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Download Clinical Clerkship Manual - Alabama College of Osteopathic Medicine
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Clinical Clerkship Manual TABLEOFCONTENTS PhilosophyofOsteopathicMedicine. ...............................................................................................1 OsteopathicPledgeofCommitment.................................................................................................1 OsteopathicPhysician’sOath. ...........................................................................................................1 Overview..............................................................................................................................................2 DivisionsofClinicalResourcesandClinicalSciences. ..................................................................2 ClinicalResourcesStaff/ClerkshipRegionalCoordinators. .......................................................2 ClinicalSciencesFaculty/Staff.......................................................................................................3 GeneralInformationandGuidelinesforClinicalClerkships.......................................................4 ClerkshipManagementSoftware ChangeofAddress ProfessionalDemeanorandTitles Appearance LiabilityInsurance PersonalInsurance Tobacco,Drug,andAlcoholUse InappropriateConduct PropertyofOthers Needle‐StickandBlood‐BornePathogenExposure EligibilityforClerkships AssignmentofCoreClerkships ClerkshipScheduleChanges CoreClerkships ClinicalClerkshipSites......................................................................................................................8 LengthofClerkships HoursofDuty Attendance Non‐ClinicalExperiences HIPPA CoreCurriculum. .................................................................................................................................11 ClassificationofClinicalClerkships OMS‐IIIClerkships OMS‐IVClerkships NumberofClerkships ThirdYearClinicalClerkshipsDescriptions OsteopathicPrinciples&PracticeDuringThirdYearClinicalClerkships FourthYearClinicalClerkshipDescriptions LocatingSelectiveorElectiveClerkships ProceduresforApplyingforClerkshipsatMilitaryEducationPrograms LocatingClerkshipsatMedicalEducationPrograms ParticipatinginOut‐of‐NetworkSelectives/Electives AdditionalOptionsforElectiveClerkships LimitsonClerkships ConfirmationofClerkshipAssignments PatientCareActivities.......................................................................................................................22 2015–2016ACOMClinicalClerkshipManual i Rev.1/25/16 MedicalRecords/Charting. ..............................................................................................................22 Portfolio/MilestoneCompetenciesLog. ........................................................................................22 GradingGuidelinesforClinicalClerkships.....................................................................................23 AssignmentofGrades GradingScale IncompleteClerkships AssignmentoftheFinalGrade FailureofaClerkship GradeAppeals COMLEXExams. ...................................................................................................................................24 COMLEXLevel1 COMLEXLevel2‐CEandLevel2‐PE StudentEvaluations...........................................................................................................................24 CompetencyBasedEvaluation StudentResponsibilityforPreceptor’sEvaluations EvaluationProcess StudentEvaluationofthePreceptor/Site Post‐ClerkshipExams. ........................................................................................................................29 OMS‐IIICOMATExams OMS‐IVPost‐ClerkshipExams GraduationRequirements.................................................................................................................30 AdditionalPoliciesandGuidelines..................................................................................................31 TipsonMakingtheMostofEachClinicalClerkship.....................................................................32 ClinicalClerkshipCoreSiteList.......................................................................................................33 ClinicalClerkshipCoreSiteMap......................................................................................................34 PolicyandStatementofNon‐Discrimination.................................................................................35 AppendixA:LearningAgreement. ....................................................................................................36 AppendixB:ClinicalSkillsNecessaryforGraduation. ..................................................................37 AppendixC:ACOMGuidelinesforStudentParticipationinClinicalSettings...........................42 AppendixD:COMATScoreReleaseProcess...................................................................................46 AppendixE:ProcessforParticipatinginSelectives/Electives..................................................47 AppendixF:SchedulingAuditionRotations&ApplyingforResidency.....................................48 AppendixG:TermstoKnow. .............................................................................................................52 AppendixH:OMS‐IICompetencies. ..................................................................................................60 AppendixI:ACOMPatient‐CenteredInterviewingEvaluation....................................................64 AppendixJ:ClerkshipRotationEvaluations. ..................................................................................66 Mid‐RotationEvaluation PreceptorEvaluationofStudent End‐of‐ClerkshipSurvey AnnualSiteSurvey 2015–2016ACOMClinicalClerkshipManual ii Rev.1/25/16 PHILOSOPHYOFOSTEOPATHICMEDICINE Osteopathicmedicinestressesacomprehensiveapproachtothemaintenanceofhealth.Therootsof osteopathicmedicaleducationlieintheemphasisitplacesonthemusculoskeletalsystem.The interrelationshipbetweenthisandotherbodysystemsisbasictohealthmaintenanceandtheprevention ofdisease.FoundedbyAndrewTaylorStill,MD,DO(1828‐1917),osteopathicmedicineutilizesfour fundamentalprincipleswhichenabletheosteopathicphysiciantolookathealthanddiseaseinaunique manner: Thebodyisaunit;thepersonisaunityofbody,mind,andspirit. Thebodyiscapableofself‐regulation,self‐healing,andhealthmaintenance. Structureandfunctionarereciprocallyinterrelated. Rationaltreatmentisbasedontheabovethreeprinciples. OSTEOPATHICPLEDGEOFCOMMITMENT Ipledgeto: Providecompassionate,qualitycaretomypatients; Partnerwiththemtopromotehealth; Displayintegrityandprofessionalismthroughoutmycareer; Advancethephilosophy,practice,andscienceofosteopathicmedicine; Continuelife‐longlearning; Supportmyprofessionwithloyaltyinaction,wordanddeed;and Liveeachdayasanexampleofwhatanosteopathicphysicianshouldbe. OSTEOPATHICPHYSICIAN’SOATH IdoherebyaffirmmyloyaltytotheprofessionIamabouttoenter.Iwillbemindfulalwaysofmygreat responsibilitytopreservethehealthandthelifeofmypatients,toretaintheirconfidenceandrespectboth asaphysicianandafriendwhowillguardtheirsecretswithscrupuloushonorandfidelity,toperform faithfullymyprofessionalduties,toemployonlythoserecognizedmethodsoftreatmentconsistentwith goodjudgmentandwithmyskillandability,keepinginmindalwaysnature'slawsandthebody'sinherent capacityforrecovery. Iwillbeevervigilantinaidingthegeneralwelfareofthecommunity,sustainingitslawsandinstitutions, notengaginginthosepracticeswhichwillinanywaybringshameordiscredituponmyselformy profession.Iwillgivenodrugsfordeadlypurposestoanyperson,thoughitbeaskedofme. Iwillendeavortoworkinaccordwithmycolleaguesinaspiritofprogressivecooperation,andneverby wordorbyactcastimputationsuponthemortheirrightfulpractices. Iwilllookwithrespectandesteemuponallthosewhohavetaughtmemyart.TomycollegeIwillbeloyal andstrivealwaysforitsbestinterestsandfortheinterestsofthestudentswhowillcomeafterme.Iwillbe everalerttofurthertheapplicationofbasicbiologictruthstothehealingartsandtodeveloptheprinciples ofosteopathywhichwerefirstenunciatedbyAndrewTaylorStill. 2015–2016ACOMClinicalClerkshipManual 1 Rev.1/25/16 Overview ThismanualprovidesanoverviewofthecurrentpoliciesandproceduresofAlabamaCollegeof OsteopathicMedicine(ACOM)pertainingtothird‐andfourth‐yearclinicalclerkships.ACOMreservesthe righttomakechangesatanytimeineducationalpolicies,schedules,trainingsites,evaluationprocedures, oranyotheraspectsoftheclinicaltrainingprogram.Changeswilloccur,asneeded,tomaintaineducational requirements,standards,orthequalityoftheprogram.Everyeffortwillbemadetonotifystudentsina timelymannerwhenchangesareimplementedandneworrevisedpoliciesareinstituted.Changeswillbe effectiveonthedateofthenotification.Anyconflictsregardingtheapplicationorinterpretationofthe policiescontainedinthismanualwillberesolvedbytheDeanofClinicalSciences,whosedecisionisfinal. TheStudentHandbookistheprimarystudentguideandtheClinicalClerkshipManualisasupplement forusebyOMS‐IIIandOMS‐IVstudentswhileonclerkships. DivisionsofClinicalResourcesandClinicalSciences MissionandBasicProcedures TheDivisionofClinicalResourcesisdedicatedtoprovidingstudentswiththehighestqualityclinical educationalopportunitiesandprovidingexceptionalservicetoeveryonewithwhomweinteract.Each studentisassignedtoacoresite,whichismanagedbyadirectorandcoordinator,andconnectedtoa regionalcoordinatorforthatgeographicalregion.Collectively,theschedulesandassignmentsare coordinatedbythesepersonnel.Clinicalassignmentsarebasedonmultiplefactors,includingavailabilityof preceptors. TheDivisionofClinicalScienceswillprovidestudentswithawell‐integrateddidacticandexperiential curriculumthatwillbroadenstudents’medicalknowledgeandtaskthemtoapplythatknowledgein clinicalsettingscommontoclinicalcare.ACOMClinicalSciencesFacultywillserveasclerkshipchairsand asfacilitatorsforclerkshipdidactics.ACOMpreceptorswillassessstudentabilitiesatthePointofCare,on rounds,andduringotherclerkshipvenues. OnlyclinicalclerkshipsscheduledthroughandconfirmedbytheDivisionofClinicalResourcesand approvedbytheDivisionofClinicalScienceswillfulfilltherequirementsoftheclinicalcurriculum.No clinicalclerkshipwillbeacceptedforcreditunlessapprovedandconfirmedinadvance. Asyllabusforeachrequiredclerkship,includingdidactics,readingassignments,andgradingcriteria,will beprovidedbytheClerkshipChair.ClerkshipChairswillalsoassignthefinalgrade. DivisionHours RegularhoursfortheDivisionsofClinicalResourcesandClinicalSciencesare8:00a.m.to4:30p.m.Central Time,excludingdayswhentheACOMcampusisclosed.Itisrecommended,becauseofvaryingschedules, thatcommunicationbetweenstudentsandtheDivisionsismadeprimarilyviaemail.Alongwithemail,the ACOMvoicemailsystemisactivetwenty‐fourhoursaday,includingweekendsandholidays.Voicemail mayanswercallsifstaffmembersareunavailable.Anemergencycallschedulewillbepublishedannually. ClinicalResourcesStaff/RegionalCoordinators TheClinicalResourcesstaffwillprovidestudentswithguidanceandassistanceinpreparingtheirclinical clerkshipschedule.Allplansmustbesubmittedinwritingtotheassignedstaffmemberwhowillpreparea final,confirmedplan. 2015–2016ACOMClinicalClerkshipManual 2 Rev.1/25/16 STAFFNAME WilBaker,PhD CherylGibson LisaPitman,RN LeighKincer BeckyJordan,RN POSITION PHONE EMAIL AssociateDeanof ClinicalResources DirectorofClerkship ResourcesManagement RegionalCoordinator– North RegionalCoordinator– Central RegionalCoordinator– South 334‐944‐4051 251‐947‐6288 [email protected] 334‐944‐4028 [email protected] 334‐944‐4074 [email protected] 334‐944‐4075 [email protected] 334‐944‐4076 [email protected] ClinicalSciencesFaculty/Staff TheClinicalSciencesfacultyandstaffwillprovidestudentswithguidanceandassistanceinclerkship rotationdidactics,grading,andgeneralcurriculumissues. CLERKSHIPCHAIRS CLERKSHIP CHAIR PHONE EMAIL BehavioralMedicine BascomBradshaw,DO, MPH,MAS 334‐944‐4047 [email protected] EmergencyMedicine JohnT.Giannini,Jr.,MD 334‐944‐4055 [email protected] FamilyMedicine ElizabethHengstebeck, DO 334‐944‐4026 [email protected] InternalMedicine PratikShah,DO 334‐944‐4071 [email protected] Obstetrics/Gynecology VancePowell,DO, FAODME,FACOOG 334‐944‐4059 [email protected] Pediatrics HeathParker,DO 334‐944‐4049 [email protected] 334‐944‐4059 [email protected] 334‐944‐4009 [email protected] Surgery Selectives/Electives VancePowell,DO, FAODME,FACOOG StephenJ.Miller,DO, MPH,FACOFP FACULTY/STAFF NAME POSITION PHONE EMAIL StephenJ.Miller,DO,MPH, FACOFP AssociateDeanof ClinicalSciences 334‐944‐4009 [email protected] KimberlyCummings,LPN ExecutiveAssistant 334‐944‐4024 [email protected] AmandaGant ClinicalSciences Coordinator 334‐944‐4025 [email protected] 2015–2016ACOMClinicalClerkshipManual 3 Rev.1/25/16 GeneralInformationandGuidelinesforClinicalClerkships ClerkshipManagementSoftware ACOMusesE*Valuemanagementsoftwaretoscheduleclinicalclerkships,recordstudentevaluations,and managetheclinicalexperiencesofstudents.StudentsreceiveinstructionsfromtheirRegionalCoordinator withlogininformation,username,andpasswordtoaccesstheirclinicalschedule,reviewevaluations,and completeevaluationsoftheirpreceptorsandclerkshipsites. ChangeofAddress Itisimportantthateachstudent’sRegionalCoordinatorbekeptuptodateoncurrentcontactinformation. Failuretopromptlyreportachangeinmailingaddress,telephonenumber,orothercontactinformation canresultinfailuretoreceiveinformationimportanttothesuccessfulcompletionofclinicalclerkships.It istheresponsibilityofthestudenttosupplycurrentandtimelycontactinformation. ProfessionalDemeanorandTitles Allstudentsareheldtohighprofessionalstandardsregardingtruthfulnessinwordanddeedregarding academicandclinicalmatters.Studentsareexpectedtoperformatthehighestlevelofprofessionalism.Any deviationfromthatstandardasjudgedbytheclinicalsitemaybecauseforfailureofthatclerkship. ReportedviolationsofprofessionalismmayresultinreferraltotheStudentProgressCommittee. Studentswillrefertothemselvesas“Firstname,Lastname,third/fourthyearmedicalstudentatAlabama CollegeofOsteopathicMedicine”inaclinicalsetting.Asagroup,studentsarereferredtoas“Medical Students.”Studentswillrefertootherprofessionalsintheclinicalsettingbytheirappropriatetitle,suchas “Dr.Smith,”“Ms.Jones,”etc.Studentsarenevertorepresentthemselvesaslicensedphysicians.Ifa studenthasadoctoraldegreeinanyfield,thistitlecannotbeusedwhileinanyclinicalsettingwhetherina studentenvironmentornot.Studentsmayexpecttobetreatedasprofessionalsbyallclinicalpersonnelat alltimes,andinturnconductthemselvesprofessionally,ethically,andrespectfullyinregardtoallclinic andhospitalpersonnelandinteractions.Courtesyandaprofessionaldemeanoratalltimesareessential traitsforaphysician. Appearance Schoolofficialsandpreceptorsarethefinalarbitersofappropriatestudentappearance.Ifastudent’s appearanceisnotappropriate,studentsmaybeimmediatelyremovedfromclinicaldutiesandaskedto correcttheproblembeforecontinuingwithclinicalduties.Thefollowingrulesapplyatalltimeswhilethe studentisparticipatinginclerkshipactivities: Thestudentwilldressinaneatandprofessionalmanner: o Conservativehairstyles, o Conservativemake‐upandjewelry o Neatlytrimmedmoustachesandbeards o Novisiblebodypiercingortattoos o Clean,pressedwhitecoat Professionalattireincludes: o Formen:dressshirt,dresspants,tie,closedtoedressshoesandsocks o Forwomen:dressorskirtnotmorethan3inchesabovetheknee,ordressslacks, conservativedressblouseorshirt,closedtoedressshoesandpantyhoseorsocks o Noperfume,cologne,orscentedbodysprays Thestudentwillmaintainacriticalawarenessofpersonalhygiene. AwhitestudentclinicjacketdisplayingtheACOMpatchandanACOMnamebadgeisrequiredatall timesbyallstudentswheninaclinicalenvironment. 2015–2016ACOMClinicalClerkshipManual 4 Rev.1/25/16 SomefacilitiesmayrequirestudentstowearordisplaytheirsitespecificnamebadgeorIDin additiontothatrequiredbytheschool. Foractivitieswhereaninstitutionrequires“scrubs”orotheralternativeorprotectiveattire,the alternativeattirewillbeprovidedbytheinstitution,remaintheinstitution’sproperty,andremain attheinstitutionatalltimes.Scrubsarenottobewornawayfromortravelingtoandfromthe clinicaltrainingsiteandaretobereturnedtothetrainingsiteuponcompletionoftheclerkship. Theaboverequirementsapplyfromthefirstdayoftheclerkshiptotheendoftheclerkship,unless thepreceptorspecificallyrequestsdeviationfromtheabove. IfanaffiliatedhospitalorclinicalsitehasadresscodethatdiffersfromACOM’sstandards,the studentwillfollowthedresscodeofthetrainingfacility. LiabilityInsurance TheCollegeprovidesliabilityinsurancecoverageforstudentsonapprovedclinicalclerkshipswhilethey aredirectlyunderthesupervisionoftheassignedpreceptorordesignee.TheCollege'sliabilitycoverage doesnotapplytounsupervisedstudentclinicalactivity.Anyclerkshipnotofficiallyscheduledthroughthe ClinicalResourcesDivisionandapprovedbytheClinicalSciencesDivisionwillnotberecognizedforofficial credittowardgraduationrequirements. PersonalInsurance Studentsarerequiredtohavepersonalhealthinsurancewhileonclinicalclerkships.Studentsmaybe askedtoshowevidencetotheclinicaltrainingsitethathealthinsuranceisinplace. Tobacco,Drug,andAlcoholUse Unlawfulmanufacture,distribution,dispensation,possession,oruseofacontrolledsubstancebyany studentoftheAlabamaCollegeofOsteopathicMedicinewhileheorsheisonCollegeproperty,involvedin Collegeactivities,oratanyclerkshipsite,isprohibited.TheCollegewilltakedisciplinaryactionagainsta student,groupofstudents,orstudentorganizationforanyviolationofthispolicy.Astudentorstudent organizationmayalsobedisciplinedfor,andisdeemedinviolationoftheCodeofEthicsandHonorfor,the unlawfulpossessionorconsumptionatanyclerkshiprotationsiteofalcoholicbeverages,public drunkenness,orviolationofstateorlocallawsregardingalcoholuseorpossession.Useofanytobacco productornonprescriptionnarcoticisprohibitedatanyclerkshiprotationsite.Studentsarealsorequired toadheretotheTobacco,Drug,andAlcoholpolicyoftheirclerkshiprotationsitewhileintrainingatthat site,anditwillsupersedeACOM’sclerkshippolicyonlyifitsmorerestrictive.SeeACOM’sStudent Handbookathttp://www.acomedu.org/wp‐content/uploads/2014/12/2014‐2015‐ACOM‐Student‐ Handbook.pdfformoreinformation.Anydisciplinaryactionstobetakenandthedisciplinaryproceduresto beappliedforthefairadjudicationoftheallegedviolationswillbeinaccordancewithpoliciesand procedurespublishedintheStudentHandbook. InappropriateConduct TheStudentHandbookprovidesadditionalinformationaboutappropriatestudentconduct,andthe StudentProgressCommitteewilladdressissueswhichariseregardingstudentconduct. PropertyofOthers Studentswillnottaketemporaryorpermanentpossessionofhospitalorpreceptorproperty(books, journals,food,scrubs,etc.)withouttheowner'sexpressedpermission.Suchitemsshouldbereturnedat thecompletionoftheclinicalclerkship. 2015–2016ACOMClinicalClerkshipManual 5 Rev.1/25/16 Needle‐StickandBlood‐BornePathogenExposure Ifastudentexperiencesaneedlestick,puncturewound,accident,orsharpinjury,orisotherwiseexposed tobodilyfluidsofapatientwhileonaclinicalclerkship,thestudentshould: 1. Immediatelywashthearea,scrubbingskinwithsoapandwater. 2. Immediatelyreporttheincidenttotheattendingphysicianorotherappropriatesupervising physicianconcerninghis/herwhereaboutsandwell‐being.Promptreportingisessential.Insome cases,post‐exposuretreatmentmayberecommendedandshouldbestartedassoonaspossible. 3. Seekpost‐exposureservices.Clinicalsiteswillhaveapolicyinplaceforblood‐bornepathogens, withapointofcontact.Thestudentshouldfollowthepolicyofthetrainingsite.Ifonacore clerkship,contacttheCoreSiteCoordinatorforinstructions.Ifonanon‐coreclerkship,contactthe nursingsupervisororemployeehealthservice.Iftheexposureoccursafterhoursorifthestudent cannotlocateapersontoguidethem,heorsheshouldgoimmediatelytotheemergency departmentandidentifyhimself/herselfasastudentwhohasjustsustainedanexposure. 4. ContacttheDivisionofClinicalResourceswithin24hoursforinstructionregarding reportingtheincident,handlingcostsforpost‐exposuretreatment,etc. EligibilityforClerkships 1. OnlyACOMstudentscurrentlyenrolledasOMS‐IIIorOMS‐IVstudentswillbeallowedonclinical clerkships.Tobeeligibletobeginclinicalclerkships,studentsmustsuccessfullycompletetheentire courseofstudyforyeartwoandhaveachievedapassingCOMLEX1score.Tobeeligibletobegin 4thyearclerkships,studentsmustsuccessfullycompleteallcomponentsof3rdyearclerkships.Ina specialcircumstance,suchasanincompletegrade,thestudentmaybegin4thyearclerkships,buta holdwillbeplacedonthestudentrecorduntilallthirdyearrequirementsaremet,whichmay hindersubsequentregistration. 2. StudentswhopassLevelIafterthetermhasbegunmustenrollinaminimumof4credithours(at leastoneclerkship)inordertomeettheenrollmentrequirementsassociatedwithFederalStudent Loandisbursements.Formoreinformation,pleasecontacttheOfficeofFinancialAid. 3. StudentsmusthavecurrenttraininginBasicLifeSupport(BLS),AdvancedCardiacLifeSupport (ACLS),OSHA,HIPAA,UniversalPrecautionsandsteriletechnique.Trainingintheseareaswillbe providedoncampusbeforetheendofyeartwo.Attendanceismandatoryatsessionspertainingto thesetopicsprovidedatACOMandatanyclinicalclerkshipsiteatwhichtheyarerequired. 4. StudentsareresponsibletokeepacopyofBLSandACLScertificationcardsandpresenttotraining sitesuponrequest.Itistheresponsibilityofthestudenttorecertifyintheseareasbeforethe certificationexpirationdate.Studentsareencouragedtolocateandregisterforrecertification coursesthreemonthsinadvanceoftheexpirationdatetoensurethatcertificationisnot interrupted.Manycorehospitalsandotherclinicalclerkshipsitesroutinelyofferrecertification classes,oftenfreeofchargetostudents. 5. Studentsmusthavepersonalhealthinsuranceandprovideproofofinsurancetoclinicalsiteswhen requested. 6. Thefollowingdocumentationisrequiredbymostclinicaltrainingsites.Studentsmustprovide theDivisionofClinicalResourceswiththesedocumentsbyApril15oftheirOMS‐IIyear. a. Requiredimmunizationsandtitersdemonstratingimmunity: Immunizations: HepatitisBseries MMRbooster TdaPbooster VaricellaBooster 2015–2016ACOMClinicalClerkshipManual 6 Rev.1/25/16 SerumTiterstoproveimmunity: VaricellaIgGtiter MeaslesIgGtiter MumpsIgGtiter RubellaIgGtiter HepatitisBSurfaceAntibodytiter b. c. d. e. f. g. Ifdocumentationoftheaboveimmunizationsandtitersisnotcurrentandonfilewiththe DivisionofClinicalResourcesbeforeclerkshipsbegin,thestudentwillnotbeallowedto beginclinicalclerkships.Itis,therefore,importantforstudentstocomplywiththe April15deadlineforsubmissionofimmunizationandtiterdocumentationsothat discrepanciescanbeclearedpriortothestudent’sfirstscheduledclerkship.Ifyou haveaninsufficienttiterresult,thesubsequentvaccinationandfollow‐uptiterison you.SAMCEmployeeHealthwillworkwithyou,butyouareresponsibleforcosts incurred. Manyclerkshipsitesrequireanannualinfluenzavaccination,usuallybyDecember1ofeach year.Studentsarestronglyencouragedtoobtaintheinfluenzavaccinationandkeep documentationonhandtoprovidetoclerkshipsitesuponrequest. AnannualTBtestmustbecurrentandonfilebyApril15ofeachyear;chestradiographyis requiredeverytwoyearsiftheTBtestisconsideredpositive. UpdatedCertifiedBackgroundCheck:TheCertifiedBackgroundreportsubmittedfor admissiontoACOMwillnotmeetthisrequirement.Anupdatedreportmustbecompleted andonfilewiththeDivisionofClinicalResourcesbyApril15oftheOMS‐IIyear. Ten‐PanelDrugScreen:ThedrugscreencompletedforadmissiontoACOMwillnotmeet thisrequirement.AnupdateddrugscreenmustbecompletedbetweenFebruary1stand April1standonfilewiththeDivisionofClinicalResourcesbyApril15oftheOMS‐IIyear. StudentswillreceiveinstructionsfromtheDivisionofClinicalResourcesregarding procedurestoobtainanupdatedcriminalbackgroundcheckanddrugscreen. CertifiedBackground.comwillberesponsiblefortrackingandinterpretingresultsfor conductedbackgroundchecksanddrugtests,inadditiontoreportsofphysical examinationsandimmunizationssubmittedbyACOMstudents. Someclinicaltrainingsitesmayrequiredocumentationinadditiontothatlistedabove.Studentsshould paycloseattentiontoclerkshiprequirementswhenapplyingforplacementatnon‐ACOMsites. Studentsmustadheretoandcompletefacility‐specificorientationand/ortrainingrequirementsateach clerkshipsite,evenifrepetitiveofrequirementsmetatACOMorpreviousclerkshipsites.Forexample, studentsmayberequiredtoattendHIPAAtrainingateachoftheirtrainingsites. AssignmentofCoreClerkships CoresitesandclerkshipsareassignedbytheDivisionofClinicalResources.Beforecompletionofthe secondyear,studentsranktheirtopchoicesforcoresites.Usinga“scheduleoptimization”(lottery) process,theDivisionofClinicalResourceswillassigncoresitesbased,totheextentpossible,onthe student’stopchoices.Therewillbeaone‐to‐twoweektradingperiodaftercoresitesareassignedwhen studentswillbeallowedtoswitchtheircoresiteassignmentwithotherstudents,afterwhichschedules willbesetandfinalized.Afterthetradingperiodends,studentswillnotbepermittedtochangecoresites. ClerkshipScheduleChanges Studentsmayrequestchanginganelectiveorselectiveclerkshipwith60days’noticetotheDivisionof ClinicalResources.Thestudentshouldsendtherequest,withareasonforthechange,byemailtohis/her regionalcoordinator.Eachrequestwillbeconsideredonacase‐by‐casebasis. 2015–2016ACOMClinicalClerkshipManual 7 Rev.1/25/16 CoreClerkships CoreclerkshipswillbecompletedduringtheOMS‐IIIyearatanassignedcoresite.Coreclerkshipsmay requirethestudenttoworkwithavarietyofinstructorsatvariouslevels,includinginterns,residents,and attendingphysicians.Thefollowingareguidelinesfortheclinicalclerkshipexperience: Thestudentisclinicallyresponsibletothepersontowhomhe/sheisassignedatthattime. Studentswillcomplywithallrulesandregulationsatthecoresiteandanyinstitutiontowhichthey areassigned. o Ifassignedtoahospital,clinic,orotherinstitution,theinstitutionwilldefinewhatbenefitsthe studentswillhavewhileattheinstitution(e.g.discountedorfreemeals,lodging,etc.)and underwhatcircumstancesthestudentswillhaveaccesstothosebenefits. o Theinstitutionisresponsiblefordeterminingthedegreeofstudentinvolvementatthat institutionincludingaccesstothefacilityandareaswithinthefacility,clinicalaccesstopatients, accessandcontributiontothemedicalrecord,andobservationandparticipationinprocedures. o Eachstudentshouldhaveaccesstothehospitallibraryorlearningresourcescenterinthesame capacityasphysiciansandhousestaffattheinstitution. Studentswillconductthemselvesduringtheclerkshipasthoughtheywereguestsinsomeoneelse's home.Conductotherwisemayresultindisciplinaryactionbythehospitaland/orACOMincluding dismissalfromtheclerkshipand/orreferraltotheStudentProgressCommittee. Studentswillreturnanyborrowedpropertybeforetheendoftheclerkship,includingsurgicalgarb, librarymaterials,textbooks,pagersorotheritems. ClinicalClerkshipSites ACOMprovidesclinicaltrainingexperiencesprimarilyinAlabama,althoughexcellentsitesareavailablein otherlocations.Studentswillreceivethehighestqualityclerkshipexperiencesthroughtheframework establishedbytheAlabamaMedicalEducationConsortium(AMEC).Since2005,medicalstudentsfrom partnerschoolshaveservedtheirthirdandfourthyearclerkshipsinthecoresitessetupbyAMECand managedbycoresitedirectors(physicians)andcoordinators.Thisenrichedandexpandingclinical network,coupledwithmaturecoresitemanagement,addsvaluetotheclinicalclerkshipexperiencefor ACOMstudents. TheDivisionofClinicalResourcesassignsstudentstospecificcoreclerkships.Thesemandatedlearning experiencesareatsiteswithpreceptorswhoprovideACOMwithtrainingopportunitiesandfromwhom theschoolgetsqualityassessmentsofstudentsthroughouttheirclinicaltraining. Studentswillcompletethesespecificcoreclerkshipsoverthecourseoftheirthirdyearoftrainingat assignedcoresites.Theseeducationalexposuresoccurinapractical,clinicalenvironmentdesignedto developexpertiseinpatientdiagnosisandmanagement.Inadditiontooutpatientexperiencesathospital‐ basedclinics,free‐standingclinics,andphysicians’offices,studentswillbeprovidedwithinpatientclinical experiencesathospitalsandmedicalcenters. Duringthethirdyear,thestudentwillbeassignedtoacoresite.Eachsitewillbecenteredonacarefully selectedhospitalwithsufficientresourcestoprovidethethirdyearcurricularplan.Thefourthyear curriculumisintendedtobuildonthefoundationalexperienceprovidedinthethirdyear.Fourthyear experiencesareinsettingswheremoredemandsforindependencecanbeexpectedoftheseniormedical student.Flexibilityisprovidedbythreeclerkshipsofelectivetimeinthethirdyearanduptoeight clerkshipsofelectivetimeinthefourthyeartogivestudentsampleopportunitytopursuetheirspecial interests. 2015–2016ACOMClinicalClerkshipManual 8 Rev.1/25/16 AcurrentlistofACOMclerkshipsitestowhichstudentswillbeassignedcanbefoundattheendofthis document.Theseclinicalclerkshipsaredirectedtowardareasofmedicinethatareimportantinthe primarycarepractice. Formalclinicalaffiliationagreementsareinplacewiththesetrainingsites.Studentsareexpectedtocomply withthepolicies,procedures,andgeneralrulesofthetrainingfacilityatwhichanyclerkshipiscompleted. Theinstitutionisresponsiblefordeterminingthedegreeofstudentinvolvementatthatinstitution, includingaccesstothefacilityandareaswithinthefacility,clinicalaccesstopatients,accessand contributiontopatients’medicalrecords,aswellasobservationandparticipationinprocedures.Each studentshouldhaveaccesstothehospitallibraryorlearningresourcescenterinthesamecapacityas physiciansandhousestaffattheinstitution. LengthofClerkships Theminimumlengthofaclerkshipisfour(4)consecutiveweeksatthesamesitewithasinglephysicianor ahospitalresponsibletotheschoolforthestudent'seducationduringtheclerkship.Aclerkshipmaynotbe "split"unlessbyapprovalbytheAssociateDeanofClinicalSciencesatleastfourweekspriortothe scheduledonsetoftheclerkship. HoursofDuty Eachclinicaltrainingsitesetsitsownschedule.Nightcall,weekendcoverage,andholidayassignmentsare atthediscretionofthetrainingsite. Clerkshipsbeginat7:00a.m.onthefirstMondayoftheclerkshipblockandendat7:00p.m.on Fridayevening26dayslater.Deviationfromthesehoursisatthediscretionofthesupervising physicianpreceptor. Studentsmaynottakecallorremainonserviceafter7:00p.m.onthelast Fridayoftheclerkship.Ifthesupervisingphysiciandeviatesfromtheclerkshipplanandhas plannednumerous"daysoff"suchashis/herpersonalvacation,thestudentshouldcontactthe clerkshipchairforadviceandcounsel. Atypicalworkweekis60–72hoursperweek.Theworkweekshallbelimitedtoaminimumof 45hoursandamaximumof80hours,averagedoverthefour‐weekperiodoftheclerkship. Studentsmaynot“compress”theirclerkshipschedule,workingextrahourssomeweeksin ordertocompletetheclerkshipinlessthanfourweeks. Themaximumdurationofanyworkperiodwillbe24hoursandmustbefollowedbyaminimumof 12hoursoffduty.Nostudentshallberequiredtobeoncallorperformnightdutyafteradayshift morethanonceeverythreedays. Studentsshallbegivenaminimumoftwodaysoffevery14days.Thisrequirementmaybemetby givingastudenteveryotherweekendoff,butthisisatthediscretionofthesupervising physician. Departurepriortothescheduleddeparturedatewillbeconsideredanunexcusedabsenceandmay resultinfailureoftheclerkship,unlessapprovedbythesupervisingphysicianandtheclerkship chair. Onthefinalweekendoftherotation,thestudentmustbegivenadequatetimetotraveltothenext clerkshiprotationsite.ItisintendedthatSaturdayandSundayarealltraveldays,andthatall studentassignmentsarecompletedbythefinalFridayoftheclerkshiprotation. Attendance Onehundredpercentattendanceisexpectedatallclinicalclerkships.Anyabsenceduring scheduledclerkshipworkhours,foranyreason,mustbearrangedwithandexcusedbythe preceptorandreportedtotheregionalcoordinatorinadvance.Thestudentmustreportthe absencetotheirregionalcoordinatorinadvance.Ifonacoreclerkship,thestudentmustalso notifytheSiteCoordinator. 2015–2016ACOMClinicalClerkshipManual 9 Rev.1/25/16 Anyabsenceduringclerkshipworkhoursmustbemadeupbythestudentinaccordancetoaplan pre‐approvedbythepreceptor. Extendedabsenceswillnotbeexcusedfortraveltoelectiveclerkshipsand/ormedicalmission work.Studentswillusetheweekendbetweenclerkshipsfortraveltimetothenextclerkship.Ifa studentneedsadditionaltimetotraveltoageographicallydistantclerkship,thisshouldbe discussedwiththesupervisingphysicianofthecurrentclerkshipandthestudent’sregional coordinatorassoonastheneedisknown. Anabsencefromaclerkshipwillbeexcusedonlyunderextremecircumstances.Studentscannotbe absentfromanyclerkshipexperiencewithoutpermissionfromthesupervisingphysician.Absence fromaclerkshipinexcessofthreedaysoranyunexcusedabsencewillbereviewedbythe AssociateDeanofClinicalSciencesandmayresultinrepetitionorfailureoftheclerkship. Thestudentmaybeexcused,withpriorapprovalfromthestudent’sregionalcoordinator,for COMLEXUSAexaminations.OnedayofexcusedabsenceisallowedforCOMLEXLevel2CE. StudentsareencouragedtoscheduletheNBOME/COMLEXexamatatestingcenterinclose proximitytotheirtrainingsite.OnedayofexcusedabsenceisallowedfortheCOMLEXLevel2PE exam.Theseabsencesmustbeasawrittenrequestinadvancetothestudent’sregional coordinator.Studentsshoulddiscusswiththesupervisingphysicianonthefirstdayoftheaffected clerkshiptheirneedforreleasetimefortesting.Studentswishingtotakeadditionaltimefor licensureexamstudyorreview,maybeapprovedtodosobytheAssociateDeanofStudents,but willberequiredtotakealeaveofabsenceandmakeupthetimepriortograduation. ShouldastudentreceiveanoticeforJuryDuty,he/shemayobtainaletterfromtheClinical ResourcesDivisiondescribingaclinicalstudent'sdutiesandobligationsandverifyingthestatusof "fulltimestudent,"whichshouldsufficeforexcusalfromjuryduty,butdoesnotexcusethestudent fromjuryduty;onlyajudicialofficialhastheauthoritytoexcusethestudentfromservingonajury. TheClinicalResourcesDivisionwillworkwiththestudentindividuallytoensurethatsuchrequests areprovidedinatimelyandaccuratemanner. ACOMmaintains,andthestudentmustrecognize,thatfulfillmentoftheacademicprogramistop priorityandthatitisthestudent’sresponsibilitytofulfillallcourseandclerkshiprequirements. ACOMdoesnotspecificallyallowtimeofffortheUSMLEexamorforinterviewsforpostdoctoral positions.Withapprovalfromthesupervisingphysician,timemissedmaybemadeupbytaking nightcallorweekendcall. Ifapersonalhealthproblemorfamilymedicalproblempreventsastudentfrommeetingthe assignedresponsibilities,thestudentshouldimmediatelycontacttheirregionalcoordinator.A writtenphysician'snotemustbepresentedtoallinvolvedpartiesforanyabsenceexceeding24 hours.Alllosttimeisexpectedtobemadeupwithnightorweekendduty,atthedirectionofthe supervisingphysicianorSiteDirector. Dishonestytoapreceptorortheschool(suchasportrayingoneselfas"ill"whenthatisnotthe case)isinappropriatebehavior.Shouldastudentdecidetotaketimeawayfromaclerkshipfor reasonsotherthanthoselistedaboveorbefoundtobedishonestlyportrayinghis/herreasonfor beingawayfromaclerkship,the"unexcusedabsence"policywillapply.Inaddition,the circumstancesregardingtheabsencemaybereferredtotheStudentProgressCommittee. Violationsofstudentconductcanresultinadverseconsequencesuptoandincludingsuspension and/ordismissal.RefertotheStudentHandbookregardingstandardsofconductandtheStudent ProgressCommittee. Non‐ClinicalExperiences Itisimportantforstudentstoobserveandparticipateinnon‐clinicalexperiencessuchastumorboard, journalclub,orhospitalcommitteesinordertounderstandandappreciatethefullspectrumofactivitiesin whichphysiciansareinvolved.Studentsareexpectedtoparticipateinasmanynon‐clinicalexperiencesas areapprovedbythepreceptor. 2015–2016ACOMClinicalClerkshipManual 10 Rev.1/25/16 HealthInsurancePortabilityandAccountabilityAct(HIPAA) StudentswillabidebytherulesestablishedbyHIPAAwithafocusonmaintainingprivacyofProtected HealthInformation(PHI).Thisincludesprohibitionofdiscussingpatientinformationinaninappropriate mannerorsetting. CoreCurriculum ACOMentrustsitsvariousclinicaltrainingsites,SiteDirectors,andSupervisingPhysicianstotrainstudents forexcellenceinclinicalpractice.Thepreceptorsandclinicaltrainingsiteswillimplementthecurriculum inamannerthatbalancesthelearningneedsofthestudentsandtheeducationalresourcesavailableatthe site.Toenhancelearning,preceptorsandsitesareencouragedtouseavarietyofteachingtechniques, includingobservation,monitoredparticipation,videoandaudiorecordings,computers,readings, individualdiscussions,andpresentationsbystudents,faculty,andothers.Specificcurricularexpectations areoutlinedinthecurriculumsyllabusforeachoftherequiredclerkships. Theclinicalyears(3rdand4th)willconsistofclinic,hospital,andoffice‐basedtraining.Allfacultyare approvedbyACOMbasedoninterestanddedicationtoteachingaswellastheevaluationoftheCurricula Vitae(CV)andbackgroundchecks.Theclinicalcurriculareflectthemissionofthecollegethroughplanning andevaluationintheAcademicPlanningandEvaluationCommitteeforCurriculum(APECC)andtheinput andreviewoftheDean’sCabinet. Entryintoanythirdyearcourserequiressuccessfulcompletionoftheentirecourseofstudyofthesecond year.Duringthethirdyear,thestudentwillbeassignedtoacoresite.Eachsitewillcoordinatewithclinics andhospitalswithina50‐mileradiuswithsufficientresourcestoprovidethethirdyearcorecurricular plan.ThecoreexperiencewithinthesitewillconsistofthefollowingREQUIREDclerkships:onemonthof BehavioralMedicine,twomonthsofInternalMedicine,onemonthofGeneralSurgery,onemonthof Obstetrics/Gynecology,onemonthofPediatrics,andonemonthofFamilyMedicine.Theremainderofthe yearisdesignatedforselectivesandelectives. Thefourthyearcurriculumisintendedtobuildonthefoundationalexperienceprovidedinthethirdyear. TheonlyrequiredclerkshipisEmergencyMedicine.Fourthyearexperiencesareinsettingswheremore demandsforindependencecanbeexpectedoftheseniormedicalstudent.Electiveswillallowstudentsto traveltolocationsforclerkshipsintheirchosenspecialtyinpreparationforapplicationtoresidency programs. Ateachcoresite,therewillbeaCoreSiteDirectorandCoreSiteCoordinator.TheCoreSiteDirector managesthecoresiteanditsoperation,aswellasdirectinginteractionwiththeCollegeregardingstudent performance.TheCoreSiteCoordinatormanagestheday‐to‐dayactivitiesofstudents,suchaspreceptor assignment,evaluations,lectures,andpost‐clerkshipexams.TheCoreSiteCoordinatorwillcontactthe studentbeforecoreclerkshipsbeginregardingstudentexpectations,housing,orientationactivities,and otherpertinentinformation. ClassificationofClinicalClerkships Clinicalclerkshipsareclassifiedasrequiredcore,selectiveorelective: a. RequiredCoreClerkships:RequiredcoreclerkshipsareassignedbytheDivisionofClinical Resourcesandcannotbechangedbythestudent. b. SelectiveClerkships:Studentswillcompletetwoselectiveclerkshipsduringthethirdyear:one medicalselectiveandonesurgicalselective.Selectivesmustbeperformedinahospitalsetting. SelectiveclerkshipsmustbechosenfromtheselectiveclerkshipslistapprovedbyACOM.The preceptorforaselectiveclerkshipmaybeamemberoftheACOMClinicalFacultyoradjunct 2015–2016ACOMClinicalClerkshipManual 11 Rev.1/25/16 faculty,orafacultymemberofanaffiliatedmedicalschool.Ifastudentwishestocompletea selectiveclerkshipwithaphysiciannotontheapprovedfacultylist,thatphysicianmustfirst receiveapprovalthroughtheDivisionofClinicalSciences c. ElectiveClerkships:Studentswillcompletethreeelectiveclerkshipsduringtheirthirdyearand uptoeightelectiveclerkshipsduringtheirfourthyear.Electivescanbeinanyspecialtyandatany medicalfacility.Preceptorsforelectiveclerkshipsmaybeanylicensed,practicingphysician approvedbytheDivisionofClinicalSciencesandisnotrequiredtobeamemberoftheACOM ClinicalFaculty.Studentsareencouragedtoscheduleelectiveclerkshipsinavarietyofclinical practiceareasforbroad‐basedclinicalexposure.Studentsmaynotcompletemorethantwoelective clerkshipswiththesamesupervisingphysicianoverthecombinationofthethirdandfourthyear. OMS‐IIIClerkships a. CoreHospitalClerkships:ClerkshipsarecompletedduringtheOMS‐IIIyear. b. StudentshavetheoptiontocompleteselectiveclerkshipsatlocationsotherthanatACOMcoresites providedtheclerkshipsareapprovedbytheDivisionofClinicalSciences60daysinadvance. Clerkships Core:BehavioralMedicine Core:InternalMedicineI Core:InternalMedicineII Core:Obstetrics/Gynecology Core:GeneralSurgery Core:Pediatrics Core:FamilyMedicine *Selectives **Electives TOTAL CourseNumbers DOCLIN801 DOCLIN 802 DOCLIN 803 DOCLIN 804 DOCLIN 805 DOCLIN 806 DOCLIN 807 DOCLIN 810‐839 DOCLIN 840‐899 #of4WeekRotations 1 1 1 1 1 1 1 2 3 12 *SelectivesmustbechosenfromdesignatedspecialtiesapprovedbytheAssociateDeanforClinical Sciences.Formonthone,studentschoosefromamedicinespecialty,andformonthtwo,studentschoose fromasurgicalspecialty.Ifastudentchoosestofulfilltheclerkshipwithaphysiciannotontheapproved list,he/shemustfirstreceiveapprovalthroughtheDivisionofClinicalSciences SelectiveChoices:(CoursenumbersDOCLIN810‐839willbeassigned) MonthOne‐Medicine: GeneralInternalMedicine Gastroenterology Cardiology Nephrology Pulmonology Hematology/Oncology Rheumatology Neurology DOCLIN810 DOCLIN811 DOCLIN812 DOCLIN813 DOCLIN814 DOCLIN815 DOCLIN816 DOCLIN817 MonthTwo‐Surgery: GeneralSurgery DOCLIN818 Orthopedics DOCLIN819 ENT DOCLIN820 Ophthalmology DOCLIN821 Urology DOCLIN822 Urogynecology DOCLIN823 GynecologicalSurgery DOCLIN824 2015–2016ACOMClinicalClerkshipManual 12 Rev.1/25/16 ElectiveChoices:(CoursenumbersDOCLIN840‐899willbeassigned) **Electivesshallnotbewiththesamephysicianformorethantwomonthsforthecombinationofthe3rd and4thyears. GeneralInternalMedicine DOCLIN840 Gastroenterology DOCLIN841 Cardiology DOCLIN842 Nephrology DOCLIN843 Pulmonology DOCLIN844 Hematology/Oncology DOCLIN845 Rheumatology DOCLIN846 Neurology DOCLIN847 Allergy/Immunology DOCLIN848 CriticalCareMedicine DOCLIN849 InfectiousDiseases DOCLIN850 AdolescentMedicine DOCLIN851 EmergencyMedicine DOCLIN852 Endocrinology DOCLIN853 Radiology Dermatology Women’sHealth BehavioralHealth FamilyMedicine OMM Geriatrics PM&R OccupationalMedicine InternationalMedicine AddictionMedicine Pathology FQHC Pediatrics OB/GYN SportsMedicine GeneralSurgery Neurosurgery Otolaryngology Anesthesiology VascularSurgery Orthopedics ENT Ophthalmology Urology DOCLIN854 DOCLIN855 DOCLIN857 DOCLIN861 DOCLIN862 DOCLIN863 DOCLIN864 DOCLIN865 DOCLIN866 DOCLIN867 DOCLIN868 DOCLIN869 DOCLIN873 DOCLIN874 DOCLIN875 DOCLIN876 DOCLIN877 DOCLIN878 DOCLIN879 DOCLIN880 DOCLIN881 DOCLIN882 DOCLIN883 DOCLIN884 DOCLIN885 SAMPLESTUDENTSCHEDULE‐ThirdYear Fall2015 SemesterCourses Credit Hours ElectiveI InternalMedicineI InternalMedicineII SelectiveI GeneralSurgery TOTAL 4 4 4 4 4 20 Spring2016 SemesterCourses SelectiveII FamilyMedicine OB/GYN Pediatrics BehavioralMedicine TOTAL Credit Hours 4 4 4 4 4 20 Summer2016 Semester Courses ElectiveII ElectiveIII TOTAL Credit Hours 4 4 8 OMS‐IVClerkships a. EmergencyMedicine:OMS‐IVstudentswillcompleteafour‐weekemergencymedicineclerkshipat theircoresiteoranaffiliatedsite. 2015–2016ACOMClinicalClerkshipManual 15 Rev.1/25/16 Clerkships Core:EmergencyMedicine **Electives TOTAL CourseNumbers DOCLIN903 DOCLIN 940‐999 #of4WeekRotations 1 9 10 ElectiveChoices:(CoursenumbersDOCLIN940‐999willbeassigned) **Electivesshallnotbeinthesamespecialtyformorethanfourmonthsforthecombinationofthe3rdand 4thyears.Studentsmaynotpreceptwiththesamephysicianformorethantwomonthsforthecombination ofthe3rdand4thyears. GeneralInternalMedicine DOCLIN940 Gastroenterology DOCLIN941 Cardiology DOCLIN942 Nephrology DOCLIN943 Pulmonology DOCLIN944 Hematology/Oncology DOCLIN945 Rheumatology DOCLIN946 Neurology DOCLIN947 Allergy/Immunology DOCLIN948 CriticalCareMedicine DOCLIN949 InfectiousDiseases DOCLIN950 AdolescentMedicine DOCLIN951 EmergencyMedicine DOCLIN952 Endocrinology DOCLIN953 Radiology Dermatology Women’sHealth BehavioralHealth FamilyMedicine OMM Geriatrics PM&R OccupationalMedicine InternationalMedicine AddictionMedicine Pathology FQHC Hospice&PalliativeCare Pediatrics OB/GYN SportsMedicine GeneralSurgery Neurosurgery Otolaryngology Anesthesiology VascularSurgery Orthopedics ENT Ophthalmology Urology DOCLIN954 DOCLIN955 DOCLIN957 DOCLIN961 DOCLIN962 DOCLIN963 DOCLIN964 DOCLIN965 DOCLIN966 DOCLIN967 DOCLIN968 DOCLIN969 DOCLIN973 DOCLIN974 DOCLIN975 DOCLIN976 DOCLIN977 DOCLIN978 DOCLIN979 DOCLIN980 DOCLIN981 DOCLIN982 DOCLIN983 DOCLIN984 DOCLIN985 DOCLIN999 SAMPLESTUDENTSCHEDULE‐FourthYear Fall2015SemesterCourses ElectiveI ElectiveII ElectiveIII ElectiveIV ElectiveV TOTAL Credit Hours 4 4 4 4 4 20 Spring2016SemesterCourses EmergencyMedicine ElectiveVI ElectiveVII ElectiveVIII ElectiveIX TOTAL 2015–2016ACOMClinicalClerkshipManual Credit Hours 4 4 4 4 4 20 16 Rev.1/25/16 NumberofClerkships Studentswillcomplete22clinicalclerkshipsinthethirdandfourthyear,eachofwhichisrepresentedasa courseonthestudent’stranscript.Twelveclerkshipsarecompletedduringthethirdyearandten clerkshipsarecompletedduringthefourthyear. ThirdYearClinicalClerkshipDescriptions: DOCLIN801)BehavioralMedicine: Fourweeksfocusingontheevaluation,intervention,andmanagementofthepsychiatricpatient.Emphasis isplacedonthemedicalstudentlearningthetriageandcommunityintegrationoftreatmentmodels, treatingthepatientinthesettingclosetohomeratherthantheinpatientpsychiatrichospital.Thismonth willoffertheintegrationofthepsychiatrictreatmentmodelwiththegoalofcommunitytreatmentand placementforthementallyillpatient. DOCLIN802)InternalMedicineI: Fourweeksoftraininginclinicandhospitalsettingsleadingtoafoundationalunderstandingofgeneral medicalproblemsintheadultmaleandfemalepatients.Thisprecedesandrepresentsarequirementfor InternalMedicineII. DOCLIN803)InternalMedicineII: FourweeksoftrainingwiththesameobjectivesasIMI.Increasestheconsolidationofeducationalgoalsby providingcontinuityofenvironmentandfacultyfoundinIMI. DOCLIN804)Obstetrics/Gynecology: Fourweeksoftrainingintheinpatientoroutpatientsettingtoobtainacceptablecompetencyforamedical studentinthecareofmedicalandsurgicalissuesrelatedtothefemalegenitourinarysystem.Thiswill includetheevaluationandcareofthepregnantpatientforprenatal,deliveryandpost‐natalperiod. DOCLIN805)GeneralSurgery: Fourweeksoftraininginthehospitalsettingunderthesupervisionofahospital‐basedgeneralsurgeon(s). Thiswillincludetheevaluation,surgicalintervention,consultation,andfollow‐upoftheadultmaleand femalepopulation. DOCLIN806)Pediatrics: Fourweeksofclinicaltrainingintheoutpatientand/orinpatientsetting.Thestudentwilllearntotakean appropriatehistoryformaleandfemalepatientsfrombirthtoadulthood.Emphasiswillbeplacedon preventivehealthmanagementforevaluationofgrowthmilestones,aswellasimmunizationstrategies. Identificationoftheacutelyillpatientwillbeintegratedintotheexperience. DOCLIN807)FamilyMedicine: Fourweeksoftrainingwithafamilyphysicianstudentswillworkwithafamilyphysicianinordertogaina morecompleteperspectiveoftheuniquenessoffamilymedicineandfurthertheirlearningofclinical knowledgeandskillsetsnecessarytopracticemedicineinavarietyofoutpatientandinpatientsettings. DOCLIN810‐839)Selectives: TherearetwoSelectiveClerkshipsthatarerequiredinthethirdyear:oneinmedicine,theotherinsurgery. TheymustbedoneinahospitalsettingwithpreceptorsthatareapprovedbytheDivisionofClinical Sciences.Eachstudentwillbeassignedtoonephysician/physiciangrouptofollowandworkwithfaculty throughouthis/herscheduleofclinicalactivity.Allselectiveclerkshippreceptorswillbeapprovedbythe AlabamaCollegeofOsteopathicMedicine’sDivisionofClinicalSciences..TheDivisionofClinicalResources willofferapre‐approvedsetofclerkshipsitesfromwhichthestudentsmaychoosetherequiredselective clerkships,butstudentswillnotbelimitedintheirchoicetoonlythesesites.Siteevaluationsarecollected andreviewed. 2015–2016ACOMClinicalClerkshipManual 17 Rev.1/25/16 DOCLIN840‐899)Electives Electivesmaybecompletedinanydiscipline,withanylicensedpracticingphysicianapprovedbythe DivisionofClinicalSciencesandarenotrequiredtobecompletedwithamemberoftheACOMclinical faculty. OsteopathicPrinciples&PracticeDuringThirdYearClinicalClerkships Duringallclerkshiprotations,studentswillworktoincorporateosteopathicstructuraldiagnosisand treatmenttechniquesinallhospitalandoutpatientareas.Studentswillpre‐round;attendrounds,andpost roundatthediscretionofthepreceptor.Studentswillalsoobserveandparticipateinpatientcareatthe discretionofthepreceptor.Studentswillcompletethegradingelementsofthisexperienceduringtheir coreclerkshiprotations.Pleasenote:ThisisNOTaclerkship.Thisisacurricularrequirementthatwill runthroughoutthelengthofthethirdyear.Completionisrequiredinorderforstudentstostarttheir OMS‐IVyear.Formoreinformation,pleaseconsulttheOPPforClerkshipssyllabus. FourthYearClinicalClerkshipDescriptions DOCLIN903)EmergencyMedicine: Fourweeksoftrainingwithaprerequisiteofsuccessfulcompletionoftheentirethirdyearoftrainingprior toentry.Studentswillbeeducatedintheinitialevaluationandstabilizationoftheacutelyillortraumatized patient.EducationofthetriageprocessattheentryintotheEmergencyDepartmentisincludedinthe experience. DOCLIN940‐999)Electives Electivesmaybecompletedinanydiscipline,withanylicensedpracticingphysicianapprovedbythe DivisionofClinicalSciencesandarenotrequiredtobecompletedwithamemberoftheACOMclinical faculty. LocatingSelectiveorElectiveClerkships a. Ifthestudentfindsaselective/electiveclerkshipthat(s)hewouldliketodowithintheACOM network,(s)heshouldcontacther/hisRegionalCoordinatorbyemailtorequesttheclerkship.The majorityofACOMpreceptorsareclinicianswithbusypractices,sotheymaynotalwaysbeavailable atthetimeforwhichtheclerkshipisrequested. b. PersonalorProfessionalContacts IfastudentisinterestedincompletingaclerkshipwithaphysicianwhoisnotanACOM credentialedpreceptor,butwhoisinterestedinacceptingstudentsforclinicalclerkships,that studentmayrequestapprovalfromtheDivisionofClinicalSciences. Forelectiveclerkshipswithanewpreceptor,thestudentshouldsendthephysician'sname, practicename,telephonenumber,ande‐mailtotheAssociateDeanofClinicalSciences. Forselectiveclerkships,thephysicianmaybecredentialedasamemberoftheACOM ClinicalFaculty. AffiliationAgreements:Astudentwhorequestsaclerkshipwithaphysicianwhoisnota credentialedACOMpreceptormustdetermineiftheclinicorhospitalwherethepreceptor practiceswillrequireanaffiliationagreementandwhatsupportingdocuments (immunizations,certificateofinsurance,etc.)shouldbeprovided.Thisinformation,along withcontactinformation(name,address,telephonenumber,andemailaddress)forthe clinicorhospitalmustbeprovidedtothestudent'sRegionalCoordinatoratleast120days inadvanceoftheclerkshipstartdate. 2015–2016ACOMClinicalClerkshipManual 18 Rev.1/25/16 ApplyingforClerkshipsatMedicalEducationPrograms Aphysicianwhoholdsafacultyappointmentwithanotherschoolofmedicineisnot requiredtobecomeamemberoftheACOMClinicalFaculty. Studentsmayapplyforclerkshipsatothermedicalschoolsandgraduatemedicaleducationprograms. Theseclerkshipsareoftenusedto"audition"forGMEprograms.Eachtrainingsitewillhaveitsown applicationguidelinesandprocesses,whichtypicallycanbefoundontheinstitution'sorprogram's website.Pleasenotethattheapplicationprocesswillvarywithdifferentprogramsandcanbetime‐ consuming.Someprogramswillallowstudentstoapplyforaclerkshiprotationonline,whileothers willrequirethesignatureoftheAssociateDeanofClinicalSciencesbeforeprocessingtherequest. StudentsmustcompletetheirportionoftheapplicationandforwardittohisorherRegional Coordinator,alongwithachecklistofallitemsthatthehostprogramrequiresforacompletedstudent packet.Iftheapplicationiscompletedonline,theapplicationchecklistmustbeforwardedtothe RegionalCoordinator.Ifthereisanapplicationfee,acheckshouldbeincludedwiththeapplication.The RegionalCoordinatorwillforwardthecompletedapplicationpacket,alongwiththesupporting documents,suchasimmunizationrecordsandcertificateofliabilityinsurance,tothehostprogram. Studentsareresponsibleforsecuringhousingandforallcostsassociatedwiththeseclerkships. Clerkshipsatmedicaleducationprogramsshouldberequestedatleast120daysinadvancetoallow timetocompletethenecessaryprocesses.Applicationsreceivedlessthansixtydayspriortothestart dateoftheclerkshipmaynotbeapproved.Inthatsituation,thestudentmaybeplacedatanalternative clerkshipsiteatthediscretionoftheDivisionofClinicalSciences. (Note:ActiveDutyMilitaryclerkshipswillfollowtheseproceduresaswell.) LocatingClerkshipsatMedicalEducationPrograms: StudentswillbeprovidedalistofpotentialresidencysitesbyMay1ofeachyearforthepurposeof schedulingauditionrotations.Studentswillfinditextremelyusefultoperformauditionrotationsat residencyprogramstowhichtheyareinterestedinapplyingforresidency.Itisstronglyrecommendedthat eachstudentperformauditionrotationsinatleastthree(3),ifnotfour(4),residencyprogramsinwhich theyareinterested.TheusualauditionrotationseasonopensinJuneoftheOMS‐IIIyearandconcludesin lateNovemberoftheOMS‐IVyear. Studentsmayfindthefollowingwebsiteshelpfulinlocatingclerkshipsatmedicaleducationprograms: AOAOnlineOpportunitiesdatabasehasinformationaboutosteopathicresidencyprograms.Most programsacceptvisitingstudentsforclerkships.Informationcanbefoundatthefollowingaddress: http://www.opportunities.osteopathic.org/ FRIEDAOnlineisanonlinedatabasemaintainedbytheACGMEofaccreditedGMEprograms. http://www.ama‐assn.org/ama/pub/education‐careers/graduate‐medical‐education/freida‐ online.page AAMC‐MemberProgramhttp://www.aamc.org/students/medstudents/electives VisitingStudentApplicationService(VSAS)SomeprogramsrequirestudentstoapplythroughVSAS. Detailscanbefoundathttps://services.aamc.org/20/vsas/ Studentsmayalsocontactprogramsdirectlyorreviewtheirwebsite(s). 2015–2016ACOMClinicalClerkshipManual 19 Rev.1/25/16 ParticipatinginOut‐of‐NetworkSelectives/Electives a. StudentResponsibilities Studentidentifiespreceptororresidencyprogramandgetstentativeapprovalforclerkship frompreceptor/program. Studentrequestsapprovalviae‐mailfromtheAssociateDeanofClinicalSciences.Approval requestshouldincludethecompletedOutofNetworkRequestform,whichliststhe followinginformation:preceptor’snameandCV;practicenameandcontactinformation, includingtelephoneande‐mailaddress;plusforwardthee‐mailthestudentreceivedfrom preceptor/programindicatingapprovalforclerkship. b. DivisionofClinicalSciences TheAssociateDeanofClinicalSciencessendsapprovalviae‐mailtostudentandcopies RegionalCoordinator c. DivisionofClinicalResources RegionalCoordinatorusesinformationfromtheOutofNetworkRequestformtomake initialcontactwiththepreceptor/program.Additionalinformationcanbeaccessedat http://opportunities.osteopathic.org/search/search.cfmor http://www.ama‐assn.org/ama/pub/education‐careers/graduate‐medical‐ education/freida‐online.page RegionalCoordinatorconfirmsandprovidestheinformationasrequiredbythe preceptor/program/institution.Theestablishmentofcommunicationwiththehost institution/agencywillstarttheclockforexchange,reviewandapprovaloftheclerkship activity.IfapprovalfrombothACOMandthehostinstitutionisnotsecuredby60daysfrom thestartdate,theprobabilityofcompletingthenecessaryrequirementsintimetostartthe clerkshipissignificantlydecreased. Ifanaffiliationagreementisrequired,thestudentDOESNOTnegotiateit–theRegional Coordinatordoes. d. KeyAssumptionstoGuideandDirectOut‐of‐NetworkActivities RequestforapprovalforelectiveclerkshipsmustbereceivedatACOM120dayspriorto requestedclerkship. ParticipationinanelectiveclerkshipwillbeatthefinaldiscretionoftheACOMandthehost institution. Studentsmustpayanyapplicationand/orregistrationsfeesandmeetanyadditional requirementsofhostagency/institutionasnotedinVisitingStudentApplicationServiceor presentedbytheprogram. Allapplicationsandsupplementalmaterialsmustbecompleted90dayspriortothestartof aclerkship. AcompletedsubmissiontoACOMorthehostinstitutiondoesnotguaranteeapprovalor acceptance. AdditionalOptionsforElectiveClerkshipRotations Studentsmayconsiderthefollowingoptionswhenplanningelectiveclerkships: a.InternationalStudies:OMS‐IVstudentswhoareingoodstandingmaycompleteuptotwo internationalclerkshipsinvolvingtheclinicalcareofpatients.Theprimarysitesupervisorfor internationalclerkshipsmustbealicensedphysicianqualifiedtopracticewithinthehostcountry. Studentswillberesponsibleforobtainingtheappropriatevisaandimmunizationsorother prophylaxisrequirements.Internationalclerkshipsmustbeapprovedatleast60daysinadvance 2015–2016ACOMClinicalClerkshipManual 20 Rev.1/25/16 bytheDivisionofClinicalSciences.Theguidelines/applicationforinternationalclerkshipcanbe obtainedfromtheDeanofStudents. b.ResearchElective:Studentswhoareingoodstandingmaycompleteuptotworesearchelectives withpriorapprovalbytheDivisionofClinicalSciencesandwithsponsorshipbyanACOMon‐ campusfacultymemberoranACOMadjunctclinicalfacultymember.Aresearchelectivemay involve,butisnotlimitedto,thefollowing:clinicalinvestigation,policystudies,orhealthservices researchandmaybelaboratory‐based,practice‐based,orboth.Researchelectivesmustbe approvedatleast60daysinadvancebytheDivisionofClinicalSciences.Guidelines/Applications fortheresearchelectivecanbeobtainedfromtheDivisionofClinicalResources. d.Off‐CycleClerkships:IfanOMS‐IVstudentisacceptedforanelectiveclerkshipatatrainingsite thathasaclerkshipscheduledifferentfromACOM,thestudentmustfirstaskifthatsitewillaccept theACOMclerkshipschedule.Siteswilloftenaccommodatevaryingstudentschedulesinorderto recruitapplicantsfortheirresidencyprograms.IfthetrainingsitewillnotaccommodatetheACOM clerkshipschedule,theDivisionofClinicalScienceswillreviewthestudent’srequestforalternate schedulingonacase‐by‐casebasis. LimitsonClerkships a. Throughoutyears3and4,thestudentwillnotbepermittedtocompletemorethanfive elective/selectiveclerkshipsinthesamespecialty.Forexample,astudentwhoisinterestedin cardiologycoulduseamedicalselectiveincardiologyandthenuptofourelectiveclerkshipsin cardiology. b. Studentsmaynotcompletemorethantwoelective/selectiveclerkshipswiththesamepreceptor. c. Studentsmaycompleteonlyoneclerkshipwithapreceptorwhoisamemberofthestudent’s family.Aclerkshipcompletedwithafamilymembermustbeanelectiveclerkship. d. Guidelinesonstudentparticipationinclinicalactivitieswhileonclerkshiprotationsareincludedin thisdocumentasAppendixC.Theyaremeanttoberecommendationsforpoliciesconcerning studentinvolvementintheclinicalsettingatallclerkshiprotationvenues. ConfirmationofClerkshipAssignments Itistheresponsibilityofthestudenttocontacteachsite7dayspriortoarrivaltoconfirmtheclerkship, obtaininstructionsregardingstarttime,dresscode,housingarrangementsandtoreceiveanyspecial instructionsorassignmentsfortheclerkship.Itisrecommendedthatthesecontactsbemadeatleast2 weeksinadvance.Thestudentshouldsendaletterofintroductionand/oraCV,andaphotographbefore startingtheclerkshipasawayofintroducingthemselves(somesiteswillrequiretheseitems).Forany clerkshipoccurringatacoresite,itisveryimportanttoworkwiththeSiteCoordinatortoconfirmthe clerkshipandcoordinateclerkshipdetails.Somecoresitesaskthatstudentsnotcontactpreceptors directly,buttoarrangeclerkshipsthroughtheSiteCoordinator.Thestudentshouldconferwiththe Coordinatorattheircoresitetodeterminethebestmethodtoconfirmclerkshipsatthatsite. 2015–2016ACOMClinicalClerkshipManual 21 Rev.1/25/16 PatientCareActivities Theclinicalsitewilldefinethedegreeofstudentinvolvementinpatientcareactivitiesatthatfacility. Studentsmustcomplywithallofthegeneralandspecificrulesandmedicalethicsestablishedbythe hospital,clinic,orfacilityatwhichtheyarebeingtrained. Amedicalstudentisnotlegallyorethicallypermittedtopracticemedicineorassumeresponsibilityfor patientcare.Astudentmaybeinvolvedinassistinginthecareofapatient,butonlyunderthe supervisionofalicensedphysician.Theattendingphysicianisresponsibleforthemedicalcareofthe patient.Astudentmaynotadministertherapyorperformprocedures,exceptunderthesupervisionofa licensedphysiciantowhomthestudenthasbeenformallyassigned. MedicalRecords/Charting Policiesregardingdocumentationbymedicalstudentsinmedicalrecordswillvaryamonghospitalsand clinics.Somesitesallowstudentstowritefullnotesandordersdirectlyintothepatient'schart.Inthis case,thesupervisingphysicianmustalsodocumentthehistoryofpresentillness,anyrelevantphysical examinformation,aswellasanassessmentandplan.Studentnotesarenevertoserveastheattending physician'snotes.Somesiteshaveseparatepagesinthechart,oftenbrightlycolored,setasideforstudent documentation.Thisallowsthestudenttopracticetheirdocumentationskills,butwillnotbecomeapart ofthepermanentmedicalrecord.Thesenotesshouldalsobereviewedandsignedbythesupervising physician.Ifdictationorcomputerizedentrybystudentsisallowed,thosenotesmustalsobereviewed andsignedbytheattendingphysician.Studentsareresponsibleforproactivelyobtaining charting/documentationinstructionsfromthepreceptororsitecoordinatorateachclerkshipsite.The studentmustalwayssignanddateallentriesintothemedicalrecordbynameandeducationalstatus,such asJohnSmith,OMS‐III. Portfolio/MilestoneCompetenciesLog Studentsmustrecordclinicalthinkingandproceduralskillswitnessedbytheirpreceptorsinthe Portfolio/MilestonesCompetenciesLoginthePxDxsectionofE*Value.Eachskillwillbelistedas "performed,""assisted,"or"observed."Studentsshouldaccessthelogdailywhileoneachclinicalclerkship inordertorecordandverifyeachclinicalskill.Studentsmustmakesuretheyareaccuratelylogging theirexperienceswitheachsymptom/problemandclinicalskillduringtheirOMS‐IIIyear.Doingso isimportantbecauseACOMwillgeneratealetteronthestudent’sbehalfforauditionrotationsand residencyapplicationsthatspeakstothestudent’scompetencyintheseareas.Iftheportfolioisincomplete, thenthiscompetencylogisincomplete,andpotentialResidencyProgramDirectorswillnotbeabletoseea truepictureofthestudent’sabilities. Studentgradeswillnotbeinfluencedbythenumberofclinicalskillsrecorded,butthelogwillserveasa methodforstudentstotracktheirperformanceofcommonskillstypicallyencounteredduringclinical clerkships.Assuch,thislogwillbecomeanimportantassettothestudentwhenapplyingforresidency.In addition,thelogwillserveasatooltoassistACOMtoevaluatetheclinicalexperiencesreceivedbystudents atvarioustrainingsites. 2015–2016ACOMClinicalClerkshipManual 22 Rev.1/25/16 GradingGuidelinesforClinicalClerkships AssignmentofGrades AgradeforeachclerkshipwillbeassignedbytheClerkshipChairs.Detailscanbefoundintheclinical syllabusforeachclerkship.Theelementsrequiredforeachcoreclerkshipincludeapost‐clerkshipCOMAT examination,evaluationbytheSupervisingPhysicianorCoreSiteDirector,attendanceandparticipationat grandroundsorotherconferences,clerkshiprotationdidactics,casestudies,andquizzesororalexams. Studentswhodonotreceiveapassingscorewillberequiredtoremediatecertainportionsoftheclerkship. Thefinalgradewillbeassignedandapprovedwithin14daysofthecompletionoftheclerkship.Aletter gradeisassignedforeachclerkship.Studentsmustscore70%orhigheroneachgradingelementto passtheclerkship. GradingScale Theacademicstatusorgradingofmedicalstudentperformanceisdeterminedattheendofeachsemester. Gradesaredeterminedthroughaveragingscorescollectedthroughassignment(s)scores,quiz(s),practical results,evaluations,andCOMATexams.Eachclerkshiphasasyllabuswhichwillexplainindetailhowthe gradesarecalculated.GradesshallbeassignedtoindividualstudentsonthebasisoftheClerkshipChair’s judgmentofthestudent’sscholasticachievementusingthegradingsystembelow: QualityofPerformance Excellent Good Satisfactory Failure Grade A B C F OtherGradingSymbols Incomplete AdministrativeWithdrawal Withdrawal Grade I AW W ClerkshipChairswillreportanumericgradetotheregistrar.AlettergradeofA,B,C,orFwillbe assignedtothescoreforthecoursebyregistrarbasedonthefollowingscale: A=90‐100%B=80‐89%C=70‐79%F=<70% TheminimumsatisfactorygradeforeachelementofacoreclerkshipisC.GradesofA,B,C,andFwillbe factoredintotheGPAcalculation.GradesofI,AW,andWwillnotaffectGPA. IncompleteClerkships "AgradeofIncomplete(I)maybeassignedifthestudent’sdidacticworkinaclerkshiprotationis incompleteorifthestudentwillberequiredtotakearemediationexam.TheAssociateDeanofClinical Scienceswillestablishadeadlineofnotmorethan90daysforthestudent’scompletionand/or remediationofremainingcoursework,andthegradeofIncompletewillbereplacedoncethestudenthas completedallassignedcourseworkorremediation.Astudentwhofailstocompleteallcourseworkbythe deadlinewillbeassignedagradeofF." AssignmentoftheFinalGrade ThefinalgradeforeachstudentwillbeassignedbytheClerkshipChair.TheClerkshipChairsreservethe righttousetheirdiscretiontomodifyastudent'sgradebaseduponstatedcriteriaand/orcircumstancesin additiontothosereferencedinthisdocument.Studentsmustscore70%orgreaterforeachrequired gradingelement. 2015–2016ACOMClinicalClerkshipManual 23 Rev.1/25/16 FailureofaClerkship Astudentwhofailsaclerkshipwillberequiredtorepeatandpassthatclerkshippriortograduation.This mayresultinthestudentnotbeingabletograduateasscheduled.Anystudentwhofailsaclerkship rotationwillbereferredtotheStudentProgressCommittee. GradeAppeals QuestionsregardingaclerkshiprotationgradearetobedirectedtotheClerkshipChaironly.Studentsare nevertocontactthesupervisingphysicianwhoevaluatedthem.RefertotheStudentHandbookfor proceduresonhowtoappealaclerkshiprotationgrade. COMLEXExams TheCOMLEX‐USAseries,administeredbytheNationalBoardofOsteopathicMedicalExaminers(NBOME), isanexaminationsequencewiththreeLevels.Whileallexaminationlevelshavethesametwo‐dimensional contentstructure,thedepthandemphasisofeachlevelparallelstheeducationalexperiencesofthe candidate.ThisprogressivenatureoftheCOMLEX‐USAexaminationsensurestheconsistencyand continuityofthemeasurementobjectivesoftheosteopathicmedicallicensingexaminations(www. nbome.org). StudentsmusttakeandpassCOMLEXUSALevel1,COMLEXUSALevel2‐CEandCOMLEXUSALevel2‐PEto meetgraduationrequirements.StudentswhofailCOMLEXLevel1or2maybeplacedonadministrative leaveofabsenceandrequiredtoparticipateinexampreparationcoursesorprograms. Examinationdateswillbeprovidedtothestudents.AstudentwhofailsaCOMLEXexamwillremainin goodstandingwiththecollegeuntildeemedotherwisebyrecommendationoftheStudentProgress CommitteetotheDean.Multipleattemptsoneachexamareallowed;however,pleasenotethatmanystate licensureboardsmayhavelimitsonthenumberofexamstakeninissuingmedicallicenses. COMLEXLevel1 StudentsarerequiredtotakeCOMLEXUSALevelIassoonaspossiblefollowingcompletionofthesecond yearandtheymusttakeitnolaterthanJune30th.Studentsarenotallowedtostartclerkshipsuntilthey haveachievedapassingscoreonCOMLEXLevelIexam. COMLEXLevel2‐CEandLevel2‐PE PassageofStep2CognitiveEvaluation(CE)andStep2PerformanceEvaluation(PE)isrequiredfor graduation.PassingscoresmustbedocumentednolaterthanMarch1oftheyeargraduating.Initial attemptsatStep2examsmustbescheduledbyJuly1oftheyearprecedinggraduation. StudentEvaluations CompetencyBasedEvaluation AStudentEvaluationwillbecompletedbythesupervisingphysicianatthecompletionofeachclerkship. Theevaluationwillbebasedonthestudent'sbehaviors,knowledge,andskillsobservedbythepreceptor andothermembersofthehealthcareteamineachofthefollowingcorecompetencies: 2015–2016ACOMClinicalClerkshipManual 24 Rev.1/25/16 OSTEOPATHICPHILOSOPHYANDOSTEOPATHICMANIPULATIVEMEDICINE OMMKnowledge:Articulatesanddemonstratesanunderstandingoftheosteopathicapproach topatientcare. OMMTreatment:DemonstratesanabilitytoformulateanOMMtreatmentplan. MEDICALKNOWLEDGE ProfessionalKnowledge:Demonstrateseffectiveuseofmedicalknowledgenecessaryfor patientcareandaccessesinformationthroughconsultationsand/orliteraturesearches. PATIENTCARE HistoryTaking:Obtainsrelevantinformationandperformsacompleteandaccuratehistory. PhysicalExamandDocumentation:Performsacompleteandaccuratephysicalexamination andprovidesaccurateandmeaningfuldocumentation. Diagnosis:Synthesizesclinicalfindingsand/orlaboratorydatatoformulateanappropriate differentialdiagnosis. TreatmentPlan:Writesanappropriatetreatmentplan. SkillsandProcedures:Usesinstrumentsandperformssimpleprocedurescorrectly. INTERPERSONALANDCOMMUNICATIONSKILLS InterpersonalCommunicationandInteraction:Demonstrateseffectivelistening, questioning,andnarrativeskillstocommunicatewithpatients,families,andotherhealthcare professionals,beingsensitivetocultural,religious,andlanguageissues. PresentationSkills:Organizesandreportscasepresentationinformationinalogicaland meaningfulformat. PROFESSIONALISM MotivationandProfessionalism:Demonstrateswillingnesstolearnandacceptinstruction; maintainsprofessional,respectful,andcooperativerelationshipswithothers(preceptors,staff, patients,andfamilies). PRACTICE‐BASEDLEARNINGANDIMPROVEMENT DiagnosticandTherapeuticEffectiveness:Usesreliableandcurrentinformationindiagnosis andtreatment;demonstratestheabilitytoextractandapplyevidence;makesself‐ improvementsasneeded. SYSTEMS‐BASEDPRACTICE KnowledgeofHealthcareDeliverySystems:Understandsthebasicbusinessapplicationsina medicalpractice;showsoperationalknowledgeofhealthcareorganizations;understandsthe roleofthestudentasamemberofthehealthcareteam;attendsandparticipatesinlocal meetings. LocalHealthcareAdvocacy:Understandslocalhealthcareneedsandchallenges;makes appropriateuseoflocalmedicalresourcesonbehalfofpatients. AtACOMthesecompetenciesaredefinedwithinthefollowingstandardsstatements,asarticulatedinthe tableonthenextpage(s). 2015–2016ACOMClinicalClerkshipManual 25 Rev.1/25/16 Graduate Characteristics ACOM Program Educational Outcomes 1 2 3 4 5 6 Knowledge: Medical Expert 7 8 9 10 11 12 13 14 15 16 Skills: Culturally Aware Communicator 17 18 19 20 To integrate information about normal structure and function of living systems with an emphasis on humans. To relate to the normal state the variations in structure and function that lead to disease. To comprehend biochemical and physiological analytic methods, including techniques, application, pitfalls, and interpretation. To categorize, describe, and use various therapeutic methods including osteopathic manipulative medicine in their application to human illness. To possess a clinically useful understanding of the elements of diagnostic reasoning. To identify those urgent, life-threatening, or painful human conditions that require immediate and specific interventions, including the initiation of appropriate initial therapy for those with life-threatening vascular, pulmonary, or neurologic conditions; the recognition and outline of initial management for patients requiring critical care; and/or the plan for and initiation of management strategies to relieve pain and ameliorate the suffering of patients. To interpret and apply the scientific method in the acquisition of new knowledge, the interpretation of published knowledge, and the application to problem solving in the laboratory and clinical settings. To employ mathematical and epidemiological principles in the application of fundamental methods of data reduction and analysis to clinical problems. To know the cardinal ethical principles and their application in medicine. To describe the elements of social structure and to use this information in the understanding and management of human behavior and illness. To describe the basic elements of State and national health care system, its funding, and the effects of these factors on individual and community health. To demonstrate awareness of the financial, political, and other situations that pose potential and real conflicts of interest to the practice of medicine and to strive to avoid such entanglements. To collect and record in a concise, reliable, and cohesive fashion the key elements of a clinical history including elements of mind, body and spirit. To perform and record accurately the findings observed in a physical assessment. To collect, perform, and/or interpret essential laboratory assessments and diagnostic procedures. To use electronic resources for self-education, the education of others including patients and their families, and for direct patient care. To formulate a comprehensive list of diagnostic considerations based upon integration of historical, physical, laboratory findings and diagnostic modalities including imaging ability to formulate an appropriate therapeutic response to it. To demonstrate a step-wise process of diagnostic refinement through the application of clinical reasoning. To communicate, by oral and written means, knowledge, knowledge interpretation, and recommendations to a wide range of audiences, including patients, patients’ families, peers, instructors, and other health care professionals, being responsive to and mindful of the needs and cultural background of the audience. To demonstrate self-education through the use of a comprehensive range of educational modalities. AOA Comp OPP MK OPP MK MK OPP PC OPP PC 2 OPP; PC MK 4, 1,10 OPP PBLI PBLI 7 P OPP PC SBP SBP OPP ICP PC OPP ICP OPP PC 1 1 3 OPP PBLI OPP PBLI PC 2 OPP ; P 2 OPP; ICP 5,6,9 OPP; P 2015–2016ACOMClinicalClerkshipManual EPA 26 Rev.1/25/16 21 Behaviors: Dutiful Scholar, Manager, and Collaborator 22 23 24 25 26 27 28 Attitudes: Professional Health Advocate 29 30 31 32 To provide a precise, timely, and comprehensive approach to patient care and its documentation. To exhibit compassion in dealings with patients without regard to ethnicity, gender, financial situation, social condition, or incapacity. To conduct all interpersonal communications and activities, including those with colleagues, staff members, patients, families, and teachers, with dignity, appropriateness, and cultural awareness. To use the highest ethical principles in interpersonal relationships and in professional activities, including direct patient care and research. To employ the cardinal ethical principles and their application in medicine. To use the principles of self-initiated learning in approaching new challenges. To be respectful of others and of their beliefs, opinions, and privacy. To be scrupulously honest in all matters of professional life. To provide compassion in matters that deal with the life, health, suffering, and dying of individuals under his/her care. To assume responsibility when appropriate with one’s position, training, and experience and to defer responsibility to those with higher qualifications when necessary or other members of the healthcare team appropriate. To maintain curiosity that will promote full inquiry and problem resolution in all professional matters contributing to the whole interprofessional team of patient care. To work with patients and their families in a respectful and confidential manner that is appropriate to their educational level and preserves their dignity. To demonstrate advocacy for the interests and needs of the patient and place those interests and needs above one’s immediate needs. OPP SBP OPP; PC: P OPP; PC MK OPP; P OPP; P P OPP; PC; P;SBC;IPC P; IPC P; IPC P OPP SBP AOA (American Osteopathic Association) Competency Legend: Osteopathic Principles and Practices Medical Knowledge Patient Care Interpersonal and Communication Skills Professionalism OPP MK PC ICP P PBL SBP Practice Based Learning and Improvement System Based Practice EPA EPA EPA EPA EPA EPA EPA EPA 1 2 3 4 5 6 7 8 EPA 9 EPA 10 AAMC (Association of American Medical Colleges) EPA (Core Entrustable Professional Activities for Entering Residency) Legend: Gather a history and perform a physical examination Develop a prioritized differential diagnosis and select a working diagnosis following a patient encounter Recommend and interpret common diagnostic and screening tests Enter and discuss patient orders/prescriptions Provide documentation of a clinical encounter in written or electronic format Provide an oral presentation/summary of a patient encounter Form clinical questions and retrieve evidence to advance patient care Give or receive a patient handover to transition care responsibility to another health care provider or team Participate as a contributing and integrated member of an interprofessional team Recognize a patient requiring urgent or emergent care, initiate evaluation and treatment, and seek help ThePreceptorEvaluationoftheStudentisalistofobservablebehaviorsdirectlyreferencingthese ProgramEducationalOutcomes. 2015–2016ACOMClinicalClerkshipManual 1, 2, 3, 4 27 Rev.1/25/16 9 StudentResponsibilityforPreceptor’sEvaluations Itistheresponsibilityofthestudenttoensurethatpreceptors’evaluationsaresubmittedtotheDivision ofClinicalResourcesatthecompletionofeachclerkship.TheClinicalResourcesstaffwillassistwith obtainingtheevaluationifapreceptorisneglectfulincompletingtheevaluationform,butthe responsibilityrestswiththestudent.Ifastudenthasdifficultyingettinganevaluationsubmitted,heor sheshouldinformhisorhercoresitecoordinatorattheendoftheclerkship.Themoretimethatpasses afteraclerkshipiscompleted,themoredifficultitbecomestoreceiveanaccurateevaluation.Thestudent's transcriptwillnotbecompleteuntilallevaluationshavebeenposted.ApplicationforGraduateMedical Education(GME)programscannotbesubmittednordiplomasissuedwithoutacompletetranscript. PreceptorsmaycompleteanonlineevaluationthroughtheE*Value.Ininstanceswhenapaperevaluation isrequestedbythepreceptor,onewillbesenttothetrainingsite.Studentsmayalsogiveacopyofthe evaluationtothepreceptor.Theevaluationcanbefaxed,mailed,orsentbyemailtotheDivisionofClinical Resources.Pleasenotethatevaluationsreceiveddirectlyfromstudentswillnotbeacceptedbythe DivisionofClinicalResources.Theevaluationmustbereceivedfromthepreceptorortrainingsite. PreceptorsforCoreClerkships:ThecoordinatorateachcoresitewillworkwiththeDivisionofClinical Resourcestoupdatepreceptorinformation.Thepreceptorlistedforacoreclerkshipmaynotbethe primarypreceptor,butthesupervisingphysicianwhooverseesthecoreclerkship.Thestudentshould addressanyconcernsregardingthepreceptorlistedforcoreclerkshipswithhis/herSiteCoordinatorby thesecondweekoftheclerkship. IndividualPreceptors:ThestudentshouldalsomakecertainthattheDivisionofClinicalResourceshasa correctemailaddressforthepreceptor,orthepersonwhoshouldreceivetheemailnoticethatan evaluationisdue(suchasapracticemanager).Thisinformationshouldbereceivedbythestudent's RegionalCoordinatorbythesecondweekoftheclerkship. PreceptorsatMedicalEducationPrograms:WhenonaclerkshipatanothermedicalschoolorGME program,thestudentshouldconsultwiththemedicaleducationcoordinatoratthatprogramregarding theirproceduresforpreceptor’sevaluations.Evaluationproceduresmayvaryateachsite.Insomecases, onepreceptormaycompletetheevaluationonline.Inothercases,studentsmayworkwithmultiple preceptorswhocontributetotheevaluation.Inthiscase,thecoordinatororsupervisingphysicianatthe hostsitewillcombinetheinputreceivedfromallevaluatorsandsubmitoneoverallevaluationtothe DivisionofClinicalResources. Pleasenote:aresidentphysicianmaynotqualifyasapreceptor;therefore,aresidentmaynotsubmita PreceptorEvaluationofStudentformtoACOM. Itistheresponsibilityofthestudenttodeterminetheevaluationprocessatthehostsiteandprovide thatinformation,alongwiththenameandcontactinformationofthepreceptorofrecord,tothe DivisionofClinicalResources.Thisinformationshouldbereceivedbythestudent'sRegional CoordinatoratACOMbythesecondweekoftheclerkship. EvaluationProcess a. Theevaluationprocessshouldbeginduringthefirstweekoftheclerkship.Studentsshouldmeet theirpreceptoratthebeginningoftheclerkshiptodiscussexpectationsforclinicalandacademic performanceandcompleteaLearningAgreement(SeeAppendixA).Thisprovidesthestudentwith theopportunitytobecomefamiliarwithandmeetpreceptorexpectationsandavoidbeing surprisedbytheevaluationattheendoftheclerkship.Studentsshouldnothesitatetorequest clarificationofanythingthatisnotmadeclearbythepreceptor.Thestudentshouldprovidethe preceptorwithacopyoftheMid‐ClerkshipEvaluationForm.Ifthepreceptordoesnothaveacopyof theclerkshipsyllabus,thestudentshouldprovideacopyatthebeginningoftheclerkship. 2015–2016ACOMClinicalClerkshipManual 28 Rev.1/25/16 b. Twoweeksintotheclerkship,thestudentshouldaskforaninformalmid‐clerkshipevaluation.The studentshouldreviewtheMid‐ClerkshipEvaluationFormwiththepreceptor,discussareasof competencythatwillbeevaluatedattheconclusionoftheclerkshiprotation,andaskfortheirinput onhisorherperformancetodateandspecificrecommendationsforimprovement.Thisisnot intendedtobeaformalevaluationandthestudentisnotrequiredtosubmitthemid‐clerkship evaluationformtoACOM.Thestudentisencouragedtomakenotesandtokeeptheformforhisor herrecords. c. Itistheresponsibilityofthestudenttoensurethatevaluationformsarecompletedandsubmitted onlineorturnedintotheSiteCoordinatorortheOfficeofClinicalSciencesatthecompletionofthe clerkshiprotation.StudentsshouldinformtheOfficeofClinicalResourcesofanydifficultyin obtaininganevaluationbythepreceptorattheendofthatclerkshiprotation. d. Thecommentssectionoftheevaluationformisdesignedtoidentifythestudent'sstrengthsand areasforimprovement.CommentsmayalsobeusedascontentfortheMedicalStudent PerformanceEvaluationfortheresidencymatchprogram.Studentsareencouragedtoinformthe preceptorabouttheimportanceofmakingspecificcommentsabouttheirclinicalperformance. StudentEvaluationofthePreceptor/Site Studentsarerequiredtocompleteevaluationsregardingtheirclerkshipexperience.Studentfeedback receivedfromtheevaluationswillassistintheoverallassessmentandimprovementofclinicalclerkships andfuturefacultydevelopmentprograms.Inordertoassistcoresitestoimprovestudentexperiences,a summaryofstudentcommentswillbereportedanonymously,inredactedform,tothosetrainingsitesand preceptorsonanannualbasis.Thefollowingevaluationsaretobecompletedwithinsevenbusinessdays followingthecompletionfortheclerkship. ForRequiredClerkships: 1. EvaluationofPreceptor:Providesfeedbackthatcanbeusedtoassessandimprovetheteaching ofuptothreepreceptorsforeachclerkship. 2. EvaluationofSite:Providesfeedbackthatcanbeusedtoassessandimprovelearning opportunitiesandthelearningenvironmentofspecificclerkshipsites. 3. AcademicSurvey(CoreClerkshipsonly):Providesfeedbackthatcanbeusedtoassessand improvetheclerkshipsyllabus,learningmaterials,assignments,activities,andthe instructional/supporteffortsoftheclerkshipchair. ForSelective/ElectiveClerkships: 1. EvaluationofClerkship:Providesfeedbackthatcanbeusedtoassessandimproveselectiveand electiveclerkships. Post‐ClerkshipExams OMS‐IIICOMATExams OMS‐IIIstudentscompletingcoreclerkshiprotationsinBehavioralMedicine,InternalMedicineII,OB/GYN, GeneralSurgery,PediatricsandFamilyMedicinewilltaketheCOMAT(ComprehensiveOsteopathicMedical AchievementTests)subjectexaminationprovidedbytheNationalBoardofOsteopathicExaminers (NBOME).Therearenopost‐clerkshipexamsforIMI,selectiveorelectiveclerkships.Beforebeginning 2015–2016ACOMClinicalClerkshipManual 29 Rev.1/25/16 clerkships,studentswillreceiveinstructionsfromtheDivisionofClinicalResourcesonhowtodownload theNBOMEbrowserandrunasystemscheckontheircomputersinordertoaccessCOMATexams. AmandatoryOPPCOMATwillbeadministeredbytheendofthe3rdyear.Studentshavetheoptiontotake theEmergencyMedicineCOMATanytimepriortotakingtheCOMLEX2CEexambyfollowingthe instructionsbelow. COMATexamsareadministeredonlineonthelastdayoftheclerkshipinaccordancewithNBOME guidelines.TheexamsareproctoredbytheClinicalSiteCoordinatorortheirdesigneeateachcoresite. StudentswillreceiveinstructionsfromtheSiteCoordinatorregardingthetimeandplacetoreportforthe exam.COMATexamsmustbetakenonthedaythattheyarescheduled.Pleasenote:studentsmustinform boththeirSiteCoordinatorandtheClinicalSciencesCoordinatorregardingwhentheywouldliketotake theOPPexamandtheEmergencyMedicineexamatleasttwo(2)weekspriortotheanticipatedexamdate. COMATexaminationstructure,contentoutlinesandpracticeexamsforeachsubjectcanbefoundat http://www.nbome.org/comat. COMBANK2hasbeenpurchasedforyouruseinpreparingforeachCOMAT.Itisstronglyrecommended thatyoumineCOMBANKbydisciplineforpracticequestions,whichwillgreatlyhelpyouprepareforeach COMAT. OMS‐IVPost‐ClerkshipExams Therearenopost‐clerkshipexamsforcoreEmergencyMedicine,selective,orelectiveclerkships. GraduationRequirements AmedicalstudentwhohasfulfilledalltheacademicrequirementsmaybegrantedthedegreeDoctorof OsteopathicMedicineprovidedthemedicalstudent: 1. 2. 3. 4. Hascompliedwithallthecurricular,legal,andfinancialrequirementsofACOM; Hassuccessfullycompletedallcourseworkrequirementsinnomorethansixyears; Attends,inperson,theceremonyatwhichtimethedegreeisconferred; HastakenandpassedCOMLEXLevel1,Level2‐CE,andLevel2‐PEadministeredbytheNational BoardofOsteopathicMedicalExaminers(NBOME);and 5. Hasdemonstratedtheethical,personal,andprofessionalqualitiesdeemednecessaryforthe successfulandcontinuedstudyandpracticeofosteopathicmedicine. Studentswhosegraduationdateisdelayedwillbeallowedtowalkacrossthestagewiththeirincoming classaslongastheywillbeabletofinishtheirclerkshipsbeforeDecember31ofthegraduationyear.To walkacrossthestagetheymusthavepassedCOMLEXLevel1andbothpartsofCOMLEXLevel2. TheDivisionofStudentServiceswillkeepaprogressingchecklisttoconfirmacademicmilestones andapprovepromotionfromoneyeartothenextforeachstudent.TheRegistrarwillconfirmand dateeachmilestonetodocumentthestudent’sprogressfrommatriculationtograduation.The AssociateDeanofStudentswillconfirmeachstudent’schecklistand,uponcompletion,willpresent qualifyingstudentstotheACOMfacultyforavotetorecommendeachstudenttotheBoardof Directorsforgraduation.ThedegreeofDoctorofOsteopathicMedicinewillbeconferredbythe BoardofDirectorsuponthosestudentswhohavefulfilledallacademicrequirementsofACOM. 2015–2016ACOMClinicalClerkshipManual 30 Rev.1/25/16 AdditionalPoliciesandGuidelines ContacttheappropriateclerkshipsiteorACOMClinicalResourcesstaffwhenyouhavequestions. Readallpolicies/proceduresandcourse/clerkshipsyllabiandmakesureyouunderstandallclerkship requirementsbeforebeginningaclerkship. Beproactive–youareresponsibleforyourschedule;youshouldknowwhatisexpectedofyou, completeallforms,evaluations,etc.ontimeandrespondpromptlytophonecalls,e‐mails,andany othercorrespondence. Adheretotimeframes,especiallyforschedulechanges,absences,etc. Seekpermissioninadvancetobeabsentfromyourclerkshipforanyreason. Clinicalclerkshipsinmedicalschoolareafull‐timecommitment.Non‐clerkshipactivitiesmustnot supersedeorconflictwithyourclinicaldutiesandacademicassignments. Failureofthestudenttofollowallspecifiedpoliciesmayresultinapproachingagraduationdatewith requirementsunfulfilled,whichwouldimpacttheabilitytoparticipateincommencement,on‐time graduation,and/ordateofbeginningpost‐graduatetraining. Forissuesarisingatacoresiteregardingin‐housematters,workwithlocalstaffusingappropriate procedurestoresolvetheissuelocally. Ifadviceisneededregardingclerkshiporotherrequirements,seekthatfromappropriatestaffor faculty;wedonotrecommendseekingclarityfromclassmatesornon‐ACOMaffiliatedcoresite, hospital,orotherpersonnel.Remainfullyawarethatnoallowancescanbemadeforreceiving incorrectadvicefrominappropriatesources. Duringclinicalclerkships,studentsareconsideredtobepartofthepatientcareteamattheapplicable trainingsite;assuch,thestudentisaprofessional‐in‐training,hasduties,responsibilities,andalevelof expectationregardingperformancethatissignificantlydifferent,oftenhigher,thanduringthefirsttwo yearsofmedicalschool.Studentbehavioristobeabovereproachatalltimes. Sexualharassmentofanykindwillnotbetolerated.Ifastudentfeelsthatheorsheisbeingsubjected tosexualharassmentbyanytrainingsitepersonnelsuchaspreceptor,hospitalstaffmember,orany otherpersonassociatedwiththeclerkship,he/sheshouldimmediatelycontacttheirregional coordinator.Allreportsandallegationsofsexualharassmentwillbetakenveryseriously.Bythesame token,studentsmustneverengageinactivitythatcouldbeconsideredbyotherstoconstitutesexual harassment.Studentsshouldrefrainfromdevelopingrelationshipswithpreceptorsorothertraining sitepersonnelthatgobeyondwhatwouldbeconsideredatypicalprofessionalrelationship. Studentsareimmediatelyaccountabletotheirassignedclinicalpreceptor(s)forcarryingoutallpatient careandacademicassignmentsinatimely,professional,andhighqualitymanner.Thestudentisalso accountabletotheDirectorofMedicalEducationorSiteSupervisorforbeingawareofandcomplying withgeneralandsite‐specificpolicies/procedures,inadditiontothoseofACOMingeneralandthis manual. Studentswhoareillorexperienceanemergencysituationthatrendersthemunabletofulfillclerkship requirementsandwhichnecessitatesabsencemustpersonally(notbyemail)contacttheclinical supervisors/preceptorandcoresitecoordinatorandtheirACOMRegionalCoordinator. 2015–2016ACOMClinicalClerkshipManual 31 Rev.1/25/16 TipsonMakingtheMostofEachClinicalClerkship (takeninpartfromtheAmericanAcademyofFamilyPhysiciansDivisionofMedicalResources) Befamiliarwithandabletoapplythecorecontentoftheclerkshipspecialty.Beforeyourclerkship begins,taketimetoreviewoneortworelevanttextbooksandotherprimaryresourcesandgooverany notesyoumayhave.Besuretodrawonthisbodyofknowledgeasyoudemonstrateyourdiagnosticskills. Readasmuchasyoucanabouttheillnessesofthepatientsyouareseeing.Monitoryourpatients' chartsdaily.Researchpatientproblemsusingjournals,referencemanuals,andinternetsources,suchas UpToDate.Askyourpreceptortorecommendresourcestoenhanceyourunderstanding. Beateamplayer.Gettoknowyourpatientcareteam–whotheyare,whattheydo,andhowyourrole interactswiththeirs.Truestandoutsevenlyshareresponsibility,arewell‐liked,andcommunicate effectivelywithotherteammembers. Dressprofessionally,beontime,andbeenthusiastic.Attitudeandappearancecount.Takeextracare onyourclerkshipstolookyourbest.Unlessyouknowthatscrubsareacceptableattire,donotwearthem. Makesureyourstyleofdressisappropriateforthesetting.Showingupearlyorstayinglatecanalsoscore youpoints–aslongasyouarebeingproductiveandlearningintheprocess(notjust"hangingout"). Finally,ineverythingyoudo,showenthusiasm. Establishalearningagreementwithyourpreceptoratthebeginningofeachclinicalclerkship.This exerciseaffordsyouandthesupervisingphysicianatouchstoneforyoutolearntheclinicaldecision‐ makingandproceduralskillsyouwantfromtheclerkship.Agreeingongoalsandunderstandinghow informationwillbetaughtensuresthatyourclinicalexperienceisvaluable. KeepyourmilestonesinPxDxuptodateforeachclerkship.Recordsuchthingsasthenumberof patientsyouseeeveryday,thetypesofillnessesyourpatientshave,anyofyourmedical"firsts"(i.e.,the firstphysicalyouperform,thefirstbabyyoudeliver,etc.),andanyexpectationsyouhavefortheclerkship beforeyoubegin.Thiswillhelpyourememberyourexperiencesandprocessyourfeelings.Whenitistime tochooseaspecialty,PxDxwillhelpyoureconcileyourexperienceswithyourexpectationsandgoals. Learntoaskenoughquestionstosatisfyyourhungerforknowledgewithoutmonopolizingprecious time.Althoughyoudon'twanttostifleanimportantquestion,itisnecessarytomakethemostoflimited timewithpreceptors.Payattentiontootherhealthprofessionals,aswellasotherstudents,andlearnfrom allofthem. Maximizetimespentwaitingduringclerkships.Sinceyouneverknowwhenyouwillhaveextratime, don'tgoanywherewithoutsomethingtoread.Keepingjournalarticlesorreferencematerialswithyouwill affordyoutheopportunitytostudy,readuponapatient,orprepareforyournextsetofrounds. Duringdowntime,resisttheurgetoengageinexcessivenon‐clerkshiptasks,suchastexting,web surfing,orpersonalphonecalls.Yourpreceptormayinterpretthisasboredom,distractionor disinterest.Instead,checkoutonlineresources,completeclerkshipassignments,readaboutyourpatients, orprepareforotherdidacticsorthepost‐clerkshipexamination. 2015–2016ACOMClinicalClerkshipManual 32 Rev.1/25/16 ClinicalClerkshipCoreSiteList (currentasofDecember,2015) HOSPITAL CORESITELOCATION SOUTHERNREGION DWMcMillan Brewton,AL SoutheastAlabamaMedicalCenter Dothan,AL SouthBaldwinHospital Foley,AL AltaPointeHealthSystems Mobile,AL SpringhillMedical Mobile,AL MobileInfirmary Mobile,AL FranklinClinic* Mobile,AL GulfCoastHospital PanamaCity,FL Baptist&WestFlorida Pensacola,FL CapitalRegionalMedicalCenter Tallahassee,FL TroyRegional Troy,AL CENTRALREGION NortheastAlabamaRegional Anniston,AL St.Vincent’sEast Birmingham,AL Samford/Brookwood Birmingham,AL CahabaMedicalCare* Centreville,AL JacksonHospital Montgomery,AL CoosaValleyMedicalCenter Sylacauga,AL NORTHERNREGION DecaturMorganHospital Decatur,AL ElizaCoffeeMemorial Florence,AL GadsdenRegionalMedicalCenter Gadsden,AL MarshallMedicalCenter Guntersville,AL Crestwood Huntsville,AL HelenKellerHospital Sheffield,AL *FederallyQualifiedHealthCenter(FQHC)site 2015–2016ACOMClinicalClerkshipManual 33 Rev.1/25/16 ClinicalClerkshipCoreSiteMap (currentasofDecember,2015) 2015–2016ACOMClinicalClerkshipManual 34 Rev.1/25/16 POLICYANDSTATEMENTOFNON‐DISCRIMINATION TheAlabamaCollegeofOsteopathicMedicinedoesnotdiscriminateonthebasisofage,race,color, sex,gender,sexualorientation,religionorcreed,nationalorethnicorigin,ordisabilityinits programs,activities,hiring,ortheadmissionofstudents. Thispolicyappliesinrecruitmentandadmissionofstudents,employmentoffacultyandstaff,and scholarshipandloanprograms.Thispolicyisalsofollowedintheoperationofallotherprograms, activitiesandservicesoftheCollege. (TherevisedstatementabovewasapprovedbytheBoardofDirectors,AlabamaCollegeofOsteopathic Medicine,May13,2014) ACOMsubscribestotheprinciplesandadherestotherequirementsofstateandfederallawpertainingto civilrightsandequalopportunity,inaccordancewiththerequirementsofTitleVIoftheCivilRightsActof 1964,asamended;TitleIXoftheEducationAmendmentsof1972;Section504oftheRehabilitationActof 1973,asamended;andtheAgeDiscriminationActof1975,asamended. EvidenceofpracticesinconsistentwiththispolicyshouldbereportedtotheDirectorofHumanResources, whoisthedesignatedcoordinatorofACOM’snon‐discriminationprogram.Inquiriesregardingcompliance withthesexdiscriminationprovisionsofTitleIXmayalsobedirectedtotheAssistantSecretaryforCivil Rights,DepartmentofEducation,Washington,D.C. 2015–2016ACOMClinicalClerkshipManual 35 Rev.1/25/16 APPENDIXA:LEARNINGAGREEMENT ACOMLearningAgreementforClerkshipRotations Todevelopasetofmutually‐agreed‐uponlearningobjectives,studentsandpreceptorsshoulddiscussthe questionsbelowonthefirstorseconddayoftheclerkshiprotation. Student:________________________________________ Preceptor:__________________________________ RotationDiscipline:___________________________ Site:________________________________ I.Whatskillsorknowledgedoesthestudenthopetolearninthisclerkshiprotation? (Thissectionmaybecompletedpriortomeeting.) 1._____________________________________________________________________________ 2.____________________________________________________________________________ 3.____________________________________________________________________________ II.Whatskillsorknowledgedoesthepreceptorthinkthestudentmostneedstolearninthis clerkshiprotation? 1.____________________________________________________________________________ 2.____________________________________________________________________________ 3.____________________________________________________________________________ III.Basedonthetwosetsofgoalsabove,whatspecificlearningobjectives*dothestudentand preceptoragreeshouldbeaccomplishedinthisclerkshiprotation?(Pleaselistatleastthree) 1.____________________________________________________________________________ 2.____________________________________________________________________________ 3.____________________________________________________________________________ *Pleasenotethatlearningobjectivesneedtodescribewhatthestudentwillbeabletodooncompletingtheclerkship rotation.Pleaseuseobjectiveswithinthisclerkshiprotationsyllabus. IV.Whatactivitieswillmosthelpthestudentaccomplishtheabovelearningobjectives? 1.__________________________________________________________________________ 2.__________________________________________________________________________ 3.__________________________________________________________________________ SIGNATURES Student: Preceptor: Date: Studentsarerequiredtosubmitthisdocumentelectronicallyontheappropriatesoftwareplatformandstrongly encouragedtokeepthesignedlearningagreementfortheirrecords. 2015–2016ACOMClinicalClerkshipManual 36 Rev.1/25/16 APPENDIXB:CLINICALMILESTONESLIST CLINICALMILESTONESNECESSARYFORGRADUATION I. RequiredSymptoms/Problems:StudentsmustcompletethefollowingmilestonesintheirE*Value portfoliosinordertograduate. o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o AbdominalMassOrPain AbnormalECG AbnormalSerumLipids AcidBaseDisorders AcuteIllnessInAnInfant/Child AllergicReactions Anemia/Pallor BackPain BreastDisorders ChestDiscomfort/AnginaPectoris Women’sHealth,Contraception Diarrhea/Constipation Dizziness/Vertigo DifficultySwallowing DomesticViolence Dyspnea/Breathlessness EarPain,HearingLoss/Deafness ElectrolyteDisorders EyeRedness/Pain Falls Fatigue Fever/Chills Fractures/Dislocations/JointInjuries GaitDisturbances GastrointestinalBleeding GeneticDisorders Headache Hemoptysis Hyperglycemia/DiabetesMellitus Hypertension Immunocompromise/Immunodeficiency ImpairedConsciousness,MemoryDisturbances,Dementias Jaundice(Adult&Infant) JointPain,Non‐Traumatic Leukocytosis/Leukopenia Lymphadenopathy MoodDisorders,Anxiety/Depression Murmur/AbnormalHeartSounds Numbness/Tingling/Paresthesias,PainfulLimb PapAbnormality PelvicMass,Pain/Dysmenorrhea,AlteredMenses,VaginalBleeding‐Abnormal PeriodicHealthExamination/Growth&Development Pregnancy/Delivery PreventiveHealthCare/CancerScreening/STIScreening PsychoticPatient/DisorderedThought RenalFailure:AcuteOrChronic 2015–2016ACOMClinicalClerkshipManual 37 Rev.1/25/16 o o o o o o o o o o o o o o o o o o o o o o Rhinosinusitis(Rhinorrhea/Sneezing/NasalCongestion/SinusCongestion) ScrotalMass/Pain Seizures(Epilepsy) SexualDysfunction/Contraception Shock/Hypotension SkinLesions SleepDisturbances SoreThroat SpeechAndLanguageAbnormalities/Dysphonia/Hoarseness SubstanceAbuse/DrugAddiction/Withdrawal SuicidalBehavior/Prevention Syncope/Pre‐Syncope/LossOfConsciousness ThromboembolicDisorders UrinaryDisorder/Incontinence/IncompleteEmptying/Frequency Vaginal/PenileDischarge VisualDisturbance/Loss Vomiting/Nausea Weakness/Paralysis WeightGain/Obesity WeightLoss Wheezing/Cough Women’sHealth,Contraception II. ThePortfolioProcess:EachofthehealthconcernslistedinPartIabovehasfivecategoriesof competencythatstudentsmustself‐check. o Thefivecategoriesstudentsmustself‐checkareasfollows: Performanaccuratefocusedorcompletemedicalhistoryandphysicalexambasedon thepresentingcomplaintandappropriatetotheclinicalsetting. Formulateadifferentialdiagnosisappropriatetothepatientandclinicalsetting. Orderandaccuratelyinterprettestsandproceduresinordertonarrowthedifferential diagnosistoaworkingdiagnosis. Accuratelydescribeorperformprocedurestodiagnoseandtreatthepatient’sproblem. Craftatreatmentplanappropriatetothepatient’sproblemandsituation. III. RecommendedSymptoms/Problems:Studentsshouldbeabletodiagnoseandtreatthehealth concernslistedbelow,buttheyarenotrequiredtologtheseintotheirE*Valueportfolios. o o o o o o o o o o o o AbnormalLiverFunctionTests AbnormalitiesOfWhiteBloodCells AttentionDeficit/LearningDisorder/SchoolFailure BehaviorDisorder BleedingTendency/Bruising Burns CardiacArrest/RespiratoryArrest Cyanosis/Hypoxia DepressedNewborn DevelopmentDisorder/DevelopmentDelay Diplopia EatingDisorders 2015–2016ACOMClinicalClerkshipManual 38 Rev.1/25/16 o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o Edema/Anasarca/Ascites FailureToThrive FetalDistress/Non‐ReassuringFetalStatus HairandNailDisorders HeadInjuries/BrainDeath/TransplantDonation Hematemesis Hematuria HirsutismandVirilization Infertility InvoluntaryMovementDisorders/TicDisorders IssuesOfDyingPatients/DeliveringBadNews Limp/PaininLowerExtremityinChildren Menopause Mouth/OralDisorders NeckMass/Goiter PersonalityDisorders Poisoning Polycythemia/ElevatedHemoglobin PregnancyLoss Prematurity PelvicRelaxation/PelvicOrganProlapse Proteinuria Pruritus PupilAbnormalities SexualMaturation SexuallyConcernedPatient,GenderIdentityDisorder SuddenInfantDeathSyndrome SpinalInjuries Splenomegaly Strabismusand/orAmblyopia TallStature,ShortStature Tinnitus Torticollis IV. Procedures:StudentsarerequiredtologproceduresintotheirE*Valueportfolios. o o o o o o o o o o o o AirwayManagement(specifytypeinnotessection,i.e.nasotracheal,oropharyngeal,etc.) APGARandDubowitz/BallardAssessment Arterialpuncture–forbloodgases(ABG) Arthrocentesis BreastExam CaesareanSection Calculatemedicationdosagebyweightandwriteaprescription;signedbyphysician CardiacultrasoundandDopplerstudies Casting/Splinting,Elbow Casting/Splinting,Knee/Ankle Casting/Splinting,LowerExtremity Casting/Splinting,Other(SpecifyinNotesSection) 2015–2016ACOMClinicalClerkshipManual 39 Rev.1/25/16 o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o Casting/Splinting,Shoulder Casting/Splinting,ThumbSpica Casting/Splinting,UpperExtremity Casting/Splinting,Wrist/Hand Colposcopy DigitalRectalExam Ear,EvaluationandTreatment–CerumenRemoval Ear,EvaluationandTreatment,EACforeignbodyremoval/wickinsertion Echocardiography EKGInterpretation Electroencephalogram Endoscopy(specifytypeinnotessection) Episiotomyandrepair Eye,EvaluationandTreatment–EvaluationofCornealAbrasion Eye,EvaluationandTreatment–Evaluationofforeignbodywithlideversion Eye,EvaluationandTreatment–sliplampuse Eye,EvaluationandTreatment–Tonometry Eye,EvaluationandTreatmentofconjunctivalforeignbody Eye,EvaluationandTreatmentofcornealforeignbody FemalePelvicExam,BimanualExam(enterspecificpathologyfoundinnotessection) FemalePelvicExam,PAPSmear(enterspecificpathologyfoundinnotessection) H&PPrevention/HealthMaintenance Herniaexamination HistoryandPhysical–Complete/Comprehensive Injection–Sub‐Q/Intradermal,IM(specifyinnotessection) IntravascularAccess,CentralLine(specifylocationinnotessection) IntravascularAccess,CentralLine/Subclavian IntravascularAccess,Intraosseous IntravascularAccess,Peripheral LumbarPuncture MaleGenitalExam MentalStatusExam Mouth/DentalEvaluationandTreatment–regionalDentalBlock Mouth/DentalEvaluationandTreatment–TreatmentofAphthousUlcers Mouth/DentalEvaluationandTreatment–treatmentofDrySocketS/PExtraction NasogastricTubePlacement NewbornManagement,UncomplicatedDelivery NewbornManagement–NewbornResuscitation Nose,EvaluationandTreatment–foreignbodyremoval Nose,EvaluationandTreatment,EpistaxisControl(specifymethodusedinnotessection) OfficeEncounter,ChronicComplexCare OfficeEncounter,RoutineAcuteProblem OsteopathicManipulationTreatment(OMT) OsteopathicStructuralExam OtherProcedures(specifyinnotessection) Paracentesis PerformOPPautonomics PerformOPPlymphatics 2015–2016ACOMClinicalClerkshipManual 40 Rev.1/25/16 o o o o o o o o o o o o o o o o o o o o o o o o o PeritonealLavage,Diagnostic Pre‐NatalCare ProvideHealthPromotion/DiseasePrevention PsychiatricAssessment(describeinnotessection) PulmonaryFunctionTests Removesuturesorstaples ResuscitationTeamMember(specifyroleinnotessection,i.e.Leader,Compressor,etc.) SkinLesionExcision StressTesting SurgicalAssist(specifytypeinnotessection) Suturing,extremities(indicatetypeofanesthesiainnotessection) Suturing,Face(indicatetypeofanesthesiainnotessection) Suturing,Hand/digits(specifytypeofanesthesiainnotessection) Thoracentesis Thoracostomy,TubeorNeedle(specifyinnotessection) Ultrasound,bedside–FAST(FocusedAssessmentwithSonographyforTrauma) Ultrasound,OtherthanFAST(specifyincommentssection) UrinalysisbyDipstick UrinaryCatheterInsertion VaginalDelivery–Spontaneous/Induced/VacuumExtraction/Forceps(specifyinnotessection) VaginalDelivery,Spontaneous Venipuncture VisionScreening WellChildDevelopmentExam X‐RayStudies(specifytypeinnotessection,i.e.chest,abdominalseries,etc.) 2015–2016ACOMClinicalClerkshipManual 41 Rev.1/25/16 APPENDIXC:ACOMGUIDELINESFORSTUDENTPARTICIPATIONINTHECLINICALSETTING ACOMGUIDELINESFORSTUDENTPARTICIPATIONINTHECLINICALSETTING These Medical Student Patient Care Duties' represent a minimum mandatory regulations to be consideredbyapolicymakingbodyatyourhealthcareorganizationgiventhelocalstandardofcare andapplicablestateandfederalrules,regulations,andlawstotheextentsuchareapplicable.Ifyour hospitalpolicyismorerestrictive,thenACOMstudentsmustadheretoyourpolicyasyoudirect.To theextenttherecommendationsthatfollowarenotapplicabletoorappropriateforyourhealthcare organization given the local standard of care and/or because applicable state and federal rules, regulations, and laws are more restrictive, it is advisable to document the analysis and final conclusionsandmodifytheserecommendedguidelinesaccordingly. MedicalStudentPatientCareDutiespermittedandprohibited I. Definitions: DirectPhysician Supervision: Thephysicianmustbepresentintheirofficesuiteoronhospitalgroundsand immediatelyavailabletofurnishassistanceanddirectionthroughoutthe performanceofthefunction/procedure.Itdoesnotmeanthatthephysicianmust bepresentintheroomwhenthefunction/procedureisperformed. PersonalPhysician Supervision: Thephysicianmustbeinattendanceintheroomfrombeginningtoend,without interruption,duringtheperformanceofthefunction/procedure. LimitedPhysical Exam: Thisincludessuchcomponentsasthehead/neck,skin,chest,cardiac,abdominal, neurologicandmusculoskeletalexams;thisspecificallyexcludesgenitourinary, breastandrectalexams. II. ScopeofDutiesPermitted: MedicalStudentswillbesupervisedbyACOMcredentialedattendingphysicianswhileonACOM clerkshiprotations.Eachstudent’sessentiallearningtaskwhileonclerkshiprotationsistoimprove theabilitytodothefollowing: Performanaccuratemedicalhistoryandphysicalexambasedonthepresentingcomplaint andappropriatetotheclinicalsetting. Formulateadifferentialdiagnosisappropriatetothepatientandtheclinicalsetting. Orderandaccuratelyinterprettestsandproceduresinordertonarrowthedifferential diagnosistoaworkingdiagnosis. Accuratelydescribeorperformprocedurestodiagnoseandtreatthepatient’sproblem. Craftatreatmentplanappropriatetothepatient’sproblemsandsituation. Workwithpatientsandmembersofthehealthcareteamethicallyandprofessionally. Bystudentyear,thescopeofdutiesmedicalstudentsmayperforminordertocompletetheabove learningtasksare: 2015–2016ACOMClinicalClerkshipManual 42 Rev.1/25/16 FirstYearStudents: FirstYearStudentsarepermittedtoperformthefollowingfunctionsonly: Observationandfollowonly HistorytakingunderPersonalPhysicianSupervision SecondYearStudents: SecondyearStudentsarepermittedtoperformthefollowingfunctionsonly: AllfunctionspermittedforFirstYearStudents,asstatedabove Historytakingunderdirectphysiciansupervision LimitedPhysicalExaminationunderpersonalphysiciansupervisionuntilphysiciandetermines competency,afterwhichstudentmayperformLimitedPhysicalExaminationunderdirect physiciansupervision; ThirdandFourthyearStudents: ThirdandFourthYearstudentsarepermittedtoperformthefollowingfunctionsonly: AllfunctionspermittedforFirstandSecondyearStudents,asstatedabove Underdirectphysiciansupervision,may‘round’onpatients,toinclude o Gatheringlab,radiology,nursingandotherinformation/results o Obtaininghistory o PerformingLimitedPhysicalExam o Developinginterimassessmentsandrecommendations Forgenitourinary,breastorrectalexam,studentmayperformexamunderpersonalphysician supervision,ifthesupervisingphysiciandeterminesthestudent’sreadinessandagender‐ appropriatechaperoneispresent,asindicated. Underdirectphysiciansupervision,maywritestudentnotesregardingE/Mservicesor procedures: o o Ifsuchstudentnotesaretobeplacedinthepatientchart,theymustbeclearlylabeled asstudentnotesandco‐signedbythesupervisingphysicianwithin48hours;these studentnotesarejustthat–studentnotes.Theyarenottheprogressnoteforthe patientandneverstandaloneassuch. Ifsuchnotesarestrictlyfortheeducationalexperienceofthestudentandwillnotbe placedinthechart,theymustnotusepatientidentifiersandshouldbeshreddedas consistentwithhospitalHIPAApolicies. Maywriteordersonthechartwhichmustbeimmediatelyreviewedandcountersignedby supervisingphysicianbeforeanyactionistakenbasedonthoseorders. Thefollowingproceduresmaybeperformedby3rdor4thyearmedicalstudentsonlyif(a)the supervisingphysiciandeterminesthestudent’sreadinesstostarttoperformtheprocedure underpersonalsupervision,and(b)thesupervisingphysicianhastheappropriateprivileges, competencyandteachingproficiencytoperformandeducatemedicalstudentsintheir performance,and(c)uponobtainingappropriatepatientconsent. o Thefollowingproceduresmustbeperformedunderthepersonalsupervisionofthe physicianuntilthephysiciandeterminesthestudentiscompetenttoperformthe procedureunderdirectphysiciansupervision: 2015–2016ACOMClinicalClerkshipManual 43 Rev.1/25/16 PerforminsertionofIVsordrawblood–stickattemptslimitedtotwo(2)per patient OcularExamwithSlit‐Lamp Warttreatment InsertionofFoleycatheter o Thefollowingproceduresmustalwaysbeperformedbythestudentunderpersonal physiciansupervision: AirwayManagement(i.e.nasotracheal,oropharyngeal,etc.) APGARandDubowitz/BallardAssessment Arterialpuncture–forbloodgases(ABG) Arthrocentesis BreastExam CardiacultrasoundandDopplerstudies Casting/Splinting,Elbow Casting/Splinting,Knee/Ankle Casting/Splinting,LowerExtremity Casting/Splinting,Other Casting/Splinting,Shoulder Casting/Splinting,ThumbSpica Casting/Splinting,UpperExtremity Casting/Splinting,Wrist/Hand Colposcopy Ear,EvaluationandTreatment–CerumenRemoval Ear,EvaluationandTreatment,EACforeignbodyremoval/wickinsertion Echocardiography EKGInterpretation Electroencephalogram Episiotomyandrepair Eye,EvaluationandTreatment–EvaluationofCornealAbrasion Eye,EvaluationandTreatment–Evaluationofforeignbodywithlideversion Eye,EvaluationandTreatment–Tonometry Eye,EvaluationandTreatmentofconjunctivalforeignbody IntravascularAccess,Peripheral IntravascularAccess,Central LumbarPuncture Mouth/DentalEvaluationandTreatment–TreatmentofAphthousUlcers NasogastricTubePlacement NewbornManagement,UncomplicatedDelivery NewbornManagement–NewbornResuscitation Nose,EvaluationandTreatment–foreignbodyremoval Nose,EvaluationandTreatment,EpistaxisControl OsteopathicManipulationTreatment(OMT) ProvideHealthPromotion/DiseasePrevention PsychiatricAssessment PulmonaryFunctionTests Removesuturesorstaples ResuscitationTeamMember(specifyrolei.e.Leader,Compressor,etc.) SkinLesionExcision SurgicalAssist Suturing,extremities(indicatetypeofanesthesia) Suturing,Face(indicatetypeofanesthesia) 2015–2016ACOMClinicalClerkshipManual 44 Rev.1/25/16 Suturing,Hand/digits(indicatetypeofanesthesia) Ultrasound,bedside–FAST(FocusedAssessmentwithSonographyfor Trauma) Ultrasound,OtherthanFAST UrinalysisbyDipstick UrinaryCatheterInsertion VaginalDelivery,Spontaneous WellChildDevelopmentExam X‐RayStudies(i.e.chest,abdominalseries,etc.) Theabovenotwithstanding,dutiesandactivitiesofstudentsmustnotconflictwithhospitalpolicies. III.ScopeofDutiesProhibited MedicalStudentsarestrictlyprohibitedfromperforminganyandallfunctionsthatarenotspecifically permitted.Additionally,medicalstudentsarespecificallyprohibitedfromperformingthefollowing: Giveverbalortelephoneorders. Writeordersregardingend‐of‐life,suchasDNR 2015–2016ACOMClinicalClerkshipManual 45 Rev.1/25/16 APPENDIXD:COMATSCORERELEASEPROCESS COMATSCORERELEASEPROCESS 2015–2016ACOMClinicalClerkshipManual 46 Rev.1/25/16 APPENDIXE:PROCESSFORPARTICIPATINGINSELECTIVES/ELECTIVES PROCESSFORPARTICIPATINGINSELECTIVES/ELECTIVES 2015–2016ACOMClinicalClerkshipManual 47 Rev.1/25/16 APPENDIXF:SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY: OMS‐IIIDETAILEDTIMELINE June July October–March December–April January EarlyFebruary March–December March April–June May June/July July TakeCOMLEXLevel1 BeginCORERotations ContinueworkingonyourCurriculumVitae(CV) Evaluationyourcompetitiveness–compareboardscorestodisciplineminimums, lookatprogramrequirements,etc. BeginrequestingLettersofRecommendation(LoRs)andinformauthorsofthe newLoRprocessforERAS Researchresidencyprogramsandrequestinformationand/orapplication material(AOAOpportunities,AMA’sFREIDA,PCOMMedNet) WriteyourPersonalStatement(s) VisittheERASWebsitetofamiliarizeyourselfwiththetimeline,homepage,and otherimportantinformation Begincontactingprograms(Non‐VSAS)regardingauditionrotationavailability andimportantdates VSASauthorizationswillbeissued SeasonopensforCOMLEXLevel2‐PE BeginapplyingforVSASawayauditionrotations(ifapplicable) PutfinaltouchesonyourCVandPersonalStatement CompleteyourResidencySelectionFactSheet;meetwithpreceptorsandchosen advisorstodiscussyouroptions ERAStokensaredistributedthroughemail MyERASsiteopenstoapplicantstoregisterandbeginworkingontheir applications TakeCOMLEXLevel2‐CE AuditionRotationseasonbegins DeadlinetosubmitMSPEQuestionnaire 2015–2016ACOMClinicalClerkshipManual 48 Rev.1/25/16 SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY: OMS‐IIIVISUALTIMELINE 2015–2016ACOMClinicalClerkshipManual 49 Rev.1/25/16 SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY: OMS‐IVDETAILEDTIMELINE July–December July15 EarlySeptember September15 September–January October1 November1 LateNovember January Mid‐January February LateFebruary Mid‐March March–April Mid‐May June/July AuditionRotationseasoncontinues NMS/AOAMatchRegistrationOpens ERASPostOfficeopens MaybeginapplyingtoAOA‐accreditedresidencyprogramsonly MayscheduleanappointmenttoreviewMSPEoncampus NRMPopensforregistrationfortheallopathicmatch Applicantscanbegintoapply/transmittheirERASapplicationstoACGME residencyprograms Residencyprograminterviews MedicalStudentPerformanceEvaluation(MSPEs)arereleasedtoprograms RecommendeddatebywhichstudentsshouldberegisteredfortheAOAMatch Instructionsforsubmittingrankorderlistsandobtainingmatchresultsare providedtoNMSregisteredstudentsandprograms NRMP(allopathic)ApplicantRegistrationDeadline–afterthisdateyouwillhave topaya$50lateregistrationfee Urologymatchresultsareavailable FinaldateforsubmissionofstudentandprogramRankOrderListtoAOAMatch. NoAOARankOrderListsorregistrationfortheMatchwillbeacceptedafterthis date. NMSOsteopathicMatchResultsreleasedtoallparticipants DOScramble–beginningat12:00ETonthisdate,studentswhodidnotmatchto apositionandprogramswithpositionsavailablemaycontacteachotherin ordertofillavailablepositions NRMPLateRegistrationDeadline NRMPRankOrderListDeadline NRMPMatchResultsreleased SupplementalOfferandAcceptanceProgram(SOAP)begins SendResidency/StateLicensingFormsthatneedtobesignedbyACOMand requestsforgraduationverificationletterstotheDepartmentofStudent Services SendthankyouletterstoyourpreceptoradvisorsandLoRauthorslettingthem knowwhereyoumatchedandhowmuchyouappreciatetheirsupport Graduation ResidencyOrientation(ProgramDependent);BeginResidency 2015–2016ACOMClinicalClerkshipManual 50 Rev.1/25/16 SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY: OMS‐IVVISUALTIMELINE 2015–2016ACOMClinicalClerkshipManual 51 Rev.1/25/16 APPENDIXG:TERMSTOKNOW TERMSTOKNOW AA AnAffiliationAgreementisbetweenaninstitutionandanotherentityforpurposes of providinganeducationalopportunityforstudentsgenerallyinasupervisory situation. AACOM TheAmericanAssociationofCollegesofOsteopathicMedicineisanon‐profit organizationthatsupportstheUnitedStates'collegesofosteopathicmedicine andservesas aunifyingvoiceforosteopathicmedicalresources.http://www.aacom.org/ AAFP TheAmericanAcademyofFamilyPhysiciansisthenationalassociationoffamily doctors. http://www.aafp.org AAMC TheAssociationofAmericanMedicalCollegesisanon‐profitorganizationbased in Washington,DCandestablishedin1876.ItadministerstheMedicalCollege AdmissionTest. TheAAMCoperatestheAmericanMedicalCollegeApplication ServiceandtheElectronic ResidencyApplicationServicewhichfacilitatestudents applyingtomedicalschoolsand residencyprograms,respectively.https://www.aamc.org/ ACGME ACLS ACOM AHEC TheAccreditationCouncilforGraduateMedicalEducationisresponsibleforthe Accreditationofpost‐MDmedicaltraining(residency)programswithintheUnited States. http://www.acgme.org/acgmeweb/ AdvancedCardiacLifeSupport AlabamaCollegeofOsteopathicMedicine AlabamaHealthEducationCenters Allopathic Medicine Thesystemofmedicalpracticewhichtreatsdiseasebytheuseofremedieswhich produce effectsdifferentfromthoseproducedbythediseaseundertreatment. M.D.spracticeallopathicmedicine. ALOMA TheAlabamaOsteopathicMedicalAssociationisanon‐profitprofessional organization comprisedofosteopathicphysicians,residents,interns,andmedical students. http://aloma.org/ AMA AmericanMedicalAssociation http://www.ama‐assn.org AMEC AlabamaMedicalEducationConsortium http://www.amecdo.com AOA AOA Opportunities Database ArchivalList ATLS TheAmericanOsteopathicAssociationisthemainrepresentativeorganizationfor osteopathicphysiciansintheUnitedStates. http://www.osteopathic.org/ Awebsitededicatedtoosteopathicmedicalinternshipsandresidencies.The ProgramSearch featureisusedbyosteopathicmedicalstudents,internsor residents,hospitalsorother agencies/organizationslookingforprogram informationinpreparationfortheOsteopathic Matchwhichisscheduledyearlyin earlyFebruary. http://www.opportunities.osteopathic.org/index.htm ListofpreceptorskeptbytheACOMClinicalResourcesdepartmentwhichtracks thestatus ofallpreceptors,whetheractive,inactiveorother. AdvancedTraumaLifeSupport 2015–2016ACOMClinicalClerkshipManual 52 Rev.1/25/16 rd th Audition Rotation Electiveclerkships(rotations)duringthe3 and4 yearsatsiteswithresidency programsinwhichastudentisinterested. BLS CAF ChartRounds Clerkship CME COCA COI COMAT COMLEX‐USA COMLEXLevel1 BasicLifeSupport ReferstotheCommonApplicationFormthatiscompletedaspartoftheERAS application process. Reviewofahospitalizedpatient'scurrentrecordsbyagroupofhealthcare professionals. Chartroundscanbeundertakenforavarietyofreasonssuchas assessmentofpatient progress,planningofinterventions,oreducationofstaff. A4‐weekperiodoftraininginamedicalcoreorspecialty. ContinuingMedicalEducation TheAOACommissiononOsteopathicCollegeAccreditationservesthepublicby establishing,maintaining,andapplyingaccreditationstandardsandprocedures toensure thatacademicqualityandcontinuousqualityimprovementdelivered bythecollegesof osteopathicmedicine(COMs)reflecttheevolvingpracticeof osteopathicmedicine.The scopeoftheCOCAencompassestheaccreditation ofCOMs. http://www.osteopathic.org/inside‐ aoa/accreditation/predoctoral%20accreditation/Pages/default.aspx CertificateofInsurance ComprehensiveOsteopathicMedicalAchievementTest(shelfexam);nationally standardizedexaminationmodulesusedtoassessstudents,includingforthe purposesof evaluatingresourcesequivalencyacrossclinicalclerkshipsites. Exam willbeadministered atthecompletionofcoreclerkships,generallyonthelast day,inaproctoredsetting. http://www.nbome.org/comatmain.asp TheCOMLEX‐USAComprehensiveOsteopathicMedicalLicensingExamination seriesis designedtoassesstheosteopathicmedicalknowledgeandclinicalskills considered essentialforosteopathicgeneralistphysicianstopracticemedicine withoutsupervision. http://www.nbome.org/comlex‐cbt.asp?m=can Candidatesareexpectedtodemonstratebasicscienceknowledgerelevantto medical problems.Level1emphasizesthescientificconceptsandprinciples necessaryfor understandingthemechanismsofhealth,medicalproblemsand diseaseprocesses. Level1,takeninone‐day,isaproblem‐andsymptom‐basedassessment integratingthe basicmedicalsciencesofanatomy,behavioralscience, biochemistry,microbiology, osteopathicprinciples,pathology,pharmacology, physiologyandotherareasofmedical knowledgeastheyarerelevanttosolving medicalproblems.Theexaminationconsistsof twofour‐hourtestsessions,each containingquestionsrelatedtodiverseclinical presentationsandprinciples. The examisadministeredataregionaltestingcenter. ~ACOMstudentsarerequiredtotaketheCOMLEXLevel1assoonaspossible after completionoftheirsecondyear. ItmustbetakenpriortoJune30. Students arenotallowed tostartclerkshipsuntiltheyhaveachievedapassingscoreonthe COMLEXLevel1. A3‐digitstandardscoreof400ora2‐digitstandardscoreof75isrequiredtopass the examination. 2015–2016ACOMClinicalClerkshipManual 53 Rev.1/25/16 COMLEXLevel 2‐CE(Cognitive Examination) Candidatesareexpectedtodemonstrateknowledgeofclinicalconceptsand principles involvedinallstepsofmedicalproblem‐solvingasdefinedby Dimension2.Level2‐CE emphasizesthemedicalconceptsandprinciples necessaryformakingappropriatemedical diagnosesthroughpatienthistoryand physicalexaminationfindings. Level2‐CE,takeninone‐day,isaproblem‐basedandsymptom‐based assessment integratingtheclinicaldisciplinesofemergencymedicine,family medicine,internal medicine,obstetrics/gynecology,osteopathicprinciples, pediatrics,psychiatry,surgery,and otherareasnecessarytosolvemedical problemsasdefinedbytheLevel2‐CEblueprint.A similarproblem‐symptom basedapproachisusedinLevel2andinLevel1.Theexamination consistsoftwo four‐hourtestsessions,eachcontainingquestionsrelatedtodiverseclinical presentationsandprinciples. Theexamisadministeredataregionaltesting center. ~ACOMstudentsarerequiredtopasstheCOMLEXLevel2CEforgraduation. Passingscores mustbedocumentednolaterthanMarch1ofthegraduation year. Studentsareallowedone dayexcusedabsenceforCOMLEXLevel2CE. A3‐digitstandardscoreof400ora2‐digitstandardscoreof75isrequiredtopass the examination COMLEXLevel 2‐PE (Performance Evaluation) TheLevel2‐PEisaone‐dayexaminationofclinicalskillswhereeachcandidatewill encountertwelvestandardizedpatientsoverthecourseofaseven‐hour examinationday. TheexaminationtakesplaceatNBOME’sNationalCenterfor ClinicalSkillsTestingin Conshohocken,Pennsylvania(borderingPhiladelphia, Pennsylvania). ~ACOMstudentsarerequiredtopasstheCOMLEXLevel2PEforgraduation. Passingscores mustbedocumentednolaterthanMarch1ofthegraduation year. Studentsareallowedone dayexcusedabsencetotaketheCOMLEXLevel2PE.Traveldaysmustbemadeup. COMLEXLevel3 Candidatesareexpectedtodemonstrateknowledgeofclinicalconceptsand principles necessaryforsolvingmedicalproblemsasindependentlypracticing osteopathicgeneralist physicians.Level3emphasizesthemedicalconceptsand principlesrequiredtomake appropriatepatientmanagementdecisions. Level3, takeninone‐day,isaproblem‐based andsymptom‐basedassessment integratingtheclinicaldisciplinesofemergencymedicine, familymedicine, internalmedicine,obstetrics/gynecology,osteopathicprinciples,pediatrics, psychiatry,surgery,andotherareasnecessarytosolvemedicalproblems.Level3, likeLevel 2‐CEandLevel1,isproblem‐basedandsymptom‐basedinpresentation. Theexamination consistsoftwofour‐hourtestsessions,eachcontainingquestionsrelatedtodiverseclinical presentationsandprinciples.The testisgenerallytakeninthefirstyearofresidency. A3‐digitstandardscoreof350ora2‐digitstandardscoreof75isrequiredtopass the examination. COMSAE CoreClerkships CoreSite Connections CRNA CRNP CSC ComprehensiveOsteopathicMedicalSelf‐AssessmentExaminationisaself‐ assessment examinationforosteopathicstudentsandresidentstogaugethe baseoftheirknowledgeand abilityastheypreparetotakeaCOMLEX‐USA cognitiveexamination. Thispre‐testis administeredtoACOMstudentsfourtimes priortotheactualCOMLEXLevel1test. http://www.nbome.org/comsae.asp Thebasicclerkshipsthatallstudentsmustcomplete. Inthirdyear,thisincludes family medicine,behavioralmedicine,internalmedicine,pediatrics,general surgery,and obstetrics/gynecology. Infourthyear,theonlycoreclerkshipis emergencymedicine. ReferstoinitialmeetingsbetweenCoreSiteCoordinators(CSC)andstudents assignedto theirsites. CertifiedRegisteredNurseAnesthetist CertifiedRegisteredNursePractitioner CoreSiteCoordinator 2015–2016ACOMClinicalClerkshipManual 54 Rev.1/25/16 CSD CV Dean’sLetter Didactics CoreSiteDirector Acurriculumvitaeisawrittenoverviewofaperson'sexperienceandother qualifications. SeeMSPE Instructionbylecture,textbook,discussionboards,andjournalclubs. Differential Diagnosis Theprocessofweighingtheprobabilityofoneconditionversusthatofothers, possibly accountingforapatient'ssituation.Thedifferentialdiagnosisofrhinitis(a runnynose) includesallergicrhinitis(hayfever),theabuseofnasaldecongestants andthecommoncold. Discharge Summary Adocumentpreparedbytheattendingphysicianofahospitalizedpatientthat summarizes theadmittingdiagnosis,diagnosticproceduresperformed,therapy receivedwhile hospitalized,clinicalcourseduringhospitalization,prognosis,and planofactionuponthe patient’sdischargewithstatedtimetofollowup. DO DoctorofOsteopathicMedicine Elective Clerkships Electiveclerkshipsarechosenbythestudentsbasedontheirinterests. EMR(EHR) ERAS E*Value EVOS ElectronicMedicalRecordsorElectronicHealthRecords TheElectronicResidencyApplicationServiceisproducedbyAAMCtotransmit residency applications,lettersofrecommendation,Dean’sLetters,transcripts,and othersupporting documentstoresidencyprogramdirectorsviatheInternet. https://www.aamc.org/services/eras/ Softwareusedtomanage3rd and4th yearclerkships. E*ValueOptimizationSchedulingTool FERPA TheFamilyEducationalRightsandPrivacyActof1974. Definestheprivacyrights of studentsinacademicsettings. FREIDA FellowandResidencyElectronicInteractiveDatabase. FREIDAOnlineisa databasewith morethan7,800graduatemedicaleducationprograms accreditedbyACGMEaswellas morethan200combinedspecialtyprograms.http://www.ama‐ assn.org/ama/pub/education‐careers/graduate‐medical‐education/freida‐online.page? FQHC FederallyQualifiedHealthCenters FSMB TheFederationofStateMedicalBoardsisanationalnon‐profitorganization representing the70medicalandosteopathicboardsoftheUnitedStatesandits territories. http://www.fsmb.org/ GME GraduateMedicalEducation. Anofficesponsoringandmanagingresidency andfellowship programsaccreditedbytheACGME. GrandRounds H&P Aformalmeetingatwhichphysiciansdiscusstheclinicalcaseofoneormore patients.Grand roundsoriginatedaspartofresidencytrainingwhereinnew informationwastaughtand clinicalreasoningskillswereenhanced.Grandrounds todayareanintegralcomponentof medicaleducation.Theypresentclinical problemsinmedicinebyfocusingoncurrentor interestingcases.Theyarealso sometimesutilizedfordisseminationofnewresearch information. Shorthandforhistoryandphysical,theinitialclinicalevaluationandexaminationofthe patient. 2015–2016ACOMClinicalClerkshipManual 55 Rev.1/25/16 HCAHPS TheintentoftheHospitalConsumerAssessmentofHealthcareProvidersand Systems initiativeistoprovideastandardizedsurveyinstrumentanddata collectionmethodology formeasuringpatients'perspectivesonhospitalcare. PriortoHCAHPStherewasno nationalstandardforcollectingorpubliclyreporting patients'perspectivesofcare informationthatwouldenablevalidcomparisonsto bemadeacrossallhospitalstomake "applestoapples"comparisons. Alsoknown astheCAHPS®HospitalSurvey,orHospital CAHPS.http://www.hcahpsonline.org/home.aspx HCHCA TheHoustonCountyHealthCareAuthorityistheumbrellaorganizationwhich owns ACOMandSAMC. HIPPA TheHealthInsurancePortabilityandAccountabilityActof1996whichdefinesthe privacy rightsofpatientsandhealthcareinformation. ICD‐10 ICD‐10isthe10threvisionoftheInternationalStatisticalClassificationofDiseases and RelatedHealthProblems(ICD),amedicalclassificationlistbytheWorld HealthOrganization (WHO).Itcontainscodesfordiseases,signsandsymptoms, abnormalfindings,complaints, socialcircumstances,andexternalcausesofinjury ordiseases. IRB Aninstitutionalreviewboard,alsoknownasanindependentethicscommittee (IEC),ethical reviewboard(ERB)orresearchethicsboard(REB),isacommittee thathasbeenformally designatedtoapprove,monitor,andreviewbiomedical andbehavioralresearchinvolving humans.” IT(IS) JournalClub InformationTechnology(InformationSystems) Aformofeducationinwhichagroupofphysiciansdiscuss,analyze,andreviewa limited numberofarticlesfrommedicaljournals,oftenonaweeklyormonthly basis. Learning Agreement Adocumentthatthestudentandpreceptorcreatetogetheratthebeginningof aclerkshipto definelearninggoals. LetterofGood Standing Officialdocumentfromtheschoolthatstatesthatastudentisingoodacademic standingand hasnoissuespreventingthestudentfromstartingclerkships. Locumtenens Alocumphysicianisaphysicianwhoworksintheplaceoftheregularphysician whenthat physicianisabsent,orwhenahospital/practiceisshort‐staffed. LoR LetterofRecommendation LRC LearningResourceCenter TheMatch DuallyreferstotheAOAmatchwhichisadministeredbytheNMSandthe ACGMEmatch whichisadministeredbytheNRMP. Osteopathicstudentsmay registerforbothmatch processes,butifastudentismatchedintheAOAmatch (inFebruary),theyaredropped fromthesubsequentNRMPsothatthereisno possibilityofmatchingintwoprograms. MatchDay Thedatewhenstudentsfindoutiftheyhavematchedtoaresidencyprogram. MD MOA(MOU) AbbreviationforDoctorofMedicine AMemorandumofAgreement(MemorandumofUnderstanding)orcooperative agreement isadocumentwrittenbetweenpartiestocooperateonanagreed uponprojectormeetan agreedobjective. 2015–2016ACOMClinicalClerkshipManual 56 Rev.1/25/16 MSPE TheMedicalStudentPerformanceEvaluation(formerlyknownastheDean's Letter)isa comprehensiveassessmentofmedicalschoolperformancegenerally through3rdyearof medicalschool. Includesgradecomparisongraphs,class rankfortopquartilestudentsfor years1‐2andpreceptorcommentsfrom clerkships. NALS NeonatalAdvanceLifeSupport NATMATCH TheNationalMatchingServicesInc.specializesinthedevelopmentand administrationof MatchingPrograms. NATMATCHistheserviceusedinthe osteopathicmatch. https://natmatch.com/ NBME TheNationalBoardofMedicalExaminersisanindependent,not‐for‐profit organization thatservesthepublicthroughitshigh‐qualityassessmentsof healthcareprofessionals. http://www.nbme.org/ NBOME TheNationalBoardofOsteopathicMedicalExaminersistheleadingassessment organizationfortheosteopathicmedicalprofession.Itsmissionistoprotectthe publicby providingthemeanstoassesscompetenciesforosteopathicmedicine andrelatedhealth careprofessions.TheNBOMECOMLEX‐USAexaminationseries providesthepathwayto licensureforosteopathicphysiciansintheUnitedStates.http://www.nbome.org NMS NRMP TheNationalMatchingServicesspecializesinthedevelopmentand a dministrationof MatchingPrograms. NMSadministerstheAOAMatch.https://www.natmatch.com/ TheNationalResidentMatchingProgramwhichisanationalprocesstomatch medical studentsandotherapplicantswithhospitalstoobtaininternshipsand residencies. ApplicantssubmitaconfidentiallisttotheNRMPrankingtheirdesired placeofresidency. Participatinghospitalsalsoenteraconfidentiallistofthose mostdesiredapplicants. Ona uniformdate(mid‐March),alloftheapplicants andhospitalsareinformedoftheresultsof thematch.http://www.nrmp.org Off‐Cycle Student Astudentwhohashadaninterruptionintheirclerkships. OGME OsteopathicGraduateMedicalEducation OMM(OMT) OsteopathicManipulativeMedicine(OMM),alsoknownasOsteopathic Manipulative Treatment(OMT),isacoresetoftechniquesofosteopathyand osteopathicmedicine distinguishingthesefieldsfromallopathicmedicine. OPP OsteopathicPrinciplesandPracticesisthetitleoftheclasswherestudentslearn OMM (OMT). OPTI AllOGMEprogramsarepartofanOsteopathicPostdoctoralTrainingInstitution. EachOPTI isacommunity‐basedtrainingconsortiumcomprisedofatleastone collegeofosteopathic medicineandonehospitalandmayincludeadditional hospitalsandambulatorytraining facilities.http://www.osteopathic.org/inside‐aoa/Education/OGME‐development‐ initiative/Pages/what‐is‐an‐opti.aspx OSHA TheOccupationalSafetyandHealthAdministrationisanagencyoftheUnited States DepartmentofLabor.OSHA'smissionisto"assuresafeandhealthful workingconditionsfor workingmenandwomenbysettingandenforcing standardsandbyprovidingtraining, outreach,educationandassistance".https://www.osha.gov/ PA PALS PhysicianAssistant PediatricAdvancedLifeSupport 2015–2016ACOMClinicalClerkshipManual 57 Rev.1/25/16 PE Personal Statement PGY PreliminaryYear PRN RC ROL SAMC PerformanceEvaluation.SeeCOMLEXLevel‐2PE Consistsofinformationaboutthestudent’sprofessionalbackground,academic andclinical qualifications,howthedecisionwasmadetopursuemedicine, chosenspecialty,andcareer goals. PostGraduateYear Oneyearpositioninagivenfield(e.g.InternalMedicineorSurgery)usually preceding traininginanotherspecialty. Abbreviationforprorenata,aLatinphrasemeaning"asneeded." RegionalCoordinator RankOrderList SoutheastAlabamaMedicalCenter http://www.samc.org/ SARHA TheSoutheastAlabamaRuralHealthAssociatesisaprivate,non‐profit corporation establishedin1983toensuretheavailabilityofqualitymedical servicestoallresidentsof southeastAlabama. SARHAcurrentlyprovidesprimary andpreventivehealthservicesto theresidentsofBarbour,Coffee,Crenshaw, Dale,Geneva,Henry,Houston,Pikeand surroundingcounties.http://www.sarhaonline.com/ Scramble TheperiodaftertheAOAMatchinwhichstudentswhoarenotmatchedintoa programcan “scramble”tofindanavailableslot. SEAMED Selective Clerkships ShelfExam SOAP SOAPnote STAT TransitionalYear SoftwareusedbyACOMstudentstoaccesscurricularinformation. StudentsinthethirdyeararerequiredtotakeoneMedicineSelectiveandone Surgical Selective. Therearechosenfromadefinedlistofcourses. SeeCOMATorUSMLE TheSupplementalOfferandAcceptanceProgramisaprocessforunmatched studentsinthe NRMPmatchtofindresidencyprograms.http://www.nrmp.org/residency/soap/ TheSOAPnote(anacronymforsubjective,objective,assessment,andplan)isa methodof documentationemployedbyhealthcareproviderstorecordnotesin apatient'schart. AbbreviationfortheLatinwordstatim,"immediately." Oneyearpositionwithrotationsthroughvariousdisciplines(e.g.InternalMedicine, Surgery, etc.);alsoprecedestraininginotherspecialties. Traditional TheTRIprogramsinvolveaone‐yearcommitmentbetweenthestudentandthe institution Rotating foranOGME‐1internshipprogramonly. Internship(TRI) USMLE TheUnitedStatesMedicalLicensingExaminationissponsoredbyFSMBandNBME, resultsofUSMLEarereportedtomedicallicensingauthoritiesintheUnitedStates andits territoriesforuseingrantingtheinitiallicensetopracticemedicine. USMLE’sthreestepsassessaphysician’sabilitytoapplyknowledge,concepts,and principles thatareimportantinhealthanddiseaseandthatconstitutethebasis ofsafeandeffective patientcare. Allopathicmedicalstudentsarerequiredtotakethisexam. Osteopathic studentsareencouragedandmayberequiredto taketheUSMLEiftheyintendtoapplyfor allopathicprograms.http://www.usmle.org Currentminimumpassingscoresare: Step1:192Step2CK: 209Step3:190 2015–2016ACOMClinicalClerkshipManual 58 Rev.1/25/16 USMLEStep2CK ClinicalKnowledgeExam(MDEquivalenttoCEExam) USMLEStep2CS ClinicalSkillsExam(MDEquivalenttoPEExam) VideoConferencingUnit VCU VirtualMeetingRoom VMR VisitingStudent VSAS Astudentwhois“away”fromtheirhomeprogramwhiletakingelectiveclerkships. TheVisitingStudentApplicationService(VSAS®)isanAAMCapplication designedto streamlinetheapplicationprocessforsenior"away"electivesThis servicerequires studentstosubmitjustoneapplicationforallinstitutions, effectivelyreducing paperwork,miscommunication,andtime.AllCOCA accreditedAACOMmembercolleges, withrisingfourthyearclasses,areVSAS homeschools.Studentsinaccreditedschools mayuseVSAStosubmit applications. ~ACOMStudentswillhaveaccesstoVSASbeginning inMarchof thirdyear.http://www.aamc.org/students/medstudents/vsas/ 2015–2016ACOMClinicalClerkshipManual 59 Rev.1/25/16 APPENDIXH:OMS‐IICOMPETENCIES OMS‐IICOMPETENCIES Bytheendoftheirsecondyear,ACOMstudentsarefullycompetentintheareaslistedbelow,as demonstratedthroughcoursework,especiallywithinthePrimaryClinicalSkillsandFoundations of ModernHealthcarecourses. Performedand/or Evaluatedin Competencies Description SimulatedEnvironment Appearance,attire,and behavior Medicalethics Properuseofsocialmedia Professionalism & Lifelong Learning Demonstratesprofessional appearance, attire, Evaluated duringastagingprocess prior to andbehaviorduringallstandardizedpatient standardizedpatientencountersandsimulation encounters,simulationsessions,andallother sessions.AssessedinFMHCcourseaswell. workplaceenvironments Understandandcritically analyze medical ethics Completed MedScapesurvey regarding “Top 20 terms(beneficence,non‐maleficence,autonomy, MedicalEthicalDilemmasPhysiciansFace”and informedconsent)andissues Analyzedimportantcasesinsmallgroup environment Demonstrateproperuse of social media Small grouparticlepresentations and discussion Completedafterformativesessionsin preparationforOSCE’s;Createdpersonal medical oathinFMHCcourse Simulation sessions Self‐reflection Demonstratestheabilitytoself‐reflectinan accurateandmeaningfulmanner Teamwork Demonstratestheability to work as a team with otherstudents Communication Skills Utilizesspecificpatient‐centered skills in every Performed andevaluatedduring standardized patientencounter patientencounters Utilizesspecificpatient‐centered skills that are Performed andevaluatedduring standardized appropriatetothepediatric patient patient encounters TheHistory and Physical Examination Performsanaccurate and efficient focused Performed andevaluatedduring standardized historyandphysicalexamincludingaHPI, patientencounters.Studentscompleted PMFSH,andROS approximately26standardizedpatient encountersperformingafocusedhistoryand physical exam. Performed andevaluatedduring standardized Performsacompleteand accurate history and patientencounters.Studentscompleted3 physicalexamasappropriateforthepatient includingaHPI,comprehensivePMFSH comprehensivehistoryandphysicalexamona includingasexualandreproductivehistory, standardizedpatient. completeROS,andhead to toe physical exam Performsanappropriateadolescentmedical interview Utilizesappropriateresources to plot a growth Students completedapproximately 3 history and chart,determineapediatricpatient’s physicalexamsonpediatricstandardizedpatient immunizationsneeds,andprovideanticipatory encountersincludinginfants,toddlers,andolder guidance children. Performsapreparticipation physical evaluation Performed onlocalathletes at event held at under supervision ACOM Advanced Medical Interviewing Skills Demonstratesappropriate techniques to Performed andevaluatedduring standardized managingapatientexhibitingstrongemotions patientencounters includingtheuseofstatementsdemonstrating empathy,respect,support/partnership Demonstratesappropriate techniques when Performed andevaluatedduring standardized communicatingwithpatientswhoaredepressed patientencounters oranxious Patient‐centered communication Adaptingtothepediatric interview Focusedhistoryandphysical examappropriateforthe patient’schiefconcern Comprehensivehistoryand physicalexam Theadolescentinterview Thepediatricswell‐child historyandphysicalexam Preparticipationphysical evaluation Respondingtostrong emotions Communicating with depressedoranxious patients 2015–2016ACOMClinicalClerkshipManual 60 Rev.1/25/16 Competencies Communicatingwith patientsabouttobacco, alcohol,andsubstanceuse Advancedirectives Givingbadnews Communicatingneartheend oflife Generalobservation Mentalstatus Vitalsigns Skin,Hair,andNails HEENT Neck Lymphnodes Chestandlungs Cardiovascularand peripheralvascular Abdomen Anus,rectum,andprostate (tasktrainers*and standardizedpatients) Musculoskeletalincluding orthopedicmaneuvers Breast(tasktrainers*and standardizedpatients) Screeningneuroexam Femalegenitaliaandpelvic includingspeculumand bimanual(tasktrainers*and standardizedpatients) Description Demonstratesappropriate techniques to communicatewithpatientsabouttobacco, alcohol,andsubstanceuseincludingthe administrationandinterpretationofvalidated tools Demonstratestheability to discuss advanced directiveswithapatient Demonstratesappropriate techniques when communicatingwithpatients about bad news Demonstratesappropriatetechniqueswhen communicatingwithpatientswhoarenearthe endoflife Physical Exam Skills Demonstratestheabilitytomakeaccurateand meaningfulobservations regarding patients Demonstratestheability to evaluate the mental statusofapatientincludingtheadministration andinterpretationofvalidated tools Obtainsaccuratevital signs and interprets the results Performsanaccurate and thorough examination oftheskin,hair,andnails Performsanaccurateandthoroughexamination ofthehead,eyes,ears, nose, and throat Performsanaccurate and thorough examination oftheneck Performsanaccurate and thorough examination ofthelymphnodes Performsanaccurate and thorough examination ofthechestlungs Performsanaccurate and thorough examination ofthecardiovascularandperipheralvascular systems Performsanaccurate and thorough examination oftheabdomenincludinganevaluationfor peritonealsigns Performsanaccurate and thorough examination oftheanus,rectum,andprostateincludingfecal occultbloodtestingwhen indicated Performsanaccurateandthoroughexamination ofthemusculoskeletalsystemincludingthe appropriateuseoforthopedic maneuvers Performsanaccurate and thorough examination ofthebreasts Performsanaccurate and thorough examination ofneurologicalsystemincludingtheevaluation ofthecranialnerveswithafundoscopicexam, motorandsensoryexam,DTR’s,andevaluation ofcoordinationandgait Performsanaccurate and thorough examination ofthefemalegenitalia Performedand/or Evaluatedin SimulatedEnvironment Performed andevaluatedduring standardized patientencounters Performed skillsusingroleplaying Performed skillsusingroleplaying Performedskillsusingroleplaying Performedandevaluatedduringstandardized patient encounters Performed andevaluatedduring standardized patientencounters Performed andevaluatedduring standardized patientencounters Performed andevaluatedduring standardized patient encounters Performedandevaluatedduringstandardized patient encounters Performed andevaluatedduring standardized patient encounters Performed andevaluatedduring standardized patient encounters Performed andevaluatedduring standardized patientencounters Performed andevaluatedduring standardized patientencounters Performed andevaluatedduring standardized patientencounters Performed andevaluatedduring standardized patientencounters Performedandevaluatedduringstandardized patientencounters Performed andevaluatedduring standardized patient encounters Performed andevaluatedduring standardized patientencounters Performed andevaluatedduring standardized patientencounters 2015–2016ACOMClinicalClerkshipManual 61 Rev.1/25/16 Competencies Malegenitalia(standardized patients) Structuralscreeningexam Treatment Basicandadvancedairway management Bladdercatheterization (tasktrainer*) Castingandsplinting Lumbarpuncture(task trainers*) Nasogastrictubeinsertion Steriletechnique Suturing VascularincludingIVandIA puncture(tasktrainers*) EKGinterpretation Chestx‐rayinterpretation SOAPnotes Oralcasepresentation Differentialdiagnosis Researching&evaluating availableresources Point‐of‐careresources Description Performedand/or Evaluatedin SimulatedEnvironment Performsanaccurate and thorough examination Performed andevaluatedduring standardized ofthe malegenitalia patient encounters OMM Incorporatesandosteopathic structural Performed andevaluatedduring standardized screeningexamefficientlyintothephysicalexam patientencounters Providessafeandeffective osteopathic Performed andevaluatedduring standardized manipulativetreatmentintheappropriate patientencounters patient Procedural Skills Performed usingtasktrainers* Describesbasicandadvanced airway managementtechniquesanddemonstratesthese skillsonatasktrainer*. Performed usingtasktrainers* Demonstratestheappropriate technique for performingabladdercatheterizationonamale andfemalepatient Demonstratestheappropriate technique for castingandsplintinganextremity Performed usingtasktrainers* Demonstratestheappropriate technique for performingalumbar puncture Performedusingtasktrainers* Demonstratestheappropriatetechniquefor performinganasogastric tube insertion Demonstratestheappropriate use of sterile technique Performedusingtasktrainers* Demonstratestheappropriatetechniquefor suturingawound Performed usingtasktrainers* Demonstratestheappropriate technique for performinganintravenousandintra‐arterial puncture Assessed intheCardiovascular System course. Demonstrateabilityto accurately read and interpretEKGresults. Assess in theRespiratorySystem course. Demonstrateabilityto accurately read and interpretachestx‐ray. Written & Oral Communication Documentsthesubjective, objective, assessment Performed andevaluatedduring standardized andplanportionsofapatient’snoteaccurately patientencounters.Studentscompleted andconcisely approximately26SOAPnotesincluding formulationofadifferential diagnosis. Providesanaccurate and concise oral case Performed andevaluatedduring standardized presentation patientencounters Clinical Reasoning Utilizeselectronicresources to create an Performed duringsimulation debrief sessions. AlsoassessedinFMHCcourse. appropriatedifferentialdiagnosisbasedona patient’spresentingproblems Information Mastery Demonstrateshowto access and critically Participatedinjournalclub small group analyzejournalarticles,PubMed,andother experience referencesources. Performed duringsmallgroup sessions Demonstratestheappropriate use of point‐of‐ careresourcestoanswerclinicalquestions includingDynamed,Epocrates,PEPID,and UpToDate 2015–2016ACOMClinicalClerkshipManual 62 Rev.1/25/16 Competencies Description Performedand/or Evaluatedin SimulatedEnvironment Life Support Courses BasicLifeSupport(BLS) AdvancedCardiacLife Support(ACLS) Infectioncontrol Isolationprecautions Childabusereporting Legaljurisprudence HIPAA CertificateofsuccessfulcompletionthroughAHA approved program Certificate ofsuccessfulcompletion through AHA approvedprogram Guidelines for Healthcare Professionals Demonstratestheappropriateuseofuniversal CompletedOSHA‐approvedtrainingmoduleand precautionsforpreventingthetransmissionof subsequentassessment bloodborneinfections. Completed OSHA‐approved training module and Demonstratestheappropriate use of isolation subsequentassessment precautionstopreventthetransmissionof infectionssuchastuberculosisandMRSAin healthcaresettings. Certificate verifyingunderstanding of proper child abuse reportingprocedures Assessed in FMHCcoursethrough small group Demonstrateunderstanding of legal issues in the medicalprofession casepresentations Assessed in FMHCcoursethrough small group Demonstrateunderstanding of laws and guidelinesassociatedwithHIPAA casepresentations *Mosttasktrainersarelifelikemodelsofbodyparts,suchasanarmorpelvis.Alltasktrainershavetheability to breakdownaspecificskillintoitsindividualstepsasnewskillsaretaughtandlearned. 2015–2016ACOMClinicalClerkshipManual 63 Rev.1/25/16 APPENDIXI:ACOMPATIENT‐CENTEREDINTERVIEWINGEVALUATION ACOMPatient‐CenteredInterviewingEvaluation Tothestudent:Pleaseaskacorepreceptororthatpreceptor’sresidenttoobserveyourperformanceofa historyandphysicalandgiveyoufeedbackusingthisrubricasaguide. Student:________________________________________ Preceptor:__________________________________ Role:___________________________ Date:________________________________ StepOne:SetstheStagefortheInterview Signature:___________________________________ KeyElements: (Preceptor) Washeshandsonenteringroom Welcomesthepatient(demonstratesgenuineinterestinpatientasaperson) Usesthepatient’snameandasksforpreferredwayofbeingaddressed Introducesselfandidentifiesrole(firstandlastname,medicalstudent/studentphysician) MeetsExpectations DoesNotMeetExpectations StepTwo:Elicitschiefconcernandsetstheagenda KeyElements: Indicatesthetimeavailable Obtainsalistofallissuesthepatientwantstodiscuss(“Whatbringsyouintoday?”,“Isthere anythingelseyouwouldliketodiscuss?”) MeetsExpectations DoesNotMeetExpectations StepThree:Beginstheinterviewwithanopen‐endedquestionorrequest KeyElement: Startswithopen‐endedrequest/question(“Tellmeabout…”,“Tellmemore…”) MeetsExpectations DoesNotMeetExpectations StepThreecont’d:Usesnonverbalencouragement KeyElements: Smile Openbody Forwardlean Touch(referstotheuseoftouchwhenrespondingtofeelingsandemotions;handshakesand physicalexaminationdonotmeettheintentofthisitem) Eyecontact Nod MeetsExpectations DoesNotMeetExpectations StepFour:Elicitsthepersonaland/oremotionalcontext KeyElements: Elicitspersonalcontext(psychologicalandsocialcontextofthesymptom) Elicitsemotionalcontext(“Howareyoudoingwiththis?”,“Howhasthisaffectedyou emotionally?”) MeetsExpectations DoesNotMeetExpectations 2015–2016ACOMClinicalClerkshipManual 64 Rev.1/25/16 StepFourcont’d:Respondstofeelingsandemotions KeyElements: Statementsthatdemonstrateempathy:“Icancertainlyunderstandwhyyouwouldbeupset underthecircumstances.”“Anyonewouldfinethisdifficult.”“Yourreactionsareperfectly normal.”“Thiswouldbeanxiety‐provokingforanyone.”“Icanunderstandwhyyouareso angry.”“Icanseethatthisisupsettingforyou.”“Thisishardtotalkabout.” Statementsthatdemonstraterespect:“I’mimpressedbyhowwellyou’recoping.”“Iadmire yourresilience.”“Irespectthefactthatyouhavecontinuedworkinginspiteofyourpain.” Statementsthatdemonstratesupport/partnership:“IwanttohelpyouinanywaythatIcan.” “Nomatterwhathappens,IwilldowhateverIcantoassistyou.”“Let’sworktogether.” “Together,wecanworkoutsomesolutionsthatmayhelp.” MeetsExpectations DoesNotMeetExpectations StepFive:Transitiontothemiddleoftheinterview KeyElements: Ensurespatient’sreadinesstotransition(“Ifitisokaywithyou…”) Indicatesthatboththecontentandstyleoftheinterviewwillchange(“Iwouldliketoswitch gearsandaskyousomemorespecificquestions.”) Brieflysummarizesthepatient‐centeredportionoftheinterview MeetsExpectations DoesNotMeetExpectations StepSix:PhysicalExamination KeyElements: Performsosteopathicstructuralexaminationinconjunctionwithaccuratephysicalexamination appropriatetopatient’sclinicalsituation Offersspecificosteopathicmanipulativetreatmentaspartofarationaltreatmentplan MeetsExpectations DoesNotMeetExpectations StepSeven:Endoftheinterview KeyElements: Orientsthepatienttotheendoftheinterview Summarizestheinformationobtainedduringthevisit Acknowledgesrelationshipwithpatientandofferssupportbeforesayinggoodbye(“Itwasnice meetingyouandIlookforwardtoworkingtogether…”) Washeshandsbeforeleavingtheroom MeetsExpectations DoesNotMeetExpectations Professionalism KeyElements: Appearanceandattire(grooming,clothing,whitecoat,etc.) Interactionwithpatient(attitude,demeanor,behaviorintheexamroom) Inappropriatebehaviororconductasreportedbystaffi.e.showinguplatetostaging, attemptingtobypassstaging,notfollowinginstructions,etc. MeetsExpectations DoesNotMeetExpectations Studentsarerequiredtosubmitthisdocumentelectronicallyontheappropriatesoftwareplatform andstronglyencouragedtokeepacopyfortheirrecords. 2015–2016ACOMClinicalClerkshipManual 65 Rev.1/25/16 APPENDIXJ:CLERKSHIPROTATIONEVALUATIONS AlabamaCollegeofOsteopathicMedicine **Mid‐RotationEvaluation** Pleasecompletethisevaluationatthemidpointoftheclerkshiprotation.Yourcooperationismostappreciated. SectionI–CoreCompetencies: Pleaseprovidefeedbackregardingtheperformanceofthismedicalstudent.Yourresponseswillhelpthe studentimprovebyidentifyinghis/herstrengthsandweaknesses Pleasenote:Itisextremelyrareforastudenttohavemorethan2or3“ExceedsExpectations.”Foreachoftheseselected,please includecommentsinthefollowingNarrativeCommentssectionsexplaininghowthestudentExceedsExpectationsinthatcategory. DoesNot Not Exceeds Meets Meet Observable Graduate Relative Expectations Expectations Expectations Goal(s) ofanOMS‐ ofanOMS‐ to Characteristic Behavior(s) ofanOMS‐ IIIstudent IIIstudent Practice IIIstudent Knowledge, Performsaneffectivehistoryandphysicalappropriate 1,13, ☐ ☐ ☐ ☐ ClinicalSkills, 14,17, tothepatient’sclinicalsituation Behaviors,& 19,21 Canpresentaconcise,accurateoralreport ☐ ☐ ☐ ☐ Attitudes Knowledge, 3,5,8, Utilizeslabandimagingappropriatelytoidentifycause ClinicalSkills, ☐ ☐ ☐ ☐ Behaviors,& 15,21 ofapatient'sproblem(s) Attitudes Createsanappropriatedifferentialdiagnosisbasedon ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Demonstrateshighethicalstandardswithempathy, honesty,andprofessionalism ☐ ☐ ☐ ☐ Demonstratesabilitytoself‐reflectappropriately ☐ ☐ ☐ ☐ 10,11 Demonstratesunderstandingandcompassionofsocial issuesandutilizesthisinpatientcare ☐ ☐ ☐ ☐ 11,12, 22,24, 26,28 Treatsallpatientsfairlyandcompassionatelyregardless ofhealthstatus,financialstanding,culturalbackground, orbeliefsystem ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 2015–2016ACOMClinicalClerkshipManual 66 Knowledge, ClinicalSkills, Behaviors,& Attitudes 3.4,5,7, thepatient'sproblems 15,17, Usesclinicalpathwaysandalgorithmswhen 18,21, appropriate 30 Usesstructuraldiagnostictechniqueswhenappropriate 1‐6,8, 15,17 Knowledge& ClinicalSkills Knowledge, ClinicalSkills, Behaviors,& Attitudes Knowledge, ClinicalSkills, Behaviors,& Attitudes Knowledge& ClinicalSkills Knowledge, ClinicalSkills, Behaviors,& Attitudes Demonstratesprioritizationofcriticalfindingsandlab abnormalitiesinordertoappropriatelyaddressa patient'sproblems Accuratelyaddressestheacuityofillnessforan individualpatientandcraftsanappropriatetreatment. 4,6,7,8, Canreference,interpret,andapplyknowledgeresources 20,25 inordertoaddressapatient’sclinicalproblem(s). 9,24, 25,27 Knowledge& ClinicalSkills 7,16, 22,28 Behaviors& Attitudes 23,27, 29 Knowledge, ClinicalSkills, Behaviors,& Attitudes 11,31, 32 Demonstratesappropriateuseofavailableelectronic resourceswhileconsistentlyapproachingthepatientin apersonable,compassionatemanner. Conductsallinteractionswithstaff,faculty,etc.withthe samelevelofrespectandhonesty,asappropriateto student’sroleonthehealthcareteam Demonstratesagenuineinterestinlearningaboutthe patient'sclinicalandbiopsychosocialsituation,andthen applieshealthcareandcommunityresources appropriately Rev.1/25/16 SectionII–NarrativeComments: Whatarethestudent’sparticularstrengths? Inwhatareasdoesthestudentneedtoimprove?PLEASElistanydeficitsthatthestudentshould addressimmediately. SectionIII–NarrativeCommentsfortheStudent’sMedicalStudentPerformanceEvaluation(MSPE) FormerlyknownastheDean’sLetterofEvaluation Whatcommentswouldyouliketoincludeinthestudent’sMSPE(Dean’sLetterofEvaluation)? SectionIV–GutCheck Atthispoint,whatlettergradedoesyour“gut”tellyouthisstudentdeserves? A B C F ________________________________________________________ __________________________________ PreceptorSignature Date ________________________________________________________ __________________________________ StudentSignature Date ThankyouforthetimeandhardworkyoudevotetowardtheeducationofACOMstudents. Yourfeedbackishighlyvaluabletotheprogram. 2015–2016ACOMClinicalClerkshipManual 67 Rev.1/25/16 APPENDIXG:CLERKSHIPROTATIONEVALUATIONS AlabamaCollegeofOsteopathicMedicine PreceptorEvaluationofStudent Pleasecompletethisevaluationwithin3daysofthestudent’slastdaywithyou.Thestudentmayneedthis evaluationcompletedinordertobeeligibleforcertainelectiverotations.Yourcooperationismostappreciated. SectionI–CoreCompetencies: Pleaseprovidefeedbackregardingtheperformanceofthismedicalstudent.Yourresponseswillhelpthe studentimprovebyidentifyinghis/herstrengthsandweaknesses. Pleasenote:Itisextremelyrareforastudenttohavemorethan2or3“ExceedsExpectations.”Foreachoftheseselected,please includecommentsinthefollowingNarrativeCommentssectionsexplaininghowthestudentExceedsExpectationsinthatcategory. DoesNot Not Exceeds Meets Meet Observable Graduate Relative Expectations Expectations Expectations Goal(s) ofanOMS‐ ofanOMS‐ to Characteristic Behavior(s) ofanOMS‐ IIIstudent IIIstudent Practice IIIstudent Knowledge, Performsaneffectivehistoryandphysicalappropriate 1,13, ☐ ☐ ☐ ☐ ClinicalSkills, 14,17, tothepatient’sclinicalsituation Behaviors,& 19,21 Canpresentaconcise,accurateoralreport ☐ ☐ ☐ ☐ Attitudes Knowledge, 3,5,8, Utilizeslabandimagingappropriatelytoidentifycause ClinicalSkills, ☐ ☐ ☐ ☐ Behaviors,& 15,21 ofapatient'sproblem(s) Attitudes Createsanappropriatedifferentialdiagnosisbasedon ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Demonstrateshighethicalstandardswithempathy, honesty,andprofessionalism ☐ ☐ ☐ ☐ Demonstratesabilitytoself‐reflectappropriately ☐ ☐ ☐ ☐ 10,11 Demonstratesunderstandingandcompassionofsocial issuesandutilizesthisinpatientcare ☐ ☐ ☐ ☐ 11,12, 22,24, 26,28 Treatsallpatientsfairlyandcompassionatelyregardless ofhealthstatus,financialstanding,culturalbackground, orbeliefsystem ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 2015–2016ACOMClinicalClerkshipManual 68 Knowledge, ClinicalSkills, Behaviors,& Attitudes 3.4,5,7, thepatient'sproblems 15,17, Usesclinicalpathwaysandalgorithmswhen 18,21, appropriate 30 Usesstructuraldiagnostictechniqueswhenappropriate 1‐6,8, 15,17 Knowledge& ClinicalSkills Knowledge, ClinicalSkills, Behaviors,& Attitudes Knowledge, ClinicalSkills, Behaviors,& Attitudes Knowledge& ClinicalSkills Knowledge, ClinicalSkills, Behaviors,& Attitudes Demonstratesprioritizationofcriticalfindingsandlab abnormalitiesinordertoappropriatelyaddressa patient'sproblems Accuratelyaddressestheacuityofillnessforan individualpatientandcraftsanappropriatetreatment. 4,6,7,8, Canreference,interpret,andapplyknowledgeresources 20,25 inordertoaddressapatient’sclinicalproblem(s). 9,24, 25,27 Knowledge& ClinicalSkills 7,16, 22,28 Behaviors& Attitudes 23,27, 29 Knowledge, ClinicalSkills, Behaviors,& Attitudes 11,31, 32 Demonstratesappropriateuseofavailableelectronic resourceswhileconsistentlyapproachingthepatientin apersonable,compassionatemanner. Conductsallinteractionswithstaff,faculty,etc.withthe samelevelofrespectandhonesty,asappropriateto student’sroleonthehealthcareteam Demonstratesagenuineinterestinlearningaboutthe patient'sclinicalandbiopsychosocialsituation,andthen applieshealthcareandcommunityresources appropriately Rev.1/25/16 SectionII–NarrativeComments: Whatarethestudent’sparticularstrengths? Inwhatareasdoesthestudentneedtoimprove?PLEASElistanydeficitsthatthestudentshould addressimmediately. SectionIII–NarrativeCommentsfortheStudent’sMedicalStudentPerformanceEvaluation(MSPE) FormerlyknownastheDean’sLetterofEvaluation Whatcommentswouldyouliketoincludeinthestudent’sMSPE(Dean’sLetterofEvaluation)? SectionIV–GutCheck Whatlettergradedoesyour“gut”tellyouthisstudentdeserves? A B C F ________________________________________________________ __________________________________ PreceptorSignature Date ________________________________________________________ __________________________________ StudentSignature Date ThankyouforthetimeandhardworkyoudevotetowardtheeducationofACOMstudents. Yourfeedbackishighlyvaluabletotheprogram. 2015–2016ACOMClinicalClerkshipManual 69 Rev.1/25/16 APPENDIXG:CLERKSHIPROTATIONEVALUATIONS AlabamaCollegeofOsteopathicMedicine End‐of‐ClerkshipSurvey Pleasecompletethissurveyby3pmonthelastdayofeachcorerotation. StudentEvaluationofSite: 1. Whatarethemainstrengthsatthisclerkshiprotationsite? 2. Whatarethegreatestchallengesatthisclerkshiprotationsite? 3. Whatelsewouldyouliketoseeatthisclerkshiprotationsite? 4. Whatcommentscanyouofferaboutyourworkingand/orlivingexperiencesatthisclerkship rotationsite? StudentEvaluationofPreceptor: 5. Whatwereyourpreceptor’sgreateststrengths? 6. Whatwerethechallengesyouandyourpreceptorfacedregardingyourlearningneeds? 7. Describethequalityoftheorientationprovidedbyyourpreceptor.Whatwasdiscussed? 8. Whatwasthevolumeofpatientsforwhichyoucared? 9. Wasthescopeofpatientproblemsadequatetomeetthegoalsandobjectivesoftheclerkship rotation? 2015–2016ACOMClinicalClerkshipManual 70 Rev.1/25/16 10. Wereyouropportunitiestoperformpatientcare/procedures/documentationatthelevelyou neededinordertolearn?Explain. StudentEvaluationofClerkshipRotation: 11. Wereyouabletomeettheeducationalobjectivesthatyouandyourpreceptoragreedtoinyour LearningAgreement? 12. Whatdidyoulikemostaboutthisclerkshiprotation?Explain. 13. Whatwerethegreatestchallengesyoufacedduringthisclerkshiprotation? 14. Doyouhaveanyothercommentsaboutthedesign/implementationofthisclerkshiprotation? StudentEvaluationofOsteopathicOpportunities: 15. Didyouincorporatecomponentsoftheosteopathicstructuralexamintothediagnosesofyour patientsthisrotation?Explain. 16. DidyouperformOMTonanyofyourpatientsthisrotation?Explain. StudentEvaluationofLibraryAccess: 17. Pleaseratetheeaseofuseinaccessing libraryresourcesinthefollowingvenues: Needs Improvement Adequate Good Excellent a) Atthebedside ☐ ☐ ☐ ☐ b) Onrounds ☐ ☐ ☐ ☐ c) Withpreceptors ☐ ☐ ☐ ☐ d) Afterhours ☐ ☐ ☐ ☐ 2015–2016ACOMClinicalClerkshipManual 71 Rev.1/25/16 Needs Improvement Adequate Good Excellent a) Atthebedside ☐ ☐ ☐ ☐ b) Onrounds ☐ ☐ ☐ ☐ c) Withpreceptors ☐ ☐ ☐ ☐ d) Afterhours ☐ ☐ ☐ ☐ 18. Pleaseratetheusefulnessofaccessed informationinmeetingclerkship/patient careobjectivesinthefollowingvenues: Other (please specify) Computer Mobile phone iPad mini e) Atthebedside ☐ ☐ ☐ ☐ f) Onrounds ☐ ☐ ☐ ☐ g) Withpreceptors ☐ ☐ ☐ ☐ h) Afterhours ☐ ☐ ☐ ☐ 19. Pleasetelluswhichdeviceyouusemost frequentlytoaccessrelevantclinical informationinthefollowingvenues: 20. Whatarethemostfrequentbarrierstoaccessingclinicalinformation? 21. Whataresomesuggestionsforimprovingaccesstolibraryinformationneededduring clerkships? Thankyouforyourparticipation.Yourfeedbackhelpsusworkcontinuouslytoimproveyour educationalexperience. 2015–2016ACOMClinicalClerkshipManual 72 Rev.1/25/16 APPENDIXG:CLERKSHIPROTATIONEVALUATIONS AlabamaCollegeofOsteopathicMedicine AnnualSiteSurvey PleasecompletethissurveybyJune1. CoreSite:___________________________________________________________ Pleaseratethefollowingaspectsofyourcoresitefacility: 1. 2. 3. 4. 5. 6. 7. 8. Howwouldyouratetheteachingatthissite? Howwouldyouratethelodgingatthissite? Howwouldyouratetheareasforroundsatthissite? Howwouldyouratetheareasforindividual/group studyatthissite? Howwouldyouratethevideoconferenceareaatthis site? Howwouldyourateyouraccesstorequired technologywhileatthissite? Howwouldyouratethesupportyoureceivedfrom thecoresitecoordinator? Howwouldyouratethissiteoverall? Needs Adequate Good Improvement Excellent ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ Pleaseanswerthefollowingquestionsregardingyourcoresitefacility: 9. Whatstrengthsdidyounoticeregardingthecoresiteadministration? 10. Whatchallengesdidyoufacewhenworkingwiththecoresiteadministration? 11. Whatstrengthsdidyounoticeregardingtheworkareasforrounds/meetings/study? 12. Whatchallengesdidyoufaceregardingtheworkareasforrounds/meetings/study? 13. Describeanynoteworthyexperiencesregardingaccessortechnology. 14. Whatweretheoverallstrengthsofthisclerkshiprotationsite? 2015–2016ACOMClinicalClerkshipManual 73 Rev.1/25/16 15. Whatweretheoverallchallengesofthisclerkshiprotationsite? 16. Howwouldyouratethissiteoverall? Pleaseanswerthefollowingquestionsregardingyour overalleducationexperienceatthissite: 17. Pleaseprovideanyfeedbackyouhaveregardingpreceptorsatthissite,sitedirector,and/orsite coordinator. 18. Pleasedescribetheopportunitiesyouhad forlearningatthissite(journalclub,tumorboard,grand rounds,etc.). Pleaseanswerthefollowingquestionsregardingyoureducationallocation(s): 19. Didyouspendanyofyourcorerotationsinaneducationallocation?Ifso,listthembelow. 20. Whatstrengthsdidyounoticeregardingtheeducationallocation(s)? 21. Whatchallengesdidyoufacewhenworkingattheeducationallocation(s)? 22. Howwouldyouratetheeducationallocation(s)overall? Thankyouforyourparticipation.Yourfeedbackhelpsusworkcontinuouslytoimproveyour educationalexperience. 2015–2016ACOMClinicalClerkshipManual 74 Rev.1/25/16
