings as well as in the emergency room. Normal processes of growth and development are emphasized, and diseases are approached within this frame of reference. The student will develop basic skills in the evaluation and management of infants and children, and will gain an understanding of the attitudes and approaches of pediatric medicine that are intended to foster optimal physical and psychosocial development of the child.

COMPETENCIES:
In the process of completing this course, students acquire the following competencies: 1) An understanding of normal growth and development from the newborn period through adolescence; 2) The ability to identify and assess clinical problem s in pediatric-age patients; 3) The knowledge and experience to develop an appropriate medical management plan for infants, children, and adolescents; 4) An understanding of the role of psychosocial factors on child health and welfare; 5) Knowledge of the principal elements of preventive pediatrics, including immunization and anticipatory guidance; 6) The ability to communicate effectively with patients/caretakers.

INSTRUCTIONAL FEATURES:
Varies somewhat from site to site. However, the general structure is:

1. One week is spent in the Normal Nursery, three weeks in Ambulatory, which may include call in the Pediatric Emergency Room, and two weeks on a general pediatrics inpatient unit.
2. There is a core lecture series that students are required to attend
3. There are various other lectures and conferences, including weekly Grand Rounds are also elements of the educational program
4. Students are required to complete a series of web-based interactive clinical cases.

ASSESSMENT:
A composite performance evaluation is prepared by the site coordinator from in formation supplied by the faculty members and house staff who worked with the student in the nursery, outpatient setting, inpatient unit, and the clinics. A clerkship examination is also given at the end of the rotation.

Updated:  11/16/22

PREREQUISITES AND PLACEMENT IN THE CURRICULUM:
Completion of M2 Year; Year Three

PURPOSE:
In the core psychiatry clerkship, students learn how to understand, diagnose and treat patients with psychiatric disorders. They are trained to conduct diagnostic interviews and perform comprehensive mental status examinations. They learn to work with multidisciplinary teams to provide psychiatric treatment in inpatient, consult/liaison, outpatient and emergency room settings, and to use a biopsychosocial framework to understand psychiatric illness.

COMPETENCIES:
In the process of completing this course, students acquire the following competencies:

1. Perform and articulate a comprehensive mental status examination, including psychiatric and neuropsychiatric elements
2. Conduct psychiatric interviews with a wide variety of patients, demonstrating ability to establish rapport and obtain information pertinent to diagnosis
3. Identify and collect other clinical data needed to diagnose behavioral disturbances, including relevant laboratory studies and psychological testing
4. Formulate a comprehensive and accurate differential diagnosis for psychiatric symptoms, using standard diagnostic nomenclature
5. Use a biopsychosocial framework to describe biological, intrapsychic, familial and sociocultural influences on patients’ presenting complaints
6. Understand the indications for, and basic principles of, commonly used psychiatric treatments, including psychodynamic psychotherapy, cognitive therapy, behavior therapy, family therapy, group therapy, pharmacotherapy and electroconvulsive therapy
7. Recognize psychiatric emergencies and perform basic emergency intervention.

INSTRUCTIONAL FEATURES:
Inpatient psychiatry units, outpatient psychiatry clinics, psychiatry emergency services, child psychiatry clinics, psychiatry consultation/liaison services, and lectures.

Reporting Instructions:
All students report to orientation at 1747 W. Roosevelt Road, Room 361, 9:00 AM on the first Monday with Drs. Blitzstein, Cooper and Graciela Bernal, instructions for site reporting will be given at this orientation.

ASSESSMENT:
Clinical evaluation, standardized patient examination, written clerkship examination.

Updated:  7/27/16

PREREQUISITES AND PLACEMENT IN THE CURRICULUM:

Completion of M2 Year; Year Three

PURPOSE:

The General Surgery Clerkship is designed to be an introduction to Surgery and selected surgical subspecialties. Students are assigned to the inpatient surgical wards and clinics. The students are taught the approach to the surgical patient and participate in pre- and postoperative care as well as perform certain invasive techniques safely. By the end of rotation, students are expected to know the indications and the contradictions and the role of ancillary services in managing surgical diseases.

COMPETENCIES:

As a result of attending this clerkship, the student should be familiar with and be able to perform the following functions:

1. Perform a complete and competent history and physical examination on surgical patients on the wards and in the Surgical Clinics
2. Review, record, and communicate clinical observations both in the chart and on rounds
3. Perform a variety of invasive procedures including nasogastric intubation, venous access, arterial puncture, wound dressing, and closure of simple wounds
4. Know when to order and how to interpret common diagnostic tests and laboratory results in surgical patients
5. Be familiar with sterile technique, common operative procedures, and the operating room environment
6. Detect and anticipate common postoperative complications
7. Gain initial exposure to selected surgical subspecialties (site specific)
8. Understand indications per various surgical procedures and their timing.

INSTRUCTIONAL FEATURES:

The students are expected to participate in all activities of the service. These include daily rounds with the Surgical Residents, outpatient clinics, teaching rounds, Interdisciplinary Conferences, conferences with the Attending Staff, and informal teaching sessions. Students will be required to take hospital night call according to a schedule developed at each site, but with a frequency not to exceed every fourth night. Students are expected to become familiar with sterile technique, common operative procedures and the operating room environment. “Scrubbing” on actual surgical procedures is encouraged during all phases of the rotation. A didactic lecture series is offered to the students and is given by the faculty in Surgery. The lecture series is attended by students from all sites, occurs on Thursday afternoon and is mandatory. The lecture series is meant to supplement and not rep lace the student’s reading and independent study.

ASSESSMENT:

Students are evaluated clinically by the Attending faculty and Senior level residents (2/3 of the grade) and have a final examination (1/3 of the final grade).

Updated:  11/16/22

Placement in the Curriculum and Prerequisites: Phase 2

Purpose:

Clinical Intersections occurs in Phase 2 and is the longitudinal portion of the Clinical Connections and Competencies course. During phase 2, students are developing their professional identities as they hopefully transition from a student-centered view to a patient-centered view. Part of this experience includes encountering individuals (patients, colleagues, other health care professionals) who navigate the experience with different values and communication skills than they have. Having an opportunity for peer connection (for wellness, reflection on patient care, career-planning), faculty support, and reflection is important for students to successfully balance the challenges of phase 2.

In this course, our goal is to promote students’ professional development while they reflect on and apply what they learned about health care systems, health equity, interpersonal communication, and the health humanities in phase 1 to the care of patients. Through the course, we intentionally revisit topics taught in phase 1 to facilitate connections to phase 2 and student reflection. Through facilitated small group discussion, students reflect on and share their experiences with one another. They are encouraged to think about how their perspective may have changed, and may continue to change, as they move through their clinical experiences. Students reflect on how various topics have been addressed in the clinical setting, through facilitated discussion about what they have seen and experienced.

In addition, students are still working to develop practical skills that they will use in the clinical setting in phase 2 and beyond, largely through procedural skill acquisition. Clinical Intersections is a satisfactory/unsatisfactory course but satisfying the course and all components is a graduation requirement. Graded components of Clinical Intersections include completion of all required assignments, attendance at all sessions, and professional engagement.

Course Learning Objectives:

• Develop student professional identity as a clinician with a patient-centered view of medicine.
• Enhance student skills to work with individuals (patients, colleagues, other health care professionals) who navigate medicine with different strengths and values
• Utilize peer connection, faculty support, and reflection to balance challenges in the clinical space
• Draw connections between your medical knowledge (phase 1) and your clinical experience (phase 2)
• Recognize ethical issues that arise in the health care setting and the role that all team members play in navigating these to ensure optimal patient care.
• Strategize a plan for the career decision-making process and planning for Phase 3.
• Demonstrate the technical skills to perform the common procedures required for graduation.
• Students will have received instruction on the performance of procedures listed below.

Instructional Features:

Major Topics for Plenaries and Small group discussions:

• Learning to Navigate the Clinical Environment
• Caring for Linguistically Diverse Patients
• Anti-Racism Curriculum
• Career Decision-Making
• Patient Safety Case Reporting: the “SAFER” Approach
• Treating Patients with Substance Use Disorder
• Death and Dying

Procedures and Skills:

• IV Insertion
• Phlebotomy
• Arterial Blood Gases (ABG
• Nasogastric Intubation (NGT):
• Time‐Out ‐ Instruction with NGT
• Escalation of Airway Support
• EKG 12 Lead Placement

Assessment Methods:

Student assessment in the Clinical Intersections course is based upon the direct observation of your skills, attitudes, and problem-solving abilities, thus you must be present at all sessions. Grades for the course are either Satisfactory or Unsatisfactory.

To receive a Satisfactory grade in the Clinical Intersections course, students must adhere to the following:

1. Attend all sessions and sign‐in as announced prior to each session.
2. Be on time for all sessions.
3. Complete all assignments on time.
4. Be professional at all times.
5. Participate fully in all session.

Updated: 12/20/23