Year 3 curriculum/LIC
Geisinger Commonwealth School of Medicine is among the first medical schools in the U.S. to adopt the Longitudinal Integrated Clerkship (LIC) model as the standard clinical experience for the entire medical school class in the third year.
The third-year MD program curriculum at Geisinger Commonwealth is an innovative hybrid of inpatient block experiences and a six-month outpatient LIC. This hybrid model provides for outstanding continuity of outpatient care with dedicated outpatient faculty, but also allows for intensive blocks of inpatient training in each core discipline. This curricular approach also helps students develop a cohort of “continuity patients” in each clerkship and allows students to take part in the initial assessment, the plan of care, the intervention and follow-up. The long-term nature of these relationships provides for a period of sequential learning with incrementally greater levels of responsibility that are not achieved in brief clerkships. It also allows for longitudinal assessment and feedback that are critical to the development of competence. In addition to the specific inpatient and outpatient clinical clerkship rotations, students also complete 80 hours of required emergency department experience and four weeks of electives and selectives.
The year is divided into two halves. During one half-year, students will complete the outpatient LIC, working in all six disciplines simultaneously. In the other half of the year, students will complete blocks (primarily in hospital settings), selectives, electives and emergency medicine.
A sample student schedule is shown below.
Longitudinal Integrated Clerkship (LIC)
During the six-month LIC, students work one-on-one with attending physicians in outpatient settings. This experience emphasizes continuity of students with their preceptors and patients, and allows the students to integrate into patient care in a meaningful way.
During the LIC, students participate in six clerkships simultaneously. “Clerkship Education Day” is held each Friday afternoon from 1:30 p.m. to 5 p.m. This time is dedicated to group learning activities, case conferences, reflections and other core curricula. Students have three half-days of “white-space” each week. This is unscheduled educational time for independent learning. Students are encouraged to follow their continuity patients to consults, surgeries or appointments with other providers. The time can also be used to gain additional experience in an area of interest.
Note that this is an example and each student will have a unique schedule.
The other half of the year is dedicated to blocks rotations primarily in hospital settings. These experiences allow for training with acutely-ill, hospitalized patients in numerous disciplines. They also provide for experience in obstetrics, surgery and anesthesia. Student will often work with interdisciplinary teams and residency teams in these settings. In addition, students must complete a two-week selective in either Introduction to Diagnostic Imaging, Pathology/Lab Medicine, Neurology/Neurosciences, Anesthesia or Clinical Problem Solving/Nutrition in Medicine. Students also complete a two-week elective in a discipline of choice, and 80 hours of emergency medicine during a block rotation. “Clerkship Education Day” is still held each Friday afternoon from 1:30 p.m. to 5 p.m. regardless of the block.
The required and elective inpatient block rotations are summarized below.
- Introduction to Diagnostic Imaging
- Pathology/Lab Medicine
- Clinical Problem Solving/Nutrition in Medicine
No. of weeks
Year 3 learning objectives
The learning objectives of all third-year clerkships are based on the general MD Curriculum Program Objectives that have been established by Geisinger Commonwealth. These include:
- Medical knowledge: Students must demonstrate understanding of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, and the application of this knowledge to the care of patients. Students must demonstrate appropriate depth of knowledge about the presentation and management of illness and the evidence-based knowledge that is the foundation of patient care.
- Practice-based learning and improvement: Students must demonstrate an ability to locate, appraise and assimilate scientific evidence for the improvement of patient care practices.
Interpersonal and communication skills: Students must demonstrate interpersonal and communication skills that result in effective information exchange, therapeutic, ethically-sound relationships and collaborative decision-making with patients, their families and professional colleagues.
- Patient care: Students must demonstrate patient care that is compassionate, appropriate and effective for the treatment of patients in the context of their families and communities. Students will demonstrate and advocate for appropriate treatment of illness and also the promotion of health maintenance, disease prevention and wellness as it pertains to each discipline.
- Professionalism: Students must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to contextual issues in a diverse patient population. This includes demonstration of a commitment to continuous learning, dedication to patient care, respect, compassion and integrity in all activities.
- Systems-based practice: Students must demonstrate an awareness of, and responsiveness to, the larger context and system of healthcare, as well as the ability to call on other resources in the system to provide optimal healthcare to patients and their families.