In June of the third year, the student begins a sequence of clerkships in internal medicine, general surgery, pediatrics, psychiatry, obstetrics and gynecology, family medicine, geriatrics and radiology. During this important phase of medical education, the student becomes virtually a full-time inhabitant of the various public and private health care affiliates of the College. The student learns to take responsibility for patient care under supervision and during this learning process interacts with attending physicians, residents, nurses, social workers and physician assistants.
Learning experiences during clerkship training are very diverse, including conferences, seminars, lectures, demonstrations, ward rounds and grand rounds; but the essence of this training is, above all, interaction with patients in both inpatient and ambulatory patient environments. It is primarily through direct encounters with patients that the student learns a systematic approach to patient care based upon accurate and comprehensive histories, thorough physical examinations, proper analysis and interpretation of laboratory and imaging data, understanding of disease mechanisms, formulation of rational therapeutic goals, and careful evaluation of treatment effectiveness.
While attending to the patient's medical problems, the student is also expected to be considerate and compassionate, appreciate the influence of sociocultural and economic factors on the patient and family, acquire understanding of ethical issues in clinical decision-making, and practice high standards of professional behavior.
At the end of year three, each student participates in a six-hour assessment of history- taking, physical examination and differential diagnosis skills through the use of standardized patients. Each student's encounter with a standardized patient is reviewed with faculty, and remedial assistance is provided to students who do not achieve an acceptable level of clinical competence.
Required clinical clerkships
|Obstetrics & Gynecology
|Patients, Doctors, and Communities
During the Ambulatory Care Program, students participate in the evaluation and therapy of adult or pediatric outpatients. Students in this program are expected to develop a sense of responsibility for continuity of patient care and appreciation of the special problems that confront the physician of first contact.
Every student is required to do a two-month Subinternship in medicine, pediatrics or adolescent medicine. Functioning as an integral member of the patient-care team, the subintern assumes many of the responsibilities of a first-year resident under supervision of the resident and attending physician staff.
A one-month clerkship in Neurology rounds out the four months of required senior year courses.
A major part of the senior year is an elective period of seven months duration. Students choose from a wide selection of electives offered by virtually every department. Through the elective program, a student may choose to obtain additional subinternship experience, further training in ambulatory medicine and primary care, or participate in a research project. Electives in clinical specialties such as cardiology, infectious disease, endocrinology, dermatology, nephrology, gastroenterology, pulmonary medicine and emergency medicine are very popular. Also available are programs in community medicine, drug abuse, alcoholism, and geriatrics. Many electives may be arranged to be taken in other medical schools in the United States or abroad. Funding is available for students to travel abroad to participate in exchange programs with overseas medical schools or obtain clinical or research experience in less developed nations.
Recent developments in the clinical curriculum:
- During clerkship rotations in the third year, students from different clerkships gather together in small groups to participate in case-based discussions of topics and issues in prevention, professionalism and ethics in a course entitled Patients, Doctors and Communities.
- Seminars and conferences on topics at the cutting edge of the scientific foundations of medicine are scheduled during third year clerkships.
- There is enhanced emphasis on learning the fundamental skills of the physician-patient interaction, ensuring that students are adequately observed during the clinical encounter and assessing students' competence in this encounter.
Required clinical experiences and electives
|Subinternship in Medicine
|Ambulatory Care Program
in Medicine, Pediatrics or
7 months of electives available in blocks of one or two months