Docstoc

Welcome to POM _Clerkship_

Document Sample
Welcome to POM _Clerkship_ Powered By Docstoc
					Welcome to Clerkship


Curriculum and Evaluation Issues
         Dr. Joyce Pickering
              July, 2007
Clerkship is the most fun part of the
curriculum!
 Also has the steepest learning curve
 Also can be quite stressful
 Thousands of med students have done it
  successfully (and enjoyed it) before you.
 Understanding how things work can be
  helpful in coping.
 During each of your rotations, you will be
  working with a team consisting (usually) of
  other students, residents at various levels,
  and attending staff.
 This team work can be one of the best parts
  of clerkship.
 Don’t hesitate to ask them when you don’t
  know something.
 Don’t forget that you are there to learn, and
  you are not there (primarily) to impress them.
Get off on the right foot . . .
 Each clerkship rotation usually starts with an
  orientation session. It is very important to show up
  on time to this session.
 Your clerkship manual has the time and location for
  the orientation session for each rotation for each
  hospital.
 Often you will only find out your call schedule once
  you arrive. Expect to be on call your first night (just in
  case.)
 You can give “call requests” but there is no guarantee
  that they will be granted. Call requests are normally
  submitted about a month before the rotation, and
  usually are submitted to the chief resident (check
  with the teaching office).
As a general rule, the same call rules that apply to residents
are applied to students.

 Current contract allows
    Maximum 6 in house calls in 28 day period
    Two weekends off per month
 Each rotation has slightly different expectations for
  call. ASK when you start.
 In general, you can “trade” calls with another student
  on your service. Make sure your senior resident is
  aware and approves, and that hospital locating
  knows.
 Please note: no call past 20:00 hrs on Sunday
  before a new rotation, or before a whole class
  teaching day.
Whole class teaching days
 Wed. Sept. 5th, 8 – 12 a.m.
     ACLS preparatory lectures
 Thursday, Jan. 31, 2008 8:30 – 4:30
     Clinical Application of the Healer Role
 Thursday, April 24th, 2008 8:30 – 4:30
     Palliative Care Day
 If you are out of town on those days, you will
  be notified about any material to be covered.
Religious holidays
 Generally can be accommodated if the
  teaching office has enough notice.
 Patient care will always take precedence
 Please note that more than 5 days missed
  (for any reason) means an automatic repeat
  rotation.
 Most services expect students to have their
  own pagers. Purchase or rent one now, and
  let “locating” at the hospital know the number.
 Wear your name tag. Most hospitals require
  that you get a hospital name tag. (The
  MUHC one works at all MUHC sites.) Ask at
  your orientation.
 Identify yourself to patients as “My name is
  John Doe. I’m a 3rd year McGill medical
  student and I’m part of the team that will be
  taking care of you.”
Remember the dress code . .
                                   Page 38, Red Book

 Generally, the “Mother rule” works well.
 Most common complaints I get:
     Showing the abdomen
     Torn jeans
     Short shorts
GOOD
NOT GOOD
GOOD
NOT GOOD
GOOD   NOT GOOD
 With special thanks to Drs. Jeff Segal, Keith
  Richardson, and Vi Nguyen (class of 2007)
  for being good sports!
Transportation
 We advise the BMW (bus, metro, walk)
 Parking is your own responsibility, and
  relatively expensive.
 Each hospital has a list of which students will
  be rotating and when, but some will not issue
  monthly permits to students.
 Punctuality and conscientiousness are very
  much noted during clerkship.
     Woody Allen: “Eighty per cent of success is
      showing up.”
 Remember to be careful about
  elevator/cafeteria/corridor conversations
  about patients – respect confidentiality.
 Respect confidentiality when looking at
  patient information on the computer – don’t
  look at results that don’t concern you.
Evaluations
 At the end of each clerkship rotation (usually
  8 weeks), the clerkship rotation director
  submits an evaluation form to my office.
 This evaluation is filled in by the clerkship
  director, and compiles data from various
  sources.
 Typical sources are the evaluation of your
  clinical supervisors, a written exam, possibly a
  Objective Standardized Clinical Exam (OSCE)
  etc.
 Your clinical supervisors will usually ask for the
  input of your senior residents as part of the
  clinical evaluation.
ROTATION              WEIGHTING                PASS REQUIREMENTS               REMEDIAL
                       OF MARKS
Medicine          Clinical : 60%         Global - 60% and                      Failure on Global mark requires 8 week remedial.
                  Written: 30%           Clinical - 60% and                    Failure on Clinical mark requires 8 week remedial.
                  Oral: 10%              Oral/Written Exams - 60% each *       Failure on the written or oral exam requires 8 week
                                         *applicable to students with “below   remedial if ward evaluation is ‘below expectations’.
                                         expectations” clinical evaluation
Surgery           Clinical : 70%         Global - 60% and                      Failure on Global mark requires 8 week remedial.
                  Written : 25%          Clinical - 60% and                    Failure on Clinical mark requires 4 week remedial.
                  Attendance/ Log 5%     OSCE - 60%                            Failure on OSCE requires a repeat oral examination.
Obstetrics &      Clinical:  50%         Global - 60% and                      Failure on Global mark requires 8 week remedial.
Gynecology        Assignment:20 %        Clinical - 60% and                    Failure on Clinical mark requires 4 week remedial.
                  OSCE:      30%         Assignment – 60% and                  Failure on Assignment requires supplemental assignment.
                                         OSCE – 60%                            Failure on OSCE requires a repeat oral or OSCE
                                                                               examination.
Pediatrics        Clinical(ward): 40%    Global - 60% and                      Failure on Global mark requires 8 week remedial.
                  Ambulatory : 20%       Clinical (Ward) - 60% and             Failure on Clinical (ward) component requires 8 week
                  Neonatology : 20%      Written - 60%                         remedial.
                  Written :      20%                                           Failure on exam requires remedial oral exam if ward
                                                                               evaluation is ‘meets expectations’ or better
                                                                               Failure on exam requires 8 week remedial if ward
                                                                               evaluation is ‘below expectations’
Psychiatry        Clinical : 55%         Global - 60% and                      Failure on Global mark requires 8week remedial.
                  Written : 15%          Clinical - 60% and                    Failure on Clinical mark requires 8week remedial.
                  OSCE: 30%              OSCE – 60%                            Failure on OSCE = Academic incomplete; student requires a
                                                                               repeat OSCE. Student can have 2 chances at passing the
                                                                               OSCE; a 2nd failure constitutes a failure on the unit and
                                                                               would require an 8 week remedial. (Note: a student who
                                                                               passes on the second attempt will pass the unit but cannot be
                                                                               assigned a global grade higher than “meets expectations”)
Family Medicine   Clinical 80%           Pass - 60% overall and                Failure on clinical evaluation requires 4 week remedial
                  Assignment 20%         60% on clinical
Geriatric         Clinical: 60%          Global - 60 % and                     Failure on Global evaluation requires 4 week remedial
Medicine          WebCT Modules: 5%      Clinical - 60% and                    Failure on clinical evaluation requires 4 week remedial
                  FEAT (portfolio):10%   WebCT Modules – Pass / Fail and       Failure on assignment requires supplemental assignment
                  Final Exam: 25%        FEAT (portfolio) – 60%
                                         Final Exam - 60%
Elective          Clinical 100%          Pass - 60%                            Failure on Global evaluation requires 4 week remedial.
            STUDENT CLERKSHIP (POM) EVALUATION FORM

Student Name: ________________________            Dates of Rotation: _______________
Rotation: ____________________________            Site(s): ________________________

Physicianship Behaviours                                  Consistently       Not
                                                                          Consistently
listened to the patient
demonstrated respect for the patient
recognized and met patient needs
respected patient confidentiality
maintained appropriate boundaries with patients
functioned well as a member of a team
was on time
completed tasks in a reliable fashion
maintained appropriate appearance and attire
demonstrated awareness of limitations
admitted errors/omissions
addressed gaps in knowledge and/or skills
accepted feedback
Narrative Comments:




Knowledge and Clinical Method                     N/A    U      BE       ME   EE         S

knowledge of basic sciences
knowledge of clinical sciences
communication skills
data collection
physical examination skills
hypothesis generation and Differential Dx.
clinical judgment
formulation of a treatment plan
written skills (medical dossier)
organizational skills
technical skills
skills that are discipline-specific (        )
Narrative Comments:
                                                            Instructions

Physicianship Behaviours:
If you observed that a student did not always demonstrate the expected behaviour(s), indicate this by placing a
checkmark in the appropriate box and elaborate in the narrative comment section. Please indicate if steps were taken
to address areas of concern and/or if the student demonstrated improvement during the rotation. Demonstration of
exceptional abilities in professionalism and/or humanism can also be indicated in the narrative. Behaviors are
monitored longitudinally throughout clerkships; your assessments in this section do not necessarily appear in the
Medical Student Performance Evaluation document (i.e. Dean’s Letter) that is used for residency application. If
certain issue(s) appear to be of a serious nature, are repetitive and/or irremediable, your assessment may be included
in the Dean’s Letter.

Knowledge and Clinical Method:
Assess student performance using the following five descriptors:
Unsatisfactory (U) (<59) = Not acceptable for a student at this level of training.
Below Expectations (BE) (60-69) = Falls short of reasonable expectations but acceptable.
Meets Expectations (ME) (70-79) = Equal to the majority of students at this level; 80% of students usually meet expectations.
Exceeds Expectations (EE) (80-89) = Unusually strong; often exceeds reasonable expectations; only 5-10% of students exceed expectations.
Superior (S) (90-100) = Far exceeds expectations; only occasionally observed in students at this level. This is an exceptional student.

The overall Clinical Mark will be a composite of the clinical supervisor(s) assessment(s) of student performance
based on all criteria: in behaviours, knowledge and clinical method. Please provide narrative comments.
Checkmark in the “BE” or “U” columns must be accompanied by a detailed narrative, based on observations.


DERIVATION OF GRADE:

                                           % Contribution                  Numerical Grade

CLINICAL MARK                                        (       )             ____________
ORAL EXAM MARK                                       (       )             ____________
WRITTEN MARK                                         (       )             ____________
OSCE MARK                                            (       )             ____________
OTHER: _____________                                 (       )             ____________
FINAL GRADE                                              100%              ____________



GLOBAL EVALUATION:

                                                           Unsatisfactory                  □
                                                           Below Expectations              □
                                                           Meets Expectations              □
                                                           Exceeds Expectation             □
                                                           Superior                        □


Clerkship Coordinator: __________________                                               Date: _________________
 Typically, because this evaluation requires
  compilation, it is not completed by the time
  you finish your rotation.
 However you should endeavor to get both
  mid way and final evaluations verbally from
  your direct supervisor and/or the clerkship
  director.
 Most evaluations are available on line. For
  those that are not, you are encouraged to
  come in and see it.
 I will ask to see you if any overall evaluation
  is “fails” or “below expectations”, or any other
  issue of concern is noted.
 The Medical Student Performance Record
  (MSPR), a.k.a. Dean’s letter, is a compilation
  of all your evaluations during medical school.
 Although not the only part, clerkship
  evaluations are an important part of the
  MSPR.
     (NB: the MSPR should not be thought of as a reference
      letter, and does not include reference letters that you may
      ask people to write for you.)
             STUDENT CLERKSHIP (POM) EVALUATION FORM

Student Name: __John Doe_________________Dates of Rotation:05/11/22 to 06/01/16
Rotation: ________General Surgery______     Site(s): ___RVH__________________
                                                                                                                                                               Instructions
Physicianship Behaviours                                     Consistently         Not
                                                                               Consistently        Physicianship Behaviours:
listened to the patient                                       X                                    If you observed that a student did not always demonstrate the expected behaviour(s), indicate this by placing a
                                                                                                   checkmark in the appropriate box and elaborate in the narrative comment section. Please indicate if steps were taken
demonstrated respect for the patient                          X
                                                                                                   to address areas of concern and/or if the student demonstrated improvement during the rotation. Demonstration of
recognized and met patient needs                              X                                    exceptional abilities in professionalism and/or humanism can also be indicated in the narrative. Behaviors are
respected patient confidentiality                             X                                    monitored longitudinally throughout clerkships; your assessments in this section do not necessarily appear in the
maintained appropriate boundaries with patients               X                                    Medical Student Performance Evaluation document (i.e. Dean’s Letter) that is used for residency application. If
functioned well as a member of a team                         X                                    certain issue(s) appear to be of a serious nature, are repetitive and/or irremediable, your assessment may be included
                                                                                                   in the Dean’s Letter.
was on time                                                                    X
completed tasks in a reliable fashion                         X                                    Knowledge and Clinical Method:
maintained appropriate appearance and attire                  X                                    Assess student performance using the following five descriptors:
                                                                                                   Unsatisfactory (U) (<59) = Not acceptable for a student at this level of training.
demonstrated awareness of limitations                         X                                    Below Expectations (BE) (60-69) = Falls short of reasonable expectations but acceptable.
admitted errors/omissions                                     X                                    Meets Expectations (ME) (70-79) = Equal to the majority of students at this level; 80% of students usually meet expectations.
                                                                                                   Exceeds Expectations (EE) (80-89) = Unusually strong; often exceeds reasonable expectations; only 5-10% of students exceed expectations.
addressed gaps in knowledge and/or skills                     X                                    Superior (S) (90-100) = Far exceeds expectations; only occasionally observed in students at this level. This is an exceptional student.
accepted feedback                                             X
Narrative Comments:                                                                                The overall Clinical Mark will be a composite of the clinical supervisor(s) assessment(s) of student performance
                                                                                                   based on all criteria: in behaviours, knowledge and clinical method. Please provide narrative comments.
Late on 2 occasions to rounds, but no further tardiness after being spoken to.                     Checkmark in the “BE” or “U” columns must be accompanied by a detailed narrative, based on observations.


                                                                                                   DERIVATION OF GRADE:

Knowledge and Clinical Method                      N/A      U       BE      ME     EE         S                                               % Contribution                  Numerical Grade
                                                                                                   CLINICAL MARK                                    ( 50 )                    ___73_______
knowledge of basic sciences                                                x                       ORAL EXAM MARK                                   (       )                 ____________
knowledge of clinical sciences                                             x                       WRITTEN MARK                                     (       )                 ____________
communication skills                                                       x                       OSCE MARK                                        ( 50 )                    ___72_______
data collection                                                            x                       OTHER: _____________                             (       )                 ____________
physical examination skills                                                x                       FINAL GRADE                                        100%                    ___73_______
hypothesis generation and Differential Dx.                                 x
clinical judgment                                                          x
formulation of a treatment plan                                            x                       GLOBAL EVALUATION:
written skills (medical dossier)                                           x
organizational skills                                                      x                                                                                  Unsatisfactory                  _
technical skills                                                           x                                                                                  Below Expectations              _
skills that are discipline-specific (            )                         x                                                                                  Meets Expectations              X
Narrative Comments:                                                                                                                                           Exceeds Expectation             _
Satisfactory rotation. Able to function well in team. Would need more initiative, but progressed                                                              Superior                        _
well during the rotation. Knowledge as expected for level.

                                                                                                   Clerkship Coordinator: __________________                                               Date: _________________
Academic Progress

                                      Core Clinical Clerkships
                       The following evaluations are presented in chronological order.


                                         Narrative Comments
 Surgery – MEETS EXPECTATIONS Satisfactory rotation. Able to function well in team. Would need
 more initiative, but progressed well during the rotation. Knowledge as expected for level.

 Psychiatry – MEETS EXPECTATIONS – Student A is a pleasant and motivated student whose interest
 fluctuated on this rotation. He needs to keep up his psychiatry knowledge. He did improve as the rotation
 progressed.

 Medicine – EXCEEDS EXPECTATIONS – Student A has an outstanding ability to manage and
 communicate with difficult patients and families. He is enthusiastic and keen to look things up. He is
 resourceful and independent. Student A is good-hearted, ethical, and principled. Student A could improve
 his knowledge base, but this will likely grow quickly since he is eager to learn. His synthesis is improving,
 but needs further work.

 Family Medicine – EXCEEDS EXPECTATIONS – Student A’s notes were very clear and he has good
 communication skills. He shows a lot of interest in pediatrics. He could demonstrate more initiative toward
 case management. His written assignment on Infant Support Services – Enfance Famille program was well
 done.

 Pediatrics – EXCEEDS EXPECTATIONS – Student A tends to be somewhat quiet in the group setting,
 but he is one of those students who gets everything done without a lot of fanfare. His histories and
 physicals were complete and accurate. He was excellent with patients and their families, and it was obvious
 that they liked and respected him. In addition he interacted very well with all members of the healthcare
 team, and was a willing worker and a real team player. On his weekends on call, he was able to work
 independently, showing good judgment and the ability to know when to call for help. His written
 documentation was well done. Student A’s clinical evaluations were above average and excellent.

 Obstetrics & Gynecology – EXCEEDS EXPECTATIONS – Student A’s performance exceeds
 expectations. He is a conscientious student who is hard working and motivated. He functions above the
 level of most of his peers and was a real pleasure to work with.
Physicianship section

                          Physicanship

  McGill University Faculty of Medicine reports
  physicianship concerns if serious or repetitive.

  No physicianship concerns were noted during the clinical
  rotations of Student A.
 As a general rule, at the Dean’s office, we do
  not change the clinical evaluations or final
  marks that are sent in.
 Physicianship comments and evaluations
  may be included.
If you are unhappy with your
evaluation . . .
 First, see your immediate supervisor (attending
  staff). If not satisfied. . .
 Second, see your site clerkship director. If not satisfied
 Third, see the Chair of the undergrad education
  committee of the department involved. If not satisfied. .
 Fourth, ask to see Dr. Pickering (398-3519) or write
  a request for an appeal to Dr. Pickering. This must
  happen within 8 weeks of the receipt of the evaluation.
 (See page 51 of the Red Book.)
In case you’ve forgotten what the Red
Book looks like . . .
Leaves etc. during clerkship
 As a general rule, we discourage these unless for
    medical reasons.
   Some may be allowed (eg. presentation at a
    conference) but you need both your clerkship director
    AND the Dean’s office permission.
   Any leave of more than 5 days out of 28 (for any
    reason) is an automatic “incomplete” – ie rotation
    needs to be repeated.
   You are allowed 5 days off at Christmas OR New
    Years but there is no guarantee as to which one, so
    don’t make travel plans.
   Check about “hospital holidays” when you start a
    rotation – remember, not all hospitals use the same
    dates.
 If you feel that things are not going well FOR
  WHATEVER REASON, address it first with
  your clinical supervisor/clerkship director.
 If you are not satisfied with their response, or
  you are uncomfortable speaking to them,
  please see Dr. Tellier or myself.
  Two tales . . .
  Tale #1.
 A student did two days of an elective, then left without
  telling anyone. When the supervisors went to fill in the
  evaluation form 4 weeks later, they failed him and wrote
  that he had unprofessional conduct (because he
  disappeared without notifying anyone.)
 When the student was contacted by the Dean’s office to
  get his side of the story, he said he had been harassed
  (verbally), and that the elective had been very poorly
  organized. This was why he had left.
 Although the student’s allegations were looked
  into and some changes were made, the fact that
  these allegations only came up AFTER he was
  told he had been failed, significantly weakened
  his case.
Tale # 2.
 Jan 19th: Med student (MS) e-mailed his family med
  supervisor saying that a female patient of his had
  called his home and said she’d fallen in love with him.
  MS says he told her that it was inappropriate for her
  to call his house, and that it would be impossible to
  see her. MS was worried that she would continue to
  harass him and asked for his supervisor’s advice.
 Supervisor e-mailed back the same day telling MS he
  did the right thing and if she actually comes to the
  house, to call the police. With MS’s permission, the
  supervisor e-mailed Dr. Pickering a copy of the e-mail
  correspondence.
 Feb. 4th, Dr. Pickering received a letter from the
  Director of Professional Services of the hospital. He
  has been notified by a staff psychiatrist that a patient
  claims that a medical student (MS) made sexual
  advances (drove her home, kissed her on the lips.)
  Patient was not complaining, in fact the patient felt
  complimented by these advances, but the psychiatrist
  reported it because it was unprofessional behaviour.
  The patient told the psychiatrist about it on Jan 26th.
  The patient was reluctant to have it reported, but
  finally agreed.
 Feb. 6th. Dr. Pickering called the psychiatrist. The
  psychiatrist had meanwhile seen the patient again
  (Feb. 2nd). The psychiatrist told the patient that he
  had reported the event. The patient felt “bad” and
  then retracted almost everything she had said.
 Because the student notified the supervisor
  BEFORE the patient mentioned anything, the
  student’s account was more credible and the
  case was closed.
 These sorts of incidents are UNUSUAL but
  illustrate the point . . .

  “A ounce of prevention is worth a pound of
  cure.”
For the Introduction to Clerkship
course (1 week) :
 All sessions are mandatory (unless marked
  otherwise)
     Please sign in as requested
     Signing for anyone else or having them sign
      for you is unprofessional behaviour.
     If you have reasons to be absent (eg doctor’s
      appointment etc), please provide
      documentation to Nicole Guedon
      (clinicaladmin.med@mcgill.ca).
 Please . . .
      Arrive on time
      Don’t leave in the middle
 Lecturers in turn have been asked to ensure
  they finish on time and respect the break
  times scheduled.
 Please make all class announcements at
  11:50, or at 15:50.
 All material that you will be tested on will be
  covered in the lectures
 Readings are to reinforce lectures, but not to
  cover any new material.
 Some lectures will only be posted on line
  after the session is given.
 Marking Scheme;
     50% attendance
     50% MCQ question exam
         Questions from all sessions, including this one.
“Clerkship – the Student’s View” and Senior
clerkship information: Monday 15:00
 Optional session.
 Three students (class of 2007) will give you some
  “student to student” pointers. (30 minutes)
 This will be followed by an information session given
  by Dr. Pickering for those who would like to start
  thinking about senior clerkship rotation sequences
  (15 minutes)
 All information will be available on line
 All information will be repeated at our Senior
  clerkship information session in October, before you
  are asked to make any choices.
Now onto your favourite director of
student affairs
                     Who will talk about
                      personal coping
                      strategies…
                     Career planning . . .
                     And much, much more .
                      ..

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:22
posted:6/20/2012
language:English
pages:47