Method:  In August 2002, through purposeful sampling, the authors targeted for open-ended interviews 32 third-year medical students at the University of California, San Francisco in the first core internal medicine clerkship. Interviews averaged 45 minutes in length and were audiotaped, transcribed, and analyzed using a grounded theory approach.

In their third year, all medical students take the required 12-week medicine clerkship. In addition, there are more than 55 electives in a wide range of subspecialties for third and fourth year students.


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These 3rd year medical students were spread across four distinct sites at the University of Illinois (Chicago, Peoria, Rockford, Urbana). An analysis of covariance was used to test for differences between groups. In this case, differences in the first clerkship rotation were compared with respect to:

The first day of each clerkship includes an orientation. Each clerkship has an education coordinator who will manage your schedule while you are in their clerkship, assign faculty and residents to evaluate your performance, and serve as your primary contact for all administrative issues.

The clerkship places students in the family medicine residency programs at HSHS St. Elizabeth's Hospital, Mercy Hospital St. Louis and SSM St. Mary's Family Medicine Residency. Residents at all programs have been informed of student learning objectives and goals and given instruction on teaching methods and learning theory.

Our family medicine preceptors are volunteer clinical faculty who practice in the community. We have a wide variety of preceptors located throughout the St. Louis region in urban, suburban and rural sites. All have been informed of the clerkship goals and objectives and given instruction on teaching methods and grading procedures.

A major goal of the year three clerkship in internal medicine is to develop the capacity to obtain a comprehensive medical history and to perform a detailed physical examination under the supervision of faculty attendings and resident physicians. You will be expected to participate in the care of your patients and will learn to identify patient problems based on findings in the history and physical examination.

For each problem, you will produce a differential diagnosis, identify a working diagnosis and develop a diagnostic and therapeutic plan. While on inpatient services, you will learn to give a concise, organized oral presentation of a patient's case. Developing a regular reading program will strengthen this knowledge base in internal medicine.

You will have the opportunity to complete an evaluation of your experience in internal medicine. All replies remain confidential and are important to the department in efforts to evaluate and improve the clerkship.

On the first day of the clerkship, you will meet their assigned team at the hospital to which you were assigned in your introductory letter. If you cannot locate the neurology team to which you have been assigned, page the neurology resident on call.

The surgery clerkship experience focuses on general surgery, offering you the opportunity to function as a surgical team member. The basics of general patient evaluation are adapted to the surgical setting to include assessing patients pre- and post-operatively. Building on general pathophysiology and clinical medicine, you will apply problem-solving and critical thinking skills in determining surgical risks and indications for a range of common surgical procedures.

The Medicine Clerkship is an active learning experience in which students learn clinical medicine by engaging in the care of patients. The goal of the clerkship is for each student to develop the knowledge, skills, and professional attributes essential to the practice of internal medicine. By the end of the course, the student should be able to perform a complete history and physical examination: write orders and notes; develop the problem list, differential diagnosis, diagnostic strategy, and management plan for common medical problems; and interact as a professional with the patient, family, and members of the medical team. The clerkship is an eight-week course taken starting in the second half of the second year of medical school. Students are assigned to inpatient medical services at NewYork-Presbyterian Hospital/Weill Cornell, NYP/Queens, NYP/Brooklyn Methodist, Houston Methodist Hospital, and Memorial Sloan Kettering Cancer Center. Clerkship students attend regular, small group tutorials and tutor groups, as well as teaching rounds, grand rounds, and an interprofessionalism day with other house staff. Under the direction of Bryan Leppert, M.D., Aram Annie Kim, M.D., both faculty in the Section of Hospital Medicine, and Stephen Andrew McCullough, M.D., faculty in the Division of Cardiology, the Medicine Clerkship leadership is committed to fostering the development of each medical student and ensuring that learners achieve their goals while growing as physicians in a supportive learning environment.

The Internal Medicine Sub-Internship, led by Anthony Ogedegbe, M.D., is a four week rotation where fourth-year medical students who have completed the medicine clerkships are entrusted with many roles and responsibilities of a first-year, internal medicine resident.

Junior and senior medical students participate in a structured case-based curriculum developed from a template sponsored by the Clerkship Directors of Internal Medicine. Third-year medical students participate in twenty hours of case-based sessions with internal medicine faculty during the first few days of the clerkship. In addition, junior students have weekly problem-solving sessions with Dr. Ben-Ari and weekly ethics conferences with Drs. David Goldstein, Don Harper Mills and Ben-Ari. Fourth-year medical students also participate in a separate, one-hour problem-solving session per week with Dr. Felser. In addition, all students meet at least once weekly for a total of two-hours of case-based teaching with their respective faculty attendings on the General Medicine service. All medical students are expected to attend the New Patient Conference and all other core residency conferences.

MED 7500 (Medicine Externship I, or "Med I") is the core clinical clerkship that provides the critical foundations for not only adult inpatient medicine but also for the care of the acutely ill patient. Students will be part of inpatient care teams that will include interns, residents, and faculty.

The clerkship committee expectations of students are detailed in the evaluation forms found on E*Value. Upon completion of the first medical externship (Medicine 7500), the student should be able to conduct a complete general physical examination and appropriate special examinations. In addition to identification of relevant symptoms and physical findings, the student should know the pathophysiologic basis and clinical correlates of these findings for problem identification and problem solving, and based upon a reasoned differential diagnosis be able to plan an adequate diagnostic evaluation using principles of evidence-based medicine. Students in the second medical externship (Medicine 7501) will continue to practice and develop these skills and begin to participate responsibly in the management and treatment of patients.

All careers in internal medicine begin with a three year residency program. Following successful completion of residency training, the graduate may begin practice in general internal medicine or may choose to train further in one of the subspecialties of internal medicine.

General Internal Medicine

Doctors of internal medicine focus on adult medicine and have had special study and training focusing on the prevention and treatment of adult diseases. Much of their training is dedicated to learning how to prevent, diagnose, and treat diseases that affect adults.

Specialty training is called fellowship training, and usually adds two to three years of training beyond the residency training. Generally, applications for fellowship training are submitted during the second year of internal medicine residency training.

A student-led group, the IU School of Medicine Internal Medicine Student Interest Group provides MD students with opportunities to explore career options in internal medicine. Activities include shadowing internists for early clinical experience and participating in discussion forums with residents, general internists and medicine sub-specialists.

Medical students with an interest in internal medicine and department subspecialty areas, including geriatrics, medicine-pediatrics, and others can learn more about these fields by interacting with practitioners via clinical shadowing, informal discussions, social functions and more.

The four-week Aerospace Medicine Clerkship is offered twice annually during April and October at the Lyndon B. Johnson Space Center (located in Houston, TX) and typically begins the first Monday and concludes on the last Friday of the month. The clerkship involves formal lectures on space medicine topics and issues, familiarization with the medical aspects of International Space Station operations, design, and function as well as Exploration Medical Capability for deep space exploration. Clerkship participants are required to complete a research project and scientific poster with an accompanying 250 word abstract in a current focus area of space medicine, which will be presented in an open forum poster session for not only the JSC Space Medicine Operations and clinical community, but other interested divisions/elements at JSC.

The Emergency Medicine Clerkship is a four-week rotation designed to give students exposure to the core principles of emergency medicine. The primary locations of the clerkship are Ascension Seton Medical Center Austin and Dell Seton Medical Center. As part of the rotation, students learn to evaluate the undifferentiated patient, evaluate and stabilize the acutely ill patient, evaluate and stabilize traumatic injuries, identify and interpret abnormal vitals and apply tenets of basic and advanced life support. ff782bc1db

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