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Course Requirements, Assessment & Grading, Schedule


​Course Requirements

At all hospitals, you will be assigned to a team and you are expected to become an integral member of the team. Direct patient care under the guidance and supervision of your intern, resident and/ or attending is the most important aspect of this rotation. The more responsibility you take for your patients, the more you will learn and the more you will be taught. Students are excused to attend conferences, Foundations of Doctoring preceptor sessions, TBL sessions, and Professor’s Rounds; otherwise you should be engaging in the care of your patients and the rest of the patients on your team. 

At most hospitals, teams admit every day following a drip or rotation scheme. You will discuss with your resident which patients you will care for and you are expected to perform a complete medical evaluation, including a complete history, physical examination, and write-up. The resident and attending should encourage you to function as the primary physician for the patients you work up.  You are responsible for evaluating the patient daily before attending rounds (i.e. pre-rounding), including the collection of overnight events, review of the chart, test results, and daily history and physical examination. You should assist the ward team with the daily management of the patient.  You should try to arrange with any consulting services that you be present when the patient is discussed with the faculty consultant.  You should try to attend subspecialty conferences at which your patients are discussed and any procedures that are performed on your patients.​ 

 

Assessment & Grading

Overview of Grading:  The student’s clerkship grade includes the following components:

  • Clinical Grade 65%
  • Written Exam 15%
  • TBL Sessions 15%
  • Professionalism 5% 

Clinical Grade: The clerkship director will review all medical student evaluation forms for inconsistencies and appropriateness of ratings. Evaluations which appear to be incongruent with the student’s expected level of performance (either better or worse) will be discussed with the evaluator (attending or resident) and changes in the evaluation will be made as dictated by that discussion. 

Ultimately, the clerkship director reserves the right to assign the final grade based on all the information available. This grade will not be dictated solely by the clinical evaluation form ratings, but rather will include a broad assessment of a student’s achievement on all the required competencies described in the clerkship description. 

The weighting of the evaluations is as follows:

  • Attending: 50%
  • Resident: 33%
  • Intern: 17% 

Shelf Exam: We use the NBME Internal Medicine Shelf Examination. Students must achieve a score of 57% or higher in order to pass the written exam.  You must achieve the national mean (73%) or better on the exam in order to qualify for a grade of Honors. 

TBL Sessions:  TBL comprises 15% of the overall HAC grade.  This 15% consists of the following:

  • 5%: Cumulative iRAT score
  • 5%: Cumulative tRAT score
  • 5%: Completion of peer feedback through New Innovations 

Professionalism: Five percent of your overall grade will be tied to professional behavior throughout the clerkship. This includes being on time to all required sessions (TBL, orientations, etc.), submitting all requirements on time, and working professionally within the hospital and with the clerkship leadership. If for any reason students do not fulfill the professionalism requirements or are otherwise deemed to have had unprofessional behavior during the clerkship, this 5% will be taken away at the discretion of the clerkship director and coordinator. 

Grading Committee:  At the end of the block, a committee from the Department translates the combined evaluation into a grade. This committee consists of the course director, Dr. Christopher King, representatives of affiliated hospital sites and the chief medical residents. A grade of Honors is awarded to approximately the top 20% of students. A description of the grades follows: 

  • H-Student demonstrates advanced level of performance/ competency in course requirements. 
  • HP-Student demonstrates above expected level of performance/ competency in course requirements.
  • P- Student demonstrates expected level of performance/ competency in course requirements. 
  • F- Student does not demonstrate expected level of performance/ competency in course requirements.  
  • PR-Student demonstrates expected performance/ competency in the course requirements after remediation. 
  • IP- Student is unable to complete requirements for a block due to illness or extenuating experiences. 
  • I – Student is unable to complete requirements with a less than passing grade at the completion of the block.   

Qualification for Honors:  You must meet the national mean on the exam to qualify for Honors.  If the rest of your performance on HAC is at the Honors level and you do not meet the mean, you will receive a High Pass as your final grade. 

Qualification for High Pass:  You must pass the exam on the first attempt.  Any student needing to repeat the exam will receive a maximum score of Pass for the block.

 

Schedule

This block consists of one 8 week course. It is divided into two 4-week segments with 1 intra-session day held on the Friday of the 4th week.

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