Clinical Clerkship Program - General Student Protocol

rev: 6-14-07

Red Highlights indicate notes for class of 2009

Clinical Clerkship Schedule

A student may not participate in the Clinical Clerkship Program until s/he has completed  all requirements of the Preclerkship Program.  Typically students will enter the Clinical Clerkship Program in the Fall Semester/Summer Semester at the beginning of their third year.  Although clinical clerks register for clinical rotations on a semester-by-semester basis, the schedule of rotations is continuous; i.e., clinical clerks do not have semester breaks as they did in the preclinical program.

Each student will select (through the college process) a training center (base hospital) for approximately seventeen/nineteen months during which time s/he will complete the required hospital-based rotations, the Primary Care Ambulatory Clerkship and s/electives as time and resources permit.  Prior to entry into the clinical clerkship program, each student will be provided a schedule of the rotations s/he will be undertaking during that 17/19 months. The schedule will also indicate vacation time, if included.

Students must call the Clinical Clerkship office first to request any change in their schedule to make sure (1) that it will be allowed and (2) that  Degree Requirements will be fulfilled.

Requests for changes in schedules at the base hospital must be approved by the Director of Medical Education. Any changes MUST be finalized 4 weeks prior to the rotation's start date. Any changes in your schedule at an out of base hospital (cancellation of a rotation or change of dates) must first be approved by the Clinical Clerkship office verbally and then by the hospital. Base Hospital changes are processed electronically. Non Base Hospital changes are processed using the Non Base Hospital Application " printable Form # 1. This form must be signed by a hospital representative, indicating approval, and then received in the Clinical Clerkship office and approved at least 4 weeks prior to the beginning of the scheduled rotation. 

The schedule for the final three months of the clinical clerkship program will be developed by the student in a separate process.  Students receive information on scheduling procedures during Clinical Clerkship orientation.

Student Duties And Responsibilities

The clinical clerk is primarily a student, but s/he is also a part of the patient care team of the training agency.  Thus, the clinical clerk, as a professional-in-training has duties and responsibilities that are substantially different from those s/he has as a preclerkship program student.

A. The clinical clerkship program is a full-time commitment. Non-clerkship activities (e.g., graduate assistantships, teaching, volunteer activities, employment, class activity, etc.) may not supersede or conflict with the clinical clerk's assigned/required clinical duties and academic assignments.

B. The student is immediately accountable to his/her assigned clinical supervisor for carrying out all training assignments in a timely and professional manner.  The student is also accountable to the Director of Medical Education for complying with general program and training facility policies and assignments.  The clinical clerk is responsible for knowing and following pertinent policies described in the hospital Extern Manual and other training center documents, as well as those described in this Protocol.

C. The student's compliance with policies and protocols describing his/her duties and responsibilities in patient care is paramount.  The clinical clerk is responsible for knowing the policies which describe his/her limits in clinical practice related to the physical examination, writing orders, performing technical procedures, etc.

D. 100% attendance is expected. Unexcused or excessive absences can be the basis for an "N" grade. 

E. If the student is ill and unable to perform clerkship duties or is absent due to some other personal emergency, s/he will personally contact both the clinical supervisor on the assigned service and the Medical Education Office.  The student must notify the Clinical Clerkship Office if s/he is absent from the assigned rotation three consecutive days.

F. The clinical clerk's appearance and behavior at all times will conform to professional standards.  Unless otherwise stated, the clinical clerk will wear a clean, white clinic jacket, with proper MSU/COM and hospital identification, and dress in a manner befitting a physician.  The student will also comply with specific dress codes outlined in the training center's  documents.

G. The clinical clerk's responsibility for attendance at training center educational programs will be described in the training center's documents.  Attendance at lectures, conferences, grand rounds, etc., is expected to be recorded and considered in assessing the clinical clerk's performance.

H. The clinical clerk assumes a major responsibility in the plan for clinical clerkship evaluation.  First, the student is responsible for assuring that his/her clinical supervisor receives the appropriate forms for reporting the formal assessment of the student's clinical performance.  The student should assertively seek feedback on his/her performance throughout the course of the clinical rotation, as well as discuss with the clinical supervisor the formal evaluation report.  Second, the student is responsible for overseeing the submission of the clinical supervisor's written evaluation form to the Clinical Clerkship Office, using forms available for printing from the Office of Academic Programs' web site.

Promotion, Retention, And Graduation

In accordance with current statute, each MSUCOM student must have completed and passed/met the following requirements before entry into the Clinical Clerkship Program:

The clinical clerkship is the culminating phase of the MSU/COM educational program.  It is during this phase of the program that critical assessment must be made of the student's potential to assume the professional rights and responsibilities which will be conferred upon him/her at graduation.

The faculty are responsible for defining the standards of clinical competence and developing mechanisms by which the student's clinical competence will be assessed.  In general, clinical competence is viewed as a composite of four elements: cognitive knowledge, psychomotor/procedural skills, clinical problem solving, and professional attitudes and behavior. Performance standards for each of the clinical clerkship rotations are constantly being refined and efficient methods of valid and reliable assessment of student's performance are continuously being developed and implemented.  Students will be held accountable to the specific performance standards described to them at the beginning of each clinical rotation.  The grading and remediation policy applicable to the clerkship will also be outlined at the beginning of the service rotation.

A. The on-campus Instructor of Record in the clinical department will be responsible for assigning the official grade.  In instances where the clinical clerk has received a marginal or unsatisfactory rating by the clinical supervisor, the Instructor of Record will consult with the Director of Medical Education and clinical supervisor regarding an appropriate grade and/or strategies for remediation.

B. In accordance with the MSU/COM Policy on Promotion, Retention and Graduation of the Committee on Student Evaluation (COSE):

Section 5.1.3.  A student judged to have unsatisfactory clinical performance will be directed to appear before the Committee of Clerkship Performance for review of the student's overall performance. Students who do not pass a rotation will appear before COSE.

Medical Liability Coverage

Michigan State University provides medical liability coverage (malpractice insurance) for students enrolled in the medical education program of the College of Osteopathic Medicine.  Students are covered on in-hospital services and non-hospital rotations as they progress through the College-approved programs. Students are authorized to participate in and are covered by malpractice insurance only for the specific rotations that they are registered for and during the specific dates listed on the official schedule in the Unit III Office. Clinical rotations in affiliated hospitals are covered as long as the student is enrolled for the specific course and credits.

Students are covered by medical liability insurance when temporarily off the assigned service if they are currently enrolled for a clinical clerkship rotation in that facility, if the facility has a formal affiliation with the College. The student must complete the Clinical Enrichment Experience Application and be approved by the appropriate supervising personnel. The student is also covered by University medical liability insurance when performing under the direct supervision of his/her assigned clinical instructor.

In facilities which do not have a formal affiliation with the College, the student is covered  only when performing on the specific service for which s/he has received appropriate MSU/COM departmental approval and for which the student is registered.  That is, in a non- affiliated facility the student is not covered when s/he engages in activities other than those approved in the elective protocol.

When students are engaged in elective clinical rotations arranged for no credit and are not enrolled at MSU/COM, they are not covered by University medical liability insurance.

Important: If at any time during clinical rotations, a student is included in an "incident report," the student must immediately notify the Clinical Clerkship Office and complete the Health Professions Student Exposure Report .

Student Health Insurance

Medical Students are required by the University to obtain health insurance.  Michigan State University administrators have approved a consolidated health care plan that is offered to students.  The policy will be overseen by the staff benefits office in the Department of Human Resources (517-353-4434  x161).

Remember!!! (important info)

For problems regarding in-house matters, work with the Director of Medical Education to achieve resolution.

Contact the Clinical Clerkship Office when:

For changes in registration:  Your rotation dates MUST MATCH the scheduled dates in the Clinical Clerkship Office, as well as the course and credits for which you are registered.  This is your assurance of liability coverage.

For evaluation of your performance, try to get your trainer/s to complete the form on or before the last day of the rotation.  This saves you last minute problems meeting degree requirements caused by forgotten evaluation forms.

Evaluation Components

Receiving a grade and, therefore, meeting degree requirements, is dependent upon proper completion of evaluation material. It is the student's responsibility to ensure that all evaluation components are completed and that they are received in the Clinical Clerkship Office. For the physician's evaluation of the student, the student completes in the top portion of the Clinical Evaluation Form (available for printing from the web site) and gives the form to the supervising clinical instructor prior to completion of the rotation. The Evaluation Form should be reviewed with the student before it is forwarded to the DME's Office and from there to the Clinical Clerkship Office.

***IMPORTANT NOTICE***

As indicated, faculty evaluation of student mastery of clerkship course objectives is an important required component of your clerkship performance. The timely completion of the evaluation process at the conclusion of each clerkship rotation is an important professional behavior and contributes in a significant way to overall program improvement.

To ensure the integrity of faculty evaluation of clerkship performance, students should not serve as the direct conduit for delivery of the completed faculty evaluation to the hospital's medical education office or the Clinical Clerkship Office in Academic Programs. Ask your attending physician to follow our course protocol by sending the completed evaluation of clerkship performance to the medical education office, where they will review it and forward it on to the college. For elective clerkship rotations, the attending physician is expected to send the completed evaluation directly to the Clinical Clerkship Office.

Any evidence of tampering or modification of the faculty evaluation while it is in the possession of the student will be considered "unprofessional behavior" and will result in an "N" grade for the course and subsequent review by the Committee on Student Evaluation (COSE).

CLINICAL EVALUATION FORM
Physician's Evaluation of Student:
Clinical Evaluation Forms are to be submitted for the following required in-base rotations and all selective and elective rotations.

All clinical evaluation forms for the following rotations are accessible at the following web page below: http://www.com.msu.edu/aa/clerkship/evaluation/clerkship_eval.php.

Anesthesiology Emergency Medicine
Internal Medicine - one evaluation for each required Internal Medicine Service Obstetrics/Gynecology
Psychiatry Primary Care Ambulatory Clerkship
S/Electives Surgery

ROTATION EVALUATION FORM
Student's Evaluation of service/physician/hospital:
A Rotation Evaluation is to be completed by the student at the conclusion of every rotation. The responses are kept anonymous. 

Rotation evaluation forms are accessible at the following web page
http://www.com.msu.edu/aa/clerkship/evaluation/clerkship_eval.php