Transition to Clerkships July 5, 2013 © 2012 University of Utah School of Medicine.

Transition to Clerkships

July 5, 2013

© 2012 University of Utah School of Medicine

Pagers!

• Pick up your pager• Pick up Instruction Sheet• Sign the pager sign-out sheet• Write down your number!


Student Affairs

• Dress Code• Excused absences• Timeline• MSPE• AOA


Medical Education

• Student Assessments (Evaluation Form, Evaluation Process, OSCE, Shelf)

• Formative Feedback• Patient Logs• Final Grade (Timeliness, appeal process)• Honors• End of Third Year OSCE


PEL

• Shelf failure policy• Student evaluation of Clerkship, Faculty and

Residents• Debriefing sessions• Accommodation requests• Mistreatment• Student Handbook


Dress Code

• Formal Dress Code Policy in Student Handbook

• Dress as good or better than the attending• Ties on Psych? White Coats on Peds?


Excused Absences

• Formal excused absences through Student Affairs– Deaths, serous illness, etc– Tell your team!

• Other absences – be creative with days off


Timeline


Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May

Administrative Lottery ERAS MSPE Rank Match Grad

Exams OSCE OSCE Step 2 CK (Oct 31st) and CS (Dec 31st)

Interviews Interviews

Courses Longitudinal Preparation for Internship off Course Transition Course

Mentoring Pre-lottery Pre-ERAS LOR, CV, PS Submit Interviews Interviews Rank List

Knowledge

Simulation Sim Sim Sim Sim Specialty Sim

Tracks and Specialties

TrackSpecialties Anesthesia Emergency Physician Scientists

TrackSpecialties General Surgery Specialty Surgeries Ob-Gyn Pathology Physician Scientists

TrackSpecialties Internal Medicine Family Medicine Pediatrics Med-Peds Psychiatry Triple Board Physician Scientists

TrackSpecialties Dermatology Medical Genetics Radiology Neurology PM&R Radiation Oncology Nuclear Medicine Physician Scientists

Medical Sciences and Specialties

Acute Care

Primary Care

Applied Anatomy

Timeline

• Lottery• We will meet as a class to discuss at length

• You can take some fourth year courses now!


End of 3rd year OSCE

• Med/Ed will discuss at length• Typically ~May• Prep for Step2 CS


Timeline


Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May

Administrative Lottery ERAS MSPE Rank Match Grad

Exams OSCE OSCE Step 2 CK (Oct 31st) and CS (Dec 31st)

Interviews Interviews

Courses Longitudinal Preparation for Internship off Course Transition Course

Mentoring Pre-lottery Pre-ERAS LOR, CV, PS Submit Interviews Interviews Rank List

Knowledge

Simulation Sim Sim Sim Sim Specialty Sim

MSPE National History

• Wide variation historically• Guidelines published by AAMC in 2002

– “Letter of evaluation” rather than letter of recommendation

– Standardized format

• Release deadline move from Nov 1st to Oct 1st

Local history

• Excellent adherence to AAMC guidelines• Input fields from all other areas of Dean’s Office

(OIO, PEL, Med ED, etc.)• Compilations• 8-10 pages in length

My Vision

• Accurately portray the true consistent performance of our students

• Provide useful information to the end user (program directors)

• Maintain institutional integrity• Foster student desire to excel rather than compete

First Page

IDENTIFYING INFORMATIONChelsea Smith is a fourth-year student at the University of Utah School of Medicine applying to your program for residency training. This letter is meant to provide an overview of Chelsea’s academic performance and personal characteristics to assist you in your assessment of her application. Chelsea came to the University Of Utah School Of Medicine in 2011 after earning a Bachelor of Science degree in Biology from University of Notre Dame, and her PhD in Anthropology from the University of Utah.

First PageUNIQUE CHARACTERISTICSChelsea is a resourceful innovator, looking for opportunities in learning and service. As a first year student, she noticed that there were plenty of opportunities addressing global health for medical students, but none addressing the unique needs of Utah's own population. Over the course of the year she developed contacts within the Utah Navajo Health Service. In doing so, she created an alternative spring break program for students interested in volunteering for under-served populations just hours from Salt Lake City in Montezuma Creek and Monument Valley. Chelsea has held positions of leadership. She served as the president of the Pediatric Medicine Interest Group. Chelsea is also very excited to be the principal investigator for her research project, a quality improvement study to help identify possible socio-demographic factors contributing to poorly controlled asthma in the pediatric population. She expects to publish her abstract and to present her research findings later this year.

Second page

Second pageACADEMIC HISTORY Combined Degree: No Leaves of Absences, Extensions, Gaps: Yes. Chelsea took a personal leave of absence from August 2012 to December 2012. Coursework Remediated or Repeated: Yes. Chelsea successfully remediated her Comprehensive Clinical Skills Examination at the end of her third year. Disciplinary Action(s): No

ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II)

• Pre-clerkship Academic Record: Chelsea successfully passed all courses during the first two years of medical school, including the following units:

• Foundations of Medicine (Pass/Fail only)• Molecules, Cells and Cancer - Honors• Host and Defense• Life Cycle• Brain and Behavior - Honors• Metabolism and Reproduction• Circulation, Respiration and Regulation• Skin, Muscle, Bone and Joint


Clinical Experiences: Chelsea successfully completed all expectations for her Longitudinal Clinical Experience (LCE) and Subspecialty Clinical Experience (SCE) in her first two years of medical school, giving her over 1,700 hours of clinical exposure before beginning her Clerkship Year, Phase III. Details on LCE and SCE are provided in the Appendix.

Chelsea’s LCE faculty attending physician noted the following:

“Very professional and interested in outpatient medicine.”


• Scholarly Expectation: Medical students are required to participate in an independent program of study that promotes students’ expertise in one or more areas of medicine, their ability to perform inquiry-based research, to ask scholarly questions and to effectively communicate the rationale for and results of their scholarly work. – Chelsea reviewed patient charts and culled data from an

Intermountain Healthcare database of infectious diseases affecting Utah communities. She used these data to examine the relationship between community viral infections and childhood leukemia. Chelsea presented her work at the 2010 annual Frank Tyler Medical Student Research Symposium in Park City, UT.

Community Service Learning Experience: All students are required to participate in community service learning projects in the first two years of the curriculum. Chelsea exceeded the service requirements of the UUSOM, completed at the following venues: • 4th Street Clinic• 4th Street Triathlon• Flu Vaccines for the Homeless• Maliheh Free ClinicChelsea received an “Honors” in this service-learning requirement. “Honors” is awarded to students who completed 75+ hours directly with Utah and the surrounding communities in clinical, education and premedical programs supervised by the Office of Inclusion and Outreach.


• Professionalism: The professionalism of our students is routinely addressed throughout all elements of the 4-year curriculum. Chelsea has met the professional expectations of the UUSOM as outlined in the Student Handbook, including: Honesty, Confidentiality, Respect for others and Responsibility.


MSI Comprehensive Clinical Skills Examination (Pass/Fail): Pass MSII Comprehensive Clinical Skills Examination (Pass/Fail): Pass


ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III)

Student performance is based upon achievements in the areas of medical knowledge, patient care and professionalism. Each component is used to calculate an overall clerkship score using a four point scale: 4 = Exceptional; 3 = Above expectation; 2 = Meets Expectation; 1 = Below Expectation; 0 = Unacceptable.

Narrative comments are provided by faculty and clerkship directors and are edited the Associate Dean of Student Affairs only for grammar and length.


• Students have always been encouraged to review their final performance evaluations, and have 30 days from the time of receipt to accomplish this task.

• Now, more than ever, we are encouraging all students to review the information contained in the section “Paragraph to be included in the Student’s MSPE” to check for accuracy.

• It will not be possible to amend the content after the 30 day time period; this final paragraph will be directly imported in the MSPE and will not be changed by the Associate Dean of Student Affairs.

Clerkship MSPE ExampleInternal Medicine (12 weeks) Score: 2.97, Pass

Chelsea’s Internal Medicine attendings made the following comments about her: “Chelsea had a solid performance during this rotation and I am sure she will go on to do well.” “Student was very engaged during rounds, would read about her patient’s issues and overall did a very good job on Medicine.” “Chelsea was a valuable member of the Internal Medicine team during her first third-year clerkship.” “Chelsea was easy to work with. She seemed to really care about her patients. She was a hard worker and sought out responsibility.” “Excited about patient care and medicine. Took responsibility for patients and would call consultants. Very helpful.” “Organization, willingness to learn, works well with team (are her strengths).”


• Cumulative (year-long) performance on individual clinical competencies required for passing the clerkships

– Clinical Knowledge– Professionalism– Patient Care

• Scores (0-4 scale) taken directly from Clerkship Final Grade Form

Clinical Knowledge Score

Pass

3.65

3.79

3.81

ACADEMIC PROGRESS: Track Curriculum (Phase IV)

• Grades and narrative from any courses that have a grade submitted prior to deadline.

• A list of fourth year courses schedule to be completed

SUMMARY

• Chelsea is a caring professional who is dedicated to her profession and to community advocacy. As of the submission of this letter, she has successfully completed the University of Utah School of Medicine curriculum. Based on all aspects of Mary’s educational experience, she has demonstrated competency in all of the general domains established by the medical school and is prepared to enter residency. She is considered to be an excellent candidate for your residency program.

AOA Calculation and Class Description

• Calculated at the completion of Phase III– Step 1 score 10%– Phase I and II 40%– Phase III 50%

• No class rank is every released or made public• Descriptors are used instead of class rank or

quartiles/histograms

Summary Descriptor• Descriptors of summary performance

– “Outstanding, Excellent, Very Good, Good”

• Describe the criteria needed to achieve each level• Provide relative percentages for top descriptor only

(“Outstanding”)

Preliminary Descriptor Criteria

• Large list of potential inclusion points• Only fair to use data that were disclosed would be

on the MSPE– Not fair to include end of 2nd year OSCE for example.– Discussed with class leaders and removed

• Includes Phase II honors, Phase III grades, score and exams, Step 1 score, Step 2 score

• Should not be based on a ranking or average– i.e. “5 out of 7 clerkship honors” rather than “top 10%”

Journal Club

• First Clerkship Block– Or second clerkship block for those starting clerkships block

2• Rooms

– HSEB 2908 – Surgery– HSEB 2912 – Pediatrics– HSEB 2929 – Internal Medicine– HSEB 2931 – Ob/Gyn– HSEB 2949 – Psychiatry– HSEB 2962 – Family Medicine


Resident Panel

• Participants


Transition to Clerkships July 5, 2013 © 2012 University of Utah School of Medicine.

Documents

Transcript of Transition to Clerkships July 5, 2013 © 2012 University of Utah School of Medicine.