For successful completion of the Medicine Inpatient Clerkship, students must:
- complete all Graded Components:
• Preceptor Evaluation of Students (submitted via one45)
• Observed H&P (turn evaluation in to Clerkship Office)
• Graded H&P Write-Up (turn in to Clerkship Office)
• UNC Medicine Exam (Parts 1 and 2)
• NBME Subtest (Shelf Exam)
- complete all Pass/Fail Components:
• Five History and Physical Write-Ups (turn in to Clerkship Office)
• Admission Orders form
• Humanities in Medicine seminar / Critical Incident Report
- complete the preceptor and clerkship evaluation forms via one45
- complete the Clinical Log (on one45)
- participate appropriately in patient care activities
- demonstrate appropriate professional conduct
Students should complete the Exit Checklist to make sure all requirements are met.
Preceptor (Attending, Resident and Intern) Evaluation of Students
The following recommendations should make the evaluation process more timely, efficient, and productive:
- For each of the two 3-week rotations of the clerkship, students must submit at least one attending evaluation (may submit more than one from each rotation if desired), plus one evaluation completed by their supervising resident and one completed by the intern.
- Students working with more than one attending on a service should submit the evaluation from the preceptor who worked with the student the longest. If equal time was spent with different attendings, the student can choose which evaluation they would like to submit. If more than one attending evaluation is submitted, the evaluations will be averaged together (but we will include the comments from both in the written summary).
- Students must schedule a 10-minute mid-rotation evaluation session with their attendings for an interim assessment of their progress. It is the responsibility of the students to arrange this. Consider using a paper copy of the student evaluation form and the RIME framework to help guide the assessment. This session should also include a review of the student’s progress on the Patient Log (see below).
- Students must schedule a 10-minute session with their attending and residents at the end of each rotation for a final evaluation of their performance. The attending and residents will complete the evaluations forms on one45.
- Evaluators may send any additional confidential comments to the Clerkship office.
During the 6-week Medicine Inpatient Clerkship, one of the student’s attendings or fellows (not intern or resident) must spend at least 30-60 minutes directly observing the student perform a complete history and physical examination. The student will then present the patient to the attending or fellow. It is recommended that students try to complete this requirement during the first rotation of the clerkship to allow enough time for correcting any deficiencies. This exercise can be repeated as often as desired and the student may choose which evaluation to submit to the Clerkship office. Students should meet with their attending and/or fellow early in the rotation to plan a good time for the evaluation. Students need to return the evaluation form to Carol Carden’s office before the last day of the clerkship.
Case Write-ups: Complete History and Physical Examinations
Students are required to complete and submit to the clerkship office five (5) detailed history and physical examinations (including a problem list, differential diagnoses and a patient-oriented assessment that includes a diagnostic and therapeutic plan for each of the patient’s active problems). These H&Ps should represent a medical history and physical examination actually performed by the medical student. While students are only required to turn in five H&Ps, all students will write many more than the required number. All H&Ps should be given to the ward attending for evaluation and constructive comments. The ward attending must sign each H&P. Students should then turn in five signed H&Ps to the clerkship office. The H&Ps are due in Carol Carden’s office by the last day of the clerkship. Students not completing this assignment will have their grade reduced one grade level.
As part of your clerkship grade, one of the H&Ps (selected by you) will be graded by Dr. Klipstein using specific evaluation criteria. This H&P must completed and submitted to Carol Carden’s office by the last day of the clerkship. More H&P information is available here.
Students will hand write a set of admission orders for (at least) one patient. Students are then required to review these orders with their resident who will provide specific feedback using the Admission Orders form. The main goals of this exercise are for students to include all the key components of admission orders and to demonstrate appropriate clinical reasoning and the ability to see “the next steps” in the diagnostic and treatment plans of their patients.
Humanities in Medicine seminar / Critical Incident Report (CIR)
Writing a Critical Incident Report (CIR) and participating in the Humanities in Medicine Seminar will give you a chance to reflect with your classmates on incidents that spark a visceral reaction in you during the clerkship. See here for more information.
UNC Medicine Exam (Parts 1 and 2)
The UNC Medicine Exam is based on topics covered in several core lectures during the clerkship: diagnostic and therapeutic reasoning during the first 3-week rotation and interpretation of Chest Xrays and EKGs during the second 3-week rotation. Part 1 will be given on the last day of the first 3-week rotation and Part 2 will be given on the Monday (or perhaps Tuesday) of the last week of the clerkship. Students rotating at AHEC sites will take the exams at their AHEC site; students at UNC will take the exam in Chapel Hill. You will be informed during the rotations about the exact time and location of the exams. More information about the UNC Medicine Exam is available here.
NBME – National Board of Medical Examiners Shelf Test
The NBME Shelf test will be administered on the last day of the clerkship. All students are required to take this test and to receive a score that is at or above the 10th percentile based on the appropriate national quarterly norms provided by the NBME. Sample questions from the NBME (see pages 72-77, answers are on page 78)
Students must complete the Clinical Log on one45. Your progress on completing the Log will be assessed at your mid-clerkship meeting.