KEY MESSAGE for the CLINICAL YEARS Your actions make a difference in patient care!
Clinical years are radically different from prior schooling! Expect to be more like a physician rather than a student! Critical features include: being able to adapt being part of the team demonstrating professional behavior communicating effectively
We’re talking radically different! M3 & M4 years are an “apprenticeship.” You learn the art and science of medicine by assisting the health care team in providing care to patients. Essentially, this is your first job as a physician!
The bad news You will work extremely hard. You will work many more hours than ever before. You are at the bottom rung of the health care ladder. This is a very unfamiliar situation.
The good news!! Providing care for patients is extremely rewarding!! The participation in patient care promotes very active learning. You will learn more about medicine (and yourself) than ever before. You will be extremely well prepared for internship and beyond.
Clinical Years Students simultaneously both learn and practice the roles inherent in the profession of medicine. Science and Art Academic and Professional
Spend full days in the hospital or outpatient clinic (physically & emotionally demanding, but very rewarding) Rotations go year-round Often present 7 days a week On call or overnight shifts Study time remains intense, but you must learn to work it into your busy schedule Self education is critical Spend your time on clerkships, which are very different from “school”
Faculty will be looking for: reading weighing evidence ability to make decisions and justify them core personal & professional values acceptance of responsibility large amounts of self- learning all in the context of patient care. What is expected
anticipate a major shift in responsibility prepare for self-monitoring & self-education actively look for opportunities to develop the skills the faculty are seeking Advice
M3 Year has Grades!! Honors High Pass Pass Fail
Grades in M3 Year Society and the Faculty expect excellence. A pass grade signifies excellence and indicates that the student is appropriately progressing to the high expectations that society places on our profession. Pass is the majority grade in the M3 year.
Grading Components Performance based evaluations are the core of the profession: “Clinical Evaluations” Formal quantitative evaluations are supplementary: e.g. exams, papers Primary responsibility for grading rests with faculty Residents/Interns have input in grading
Clinical Evaluations The considered judgment of your performance level. Application of Knowledge Skills Attitudes Level of Professionalism
Recommended Percentages Honors and High Pass grades are awarded based on performance that is above the excellence level. 15% - 20% - Honors 40% -45% - High Pass
Clinical training takes place in many hospitals and other outpatient sites University of Michigan Hospitals Veterans Administration Hospital UMMC Outpatient Sites Chelsea Community Hospital St. Joseph Mercy Hospital Major sites for M3 clerkships:
Transportation Reliable transportation is necessary in the 3rd and 4th years (the bus system is not adequate) Lack of transportation is not a rationale for placement in Ann Arbor During a clerkship, you may be required to go to a site that is not your “home” site
Parking Parking is difficult for everyone –Patients –Faculty –Staff –As well as students Parking for students at the University of Michigan is very LIMITED URL: http://www.med.umich.edu/medstudents/ http://www.med.umich.edu/medstudents/ Under: Student Life; Parking Sometimes there are parking coupons available for off-site (out of Ann Arbor) students returning for required lectures. More information on these will be given during your clerkship orientations.
Housing at Off-Site Locations Family Medicine sites Toledo provides housing and meals Grand Rapids provides limited housing (no meals) Students generally request Grand Rapids if they have family/friends in the area. (Students are not placed at any sites until housing arrangements have been worked out.) None – Commute to these sites: St. Joseph Mercy Hospital Neurology @ Jackson Remember: You are a guest!
M1 & M2 Experiences have begun to prepare you for the Clerkships: Physical Diagnosis Fundamentals SPI Exercises Family Centered Experience Clinical Educator Sessions Cardiac, Pulmonary, Musculoskeletal and Neurological “Classics” M2 CCA – Feb 1,2,4,5, (2013)
Help is Available Attending Physician Senior Resident Clerkship Director/ Depart. Education Office Office of Medical Student Education: –Tamara Gay, M.D. –Eric Middleton, Ph.D. –Amy Tschirhart, M.A., LPC
Professional Behavior is Paramount Examples of unprofessional behavior might include: Inappropriate interactions with patients Drugs and alcohol Inappropriate dress (ppt)(ppt) Tardiness Breach of patient confidentiality Inappropriate interactions with staff and team Untimely response to email/pages
Extracurricular Activities M3 Clerkship Directors agree that the M3 year is a core year, and Clerkship time is essential. Time off for other extracurricular activities is not allowed: regardless of the merit of the activity. Societies/Volunteering Medical Meetings Extracurricular Educational Activities
Guidelines for Absences It is expected that you are present for all clerkship activities (the standard is 100% attendance) It is your responsibility to notify the attending faculty of an absence An absence should be arranged 3 months in advance (complete policy in handbook)
Caveat: Progression through the clinical years is not automatic; progression depends on both academic adequacy and professional behavior
You must convince the faculty that you are ready and able to be a competent physician in order to graduate in May, 2015
Overview of the 3rd Year M3 year is devoted to required rotations on major disciplines Internal Medicine 12 weeks Surgery8 weeks Pediatrics8 weeks Obstetrics/Gynecology6 weeks Psychiatry6 weeks Family Medicine4 weeks Neurology4 weeks 48 weeks
This calendar found on Page 22 of your M3 Handbook Perio ds 4/8/12 Week Experiences Periods6 Week Experiences General Scheduling Notes Introduction to the Clinical Years (M3) - Tue, 5/7/13 - Fri, 5/10/13 Weekends that occur during a clerkship will be scheduled by the department 15/13/13 - 6/9/13 15/13/13 - 6/23/13* Some clerkships have overnight call/shifts 26/10/13 - 7/7/13 2.56/24/13 - 8/4/13* 37/8/13 - 8/4/13 Official Medical School Holidays/Breaks Holiday Period BeginsHoliday Period Ends 48/5/13 - 9/1/13 48/5/13 - 9/15/13* Memorial Day11 PM, Sun 5/26/135 AM, Tue 5/28/13 Independence Day11 PM, Wed 7/3/135 AM, Fri 7/5/13 59/2/13 - 9/29/13 Labor Day11 PM, Sun 9/1/135 AM, Tue 9/3/13 5.59/16/13 - 10/27/13 Thanksgiving5 PM, Wed 11/27/135 AM, Mon 12/2/13 69/30/13 - 10/27/13 Winter Break5 PM, Fri 12/20/135 AM, Mon 1/13/14 MLK, Jr. Day11 PM, Sun 1/19/145 AM, Tue 1/21/14 710/28/13 - 11/24/13 710/28/13 - 12/8/13* M3 Vacation5 PM, Fri 5/2/147 AM, Mon 5/12/14 811/25/13 - 12/22/13 8.5 12/9/13- 2/9/14* Winter Break 12/23/13-1/12/14 Holiday Scheduling Notes Winter Break 12/23/13 - 1/12/14 Some clerkships may allow a bit more time off, but the listed times will be the minimum time that you will have for each of these holidays/breaks. 91/13/14 - 2/9/14 Subinternships 102/10/14 - 3/9/14 102/10/14 - 3/23/14 Because of the increased level of patient care responsibilities on subinternship experiences, the student's responsibiliites may take precedence over holiday time 113/10/14 - 4/6/14 Students on subinternships must discuss any time off with the attending staff 11.53/24/14 - 5/4/14* MLK, Jr. Day 124/7/14 - 5/4/14 The University and the Medical Center will host programs throughout the day, and all students are excused from classes and clinical responsibilities so that they may partake in these programs, except for subinterns, as noted above M3 Vacation May 5-11, 2014 *Please see schedule: "Official Medical School Holidays/Breaks" Other Important Dates: Senior Year EndsFriday, May 2, 2014 GraduationFriday, May 16, 2014 M4 CCA 2013May 29th -31st, and June 3rd-4th M4 CCA Makeup DatesTBA 2013-14 Clinical Calendar
Holidays Memorial Day Independence Day Labor Day Thanksgiving weekend (Thursday through Sunday) Martin Luther King Day By default Holidays will begin at 11 PM the night before and end at 5 AM the day after
M3 Longitudinal Curriculum Seminars in Medicine Series Feedback on Clinical Skills
Seminars in Medicine Most Fridays 3-5 p.m. FORD AUDITORIUM Allow multi-departmental presentations of material that crosses disciplines Allow for classmate contact Examples: –Acid-Base –Demystifying Malpractice –Management of Fluids and Electrolytes
Designed to simulate a real clinical encounter –H&P with an SPI, ordering labs and radiology, writing a note, presenting the patient You will be observed by a faculty member and will receive feedback from both the faculty member and the SPI 2 sessions during the M3 Year You will be excused from clinical responsibilities to participate M3 Feedback on Clinical Skills (FCS)
Other Curricular Considerations M4 CCA: May 2014 USMLE: Step 2 CK (Clinical Knowledge – 1 day multiple choice) Step 2 CS (Clinical Skills – ½ day practical) Summer/Fall 2014
M4 CCA Comprehensive Clinical Assessment Early in M4 Year A practical exam that tests the art and science of being a competent physician
Component III 48 Week Calendar There will be a 3 week break following Period 8 (December 23, 2013– January 12, 2014) This calendar found on Page 23 of your M3 Handbook
COMPONENT III CLERKSHIP SCHEDULING FORM 2013-14
Schedules Preference work sheets are available today and will be available on line, Wednesday, December 12, at 8 AM Cindy Murphy in the Office of Student Programs will be available for questions tomorrow morning Submission is via the internet Deadline is TUESDAY, December 18 @ 5:00 p.m. URL: https://www.umms.med.umich.edu/srsched/
Commencement of Junior Year, 2013 M3 Year begins with training sessions: Tues, May 7 – Friday, May 10 Specific orientation sessions for some Clerkships will also occur during that time (Neurology, Pediatrics and Internal Medicine) If you wish to start Period 1, attendance is REQUIRED. Period 1 begins: Mon., May 13, 2013
Questions? Sequence of clerkships does not affect academic performance There will be an informal Lunch at noon, Tuesday, December 18th in MSI 3330. Cyril Grum, M.D. Cindy Murphy Current M3 and/or M4 students
There is not a sign in sheet for today. Questions??