Academics

Third Year Clerkships

The goal of the required clerkships is to expose students to the wide range of clinical activities associated with each discipline. Students master core competencies unique to each clerkship as well as general communication and professionalism competencies that are observed in all. The majority of the inpatient experiences take place at the University of Chicago Medicine or NorthShore University HealthSystem's Evanston Hospital Campus (with the exception of Family Medicine, which is located at MacNeal Hospital in a nearby suburb). Outpatient experiences can be in a variety of clinics around the Chicagoland area, but tend to be concentrated in the University of Chicago outpatient clinics.

Internal Medicine (12 weeks)

Description

The Medicine clerkship is a three-month rotation that includes both inpatient and outpatient experiences. The goal of the rotation is to provide students with a foundation of knowledge in general internal medicine necessary to practice in any medical or surgical specialty. The rotation includes a two-week elective piece during which students may choose to concentrate on an experience in a related subspecialty.

During the twelve week clerkship, students rotate on services at the University of Chicago Medical Center and Evanston Hospital, part of the NorthShore University HealthSystem.  Students will spend 1-2 months on inpatient general medicine services and 2-4 weeks on hematology/oncology and/or cardiology services. All students will participate in a 12-week, longitudinal ambulatory experience with a University of Chicago Department of Medicine faculty member. The 2-week elective experience includes options to rotate in medicine subspecialties and related specialties such as radiology, physical medicine and rehabilitation, dermatology, emergency medicine and radiation oncology.

During each of the core rotations, students function as active members of the ward team and assume a prominent role in the management of the patients. Students also meet weekly in small groups with a faculty preceptor. In addition to teaching responsibilities, the preceptor has primary responsibility for monitoring the progress of each student during the clerkship. The preceptor is a person to whom students can turn if problems arise during the clerkship. The course directors are also readily available in case of problems.

Available teaching conferences include Resident Morning report, the Medical Morbidity and Mortality Conference and Medical Grand Rounds. Teaching conferences provided specifically for students include 5 days set aside for case-based discussion sessions and didactic lectures as well as an EKG lecture series.

Clinical Evaluation

Students are evaluated in several areas, including the quality of written and oral presentations, clinical reasoning skill, general fund of knowledge, the ability to interact with patients and colleagues, reliability in caring for patients, and humanistic qualities. Feedback about each student’s clinical performance is solicited from physicians with whom the student works. Course directors encourage each attending and housestaff physician to meet personally with each student in order to provide feedback.

Objectives

The primary objective of the medicine clerkship is to gain insight into clinical principles and practice of internal medicine. Expectations regarding oral and written case presentations, number of cases to be seen and preceptor group participation are all explicitly stated during the orientation at the start of the rotation.

Evaluation of Clinical Clerks

Students receive grades of Honors, High Pass, or Pass for performances at the Manager, Interpreter, or Reporter level respectively. The breakdown of the grades are as follows:

Medicine Grade
  • Inpatient evaluations -  35%
  • OSCEs - 20%
  • Ambulatory evaluation - 15%
  • NBME Shelf Exam - 15%
  • Observed patient encounter - 10%
  • Presentation - 5%
  • Electives - Pass/Fail
  • Preceptor Group - Pass/Fail

Recommended Textbooks

  • Symptom to Diagnosis: An Evidence Based Guide, Third Edition 2015. Stern, Cifu, Altkorn
  • Clerkship Preceptor Group and Ambulatory Syllabus
  • EKG Interpretation, Dale Dubin

Surgery and Perioperative Medicine and Pain Management (12 weeks)

Description

This clerkship is divided into four phases: four weeks of a General surgery service or Trauma, two weeks on two specialty services, and two weeks of anesthesiology.  At the UCH, there are four General surgery services. Trauma Service, and a large number of surgery subspecialty services.  Each handles patients with diseases classically associated with General surgery , Trauma, or the surgical subspecialty area.  However, there are various emphases from service to service, and the student should familiarize him/herself with these subspecialty emphases if the student has a particular interest in such areas as breast surgery, transplantation surgery, endocrine surgery, etc.  Students may also choose to do general surgery at NorthShore University Health System’s Evanston Hospital Campus, Evanston, IL where the service is more general and students have an opportunity to see a more diverse spectrum of cases. 

Students are considered a part of the team and are encouraged to participate actively in ward rounds, inpatient care, outpatient clinics, and the surgery of patients on his/her service.  Students are encouraged to do outside reading and to attend the various weekly surgical conferences.  A lecture series will be held at the U of C for all students, with students in Evanston participating via video conferencing.  The lectures will run from 6:45am-7:30am on Mondays, Tuesdays, Thursdays and Fridays.  Students also participate in case presentations at both sites.

Clinical Evaluation

A student’s clinical performance is evaluated and graded by the faculty and residents at U of C and Evanston who work with the student on each rotation.  They are asked to evaluate the student in several areas, including clinical acumen, interpersonal skills, professionalism and general knowledge. A written consensus evaluation is submitted to the departmental office by the designated faculty coordinator for that service.

Objectives

To expose students to the medical management of surgical patients and basic surgical techniques.  To provide students an opportunity to participate in peri-operative care as well as operative procedures.  Provide a didactic experience centered around management of surgical diseases and to give students an opportunity for evaluation of surgical inpatients and outpatients.

Surgery Grade

  • Clinical Performance - 60%
  • NBME ShelfExam - 20%
  • OSCE - 7%
  • Oral Exam - 10%
  • Case Log Completion - 3%

Required Textbooks

  • NMS Surgery Casebook by Bruce E Jarrell
  • Cope’s Diagnosis of Acute Abdomen by William Silen

Recommended Textbooks

  • Learning Surgery: The Surgery Clerkship Manual by Stephan F. Lowry
  • Blueprints Clinical Cases: Surgery by Michele Li

Pediatrics (6 weeks)

Description

The Pediatrics clerkship is a six week rotation. Three weeks are spent on one or more inpatient units, which could be at Comer Children's Hospital, NorthShore University HealthSystem, or La Rabida Children's Hospital.   Three days are spent in the Mother Baby Unit at the University of Chicago, and the remaining two and a half weeks are spent at an outpatient pediatrics office, some of which are off-site. We will send an electronic survey before the start of the rotation asking for location preferences and will try our best to accommodate them.

Regardless of site, Tuesday or Thursday and one Wednesday afternoon are our main teaching days. We also have an interactive experience at the Smart Museum on observational skills. Depending on the site, students are also invited and expected to take part in our resident morning and noon conferences.

Clinical Evaluation

70 percent of a student’s grade is comprised of their faculty evaluations on the outpatient, inpatient and general care nursery. Attending’s evaluate the student in several areas, including medical knowledge; proficiency in the history and physical exam; history gathering; communication of clinical data; interpersonal communication skills; practice based learning and improvement; inter-professional collaboration; teamwork; health promotion and prevention and professionalism. 25 percent of the grade is based on their performance on the Shelf Exam, and 5 percent of the grade is comprised of their demonstrated professionalism skills including completion of their Procedure encounter log on a timely basis.

Objectives

  • To learn to perform a pediatric-specific history and physical in both inpatient and outpatient settings for all ages: newborn, toddler, school-age and adolescent.
  • To learn child growth and development from birth through adolescence.
  • To become familiar with working within a family structure with your patients.
  • To learn about the common childhood illnesses and disorders, how to evaluate them, and how to treat them.

Pediatrics Grade

  • Clinical Peformance - 60%
  • NBME Shelf Exam - 25%
  • General Care Nursery - 10%
  • Professionalism - 5%

Recommended Textbooks

There is no one specific assigned textbook, but we do encourage some independent study using a review book in preparation for the end of clerkship Shelf Exam.  We have several recommended articles posted on the MedHub site for students to refer to.  In addition, the students have access to CLIPP (Computer-assisted Learning in Pediatrics Program, (www.aquifer.org), an outstanding online teaching tool that has 30 virtual pediatric cases (12 specific cases are mandatory). Last but perhaps most useful, the pediatric clerkship website (https://pedclerk.sites.uchicago.edu) is a fantastic pooled resource of current literature on a variety of general pediatrics topics you may encounter on the rotation. 

Obstetrics and Gynecology (6 weeks)

Description

The Obstetrics and Gynecology clerkship is a six week primarily inpatient experience, performed at either the University of Chicago or NorthShore University HealthSystem. Students at both hospitals spend three weeks each on the Obstetrics service and a gynecologic surgery service. Students at NorthShore will have a primarily low-risk OB and general gynecology experience, whereas students at the U of C see primarily high-risk obstetrics and rotate on either the benign gynecology or gyn-oncology surgical service. Students who rotate at NorthShore will remain at NorthShore for their entire clerkship, except orientation day and exam day, the final day of the clerkship.

The inpatient portion of the Obstetric service (OBS) comprises caring for pregnant patients who are hospitalized for complications of pregnancy, and for postpartum patients. Labor and Delivery is where the student will follow patients in labor and participate in their delivery. It is a fast-paced experience and consists of 12-hour shifts. All students will also take at least one 12 hour weekend call during the rotation, with option for more call experience based on interest.

During their inpatient gynecology rotation, students will scrub on surgical cases, care for post-operative patients, see ER consultations with their team and attend morning attending rounds. Students at the U of C will be assigned to either the benign gynecology service or the gyn-oncology service; NorthShore students may be assigned to benign or oncology cases depending on case load.

Each student at both sites will also be assigned an individual faculty preceptor. This preceptor will provide individual evaluation of clinical skills, and will mentor the student in the outpatient setting. Students will attend at least one half-day of outpatient clinic per week with their preceptor. In addition, students on the OB service at the U of C will spend 1-2 half-days per week in the high risk obstetrics clinic. Other opportunities for outpatient exposure will vary by site.

Didactic sessions will be held throughout the week at the individual sites. Some of these lectures will be video conferenced; others may be available on-line for individual viewing. Other required didactic activities will include on-line case studies, presentations to the chair and required reading from the text listed below.

Clinical Evaluation

Clinical performance is evaluated by the residents and faculty who work with the students on each rotation, as well as the student’s faculty preceptor.  Students provide evaluation cards to the residents and faculty with whom they have worked most; these evaluation cards provide both quantitative and qualitative feedback to the clerkship director, who determines a composite clinical grade. This grade, in conjunction with the preceptor’s clinical skills assessment, accounts for 60% of the overall grade for the clerkship. Performance on the shelf and oral exam, completion of online clinical cases and the experience passport account for the remainder of the final clerkship grade.

Objectives

At the end of the OB/GYN rotation, students should:

  • Understand the basic concepts surrounding reproduction, the physiologic changes of pregnancy, common obstetric complications, the process of labor and delivery and the immediate post-partum period
  • Demonstrate physical exam skills necessary to perform a pelvic exam, an exam of a pregnant woman in prenatal care and in labor, and have participated in at least one vaginal and one cesarean delivery
  • Understand the fundamentals of common gynecologic issues, including generation of a gynecologic differential diagnosis and understanding of basic treatment options both surgical and non-surgical
  • Understand the epidemiology, anatomy, screening and diagnosis of common gynecologic cancers

Obstetrics and Gynecology Grade

  • Clinical Performance - 50%
  • NBME Shelf Exam - 25%
  • OSCE - 15%
  • Case-Based Learning Sessions - 5%
  • Procedure/Case Log Completion - 5%

Required Textbook

  • Beckmann et al, Obstetrics and Gynecology; available in the campus bookstore

Psychiatry (4 weeks)

Description

The psychiatry clerkship is a four week experience that combines hospital-based work with outpatient experiences.  Three primary site assignments are available including the consultation-liaison service at University of Chicago, the community inpatient service at Northshore, and the academic inpatient service.  Each site includes University of Chicago faculty and residents.  Each site features one or two half days of clinic experiences each week.  Students also have call responsibilities a few times during the rotation that allow them to experience emergency psychiatry.

The Clerkship Sites

  • University of Chicago Medical Center (UCMC) – Primary assignment on the adult consultation-liaison (CL) psychiatry service that provides assessment and consultation to patients and physicians on UCMC medical, surgical, and subspecialty units.
  • Evanston Hospital – Primary assignment on the adult inpatient unit providing psychiatric care to both general psychiatry and dual diagnosis patients.
  • Ingalls Hospital - 
  • University of Chicago outpatient clinics – Students are assigned to weekly outpatient clinics including general adult clinics, neuropsychiatry clinic, our clinics for patients with schizophrenia, and child psychiatry clinics.

Objectives

The goal of the clerkship is to impart basic psychiatric skills and a fund of knowledge that will provide students with the tools necessary to detect and manage common mental disorders as future physicians.  Broad areas of skills include interviewing techniques, including history-taking and mental status examination of psychiatric symptoms and signs; development of psychiatric differential diagnoses and a formulation of patients’ psychiatric illness; and formulation of psychiatric treatment options, including pharmacotherapy and psychotherapy.  The fund of knowledge students must acquire includes the epidemiology, phenomenology, pathophysiology, treatment, and course of psychiatric disorders.  At the end of the rotation, mastery of these skills and areas of knowledge is assessed through written evaluations by faculty and residents of the student’s clinical performance during the clerkship, by a NBME “shelf” subject examination, and by a standardized patient exam.  More information can be obtained at our website: - - > link to Psychiatry Clerkship website.

Psychiatry Grade

  • Clinical Performance - 67%
  • NBME Shelf Exam - 33%
  • OSCE - P/F

Family Medicine (4 weeks)

Description

This month long clerkship is conducted at various clinical sites within and around the Chicagoland area. The clinical sites include community health centers, private practices and all Northshore Medical Group Locations including the Northshore Family Medicine Residency Program.  Most students are assigned to two (2) different preceptors sites, working at each two days a week. When rotating at the Northshore Family Medicine Residency Program, students work with both faculty and residents.

Students are engaged in clinical activities Tuesdays through Fridays throughout the rotation. On Mondays, students return to the University for clerkship didactics and small group discussion. Traditionally, the last Thursday of the rotation is an assigned reading day to prepare for the final exam. Students will work with their preceptors up to and including the Wednesday before the exam.

Clinical Evaluation

At the end of the first two weeks, students ask preceptor(s) to complete the Mid-Rotation Student Evaluation form and then meet with them to discuss their progress to date.  If there are two preceptors, either preceptor can complete this form, but having both of them complete a midterm evaluation is ideal.  

By the end of the third week, students should ask one of their preceptors to observe them interacting with a patient to complete the Observed History and Physical Examination form and to discuss their performance. 

Prior to a student’s last day at the assigned site(s), students should remind their preceptor(s) to complete the student evaluation form to rate their clinical performance for the clerkship on E*Value. If you have any questions about the forms, please contact the Education Coordinator or the Clerkship Directors. 

Objectives

  1. Obtain a focused history and physical examination appropriate to the patient's presenting complaint while considering common outpatient clinical problems confronted by family physicians.
  2. Generate differential diagnoses for patient's problems, with special consideration of the common and complex disorders that present in a family medicine setting.
  3. Present diagnoses and treatment plans using best evidence and understanding of pathophysiology while taking psychosocial factors into consideration.
  4. Write an accurate and concise note conveying only the most relevant points of the patient's medical history, presenting complaint, physical exam, assessment and plan.
  5. Recognize and apply health promotion and prevention counseling services at every possible clinical opportunity.
  6. Communicate appropriately with and listen to patients with compassion and empathy while applying the concepts of motivational interviewing and shared decision making when appropriate and confirming patient understanding.
  7. Triage acute care visits in the family medicine ambulatory care setting to outpatient follow up vs. emergency/urgent care or 911 while taking into consideration health care system resources.
  8. Professionalism:  Conduct professional relationships with patients, staff and colleague with the highest moral and ethical standards and understand the role of each member of the healthcare team
  9. Professionalism:  Actively seek feedback about your clinical performance and practice while taking into account any professional limitations
  10. FM Role in Health Care System:  Describe and experience the roles of family physicians in the office and community. Describe the central role of primary care in the health of the public.
  11. FM Role in Health Care System:  Recognize the value of self-care, resilience and the joy in medicine.

Family Medicine Grade

Grading is determined by a student’s performance in three areas:

  • Clinical Performance - 60%
  • Professionalism/Educational Attitude - 20%
  • NBME Shelf Exam - 20%

Recommended Reading

  • No specific assigned textbook. On the chalk site, there are multiple current review articles and resources for students. In addition, the students have access to fmCases (Family Medicine Computer-Assisted Simulations for Educating Students, https://www.aquifer.org/courses/aquifer-family-medicine/, an outstanding online teaching tool that has 40 virtual Family Medicine cases.

Neurology (4 weeks)

Description

Students in the Neurology clerkship will be assigned to either the University of Chicago Medical Center site, or the NorthShore Medical University site in Evanston. Clinical training at the two sites is similar in breadth and depth of patient exposure and educational content, with some differences in the structure and specific focus of the clinical rotations. Students are assigned on the basis of a lottery, but can communicate site preferences to be accommodated when possible. Students at both sites will be provided a joint orientation session on the first day of the clerkship, and receive parallel didactic training. Students from both sites will re-convene at UCMC for testing on the last day of the clerkship.

The UCMC Clerkship Site

During the 4 week clerkship, students participate in several venues, including the adult neurology inpatient ward, the Neurointensive care unit, the adult outpatient neurology subspecialty clinics and the neurology consult service. Two weeks will be spent on the Adult Inpatient ward, where students will make rounds with residents, attend morning conferences, and participate in daily rounds, Monday through Saturday. Students will help admit new patients and follow established patients, monitoring their examinations and assisting in care. Students will take call through midnight with their assigned resident. The goal of this rotation is experience in hands-on evaluation and management of acute neurological problems.

One week will be spent in the Outpatient Clinics, where students will work one-on-one with attending physicians in the general adult neurology subspecialty clinics. The goal of this week is to become familiar with common and unusual neurological problems by observing numerous patients in specialty clinics in areas including multiple sclerosis, neuro-oncology, sleep disorders, epilepsy, stroke, movement disorders, and diseases of the peripheral nervous system. This week will also afford opportunities to observe and assist in performing a lumbar puncture, to observe electroencephalography, and to observe an EMG.

Students have the option to spend their final week in either the NeuroICU or the Consult Service, students will participate in providing care to critically ill neurological patients, working with the NeuroICU team. Students will participate in the care of critically ill neurological and neurosurgical patients (acute ischemic stroke, intracranial hemorrhages, traumatic brain injury, hydrocephalus, intracranial hypertension, paralytic syndromes, status epilepticus) admitted to the NeuroICU or in consultation in the E.R. or other ICUs. Students will also participate in first response to acute stroke calls. The NeuroICU team will round on the patients on a daily basis. An intense experience of the care of critically ill neurological patients can be expected.  While on the Consult Service, students will participate in covering all of the adult inpatient units including Medicine, Surgery, medical/surgical ICUs, and OB-GYN. The student, along with the Consult Resident, will be the first to evaluate patients as requested by the various services.

 

The Northshore University HealthSystem Clerkship Site

 

At the NorthShore University HealthSystem site, the clerkship is directed by Dr. Octavia Kincaid.   The third year neurology clerkship at NorthShore University is an intensive clinical exposure to neurological patients. At NorthShore, students rotate through the inpatient general Neurology consult service, the stroke consult service, and the Neurology outpatient clinics, experiencing a wide variety of neurologic disorders and treatment options. 

During the Neurology Consult service rotation students will perform histories and physicals on assigned patients and develop treatment plans including a differential diagnosis, diagnostic work-up and treatment recommendations. They will follow patients throughout their hospital stay and adjust the treatment plan as needed whether in the ICU, medical or surgical units. 

Rotation on the Stroke service will involve working with the stroke team to evaluate patients with stroke from the time they enter the emergency room through diagnosis and treatment.  Students will gain insight into acute stroke treatment management as well as secondary stroke prevention. 

Rotation in the Outpatient Neurology Clinic will provide students with an opportunity to work with subspecialty attendings in the areas of epilepsy, movement disorders, multiple sclerosis, behavioral neurology, neuromuscular disorders, sleep medicine, pediatric neurology and neuro-oncology.  Throughout the rotation students will participate in didactic and case review lectures and will attend departmental conferences, both at NorthShore and at University of Chicago (via videoconferences).  Opportunities will also be provided to observe and/or assist with lumbar punctures, electroencephalography and EMGs.

Clinical Evaluation

Students are expected to be present daily during the clerkship. They will be evaluated by attending physicians on their ability to perform a complete neurological examination and interpret the abnormal findings, make a diagnosis and understand the agents used in therapy.  In addition, oral and written communication and professional behavior will be assessed. Students are expected to participate in weekly Case Discussion sessions with the teaching attending, to attend clinical conferences, and to submit a complete write-up of a case.

Objectives

  • Learn to obtain a neurological history and perform a competent neurological examination
    • Students will be provided a framework for neurological history taking and examination that they will utilize when examining patients on the floor.
    • They will also observe attendings and residents perform the neurological examination on the floor and in the clinics.
  • Learn the basics of localization in neurology
    • Students will learn about localization during an orientation session with the clerkship director.
    • They will also learn the importance of localization in diagnosis.
  • Obtain exposure to a variety of neurological disorders
    • On the inpatient floor and in the neuro-intensive care unit students will have exposure to acute presentations of stroke, seizures, multiple sclerosis, and neuromuscular disorders.
    • During the outpatient week students have the opportunity to work with attendings in specialty clinics.
  • Understand the role of diagnostic tests in neurology
    • Students will have the opportunity to see patients undergoing EMG and EEG tests.
    • They will also have the opportunity to understand the role of multiple diagnostic modalities including CT, MRI and ultrasound imaging as well as lumbar puncture and other lab investigations relevant to patients seen on the floors and in the clinics.
  • Understand the role of medical and surgical treatment and rehabilitation of neurological disorders
    • Students will have exposure to various acute and chronic modalities of medical and surgical treatment as applied to patients seen on the floor and in the clinic.
  • Obtain feedback on neurological history taking and examination
    • Students will obtain ad-hoc feedback on history /examination skills on the floors and in the clinic
    • Students on the inpatient service will present their history and physical examination to the attending, and they will be given feedback on their history taking and localization skills during presentations.

Neurology Grade

  • Clinical Performance - 50%
  • NBME Shelf Exam - 25%
  • OSCE - 25%

Recommended Reading

Overviews of Neurology, suggested as background reading during clerkship (choose one):

  • Lange’s Clinical Neurology; Ed. Aminoff MJ, Greenberg DA, Simon RP. 6th ed.
  • Blueprints in Neurology (Blueprints Series), by Frank Drislane et al.

Comprehensive textbooks of Neurology, useful for reference purposes:

  • Harrison’s Neurology in Clinical Medicine; Ed. Hauser S.
  • Merritt's Textbook of Neurology. Rowland, L.P. 11th ed.
  • Adams and Victor’s Principles of Neurology. Ropper AH, Brown R. Eighth Ed.
  • Neurology in Clinical Practice. Bradley, Daroff, Fenichel, Jankovic. 5th Ed.

Fourth Year Clerkships

The Foundations in Clinical Medicine (FICM) elective course is a seven day immersive experience designed to prepare second year students for the transition into the third year. The course uses lecture, small group discussion, and hands-on practice to expose students to data interpretation, clinical procedures, and case presentations in preparation for the clerkship experience.

The Introduction to the Clinical Biennium is a three-day event which trains rising third year students in the hands-on skills that they will need as they complete the required clerkships throughout their third and fourth years of medical school.

Topcis Covered:
     BLS Testing
     EPIC Training
     Procedure Familiarity
     Professionalism in Medicine

Funding for Off-Site Clerkship Travel

Early Morning Transportation - Uber/Lyft