clerkship handbook - University of Hawaii – Department of Medicine

DESCRIPTION OF THE THIRD-YEAR CLERKSHIP IN INTERNAL MEDICINE
INTRODUCTION
Goal of the Clerkship
The goal of the Third-Year Clerkship in Internal Medicine is to provide the opportunity to develop
experience and competence in Internal Medicine, which serves as the foundation for all
specialties and their respective residencies. To practice competently, a physician must obtain and
retain a large body of knowledge, master the skills of clinical practice, develop efficient problem
solving techniques and demonstrate compassion, integrity, self-discipline and life-long learning
skills. It is the student’s responsibility to utilize this clerkship experience to accomplish these
goals. It is the Department of Medicine’s responsibility to assure that every graduate of the John
A. Burns School of Medicine has obtained graduation level competency in Internal Medicine.
The core of this clerkship is “Patient-Based Learning,” which occurs as students evaluate patients
through history taking and physical examinations, develop comprehensive assessments including
appropriate differential diagnoses, formulate diagnostic, therapeutic and education plans and then
provide care and follow-up appropriate to the inpatient or ambulatory setting.
Design of the Clerkship
Third-Year Clerkship in Internal Medicine (MED 531/532)
MED 531 for 6B students is 11 weeks in length and consists of 5-1/2 or 6 weeks of Inpatient
Medicine and 5-1/2 or 5 weeks of Ambulatory Medicine. MED 532 for 6L students consists of 6
weeks of Inpatient Medicine (block) and 25 half days of ambulatory medicine (clinics - one half
day weekly for 21-22 weeks plus 3-4 additional half days).
Work Hours, Designated Study Time, Days Off and Holidays
Work hours
No student should work more than eighty (80) hours per week, averaged over the course of the
clerkship.
The clerkship recognizes that excessive work hours do not promote student well-being and may
endanger students, their patients and others with whom they interact.
For inpatient medicine, the earliest time that any student is permitted to arrive at the hospital is
4:00 a.m. and the earliest time that any student is permitted to see any patient, that is, to actually
talk to and examine, is 4:30 a.m. (excluding emergency situations such as Code Blues). (See
Inpatient Medicine)
The Hospital Site Coordinators and Chief Medical Residents are aware of these work hour
guidelines.
If a student is not able to complete his/her work within these work hour guidelines, the student is
advised to see his/her Hospital Site Coordinator, Chief Medical Resident or Supervising Resident.
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