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Basic Core 1 Design
Site:
Working Group
Surgery: Marjie Persons MD, Gilles Pinault MD, Howard Nearman MD, Kelly Buchanan
Internal Medicine: Debra Leizman MD, Cliff Packer MD Cindy Neczypor
Louis Stokes Cleveland VA Medical Center
Overall Design Structure
Week 1 2 3 4 5 6 7 8
Internal Medicine
UH or VA Inpatient Out patient GIM
Specialty Procedure, Education Week, and Shelf Exam
Surgery
UH or VA Inpatient Electives: Anesthesia/SICU,
Vascular and Student’s Choice
Finish elective, Oral Exam, Education Week, and Shelf Exam
Surgery
Electives: Anesthesia,
Vascular and Student’s Choice
UH or VA Inpatient Finish elective, Oral Exam, Education Week, and Shelf Exam
Internal Medicine and Surgery Sample Education Week
Mon Tue Wed Thu FriMedicine Week 8
Procedural Day
Didactics
Student Abstract and Case Conference
Musculoskeletal and Heart
SIMPLE Cases
Study Day IM Shelf
Surgery Week 8
Oral Exams Didactics
Student Abstract and Case Conference
Musculoskeletal and Heart
SIMPLE Cases
Study Day Surgery Shelf
Medicine Week 16
Procedural Day
Student Abstract and Case Conference
OSCE
Lectures
Study Day IM Shelf
Surgery Week 16
Oral Exams Student Abstract and Case Conference
OSCE
Lecture
Study Day Surgery Shelf
Sample Weekly ScheduleTime Mon Tue Wed Thu Fri Sat (1 ) On
CallSun *
5:45 am Rounds Rounds Rounds Rounds Rounds Rounds
7:00 am M&M Outpatient/ Ambulatory Clinic
Grand Rounds
8:00 am Outpatient/ Ambulatory Clinic
12:00 pm Outpatient/ Ambulatory Clinic
IQ+ SOM
1:00 pm IQ+ SOM
2:00 pm Lecture IQ+ SOM
3:00 pm Lecture Lecture Lecture Lecture IQ+ SOM
4:00 pm Lecture Resident conference (1)
GI Tumor Board (1)
Colorectal/ Breast Conference (1) or Lecture
IQ+ SOM
5:00 pm Lecture or Case Presentation (2)
6:00 pm Case Presentation
Educational Activities
Grand RoundsMorbidity and Mortality ConferenceResident ConferenceDidacticsTumor Boards – GI and BreastColorectal ConferenceIM/Surgery - Education WeekDidactics
Orientation
First Day of Surgery Clerkship Agenda REVIEW EXPECTATIONS
STUDENT LECTURES OTHER LECTURES - M&M, Tumor Boards, Resident
Lectures, etc. ELECTIVES ORAL EXAMS TAKING CALL CASE PRESENTATIONS - Group and individual with Dr.
Ponsky REVIEW GRADE PROCEDURE - CAS
H&P WORKSHOP WRITING ORDERS
OR Orientation - obtain scrubs TECHNICAL SKILLS TYING and SUTURING SKILLS
Learning Relationships
Case Presentations with the Clerkship Director and fellow students
Individual presentations with the Chairman
Individually assigned to attend clinic with a Preceptor
Students interact daily with Attendings and Residents on the service
Feedback
Students can expect formal and informal feedback
Formal CAS
Attending / Resident Feedback to Student Requests
Summative Evaluations Discussion at Mid-Point Shelf Exam Oral Exam
Feedback
Informal Conversations and Teaching opportunities
with Attendings and Residents Preceptor Feedback Individual Meeting with Chairman Feedback Progress in achieving the core clinical
conditions – Case yellow cards “Mid-Point Feedback and Review of Core Clinical Conditions”
Direct Observation
The Clerkship Director Reviews H&Ps and gives individual feedback to students
Case Presentations Rounding with Attendings and Residents See patients with Preceptor in
ambulatory/outpatient clinic
Exposure to Career Options
Elective week in surgical subspecialties Vascular week Anesthesia and Critical Care week
On-Call Schedule
On-Call – Short One day per week short call; stay until
11:00pm
On-Call – Long Two 24-hour long call; on weekend with
night float Resident
Inpatient/Outpatient Balance
Outpatient ½ day per week in Clinic
Vascular Elective/Subspecialty General
Inpatient Throughout the 8 weeks
Integration of Advance CoreLearning Objectives
Peri-Op and Acute Pain Conferences/Didactics
Critical Care/Peri-op Care Acute Pain Management Pre-operative risk assessment
1 week Anesthesia/SICU Clinical Experience See Peri-op Care daily throughout 8 weeks
Internal Medicine Sample Weekly Schedule
Time Mon Tue Wed Thu Fri Sat Sun
7:30 am
8:00 am
9:00 am Didactics
10:00 am Didactics Intern Morning Report
10:30 am Teaching Attending (4/8)
11:00 am Didactics Teaching Attending
12:00 pm Noon Conference Grand Rounds Noon Conference
Noon Conference
M&M / IQ+ SOM
1:00 pm Clerkship Director (6/8)
Chairman (4/8) Teaching Attending
IQ+ SOM
2:00 pm Clerkship Director
Chairman Teaching Attending
IQ+ SOM
3:00 pm IQ+ SOM
4:00 pm Didactics IQ+ SOM
5:00 pm Didactics
6:00 pm Didactics
Internal Medicine Educational Activities
Clerkship Director Bedside Rounds/Publication Rounds Teaching Attending Rounds Chairman Rounds Grand Rounds Morbidity and Mortality Noon Conference Intern/Student Noon Conference Didactics
Internal Medicine and Combined Medicine-Surgery Large and small groups
Specialty Procedure Day General Internal Medicine Week IM/Surgery - Education Week
Internal Medicine Orientation Combined UH and VA Inpatient and
Ambulatory Orientation sessions Detailed review of Clerkship Manual Assignments (Inpatient Services / Outpatient
General Internal Medicine physicians) Schedules / Meetings / Conferences Computer Systems Expectations
Professionalism Patient Responsibility and Workload Call and Duty Hours CAS Assessment System Feedback/Evaluations
Internal Medicine Learning Relationships
Ongoing relationships with the Clerkship Director, Bedside Rounds UH Case Report Publication Conference VA Clinical case Report UH and VA
Chairman, Teaching Attending, Ward Attendings, Residents, and Ambulatory General Internists
Internal Medicine Feedback
Students can expect formal and informal feedback
Formal CAS
Attending / Resident Feedback to Student Requests
Summative Evaluations Shelf Exam Clinical Abstract / Professionalism Mid-Point Evaluation, Feedback cards Clinical Exposure (Case Green Cards)
Internal Medicine Feedback
Informal (Feedback) Clerkship Director Attendings / Residents Teaching Attending Chairman Rounds Interactive Didactics
Internal Medicine Direct Observation
UH Director Led Bedside Rounds New Undifferentiated Patient History, Physical Diagnosis, etc. divided
between the group members All student write-up case Director and Students give Feedback
VA Director Led Publication Conferences Case Report requirement Weekly conference to prepare case for ACP
or Journal submission
Internal Medicine Direct Observation
Teaching Attending Rounds Students Present Case for feedback and
specialized education Ward Attendings and Residents
Morning Work Rounds Presentation and patient specific education
Ambulatory General Internists
Internal Medicine Exposure to Career Options
Specialty Procedure Day Cardiology Gastroenterology Nephrology Pulmonology Rheumatology
GIM Ambulatory Week Community VAMC
Internal Medicine On-Call Schedule
Call – Long and Short With Resident Every fourth night Pick up one patient every call Carry four patients at a time
Internal Medicine Inpatient – Outpatient Balance
Inpatient - 6 weeks Outpatient GIM - ~1 week Specialty / Procedural -1 day Concentrated Education/Testing 1 week
What are the unique features of this rotation?
UH/VA site preference (up to space limitations)
Immersion Inpatient Internal Medicine and Surgery
Specialty / Elective options Small and large group educational activities Student specific General Surgery / Medicine
conferences