INTERNAL MEDICINE Savannah CLERKSHIP MANUAL

INTERNAL MEDICINE
Savannah
CLERKSHIP MANUAL
CLASS OF 2017
(7/27/2015 to 7/8/2016)
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Table of Contents
Mission, Vision, Goals ................................................................. Page 3
Key Contacts ................................................................................ Page 4
Course Objectives……………………………………………....Page 5
Grading Information .................................................................... Page 7
Clerkship Syllabus ....................................................................... Page 11
Numbers & Kinds of Patients ...................................................... Page 12
Service Responsibilities – Inpatient & Outpatient ....................... Page 14
Performance Evaluation – Appeals Committee on Students ....... Page 18
Remediation Policy/Failure to meet Evaluation Standards .......... Page 18
Attendance Policy/Absences ........................................................ Page 19
Failure to meet attendance requirements ..................................... Page 20
Physical Findings/Professionalism/Knowledge Base .................. Page 21
Duty hour expectations/Requirements…………….. ................... Page 22
Clerkship Requirements - Important Dates & Information ......... Page 23
Lecture Topics .............................................................................. Page 24
On Call and Holiday Schedule ..................................................... Page 25
Student Resources ........................................................................ Page 26
FORMS
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MISSION STATEMENT FOR THE JUNIOR CLERKSHIPS
MERCER UNIVERSITY SCHOOL OF MEDICINE
Mission
The mission of the junior clerkships is to prepare broadly students for the practice of clinical
medicine by facilitating their acquisition of the knowledge, behaviors, skills, and attitudes
necessary for the compassionate and competent care of patients.
Vision
Our vision is to create lifelong learners who embody the stated values of MUSM
(collaboration, compassion, competence, excellence, integrity, respect and honesty, and
service) and who have a commitment to meeting the health care needs of Georgia.
Goals
Our goal is that students will be able to evaluate effectively a patient by performing an
appropriate history and physical that facilitates differential diagnosis and the developing of a
treatment plan.
Our goal is to ensure students obtain the core knowledge considered necessary for the practice
of medicine.
Our goal is to socialize medical students into the best of the culture of medicine such that they
develop an enduring commitment to the care of patients.
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INTERNAL MEDICINE ACADEMIC YEAR 2015-2016
CLASS OF 2017
JUNIOR MEDICINE CLERKSHIP DESCRIPTION
Welcome to the Internal Medicine Clerkship!
Following are the key faculty and staff responsible for the Clerkship.
Academic Chair: Steven Carpenter, MD
Phone: (912) 350-8372; E-mail: carpest1@memorialhealth.com
Clerkship Director: J. David Baxter, MD
Phone: (912) 350-8372; E-mail: d5335@memorialhealth.com
Year 3 Program Director: J. David Baxter, MD
Phone: (912) 350-8372; E-mail: d5335@memorialhealth.com
Clerkship Coordinator: Sandra Simmons
Phone: (912) 350-8372; E-mail: simmosa1@memorialhealth.com
Mailing Address:
Office Address:
Department of Internal Medicine
Memorial University Medical Center
4700 Waters Avenue
Savannah, GA 31404
Department of Internal Medicine Education
Center for Internal Medicine
1101 Lexington Avenue
Savannah, GA 31404
Chief Residents 2015-2016
NAMES
PAGERS
Joseph Kramer, MD 3 rd Yr. 8967
Kasra Sedarati, MD 3 rd Yr.
8463
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THE COURSE OBJECTIVES OF THE CLERKSHIP ARE AS FOLLOWS:
The student will be able to…
1. Obtain a complete and accurate medical history including asking how recently patient
has undergone appropriate screening studies.
2. Obtain an accurate social/health promotion history including asking about alcohol,
tobacco, exercise, etc.
3. Perform and record a complete and accurate physical.
4. Review laboratory tests and radiological studies and interpret possible causes and
effects.
5. Develop an accurate assessment, workable problem list and differential diagnosis on
each new patient.
6. Suggest an appropriate therapeutic plan that includes pharmacological agents and
therapeutic diagnostic studies.
7. Recognize and prioritize problems in the form of a problem list.
8. Review pertinent literature to expand your knowledge and understand the natural
history of the disease process and determine the efficacy of traditional and
nontraditional therapies.
9. Communicate effectively in oral and written form.
10. Use electronic data retrieval systems (MD CONSULT, PUB MED, HARRISONS, UP
TO DATE)
11. Recognize and maintain professional conduct.
12. Be active in the role as part of the multidisciplinary team including nurses, social
workers, colleagues, patients, and families.
13. Recognize the ethical and medical issues in patient documentation, confidentiality
issues.
14. Discuss patient issues consistent with HIPAA privacy regulations.
15. Recognize situations where biopsychosocial determinants have impact on health and
disease and identify ways to maximize therapy and safe discharge that takes into
account these issues.
16. Identify most appropriate tests in any patient encounter based on documented
sensitivity and specificity and adequately explain decision process to team.
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17. Rapidly identify life-threatening emergencies and notify team of same in a timely
fashion.
18. Interact with patients in a manner that respects individual diversity (including
religious, racial, ethnic, sexual orientation, etc.) differences.
19. Interact with patients in a courteous, caring, empathetic manner using standard good
courtesy practice (including active listening, reflective listening, not interrupting, not
judging, etc.)
20. Recognize normal structure and function of normal body systems and recognize
alterations of these body systems in the diseased state.
21. The student will be able to identify an assortment of physical findings as listed in the
student manual via the provided website and be responsible for the content of that
website which you will be tested on during the exit exam at the end of the fourth year.
22. Analyze clinical experiences and scientific information and use this information to
improve clinical experience through reflective writing.
23. Participate in an OSCE at mid-rotation and receive feedback on performance by faculty
mentor.
24. The student will learn to recognize common pathological conditions/findings using
diagnostic imaging studies appropriate for the clerkship.
Your own patients are the focus of developing these skills and your contact with them is the center of
your curriculum.
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The total grade is a sum of four components:
GRADING INFORMATION
for INTERNAL MEDICINE
10 - Journaling Entries 10%
8 - Written History & Physicals and 4-SOAP notes 10%
Ward Performance 40%
Shelf Test 40%
100% or 104% if bonus
earned
Journaling Entry Project – 10% (Pass =10; Fail = 9 or lower)
Written History & Physical and SOAP notes - 10% (8 H&Ps; 4 sets of SOAP
notes)
Must Turn in 8 H&Ps and 4 SOAP notes – Each will be critiqued by the ward attending
physicians. The physician will look for improvement in documentation skills and broadening
of assessment and plan. This is a formative exercise. It is at the discretion of the director or
the ward attending physician if all or portions of the H&P need to be redone. Maximum credit
is given if all 8 H&Ps and 4 sets of SOAP notes are turned in.
NO PARTIAL CREDIT WILL BE GIVEN!
Shelf Test - 40%
(Pass = 62% or higher; Fail = 61% or lower)
Ward Performance - 40%
(Pass = 56% or higher; Fail = 55% or lower)
This score assesses the following four areas:
• Knowledge Base ●Communication Skills/Presentation Skills ●Attitude
Problem Solving Skills/DDX
The ward performance evaluations are converted to a numerical score. The actual
grade is the average sum of all scores. The maximum obtainable score in this area is
4.0, which will result in a maximum of 40% in this area.
1. Students who are required to remediate any component of a clerkship (with the
exception of incomplete clinical encounters-ICE) may not do so during a
subsequent clerkship.
2. All remediation events must be completed within 8 weeks of the end of Year III.
Students will not be allowed to enter Year IV until all remediation events are
successfully completed.
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3. Students who fail to complete remediation within 8 weeks will be required to go
before the SPAC (Student Professional Assessment Committee.
Two (2) bonus points will be given if weekly work hour logs, procedures, numbers & kinds, and H&Ps are
up to date at the mid-term of the rotation. To be eligible to earn the two (2) bonus points at midterm,
the following minimum requirements must be met:
• 4 weekly work hour logs to include weeks 1-4 of the rotation
• ½ of the required procedures and numbers & kinds entered into MUSM One45
system
• 3 journal entries entered into the Mercer’s Blackboard system to include weeks
2-4 of rotation
• 1 H&P although 4 H&Ps would be desired
An additional two (2) bonus points will be given if weekly work hour logs, procedures, numbers & kinds,
journal entries, and H&Ps are completed by week 11 of the rotation. A total of four (4) bonus points
can be earned. If any of these components are missing, your grade will be withheld until
completion of missing component.
Minimum Score on Shelf Exam = 62%
Each student will be given a grade of pass, fail, or incomplete at the end of the rotation.
PASS – Minimal level of Competency
In order to obtain a passing grade in Internal Medicine all evaluations must be satisfactory or
better, the shelf exam must be passed and a cumulative score must be equal to or greater
than 65%.
The breakdown for final grades at the end of the year as per the Clerkship Committee and the
Curriculum Committee are as follows:
PASS FAIL Numerical Score in Dean’s Letter
MINIMUM CUMULATIVE PERCENTAGE FOR
PASSING MEDICINE ROTATION IS 65
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Journaling Project Entries – Total of 10 entries are required
Learning is more than the accumulation of facts; it includes personal growth,
interpersonal interactions, communication and professionalism. As a third year student
you will encounter things you have never experienced before. This journaling project is
a way to reflect on your experience and to learn from it.
You will be required to submit online journal entries via the Mercer Blackboard
Webpage. Ten (10) entries are required in all. Each entry should be a reflection on an
experience you had during that week. This could be an interaction with a resident
physician, attending physician, peer, patient, ancillary staff person or any significant
experience that happened during that week. Each entry should be at least a paragraph
and should include:
• A description of the experience.
• How the event affected you.
• What you learned from it.
Examples would include:
• death of a patient
• a conflict with a peer
• a mistake you made
• an ethical dilemma
• a disagreement with an attending or a resident
• a patient that you particularly liked
• an encounter with a nurse
• Anything that affected you emotionally or that makes you reflect on what it
means to be a doctor.
You are expected to check and review the Mercer Internal Medicine Savannah
Blackboard site for useful handouts, educational videos, and practice shelf exams. A
communication blog is up on the site as an open forum for the rotation as well as useful
links to assist in your educational experience.
INSTRUCTIONS - HOW TO LOG ON TO BLACKBOARD WEBSITE
1. https://bb-mercer.blackboard.com
Log in – User name (Mercer ID #) and Password (Student’s Date of
Birth in the form of YYMMDD)
2. CLERKSHIP JOURNALING – CLKSHP JOURNALING
3. Class of 2017-Savannah Campus
4. Create New Entry
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Weekly Work Hours/Procedure Log Form: - (See Form)
The weekly work hours/procedure log form shows your accountability and responsibility of
your medicine clerkship activities and procedures for the rotation. In the first section to the
left, you will see the heading DATE/# HRS WORKED. Beside each day of the week, write
the date along with the total number of hours you worked on that day provided under the date.
In the middle section under the heading TIME OF DAY WORKED provide the hours you
were actually here, i.e., 8:00a.m. – 4:30 p.m. If during this time you completed your night float
call, have the night float resident that you worked with sign their name in the night float name
box.
In the right side section, write any procedures you performed on that day. Remember this
information must also be entered in the ONE45 computer system as well as on this procedure
log form.
In the bottom section, circle the correct box if you worked inpatient or outpatient and which
team you worked with during that week. You must also total your own hours and provide
your signature as well as printed name in the box provided. Don’t forget to circle the
appropriate week number of the rotation. You must turn in at least one log sheet for each of
the twelve weeks that you are on the rotation. The Clerkship Director and Clerkship
Coordinator will review your work.
Your signature shows you are attesting that the information you have submitted is true to the
best of your knowledge. It is suggested that you keep a photocopy of each weekly log form
that you turn in for your own records.
Please note: If your hours are not totaled or if you do not provide your signature and printed
name at the bottom of the form or if you do not circle the appropriate week number, the form
will be returned to you in order for you to complete each of these tasks.
*Students are required to enter all patient encounters into the MUSM “one45” software
at the medical school. The deadline to enter the information is the Saturday after the
Shelf Exam.*
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INTERNAL MEDICINE THIRD YEAR CLERKSHIP SYLLABUS
Internal Medicine is a 12-week rotation (8 weeks Inpatient, 4 weeks Outpatient).
The clerkship is designed to give you increasing responsibility in patient care within the
hospital wards and outpatient clinics.
The overall goal of the clerkship is growing independence. The majority of your learning
comes through personal experience so, DO NOT BE A BYSTANDER. Your willingness to
go out on a limb and take risks is expected. We expect “Thinking Outside the Box.”
Your evaluation will be based on the RIME method. Each step is a synthesis of knowledge,
skill, and attitudes.
REPORTER: Can work professionally with patients and staff and accurately gather and
clearly communicate the clinical facts on your patient and with the proper terminology (this
takes basic knowledge of what is important, plus the skill and reliability to do it consistently).
INTERPRETER: At a basic level, you must identify and prioritize new problems as they
arise. The next step is to offer a differential diagnosis. Success is offering at least three
reasonable possibilities for new problems and giving your reasons. (You won’t always have
the “right” answer.) This step takes growing knowledge, skill in selecting clinical facts and
seeing yourself as part of the intellectual process.
MANAGER: This step takes even more knowledge, and more confidence, plus the skill to
select among options with your own patient, to be “proactive” rather than simply “reactive.”
Generally, your diagnostic plan should include three appropriate test options and your
therapeutic plan should offer three possible therapies. Always state your own preference (you
don’t have to be correct).
EDUCATOR: Ultimately, your ability to help patients means an openness to new knowledge
and depends on your skill in identifying questions that cannot be answered from textbooks.
Are you able to cite the evidence that new therapies and tests are worthwhile?
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Complete list of procedures for clinical clerks by December of the
Third Year – those marked in red are required while on IM
1) Venipuncture (5) (complete on I.M.)
2) Intravenous catheter placement (5) (complete on I.M.)
3) Arterial blood sample for blood gas determination (observe) (complete on I.M.)
4) ACLS certification (complete on I.M.)
Number and Kind of Patients
Students Should Encounter During Internal Medicine Clerkship
Cardiovascular System
Encounter Required Minimum Level of Care * INPATIENT OUTPATIENT
Heart Failure 2 I or II X or X
Coronary Artery 1 I X or X
Disease
Hypertension 3 I or II X or X
Endocrinology and Metabolism
Encounter Required Minimum Level of Care * I/P O/P
Diabetes 4 I or II X or X
Mellitus
Lipid disorders 3 I or II X or X
Thyroid diseases 1 I or II X or X
Gastroenterology and Hepatology
Encounter Required Minimum Level of Care * I/P O/P
Gastrointestinal 1 I or II X
Bleeding
PUD/GERD 1 I or II X
Liver diseases 1 I or II X
Hematology and Oncology
Encounter Required Minimum Level of Care * I/P O/P
Anemia 1 I or II X or X
Cancer 1 I X
Infectious Diseases
Encounter Required Minimum Level of Care * I/P O/P
HIV infection 1 I or II X or X
Skin and Soft
tissue infection
1 I or II X
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Nephrology
Encounter Required Minimum Level of Care * I/P O/P
Renal failure 1 I X
Neurology
Encounter Required Minimum Level of Care * I/P O/P
Stroke 1 I or II X
Preventive Medicine
Encounter Required Minimum Level of Care * I/P O/P
Adult Preventive
Care
1 I X
Psychiatric/Psychosocial disorder
Encounter Required Minimum Level of Care * I/P O/P
Depression 1 I X
Substance Abuse 2 I or II X or X
Pulmonary Medicine
Encounter Required Minimum Level of Care * I/P O/P
Obstructive 3 I or II X or X
Airway Diseases
Pneumonia 1 I or II X
Symptoms
Encounter Required Minimum Level of Care * I/P O/P
Altered Mental 1 I or II X
Status
Chest pain 1 II X
Dyspnea 1 II X or X
Cough 1 II X or X
Abdominal pain 1 I or II X or X
Rash 1 II X or X
Back pain 1 I or II X or X
Joint
1 I or II X or X
pain/swelling
Headache 1 I or II X or X
Dysuria 1 I or II X or X
Fever 1 II X
* Level of Care: I = Perform under supervision II = Assist with evaluation/treatment III = Observe
I/P = Inpatient O/P = Outpatient
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SERVICE RESPONSIBILITIES
YOU SHOULD ALWAYS BE AVAILABLE BY PAGER.
PLEASE KEEP YOUR PAGER ON AT ALL TIMES!
INPATIENT RESPONSIBILITIES - Inpatient Service (8 weeks – two 4-week
blocks)
You will be assigned to one of five (5) primary care residency teams composed of one
second/third year resident and one first year resident.
1. On the first day of the 12-week rotation, you will attend an Internal Medicine
Department Orientation with the Clerkship Director (Check your “Welcome” letter for
exact location.)
2. You should go to every admission – this is for your benefit and to help the team.
3. Typical (call) day – Come in at 7:00 a.m. Let both your intern and resident know you
are here. If they do not know you are here, they will not call you with an admission.
See your old patients and write notes. Go to lectures and let the team know when you
are gone and when you come back. No overnight call. Do not leave before your team
leaves.
4. You will be assigned one (1) to three (3) new patients per call day. However, it is anticipated
that the student will continue to accompany his/her team during the remainder of the on-call
day so that he/she will be exposed to further patient evaluations, clinical decisions, etc. The
student must turn in one complete “graded” history and physical per week on a new patient to
the Internal Medicine Clerkship Coordinator.
5. Call occurs every fifth (5 th ) night on the Internal Medicine teams; therefore, during a four-week
block on the Internal Medicine rotation, you will be on call seven (7) times. All medical
residents on Internal Medicine teams have four (4) total days off per 28-day block. You will
follow the same schedule as the residents on your team allowing you to have four (4) days off
during the 28-day rotation. Student call rooms are available.
6. You will attend Morning Reports in the Hospital’s Conference Room (see NEW
INNOVATIONS).
7. You will attend Grand Rounds at 8:00 a.m. on Fridays in the Medical Education Auditorium.
8. You will attend Lunch Conference daily at 12:30 pm in Conference Room C.
9. You will attend student tutorial sessions with Dr. Leighton, Dr. David Baxter or other faculty
members AS SCHEDULED.
10. On Saturday and Sunday, come in at 7:00 a.m. If your team is working, you should
work.
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11. Typical (non-call) day – Come in at 7:00 a.m. See your patients, write your notes and
round with your team. Please print out a team list (the interns will show you how).
Be prepared to present them - know the labs, radiological results and medication list.
Notes are written in Epic. See the Medical Student Tab.
12. Please check student mailboxes weekly for any correspondence. Student mailboxes are located
in the Resident’s Room at the Center for Internal Medicine, 1101 Lexington Avenue.
.
You MUST KEEP A LOG OF ALL PATIENTS THAT YOU HAVE
ACTIVELY FOLLOWED AND ENTER THEM IN THE PATIENT TRACKING
DATABASE IN MERCER’S one45 EVALUATION SYSTEM.
***ALL Epic notes are to be reviewed by the senior resident or attending daily.
***
OPTIONAL for Inpatient Students
Week of Nights (night float) starts on Monday at 7 p.m. until roughly 7 a.m. for five (5)
nights. On Monday night, page the Senior Resident on Nights. Students are excused
from all lectures during the day this week only. Students are not excused from the
OSCE, Longitudinal Course, or Mid-term Reviews.
This is a great opportunity to get your H and P's done. You can admit 1-3 patients a
night. I recommend that you present at least one (1) patient every day at morning sign
out. If possible, the patient will be followed by another medical student on the day
shift. You are ACLS certified and should respond ASAP to any and all codes. If you
are approved, the Week of Nights Policy will be provided to you prior to your start.
NOTE: ONLY ONE (1) STUDENT ALLOWED ON NIGHT FLOAT AT A TIME.
TRANSITIONING FROM INPATIENT TO OUTPATIENT ROTATIONS
Inpatient teams work Monday through Sunday. If your team is working, you are
working. Your Inpatient assignment ends on the Monday morning you are assigned to
begin your Outpatient work.
There will be times you will work the weekend and then work the entire next week
without a day off. This fits the guidelines.
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OUTPATIENT RESPONSIBILITIES - Outpatient Service (4 weeks) – No call during this
time.
1. On the first day of the 12-week rotation, you will attend an Internal Medicine Department
Orientation with the Clerkship Director (Check your “Welcome” letter for exact location.)
2. Students on the Outpatient/Ambulatory rotations will then go to their assigned
Outpatient/Ambulatory assigned location immediately following Orientation. The contact
person is listed for each location and you will be given information for that office. (See
information sheet.) Outpatient/Ambulatory students do not attend Morning Report while
on this rotation.
3. The student must attend teaching sessions as outlined under the Inpatient Rotation
Responsibilities.
4. Students attend Grand Rounds at 8:00 am on Fridays and Lunch Conference at 12:30 pm
daily at Memorial University Medical Center.
5. If the private attending is out of the office for illness, vacation, day off, etc., the student
should be assigned to the attending’s partner. If no attending is available, the student
will follow one of Memorial’s Department of Internal Medicine inpatient ward teams
until the assigned physician returns. This will be noted on your Weekly Work Hour
Log.
6. “Principles of Ambulatory Medicine” textbook is available in the Health Sciences Library
and online.
7. On the last day of the rotation, the student should return any items borrowed from the
Internal Medicine Office between 9:00 am and 3:00 pm.
8. Please be sure to check student mailboxes weekly for any correspondence. Student
mailboxes are located in the Resident’s Room in the Center for Internal Medicine.
9. Do not forget to log patient encounters in one45. Please keep a copy of your
encounters and procedures.
Directions are provided for the following Outpatient/Ambulatory locations prior
to the rotation:
OUTPATIENT/AMBULATORY
OFFICES
CONTACT or
DESIGNEE
PHONE
NUMBER
Chatham Medical Associates Ashley Fuller 912-350-7500
Dr. Yulianty Kusuma
Internal Medicine of Savannah
Dr. Steven Corse
Optim Medical Associates
Dr. Kusuma 912-349-6624
Amy 912-443-4272
YOU SHOULD ALWAYS BE AVAILABLE BY PAGER.
PLEASE KEEP YOUR PAGER ON AND WITH YOU AT
ALL TIMES!
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TRANSITIONING FROM OUTPATIENT TO INPATIENT ROTATIONS
Outpatient rotations are Monday - Friday. You are off on the weekends that you are
assigned to the outpatient/ambulatory rotation.
When you complete your last Friday of the outpatient/ambulatory rotation, you begin
work on your inpatient team on Monday at 7AM.
Current ACLS certification is a prerequisite for rotating on the Ward teams at Memorial
University Medical Center in Savannah. Failing to pass the ACLS certification will delay your
rotation start date on the Wards.
NOTE:
Students return to their assigned Outpatient/Ambulatory offices
after any conferences, lectures, tutorials, Mercer meetings, etc.,
unless otherwise directed by the Attending or Office Contact.
Observed Structured Clinical Exam (OSCE) – Mid-Rotation
This Exam will be held in Savannah. Details regarding student arrival time for this
exam will be provided by MUSM’s Clinical Skills Department prior to the Exam.
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Performance/Evaluation – Appeals Committee on Students
Mercer University School of Medicine’s grading system is a pass/fail grading system for the
Third Year Clerkship rotations. This means that you will not be compared to your colleagues
until the final Dean’s letter. This letter will have a bar graph, which will represent the
distribution of your class in each clerkship.
The total percentage that can be obtained in IM is 100, so your final numerical grade is the
percentage you achieved out of 100. The minimal percentage needed to pass is 65. If for
some reason you do not agree with your calculated total score, you may file a complaint to the
appeals committee. Your appeal must be submitted in writing one week prior to the meeting
day so members of the committee will have time to prepare to hear your case. They will
review your file in detail and notify you with their final decision.
Remediation Policy/Effect of failure to meet evaluation standards
* All remediation must be completed within 6 months of completion of the 3 rd year
curriculum. *
If a student fails to obtain a total of 65% during the rotation, the student must remediate for
one month.
If a medical student fails the shelf test on the first attempt, they will be given an incomplete for
the rotation until that time that the shelf test is retaken. If they pass the shelf on the second
attempt, they will pass the rotation. If however, they should fail the repeat shelf, they will
receive a failure grade for the rotation and they will be required to retake the rotation in its
entirety and will be assigned to a faculty member for close monitoring.
If the student should fail the ward or clinical experience, but pass the shelf test, they will be
given an incomplete until which time they remediate one month of clinical wards with a
specified attending. The student will be monitored closely and given as much guidance as
needed. They will take call, keep a logbook of cases, be assigned to an inpatient ward team,
attend conferences, and take the shelf test. They must receive satisfactory evaluations from
faculty and residents to complete remediation, earning less than a cumulative score of 3.0;
they will be required to repeat the internal medicine clerkship in its entirety. The student
should receive an average of 3.0 on their cumulative clinical performance.
If student fails the shelf and clinical, the student fails the clerkship and must repeat the
entire Internal Medicine rotation.
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Policy on Attendance/Absences
Procedure for reporting/requesting absences
Effect of failure to meet attendance requirements
Policy:
A 100% attendance is expected by all students on rotation. You are expected to participate in
all scheduled activities. As clinical and educational activities arise, other activities may be
scheduled. You should keep the hours from 7:00am to 5:00 pm available for clinical,
educational, and academic activities even if nothing is scheduled. Significant absences or
tardiness constitute a lack of professionalism and will be dealt with as such.
The Clerkship Director requires a letter from the student’s physician if the student misses more
than two (2) days or at the clerkship director’s discretion.
Excused absences are granted for sickness, death in the family, or a Mercer sanctioned
educational meeting with prior approval.
All unexcused absences will require remediation at the Clerkship Director’s discretion.
*Making up call: If for any reason you will miss a call day – you will be required to make that
day up. No switching call days between teams. You must stay on your team and remain on
call with your team. The day that the call day will be made up will be at the direction and
discretion of the Clerkship Director.
Procedure for reporting/requesting absences:
An advance written request should be submitted to the Clerkship Director via the Clerkship
Coordinator for all absences. The written request can be in the form of an e-mail. All
absences should occur with the full knowledge and permission of the Clerkship Director via
the Clerkship Coordinator and Attending Physician of your team. If you are working on your
Outpatient weeks, absences should occur with full knowledge and permission of the Clerkship
Coordinator and Resident/Attending Physician you are assigned to work with during that time.
If you are unexpectedly ill or have an emergency that requires you to be absent, you MUST
notify the Clerkship Coordinator and the attending and/or resident of the service that you are
currently working on of your illness/absence.
*All absences during the rotation will be reported to Katie Davis, Mercer Student Coordinator
at the end of each rotation. *
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Effect of failure to meet attendance requirements:
If a student misses four (4) or more days of the rotation due to excused or unexcused absences,
an Incomplete for the rotation will be given and an appropriate remediation experience will be
required. The time of the remediation will be at Christmas Break or before the beginning of
the Fourth Year or at the clerkship director’s discretion. If the student misses five (5) days or
more, a one-week remediation will be mandatory.
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PHYSICAL FINDINGS WEBSITE
• Please review physical findings on Dr. Nepal’s website:
• Go to: http://imreference.com
• Copy the link below to access the library:
http://medlib-proxy.mercer.edu/login?url=http://"
• Library site: "http://med.mercer.edu/library"
PROFESSIONALISM
It is paramount that the highest level of professional conduct be maintained at all times.
• BEWARE OF IDLE TALK ABOUT CASES ON THE WARDS,
CONFERENCE ROOMS, ELEVATORS, CAFETERIA, etc.
• Pages/beeps should be returned promptly and courteously.
• You are not to text or use cell phone in any manner during any of the
lectures!
• Lack of professionalism is a failable offense.
KNOWLEDGE BASE
• Reading is fundamental to your learning. It is advised that you read on ALL of
your clinical encounters in addition to CORE readings.
• Work on Differential Diagnoses. This supports what you have been reading.
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Medical Student Duty / Rules for the Third Year Clerkships
Mercer University School of Medicine
80-Hour week rule: Students will work no more than 80 hours a week averaged over a fourweek
block. This begins on the first day of the rotation and starts again on the first Monday of
the next four weeks. Students will work no more than 110% (88 hours) in any one week.
24-Hour Rule: Saturday call makes it impossible to guarantee 24 hours off every week.
Students should have four 24-hour periods off every 4 weeks and not go more than 2
consecutive weeks without 24 hours off.
30-Hour Rule: Students should not be “on call” or involved in inpatient care activities for
more than 30 consecutive hours. Significant, group educational activities may take place
beyond the 30 hours but not for more than 36 total hours.
You will keep track of your work hours on your Weekly Work Hours/Procedure Log
form (see Appendix). Be sure to make yourself a photocopy of your Weekly Work
Hours/Procedure Log Form before turning it in each week.
Procedures
Students are welcome to perform procedures with residents or attending. Be sure to
document the procedures on your log within one45.
Other Responsibilities
• Report to all Code Blues when your team is on call.
• Assist residents in accumulation of data, labs, old records
• You are NOT responsible for carrying more than 3-4 patients.
• You are to act professionally AT ALL TIMES (Lab coats to be worn at all
times).
• You are to work with patients in a respectful, compassionate, empathetic
manner.
• You are expected to be PUNCTUAL and DEPENDABLE.
• You are to prepare and participate in ALL educational opportunities.
• You are expected to attend all conferences UNLESS you are post call.
Particularly attend student morning report out of respect for your peers.
• You are not to text during lectures!
• You are expected to KEEP A LOG OF ALL PATIENTS that you have
ACTIVELY followed. DO NOT FORGET TO DOCUMENT
PROCEDURES!
22

THIRD YEAR CLERKSHIP REQUIREMENTS
! Important Information !
♦ ACLS mandatory class ♦8-H&P’s ♦ 4-SOAP notes
♦ 10 Journaling Entries ♦12 weekly work hour logs ♦ OSCE video session
♦Shelf Test
♦ MUSM “One45” computerized system for patient log including procedures & evaluations
Rotation I
7/27/2015 – 10/16/2015
Rotation II
10/19/2015 – 1/22/2016
Rotation III
1/25/2015 – 4/15/2016
Rotation IV
4/18/2016 – 7/8/2016
ACLS
JULY 2015
JULY 2015
JULY 2015
JULY 2015
JULY 2015
OSCE’s
(wk 7 of rotation)
H & P’s and
4 SOAP
NOTES
¿Due by
Week 11
Shelf Test
Last day of
rotation
9/8/2015 10/9/2015 10/16/2015
11/30/2015 1/15/2016 1/22/2016
3/7/2016 4/8/2016 4/15/2016
5/31/2016 7/1/2016 7/8/2016
¿An additional two (2) bonus points will be given if weekly work hour logs, procedures, numbers & kinds,
journal entries, student teaching rounds lecture evaluations and H&Ps are completed by week 11 of
the rotation. A total of 4 bonus points can be earned. If any of these components are missing, your
grade may be withheld until completion of missing component.
!!IMPORTANT INFORMATION!!
• H/P’s and SOAP notes must be printed from EPIC and signed by
the attending and reviewed with the student.
• This printing must be done prior to the patient’s discharge.
• After the patient is discharged, the student notes may no longer be
accessible
• If you fail to turn in printed H/P’s you will NOT receive credit No
excuses.
• Your IM grade depends solely on your work and fulfilling the
requirements as outlined.
23

LECTURE TOPICS
PowerPoint Presentations are on Mercer’s Blackboard website.
Atherosclerotic Heart Disease
Heart Failure
Basic Arrhythmias
Hypertension & Lipids
How to be a successful clerk
Developing a differential diagnosis for
Chest Pain
Developing a differential diagnosis for
Shortness of Breath
Dermatology
Thyroid
Diabetes
Neurology
End of Life & Medical Futility
Death Certificates
Acute Kidney Injury/Renal Emergencies
Acid Base
Intro to Infectious Disease
HIV/AIDS & Antiretroviral agents
HIV
Antibiotics & ID Cases
Pneumonia
(Rheumatology)
RA, SLE, GOUT, CPPD, OA, OSTEOPOROSIS
Anemia
Deep Vein Thrombosis
Pulmonology
Pulmonary Case Presentation
w/radiographic review
Gastroenterology
Biostatistics
Medical Jeopardy
24

HOLIDAY SCHEDULE - ON CALL
Students will be off beginning at 6pm the night before the holiday until 6am the morning
after the holiday.
Example:
Memorial Day (Monday)
Sunday at 6 p.m. the students are off and will return to work on Tuesday at 6 a.m.
CALL SCHEDULE AROUND OSCE
On the day prior to the OSCE, if the student is on wards and on call, the student will
leave at 6:00 p.m. After the OSCE, students will resume their regular schedule.
CALL SCHEDULE AT THE END OF THE ROTATION
If the student is working on wards during the last four (4) weeks of the rotation, the
student’s last day of call is the Saturday prior to the end of the rotation. Your call will
end at 6:00 pm. Your patient responsibilities will end on the Wednesday afternoon of
Week 12 of the rotation after Core Conference.
MERCER UNIVERSITY SCHOOL OF MEDICINE HOLIDAYS
Labor Day Mon., September 7, 2015
Thanksgiving Thurs., Nov. 26, 2015 & Fri., Nov. 27, 2015
Christmas Break Sat., Dec. 19, 2015 – Sun., Jan. 3, 2016
Martin Luther King, Jr. Day Mon., Jan. 18, 2016
Good Friday Fri., March 25, 2016
Memorial Day Holiday Mon., May 30, 2016
Independence Day Mon., July 4, 2016
25

STUDENT RESOURCES
IMREFERENCE.com
References for Internal Medicine Residents and Medical Students
Dr. Desh Nepal, Assistant Professor of Medicine, Mercer University
School of Medicine – Savannah Campus has developed a website to
help students and residents. Access Dr. Nepal’s website at:
http://imreference.com
The sections you will review are:
o Physical Examination (found on main page)
o Hospital Patient Management (Skills and Strategy (found on main
page)
o Medical Students Page (go to Search box)
This is the primary source for your education on the IM clerkship
• Each week on the New Innovations Calendar there will be listed the
Medical Student topic of the week.
• You are responsible for reading the articles on the website.
• You should present a brief presentation on one of the articles to your
team in an afternoon teaching session.
• Shelf prep
• You should use the USMLE World or Step Up series for study. If you
prefer other data banks of questions that is certainly fine for you to
use them.
• At least 1000 questions should be completed.
• The shelf is a difficult exam that requires daily study.
Stanford Medicine
Stanford Medicine 25 website. To access this website go online to:
http://stanfordmedicine25.stanford.edu.
“Primer to the Internal Medicine Clerkship” Second Edition
(handout)
26

Mercer University - Blackboard
Mercer University’s Blackboard page has links so that you may
access various teaching files throughout the rotation under the
Savannah Campus folder. To access blackboard go online to:
https://bb-mercer.blackboard.com/ and enter your username and
password. Contact the Clerkship Coordinator if you have any
questions.
Dr. Connelly’s Book
Dr. Tim Connelly’s book will be provided as a Handout.
"Feel free to follow Dr. Steven Carpenter and Dr. Tim Connelly on Twitter for
regular short bursts of useful medical knowledge and High Yield USMLE facts
and concepts."
27

Medical Students Page
3 rd year Medical Student (Weekly Curriculum during IM rotation)
Week 1 : Back to Basics
1. Importance of a good history
o Don’t Know Much about History NEJM 2005
o Back to Basics NEJM 2008
o CPS: 06/2005 (Weight loss / Hip and Back Pain)
2. Importance of good Physical Examination
3. Understanding Errors in Medicine
o A Key Miscommunication NEJM 2008
o
o
o
o
Transition of Care
o In the Clinic Transitions of Care Annals 2013
Medication Errors
Diagnostic Errors
o Jumping to the wrong conclusion NEJM 1998
4. Physical Examination:
o
o
o
Diagnositic: Screening Physical Exam (17 min Video)
DiGowin's Diagnostic: Chest and Vascular Exam (Video 50min)
Fundamentals of Lung Auscultation NEJM 2014 (with audio of Lung Sounds)
Week 2: Understanding the basics of Hematology
1. How to approach anemia
2. How to approach Pancytopenia
o
Chapter 57. Approach to Anemia Harrisons Principle of Internal
Medicine 18th Edition
o Investigating microcytic anaemia BMJ 2013
o Microcytic Anemia NEJM 2014
o Case 36-2013: DDx: Hemolytic Anemia
o Hemolytic anemia AAFP 2004
o Iron Deficiency Anemia: Evaluation and Management AAFP 2013
o
o
46-Year-Old Man With Fevers, Chills, and Pancytopenia Mayo Clic Proc2012
Case 23-2014: A 41-Y-O-M with Fevers, Rash, Pancytopenia, and
28

Abnormal LFT
3. How to approach thrombocytopenia
3. Physical Examination
o Investigating an incidental finding of thrombocytopenia BMJ 2013
o Thrombocytopenia in Adults: A Practical Approach to Evaluation and
Management 2006
o Thrombocytopenia in an adult - 10 min Consults BMJ 2013
o DeGowin's Diagnostic: Lymph Node Exam (13 min Video)
o Hand Hygiene NEJM 2011
Week 3: Understanding Cardiology
1. Understanding the work up of Chest Pain (Learn the Differential Diagnosis and Work up
Strategy)
o ED and Office Evaluation of Patients With Chest Pain Mayo Cli Proc 2010
o Value and Limitations of Chest Pain History in the Evaluation of Patients With Suspected
Acute Coronary Syndromes JAMA 2005
o
2. Evaluation of a person with Edema (Knowing the Differential Diagnosis)
o
Chapter 36. Edema Harrison's Principles of Internal Medicine, 18e
3. Approach to a patient with Heart Failure: Learning From Case Examples
o
Acute Pulmonary Edema NEJM 2005 (Differentiating Cardiac from Noncardiac
Cause of Pulmonary Edema)
o Missing Elements of the History CPS NEJM 2014
o Case 11-2011: A 47-Year-Old Man with SLE and Heart Failure
4. Cardiovascular Physical Examination including evaluation of Heart Sounds and Heart Murmur
o
o
Chapter 227. Physical Examination of the Cardiovascular System (Harrison's
Principles of Internal Medicine 18e)
University of Michigan Heart Sound and Murmur Library
Week 4: Understanding GIM
1. Evaluation and Management of Hypertension
o Define Stages of HTN 1 /2
o Define Goal of Treatment
o Identify the cause, if uncontrolled
29

o
Outline the treatment plan if uncontrolled - Which Anti-HTN medications to start / add
Stages of Hypertension (Table 1, Page 3) JNC 7
2014 JNC 8 Evidence-Based Guideline for the Management of HTN in Adults JAMA
2. Evaluation and Management of Hyperlipidemia:
o
o
o
o
Presence or absence of ASCVD
Calculate ASCVD Risk scores (if ASCVD is absent and LDL 190 ) AHA /
ACC
3. Approach to a patient with Generalized Fatigue
4. Sepsis
o Severe Sepsis and Septic Shock NEJM 2013
5. Physical Examination
o
DeGowin's Diagnostic: Head and Neck Exam (Multiple short Video)
Week 5: Understanding GI
1. Diarrhea and Constipation
o Evaluating the Patient With Diarrhea: A Case-Based Approach MCProc 2012
o Causes of Chronic Diarrhea NEJM 2006
o Case 38-2011: A 34-Year-Old Man with Diarrhea and Weakness
2. Evaluation and Management of GI Bleeding
o Acute Gastrointestinal Bleeding In the Clinic Annals 2013
3. Jaundice
o
Chapter 42. Jaundice Harrison's Textbook of Internal Medicine
4. Abdominal Pain
o 52-Year-Old Man With Acute Midabdominal Pain Mayo Clic Proc 2014
30

5. Physical Examination
o An Unusual Case of Abdominal Pain NEJM 2014
o Case 12-2014: A 59-Y-O M with Fatigue, Abdominal Pain NEJM 2014
o Diagnosis of Acute Abdominal Pain in Older Patients AAFP 2006
o
DeGowin's Diagnostic: The Abdomen, Perineum, Anus, and Rectosigmoid
Week 6: Understanding Nephrology
1. Acute Renal Failure
o
Case 33-2010 (Aspergillus Endophthalmitis / Posterior Uveitis / Acute Renal
Failure)
2. Chronic Kidney Disease
3. Fluid and Electrolyte Disturbances
o
o
o
IV FLUID:
o Intravenous fluid therapy in adult inpatients BMJ 2015
Sodium Disorders:
o Disorders of Plasma Sodium — Causes, Consequences, and Correction NEJM 2014
o Disorders of Plasma Sodium — Case Discussions NEJM 2014
Hypokalemia:
Case 4-2012 (Muscle Pain and Weakness)
4. Hypercalcemia and Hypocalcemia
5. Acidosis and Alkalosis
o Physiological Approach to Assessment of Acid–Base Disturbances NEJM 2014
o Physiological Approach to Assessment of Acid–Base Disturbances (Clinical Case Discussion)
6. Physical Examination
Week 7: Approach to Rheumatology
1. How to approach patients with Joint Pain
o
Chapter 331. Approach to Articular and Musculoskeletal Disorders Harrison's Principles of
Internal Medicine 18 e
2. Physical Examination:
o
o
Knee Pain
o Clinical Evaluation of the Knee NEJM 2010 (15:42)
Low Back Pain:
31

o
o
o
3-Minute Primary Care Low Back Exam (Part I) (You Tube Video)
3-Minute Primary Care Low Back Exam (Part II) (Explanation of Tests; You Tube
Video)
Spine and Extremities:
o DeGowin's Examination of the Spine and Extremities
Week 8: Approach to Neurology
1. Syncope, Dizziness and Vertigo
2. Weakness and Paralysis
o Dizziness: A Diagnostic Approach AAFP 2010
o Syncope NEJM 2001
o Syncope Circulation 2006
o
Chapter 22. Weakness and Paralysis Harrison's Principles of Internal Medicine, 18e
3. Numbness, Tingling, and Sensory Loss
o
Chapter 23. Numbness, Tingling, and Sensory LossHarrison's Principles of
Internal Medicine, 18e
4. Confusion and Delirium and Dementia
o Chapter 25. Confusion and Delirium Harrison's Principles of Internal
Medicine, 18e
o Case 37-2010: A 16-Year-Old Girl with Confusion NEJM 2010
5. Physical Examination:
o Video e42-1 (Neuro Screening Exam)
o Video e43-1 - Video e43-7
o 5 areas :
o Higher Mental Function,
o Cranial Nerves,
o Motor, Sensory,
o Gait and
o Coordination
o Cerebellar Exam:
o Standford 25 (Video and Text)
o
o
Gait Abnormalities:
o Stanford 25 (Video and Text)
Fundoscopic Exam:
o Stanford 25 (Text and Video)
32

Week 9:
Approach to Endocrinology
1. Physical Examination
o Thyroid Examination Thyroid Exam (Stanfrod 25)
2. How to approach a patient with DM
Week 10: Approach to Pulmonary Diseases
1. Dyspnea (Shortness of Breath)
2. Cough and Hemoptysis
o Investigating asthma symptoms in primary care BMJ 2013
o Case 20-2014: A 65-Year-Old Man with Progessive Dyspnea
o Case 32-2012: A 35-Year-Old Man with Acute Onset Respiratory NEJM
o Case 40-2009: A 29-Year-Old Man with Fever and Acute Respiratory Failure
NEJM
o AACP Guideline: An Empiric Integrative Approach to the mnt. of Cough Chest 2006
o Anatomy of Diagnosis NJEM CPS 2003
Week 11: Approach to Dermatology from Internal Medicine Perspective
1. Approach to the Patient with a Skin Disorder
2. Eczema, Psoriasis, Cutaneous Infections, Acne, and Other Common Skin Disorders
3. Skin Manifestations of Internal Disease
4. Immunologically Mediated Skin Diseases
5. Cutaneous Drug Reactions
6. Photosensitivity and Other Reactions to Ligh
7. Physical Examination
o
DeGowin's Diagnostic: Skin and Nail Exam (15 min Video)
33

Week 12: Approach to Oncology
Additional Readings from for 3 rd year Medical Student (How to approach!)
Cardiology
1. How to approach arrhythmia and palpitations
o Diagnosis and management of supra ventricular tachycardia BMJ 2012
o Evaluation and Initial Treatment of Supraventricular Tachycardia NEJM 2012
2. How to approach patient with Heart failure
o Diagnosis and management of chronic heart failure (10 min consultation) BMJ 2014
o Acute Pulmonary Edema NEJM 2005
GIM
1. Headache
GI / Hepatobiliary
1. Dysphagia
o Chronic migraine / Chronic Headache BMJ 2014
o Case 16-2003: A 58-Year-Old Woman with Headache
o
o
Case 38-2009: A 16-Y-O Boy with Paroxysmal Headaches and Visual
Changes NEJM
o
o
Etiology of dysphagia (Up-to-date)
Approach to the patient with esophageal dysphagia (Up-to-date)
Nephro
1. Acidosis and Alkalosis
o Interpreting arterial blood gas results BMJ 2013
Pulmonology
1. Hypoxia and Cyanosis
o Cyanosis - AJM 2013
o
34

2. COPD
o COPD Management GOLD 2014
o GOLD pocket guide for COPD management 2014
3. Asthma
o Asthma In the Clinic Annals 2014
o Mild Asthma NEJM 2013
o Asthma Lancet 2013
Rheumatology
1. Musculoskeletal Pain
o Diagnosis and Treatment of Low Back Pain (With Algorithm): ACP/APS Annals 2007
o Evaluation of Patients Presenting with Knee Pain:Part I AAFP 2003
o Ankle Pain AAFP 2006
2. Harrison's Principles of Internal Medicine, 19e
Part One: General Considerations in Clinical Medicine
Part Two: Cardinal Manifestations and Presentation of Diseases
Part Three: Genes, the Environment, and Disease
Part Four: Regenerative Medicine
Part Five: Aging
Part Six: Nutrition and Weight Loss
Part Seven: Oncology and Hematology
Part Eight: Infectious Diseases
Part Nine: Terrorism and Clinical Medicine
Part Ten: Disorders of the Cardiovascular System
Part Eleven: Disorders of the Respiratory System
Part Twelve: Critical Care Medicine
Part Thirteen: Disorders of the Kidney and Urinary Tract
Part Fourteen: Disorders of the Gastrointestinal System
Part Fifteen: Immune-mediated, Inflammatory, and Rheumatologic
Disorders
Part Sixteen: Endocrinology and Metabolism
http://medlib-proxy.mercer.edu/login?url=http://
Comments
Part Seventeen: Neurologic Disorders
Part Eighteen: Poisoning, Drug Overdose, and Envenomation
Part Nineteen: Disorders Associated with Environmental Exposures
35

MERCER UNIVERSITY SCHOOL OF MEDICINE
Department of Internal Medicine Junior Medical Students
WEEKLY WORK HOURS/PROCEDURE LOG FORM
DATE/# HRS WORKED TIME OF DAY WORKED PROCEDURE(S) PERFORMED
MON
AM to PM
Number of hours: Night float name if applicable:
DATE/# HRS WORKED TIME OF DAY WORKED PROCEDURE(S) PERFORMED
TUES
AM to PM
Number of hours: Night float name if applicable:
DATE/# HRS WORKED TIME OF DAY WORKED PROCEDURE(S) PERFORMED
WED
AM to PM
Number of hours: Night float name if applicable:
DATE/# HRS WORKED TIME OF DAY WORKED PROCEDURE(S) PERFORMED
THURS
AM to PM
Number of hours Night float name if applicable:
DATE/# HRS WORKED TIME OF DAY WORKED PROCEDURE(S) PERFORMED
FRI
AM to PM
Number of hours: Night float name if applicable:
DATE/# HRS WORKED TIME OF DAY WORKED PROCEDURE(S) PERFORMED
SAT
AM to PM
Number of hours: Night float name if applicable:
DATE/# HRS WORKED TIME OF DAY WORKED PROCEDURE(S) PERFORMED
SUN
AM to
PM
Number of hours: Night float name if applicable:
Please circle the proper category for this week. Enter the grand total work hours. Student Signature
REQUIRED
INPATIENT TEAM – Yellow Red Blue Outpatient: Ambulatory – Physician Name (print)
Green Purple
GRAND TOTAL HOURS FOR THE WEEK: Student Signature required:
Print Student Name:
Please circle correct week #: 1 2 3 4 5 6 7 8 9 10 11 12
36

-MERCER UNIVERSITY SCHOOL of MEDICINE-
Steven Carpenter, M.D., Internal Medicine Academic Chair
J. David Baxter, M.D., Internal Medicine Clerkship Director
Sandra Simmons, Internal Medicine Clerkship Coordinator
OSCE VIDEO PRESENTATION REVIEW
Rotation Dates:
Today’s date:
OSCE VIDEO PRESENTATION REVIEW
OSCE Mentor:
OSCE Mentor Signature:
Student Name:
Student Signature:
The OSCE video presentation recorded by above named student has been reviewed and
discussed with the student by the above named OSCE mentor.
37

* indicates a mandatory res pons e
*Have you ever had a therapeutic relations hip with this s tudent? (Yes or No)
Evaluation of Junior Medical Students
*1. Data Gathering-History: Obtains precis e, logical,
thorough, reliable his tory directed toward patient's
problems in a cons iderate, organized, and s ys tematic way.
n/a
Fails to meet
minimal
expectations for
s tudent at this
level of training
Meets minimal
expectations
for s tudent at
this level of
training
Meets
expectations
for s tudent
at this level
of training
Exceeds
expectations
for s tudent
at this level
of training
*2. Interview ing Skills: Pos s es s es the interpers onal
s kills important for both communicating information and
obtaining information from patients .
*3. Data Gathering-Physical Exam: Conducts a
complete, accurate, logically-‐‐‒s equenced phys ical exam
directed toward patients problems , minimizing patient
dis comfort.
*4. Basic Science Know ledge: Pos s es s es
multidis ciplinary knowledge and is able to correlate with
the clinical problem or dis eas e.
*5. Medical Know ledge: Pos s es s es an extens ive fund of
clinical information that is evident without prior
preparation.
*6. C linical Reasoning Skills: Unders tands phys iologic
meaning of patient findings and interrelates them logically
to develop a differential diagnos is ; identifies all major
problems and prioritizes workup appropriately.
*7. Humanism: Demons trates reliability, integrity,
empathy, compas s ion, and res pect for patients with
primary concern for patient's welfare.
*8. Presentation Skills: Well organized, concis e and
complete.
*9. Teachability: Appears interes ted, receives
cons tructive criticis m well
*10. Punctuality: On time, has notes done
*11. Availability: Availability on-‐‐‒call
*12. Personal Appearance: Clean, neat, well groomed,
wears badge and white coat
*Formative Comments (Coaching)
*S ummative Comments (Contribute to grade and Dean's letter)
38

W ould you like to have this student in our residency program?
No
Yes
THANK YOU FOR TAKING THE TIME TO PROVIDE THE INFORMATION NEEDED TO GIVE AN ACCURATE GRADE
TO OUR STUDENTS .
The follow ing w ill be displayed on forms w here feedback is enabled...
(for the evaluator to ans wer...)
*Did you have an opportunity to meet with this trainee to dis cuss their performance?
Yes
No
(for the evaluee to answer...)
*Did you have an opportunity to dis cuss your performance with your preceptor/s upevisor?
Yes
No
39

Student Name:
Internal Medicine 3 rd Year Clerkship
MID-TERM STUDENT EVALUATION
Class of 2016
Clerkship Rotation: Internal Medicine
Clerkship Dates: Beginning: Ending: Midterm Date: __ ___
Bonus Points: H&P’s: ____ Patient Encounters: ____ Absences: ___
Journaling Entries:
A. Overall assessment of student’s performance:
________________________________________________________________
________________________________________________________________
B. Narrative describing student’s performance:
a. Knowledge:
b. Skills:
c. Attitude:
d. Professionalism:
C. CLERKSHIP DIRECTOR’S COMMENTS:
________________________________________________________________
________________________________________________________________
STUDENT’S COMMENTS:
________________________________________________________________
________________________________________________________________
(Use other side if needed)
Clerkship Director: _______________ Student:
(J. David Baxter, MD) Signature Signature
40

INTERNAL MEDICINE FINAL EVALUATION OF CLERKSHIP
1. Were your educational goals met on your IM clerkship? If not, please explain.
____ Yes
____ No
__________________________________________________________________
__________________________________________________________________
2. Please describe the quality of teaching by the faculty and residents. If overt
weaknesses notice, please describe.
_________________________________________________________________
_________________________________________________________________
3. Were you given a mid-term evaluation?
______ Yes
______ No
4. Did the faculty and residents give you feedback on your performance
throughout the rotation?
______ Yes
______ No
If so, was it helpful?
______ Yes
______ No
5. What could the department of IM have done differently to make your educational
experience more productive?
_
6. List 5 strengths noted in the department.
_
7. List 5 weaknesses noted in the department.
_
41

Internal Medicine Clerkship Rotation
Student Evaluation of Faculty/Resident/Intern
Faculty/Resident/Intern/Backup Name:
Evaluator’s Name:
Rotation Period:
«Faculty_Name»
«Student_Name»
«BegDate» to «EndDate»
Please evaluate your faculty/resident/intern’s performance during this rotation utilizing the
following scale:
4 = Outstanding 3 = Above Average 2 = Average
1 = Below Average 0 = Unacceptable
All individual responses will be kept CONFIDENTIAL. Composite summary data will be
provided to faculty in an ANONYMOUS format. Place a check mark in the appropriate
box for each area:
Medical Knowledge
Professional Attitude
Teaching Skills
Availability to you during rotation
Value of teaching sessions on
rounds
0 1 2 3 4
Unacceptable
Below
Average
Average
Above
Average
Outstanding
Comments or suggestions for improvement:
Please return form to Clerkship Coordinator. THANK YOU!
UPDATED: 7/2015
42