Directors: Catherine Okuliar, MD & Bhumika Gandhi, MD
Coordinator: Kat Hoang
The following are general objectives for the Medicine clerkship. Students are expected to demonstrate proficiency in these areas in order to satisfactorily complete the rotation. In addition, the extent of a student’s mastery of these objectives, as outlined by the “RIME” framework below, will help guide the clinical evaluation and grade.
1. History and Physical Examination: The student shall take a complete, organized medical history and perform a thorough physical exam on each assigned patient upon admission, perform a daily evaluation for each assigned patient, and obtain a focused, problem-based history and exam in the outpatient setting
2. Case Presentation: The student shall prepare admission notes, daily progress notes, and outpatient visit notes that include pertinent clinical information, differential diagnosis, and diagnostic/therapeutic plans. The student will also learn to present this information orally in a logical, succinct manner
3. Diagnostic Decision Making: The student will formulate a differential diagnosis using history and physical exam data, develop a prioritized problem list, and select appropriate diagnostic tests for assigned patients, taking into account performance characteristics of tests (sensitivity, specificity, and likelihood ratio), cost, risk, and patient preferences
4. Test Interpretation: The student shall learn to interpret common clinical tests (complete blood count, blood smear, chemistry panels, ECG, chest X-ray, urinalysis, pulmonary function tests, body fluid cell counts), demonstrate understanding of normal variation vs abnormal results, recognize critical values that require immediate attention, and apply results to refine the differential diagnosis.
5. Therapeutic Decision Making: The student shall offer basic treatment plans, including assessing risks, benefits, and costs of treatment options, involving patients in decision-making, and utilizing clinical practice guidelines when appropriate
6. Communication and Relationships with Patients and Colleagues: The student shall establish and maintain professional rapport with patients and colleagues at all times, recognize psychosocial issues, provide patient-centered care, educate patients, and demonstrate sensitivity to cultural diversity. The student will be able to communicate verbally, in writing, and by electronic media as appropriate.
7. Bioethics of Care: The student shall learn the clinical use of advance directives and informed consent, engage in discussion regarding common ethical dilemmas that arise in clinical medicine, and recognize the importance of patient preferences, perspectives, and perceptions regarding health and illness
8. Self-directed Learning: The student shall identify clinical questions pertinent to assigned patients, locate key information sources, perform literature searches, manage information and be able to report findings to the team.
Required Clinical Experiences
- Cardiopulmonary exam (while observed by faculty)
- Obesity counseling and management
- Alcohol, Drug, or Tobacco Counseling
- EKG Interpretation
- CXR Interpretation
- Altered Mental Status
- Chest Pain
- Congestive Heart Failure
- Electrolyte & Acid/Base Disorders
- Acid/Base Disorders
- Autoimmune Disease
- Renal Disease
- Gastrointestinal Disease
- Thromboembolic Disease
- Palliative Medicine
- Geriatric Medicine
- Midpoint Feedback
- Clinical evaluations
- NBME exam score