Required rotation
This required rotation of no less than four (4) weeks in an internal medicine clerkship is intended to be a structured clinical experience under direct supervision. In a short time, all of internal medicine cannot possibly be covered; therefore, this must be considered an introductory experience. This rotation is a time to build a foundation in clinical problem-solving and decision-making; a time to build clinical experience and acumen on a foundation of didactic information.
The internal medicine department administers a post-rotation examination when the student has completed the required medicine rotation.
Elective rotation
The elective rotation is a four (4) week experience structured to further develop cognitive skills and application of didactic material in a clinical setting. Students taking the elective are strongly encouraged to participate in SIMPLE (Simulated Internal Medicine Patient Learning Experience). SIMPLE is a comprehensive Internet-based learning program for use by core internal medicine clerkship students. SIMPLE’s 36 interactive virtual patient cases are designed to comprehensively cover the CDIM- SGIM Core Medicine Clerkship Curriculum used by medical schools throughout the country.
SIMPLE is designed to supplement traditional clerkship teaching and patient care activities. It provides medical students and clerkship directors access to peer-reviewed learning materials that provide a solid foundation in internal medicine medical knowledge appropriate to the core clerkship student.
Purpose
Clinical experiences are intended to assist the student’s transition from didactic to integrated clinical evaluation and patient management. In addition to gaining specific skills, the student should also develop skill in systematic medical problem-solving and patient management abilities; establish or reinforce patterns of independent learning and self-evaluation; and improve skills in communication and medical record keeping. Under supervision, students are expected to assist in the management of acute and chronic problems. The student should also develop fundamental psychomotor skills by performing routine basic procedures under direct supervision.
Course objectives
The student should be able to:
- Elicit a record of an appropriately complete, cogent and organized medical history.
- Conduct and record an appropriately complete and accurate physical examination.
- Communicate in a facilitative, effective, efficient and educational manner with patients and their families.
- Identify the social and psychological components of patients’ medical problems.
- Use knowledge of the pathophysiology of signs and symptoms to establish clinical correlation with disease processes.
- Develop an accurate and complete problem list.
- Formulate a reasoned differential diagnosis for each problem.
- Formulate an appropriate plan for confirming the diagnosis.
- Use knowledge of the indications and limitations of clinical sources such as laboratory and roentgenographic studies, consults, family input and old records to request and interpret data pertinent to problem-solving.
- Use information from texts, syllabi and journals to study general topics related to patient’s problems.
- Observe, review, reassess and revise clinical management daily; record patient progress in the medical record; and make a verbal report to the health care team.
- Communicate clearly and succinctly to colleagues and other members of the health care team.
- Apply those technical skills commonly employed on a medical service.
- Formulate an appropriate initial treatment program taking into account the urgency of the patient’s problems.
- Formulate an appropriate ongoing health care plan for patients within their socio-economic situation.
Technical and interpretational skills
Students are expected to acquire certain technical skills and interpretation that are commonly employed in medical care. Wherever possible, appropriate students are encouraged to participate in procedures under adequate supervision.
The student should be able to:
- Record and interpret an ECG
- Perform venipuncture for blood specimens or intravenous therapy
- Test for the presence of blood (e.g. by hemoccult) in stool
- Interpret cardiac enzymes
- Interpret a complete blood count
- Interpret results of a urinalysis.
- Interpret Gram stain results of body fluids
- Interpret bedside tests of pulmonary function
- Interpret chest x-ray findings
- Interpret arterial blood gas measurements
- Interpret serum electrolyte measurements
- Interpret common chemistry measurements (e.g. CMP)
- Interpret results of body fluid analysis including joint, pleural, peritoneal, spinal