Gen Info
Core Curriculum
Expectations
Call Sch
Work Sch
Patient Work-Ups
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Attendance Written Exam OSCE End-of-Life Eval Textbooks  

 

GENERAL INFORMATION

The Medicine Clerkship is an 8-week clerkship comprised of two four-week clinical rotations 

IP rotations will occur either at Foster G. McGaw Hospital (LUMC), Edward Hines Jr. Department of Veterans Affairs Hospital (HVA), or West Suburban Hospital (WSH). 

Students doing IP rotations will be assigned to different services at each hospital site.  These service assignments are made by each site coordinator and will be made known to students by each site.

At the beginning of each rotation there will be an orientation at each site, at which time students will receive pertinent materials. 

At the end of each rotation, hospital assignments are changed.  Students are not on duty or on call over these "switch" weekends between assignments.

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CORE CURRICULUM

During the clerkship, there is a defined set of educational activities in which students must participate.

These educational activities are designed to help you meet the competencies.
 

Level I: Wednesday afternoons:  Hyponatremia, Acid Base, Rheumatological Diseases, Immuno Tests, Renal Tests, Liver Tests, Cardiacl Clinical Correlation, CBC Anemia, Pulmonary Tests, Infectious Diseases 101, OSCE Prep, OSCE review, and test prep - all students attend at Loyola.
Level II: Various days conducted at each hospital site:   14 case discussions, each with assigned readings & questions to be answered. Pulmonary nodule and lung cancer, Atrial fibrillation, GI bleed, Acute renal failure, Asthma, COPD, Mental status, Liver disease, DVT/PE, HIV, Coronary artery disease, Diabetes mellitus, Congestive heart failure, Pneumonia.

Level III

SIMPLE cases from online material.

Please note that the core ambulatory topics in Family Medicine also apply to your learning.

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CLERKSHIP REQUIREMENTS AND EXPECTATION

1.         Assist in providing care for assigned patients.  This includes: 

Constructing H&P's, problem lists with assessments and plans, orders, and progress notes or, in the outpatient setting, longitudinal care follow-up notes (all records must be countersigned);

Care conscientiously for all patients with appropriate standards of professional, ethical, and moral conduct.

Interacting with families as appropriate (at least one such interaction for each inpatient month must be witnessed and evaluated);

Performing routine clinical procedures with appropriate supervision;

            Participating in rounds and demonstrating evidence of reading around patients;

Taking call as assigned. (see below)

2.         Prepare for, attend, and actively participate in all structured clerkship activities (including ER sessions, debriefing sessions, and examinations).

During each inpatient month, a minimum of four (4) write-ups (admit notes--H&Ps, problem lists, assessments and plans--and admitting orders) must be completed by students and evaluated by housestaff or attendings using the "Write-up Evaluation/Feedback" form.  A total of eight (8) write-ups with their accompanying feedback forms must be turned in by the end of the Clerkship.  (Instructions for housestaff and attendings along with a sample copy of the form are included in the Appendix.) During both rotation months a mid evaluation form and patient data log form (verified and signed by attending) are due at the midpoint of each rotation, and the final evaluation and final patient log are due at the end of each rotation. See "Medicine Clerkship Rotation" for more information.

3.         Call (see below)

 

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CALL SCHEDULE

Students on IP rotations are assigned night call according to a schedule prepared at each hospital. Students are on-call no more than every fourth night. Responsibilities will be indicated during the orientation at each hospital.

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WORK SCHEDULE

Since the practice of medicine is not confined to a certain number of hours in a day, and since patient volume varies with a given service, it is difficult to assign students doing the Medicine Clerkship specific hours of duty. The following are guidelines only:

Work schedule: Although a 7:00am to 5:00pm, Monday through Friday, week is a reasonable expectation, the student, in assuming a professional role, must accept that patient care is a 24-hour responsibility. Circumstances will arise which warrant longer hours. Additionally, students doing IP rotations are expected to take call when assigned You are expected to work 6 days out of 7. This is limited to a maximum of 80 hours/week, including all call activities.  There will be no overnight call on Tuesdays due to the didactic sessions held on Wednesdays.

Holidays: University designated holidays will be recognized as days on which students are not expected to be on duty or on call (see Academic Policy Manual II).

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PATIENT WORK-UPS

Students are expected to do four complete H&Ps per IP rotation, write them up and discuss them with their assigned "Case Checker". Case Checker assignments are made by each hospital site coordinator and will be made known to each student at the beginning of each IP rotation. Each work-up will be evaluated by the Case Checker and that evaluation will count toward the students' Final Grades (see Evaluation and Grading Process).

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ATTENDANCE

Attendance is expected at all functions of the Medicine Clerkship, including orientation, Level I and II sessions, rounds, clinics, debriefing sessions and exams. Absences from duty on any of the required activities listed in the previous sentence must be reported according to School policy. If you need to be absent, it is your responsibility to notify those people affected by your absence - for example, your service attending (or resident, if attending not available) on IP rotations, - AND the Medical Education Office or coordinator at your assigned site. During your IP rotations, it is expected you will average one day off per week. (Please see student work hours). Planned absences must be approved through the clerkship coordinator.

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FINAL WRITTEN EXAMINATION

There will be a departmental computer exam at the end of the Clerkship. This exam will contribute 30% to your final grade. The departmental exam will cover the “core” curriculum. This exam will be administered on the last day of the clerkship. Two weeks prior to the end of each two-month clerkship, students will receive by e-mail the details of the final week.

According to school policy (see Academic Policy Manual II), all students are obliged to take required clerkship examinations on the date, time, and place specified by the department. Exceptions to this policy may be granted for:

1) reasons of illness, which must be documented by a note from a physician and/or report from the Student Health Office at Loyola addressed to the Associate Dean for Student Affairs.

2) any other emergency situation in which evidence can be provided to the Associate Dean for Student Affairs to justify absence from a scheduled examination.

Students excused from an examination by the Associate Dean for Student Affairs for an acceptable reason are responsible for making arrangements with the Department of Medicine to take a make-up exam within thirty days of their return or as soon as a make-up exam is offered by the department. Unauthorized absence from an examination normally will result in a grade of zero for that examination, the consequence of which in almost all cases is course failure. Changes in the examination schedule for individual students will not be granted.

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OSCE (Objective Structured Clinical Exam)


Before the 2nd month of your Medicine Clerkship you will be asked to perform a focused History and Physical Exam on a Standardized patient. Immediately following the H/P, you will complete an assessment and management plan on a computer through our Learning Resource Center. This encounter will be evaluated by the standardized patient and the Clerkship Director. It will comprise 10% of your overall grade. You are expected to maintain your clinical duties before and after your CEX.

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END-OF-LIFE PAPER (NO LONGER REQUIRED)

We would like you to identify a patient who has a pertinent end-of-life care issue (ie terminal cancer, anticoagulation risk, autonomy issues, etc) that you have cared for in the hospital. Subsequent to the hospital discharge, please arrange with the family for two separate visits to see the patient and family outside the hospital setting. These times can be at the Nursing Home, the patient’s home, or the clinic. There is flexibility in these times and locations. Each visit should be no less than thirty minutes.

Lastly, we are asking you to reflect on this experience with a one-page paper as it shapes you in your development as a physician. Suggested topics to cover would include but are not limited to the following:

Quality of Life
Role of Hospice
Medial Economics
Palliative Care


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FACULTY/COURSE EVALUATION:

Students are required to evaluate their experiences during the Clerkship by completing the on-line Clerkship evaluation.

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TEXTBOOKS

Medicine

There is no single text that the Department of Medicine requires you to buy solely for this Clerkship. We have recommended a number of texts that should help you in your pursuit of life-long learning. Many of these texts are referenced throughout your curriculum.


Recommended Readings From:

Harrison's Principles of Internal Medicine. 16th edition.
Editors: Fauci, et al.
Publisher: McGraw-Hill, Inc.
Internet Access: http://www.harrisonsonline.com/subscr_main.html

Cecil Textbook of Medicine. 20th Edition. .
Editors: Bennett & Plum
Publisher: WB Sauders Co.

Clinical Epidemiology The Basic Science for Clinical Medicine. 2nd edition.
Editors: Sackett, Haynes, Guyatt and Tugwell
Publisher: Little, Brown and Company

Manual of Medical Therapeutics. (Referred to as "Wash. U Manual"). 30th edition.
Editors: Boedeker EC, Dauber JH
Publisher: Little, Brown and Co

Electrocardiography

Required Readings From:

The Only EKG Book You’ll Ever Need. 4th edition.
Author: Thaler, MS
Publisher: Lippincott Williams & Wilkins

X-Ray

Recommended Readings From:

Fundamentals of Radiology. 4th edition.
Author: Squire LF
Publisher: Harvard University Press

http://www.meddean.luc.edu/lumen/gme.htm

(this website has excellent examples along with clinical scenarios)
 

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Updated: 6/28/12