Electives and Additional Fourth Year Rotations

Course Objective:

Under the supervision of the attending and staff, the student will function as a member of the specialty healthcare team and participate in daily clinical management. Provide the student an opportunity to participate in an intensive specialty clinical experience. Expose students to the commonly encountered patients as well as the complex diagnostic and management conditions in the specialty.

b. Clinical Expectations and Structure:

  1. Students will be assigned to a clinical team for a period of 4 weeks.
  2. Students should participate in all team activities, including rounding and conferences.
  3. Students should maintain a daily census of 2 – 4 patients.
  4. The clerkship Director (or preceptor) will supervise the overall educational experience, monitoring progress, providing feedback, and completing the final evaluation.

c. Learning Objectives:

Medical Knowledge

  • Demonstrate the etiology, pathogenesis, structural and molecular alterations as they relate to the signs, symptoms, laboratory results imaging investigations and causes of common and important diseases within the specialty.
  • Demonstrate the impact of factors including aging, psychological, cultural, environmental, genetic, nutritional, social, economic, religious and developmental on health and disease of patients as well as their impact on families and caregivers.
  • Describe important pharmacological and non-pharmacological therapies available for the prevention and treatment of disease based on cellular and molecular mechanisms of action and clinical effects.

Clinical Skills

Demonstrate Communication Skills

  • Demonstrate effective communication with patients and family members.
  • Demonstrate effectively verbal and non-verbal clues of a patient’s mental and physical health.
  • Demonstrate cultural sensitivities and patient wishes when providing information.
  • Demonstrate effectively communicate with physician and non-physician members of the health care team and consultants.
  • Demonstrate the ability to clearly and concisely present oral and written summaries of patients to members of the health care team.

Demonstrate Coordination of Care Skills

  • Demonstrate the effective prioritization of tasks for daily patient care in order to effectively utilize time.
  • Demonstrate effective utilization of non-physician members of the health care team including nursing, pharmacist, social workers, clinical care coordinators, physical therapists, and other hospital personnel.
  • Demonstrate appropriate indications for a consultant referral and how to appropriately utilize consultants.
  • Demonstrate effective transfer care throughout a patient’s hospitalization, including end of the day and end of service coverage.
  • Demonstrate appropriate care and follow-up for the patient after discharge from the hospital and or clinic, coordinate care plan utilizing community resources when necessary.

 Demonstrate Information Management Skills

  • Demonstrate the ability to document the patient’s admission information, daily progress, on-call emergencies, transfer notes, and discharge summaries accurately and in a timely manner.
  • Demonstrate the ethical and legal guidelines governing patient confidentiality.
  • Demonstrate effective retrieving of clinical information at the hospital including clinical, laboratory and radiologic data.
  • Demonstrate how panic/critical values are communicated from the hospital laboratory to the responsible team member.
  • Demonstrate the importance of precision and clarity when prescribing medications.
  • Demonstrate electronic or paper reference to access evidence based medicine to solve clinical problems.
  • Demonstrate continuous reevaluation and management revisions based on the progress of the patient’s condition and appraisal of current scientific evidence and medical information

Demonstrate Procedures Skills

  • List risks and benefits of common invasive procedures, and how to obtain informed consent.
  • Demonstrate the rational, risks and benefits for the procedure in language that is understandable by the patient and/or his/her family.
  • Demonstrate skill in common procedures that are performed by interns and residents.
  • List potential procedure related risks for the operator and the need for universal precautions.
  • Demonstrate the skill of documenting a procedure note.
  • Demonstrate that samples obtained are properly prepared for laboratory processing.


  • Demonstrate the ability to accept criticism and react appropriately to difficult situations.
  • Demonstrate the ability to work independently and within a healthcare team effectively.
  • Demonstrate a sensitivity and respect for patients and healthcare team members

D. Assignments:

  1.  Daily rounds, case-based discussions
  2.  Daily reading on active cases

E. Assessment:

  1. Formative feedback on communication skills
  2. Formative feedback on case-based presentations
  3. Formative feedback on daily patient management and treatment (including procedures)
  4. Formative feedback on documentation and transition of care
  5. Formative feedback on the utilization of non-physician and consultants in patient care
  6. The clerkship director or preceptor will develop a summative assessment at the end of the rotation using feedback from as many members of the health care team as possible. The preceptor will grade the student on medical knowledge, clinical skills and professional attitude. A narrative description of the student’s strengths and weakness is required.