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Phase 3

Career Differentiation and Exploration

The advanced clinical experience phase is time for learners to complete their core curriculum requirements and explore their own interests in medicine through sub-internships and electives. The required core rotations include medicine, critical care, emergency medicine and interprofessional healthcare experiences.

Requirements for advanced clinical experiences

Activity Length
Transition to Residency
2 weeks
Required rotations
18 weeks
Elective rotations
16 weeks

 

Course descriptions

MD 900 Medicine Subinternship Overview (4 weeks)
The internal medicine (IM) subinternship provides the motivated M4 student the opportunity to prepare themselves for the clinical work of residency in a way that will allow them to perform efficiently and effectively. IM residency program directors identify the following four core skills that they expect from new interns:

  • Managing time wisely
  • Communicating effectively within healthcare teams
  • Recognizing sick vs. non‐sick patients
  • Knowing when to ask for assistance

Organization and time management are critical for the busy intern and resident. During this rotation you will begin to develop a routine that will organize your daily tasks, learn to prioritize competing demands and to develop insight into your limitations and the need to ask for help.

Communication in healthcare takes many forms including the clinical documentation, oral presentation, handovers, calling consultants, communication with nursing and pharmacy, discharge planning and more. Complete, concise and accurate communication are critical for quality of care and patient safety. The sub-internship is the time to practice these communication forms not typically performed by the M3 student.

Exposure to a broad range of patients in the inpatient setting will prepare students to gather clinical data, synthesize the information, determine acuity and prioritize patients’ needs. Most importantly students should recognize the need to call for help for unstable patients. This means recognizing one’s own limitations of clinical skill and knowledge, but also being aware of the process by which accesses help.

MD 903 Critical Care Medicine overview (4 weeks)
MD 903 fills the critical care graduation requirement. During this rotation, students will have advanced clinical experience in critical care medicine. The rotation will take place in a designated intensive care unit. During this rotation students will function as first year residents under the direction of faculty and residents. At the conclusion of this rotation students will demonstrate competence in the learning objectives outlined below.

Critical care medicine (CCM) outcomes:
During the Critical Care Medicine rotation, fourth year students will:

  • Acquire more in-depth knowledge about critically ill patients.
  • Attain further clinical skills, knowledge and professional behaviors required to evaluate and care for critically ill adult patients.
  • Achieve a familiarity with the intensive care unit and working with the multidisciplinary team.
  • Learn ‘multitasking’ skills to allow the student to care for patients with complex needs simultaneously.
  • Value the role of palliative care medicine principles in the intensive care unit setting.

MD 911 Emergency Medicine Clerkship Overview (4 weeks)
The emergency department provides the safety net of care for the modern American healthcare system. While emergency medicine is a specialty built upon the nuanced, timely and critical care of the acutely ill, the specialty also administers acute unscheduled care when access to other providers or resources is limited. Emergency medicine is an inclusive and diverse specialty that crosses cultural and socio-economic boundaries on a minute-to-minute basis and is a field that requires a unique set of cognitive skills to manage the dynamic nature of patient and system needs. The primary goal of this clerkship is to structure the development of skills in the assessment and treatment of a broad range of clinical conditions, by offering the learner an abundance of patient care experiences through participation in the delivery of emergency medical care in a manner that fulfills learning needs. The faculty recognize that each student will have an independent set of needs and interests and opportunities to participate in the delivery of emergent, urgent and unscheduled care. A structured format is provided to objectively assess student progress, and to set appropriate expectations, but should be viewed as a framework on which to build a successful experience.

MD 915 IPE Selective – Interprofessional Education Rotation Overview (2 weeks)
All students are required to complete an interprofessional (IPE) education rotation on a highly-functioning interprofessional team. This clerkship requirement addresses the need for physicians-in-training to understand the roles of all members of the healthcare team and to function well within these teams. The IPE selective requirement can be fulfilled through this IPE selective course (MD 915) or on a very rare occasion at another site with preauthorization by the course director (a request in writing must be received a minimum of 30 days prior to beginning clerkship). This IPE selective can occur in a number of different settings allowing students to foster individual interests so that they can continue to develop the attitudes and skills necessary to practice medicine in a team setting.

MD 9015 Health Systems Selective Overview (4 weeks)
The purpose of this health systems selective is to broaden the M4 student experience while gaining exposure to the practical aspects of healthcare delivery. Through the selective, students will explore themes such as social determinants of health, population health, high value care and an appreciation for similarity over various clinical settings and within healthcare teams.