1. Transition to Clerkships July 5, 2013 © 2012 University of Utah School of Medicine

2. Pagers! Pick up your pager Pick up Instruction Sheet Sign the pager sign-out sheet Write down your number! © 2012 University of Utah School of Medicine

3. Student Affairs Dress Code Excused absences Timeline MSPE AOA © 2012 University of Utah School of Medicine

4. Medical Education Student Assessments (Evaluation Form, Evaluation Process, OSCE, Shelf) Formative Feedback Patient Logs Final Grade (Timeliness, appeal process) Honors End of Third Year OSCE © 2012 University of Utah School of Medicine

5. PEL Shelf failure policy Student evaluation of Clerkship, Faculty and Residents Debriefing sessions Accommodation requests Mistreatment Student Handbook © 2012 University of Utah School of Medicine

6. Dress Code Formal Dress Code Policy in Student Handbook Dress as good or better than the attending Ties on Psych? White Coats on Peds? © 2012 University of Utah School of Medicine

7. Excused Absences Formal excused absences through Student Affairs – Deaths, serous illness, etc – Tell your team! Other absences – be creative with days off © 2012 University of Utah School of Medicine

8. Timeline © 2012 University of Utah School of Medicine JanFebMarAprMayJuneJulyAugSeptOctNovDecJanFebMarAprMay Administrative Lottery ERASMSPE RankMatch Grad Exams OSCE Step 2 CK (Oct 31st) and CS (Dec 31st) Interviews Courses Longitudinal Preparation for InternshipoffCourse Transition Course Mentoring Pre-lottery Pre-ERAS LOR, CV, PS Submit Interviews Rank List Knowledge Simulation Sim Specialty Sim

9. Tracks and Specialties

10. Timeline Lottery We will meet as a class to discuss at length You can take some fourth year courses now! © 2012 University of Utah School of Medicine

11. End of 3 rd year OSCE Med/Ed will discuss at length Typically ~May Prep for Step2 CS © 2012 University of Utah School of Medicine

12. Timeline © 2012 University of Utah School of Medicine JanFebMarAprMayJuneJulyAugSeptOctNovDecJanFebMarAprMay Administrative Lottery ERASMSPE RankMatch Grad Exams OSCE Step 2 CK (Oct 31st) and CS (Dec 31st) Interviews Courses Longitudinal Preparation for InternshipoffCourse Transition Course Mentoring Pre-lottery Pre-ERAS LOR, CV, PS Submit Interviews Rank List Knowledge Simulation Sim Specialty Sim

13. MSPE National History Wide variation historically Guidelines published by AAMC in 2002 – “Letter of evaluation” rather than letter of recommendation – Standardized format Release deadline move from Nov 1 st to Oct 1 st

14. Local history Excellent adherence to AAMC guidelines Input fields from all other areas of Dean’s Office (OIO, PEL, Med ED, etc.) Compilations 8-10 pages in length

15. My Vision Accurately portray the true consistent performance of our students Provide useful information to the end user (program directors) Maintain institutional integrity Foster student desire to excel rather than compete

16. First Page IDENTIFYING INFORMATION Chelsea Smith is a fourth-year student at the University of Utah School of Medicine applying to your program for residency training. This letter is meant to provide an overview of Chelsea’s academic performance and personal characteristics to assist you in your assessment of her application. Chelsea came to the University Of Utah School Of Medicine in 2011 after earning a Bachelor of Science degree in Biology from University of Notre Dame, and her PhD in Anthropology from the University of Utah.

17. First Page UNIQUE CHARACTERISTICS Chelsea is a resourceful innovator, looking for opportunities in learning and service. As a first year student, she noticed that there were plenty of opportunities addressing global health for medical students, but none addressing the unique needs of Utah's own population. Over the course of the year she developed contacts within the Utah Navajo Health Service. In doing so, she created an alternative spring break program for students interested in volunteering for under-served populations just hours from Salt Lake City in Montezuma Creek and Monument Valley. Chelsea has held positions of leadership. She served as the president of the Pediatric Medicine Interest Group. Chelsea is also very excited to be the principal investigator for her research project, a quality improvement study to help identify possible socio-demographic factors contributing to poorly controlled asthma in the pediatric population. She expects to publish her abstract and to present her research findings later this year.

18. Second page

19. ACADEMIC HISTORY Combined Degree:No Leaves of Absences, Extensions, Gaps:Yes. Chelsea took a personal leave of absence from August 2012 to December 2012. Coursework Remediated or Repeated:Yes. Chelsea successfully remediated her Comprehensive Clinical Skills Examination at the end of her third year. Disciplinary Action(s): No

20. ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II) Pre-clerkship Academic Record: Chelsea successfully passed all courses during the first two years of medical school, including the following units: Foundations of Medicine (Pass/Fail only) Molecules, Cells and Cancer - Honors Host and Defense Life Cycle Brain and Behavior - Honors Metabolism and Reproduction Circulation, Respiration and Regulation Skin, Muscle, Bone and Joint

21. ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II) Clinical Experiences: Chelsea successfully completed all expectations for her Longitudinal Clinical Experience (LCE) and Subspecialty Clinical Experience (SCE) in her first two years of medical school, giving her over 1,700 hours of clinical exposure before beginning her Clerkship Year, Phase III. Details on LCE and SCE are provided in the Appendix. Chelsea’s LCE faculty attending physician noted the following: “Very professional and interested in outpatient medicine.”

22. ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II) Scholarly Expectation: Medical students are required to participate in an independent program of study that promotes students’ expertise in one or more areas of medicine, their ability to perform inquiry-based research, to ask scholarly questions and to effectively communicate the rationale for and results of their scholarly work. – Chelsea reviewed patient charts and culled data from an Intermountain Healthcare database of infectious diseases affecting Utah communities. She used these data to examine the relationship between community viral infections and childhood leukemia. Chelsea presented her work at the 2010 annual Frank Tyler Medical Student Research Symposium in Park City, UT.

23. Community Service Learning Experience: All students are required to participate in community service learning projects in the first two years of the curriculum. Chelsea exceeded the service requirements of the UUSOM, completed at the following venues: 4 th Street Clinic 4 th Street Triathlon Flu Vaccines for the Homeless Maliheh Free Clinic Chelsea received an “Honors” in this service-learning requirement. “Honors” is awarded to students who completed 75+ hours directly with Utah and the surrounding communities in clinical, education and premedical programs supervised by the Office of Inclusion and Outreach. ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II)

24. Professionalism: The professionalism of our students is routinely addressed throughout all elements of the 4-year curriculum. Chelsea has met the professional expectations of the UUSOM as outlined in the Student Handbook, including: Honesty, Confidentiality, Respect for others and Responsibility. ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II)

25. MSI Comprehensive Clinical Skills Examination (Pass/Fail): Pass MSII Comprehensive Clinical Skills Examination (Pass/Fail): Pass ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II)

26. ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III) Student performance is based upon achievements in the areas of medical knowledge, patient care and professionalism. Each component is used to calculate an overall clerkship score using a four point scale: 4 = Exceptional; 3 = Above expectation; 2 = Meets Expectation; 1 = Below Expectation; 0 = Unacceptable. Narrative comments are provided by faculty and clerkship directors and are edited the Associate Dean of Student Affairs only for grammar and length.

27. ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III) Students have always been encouraged to review their final performance evaluations, and have 30 days from the time of receipt to accomplish this task. Now, more than ever, we are encouraging all students to review the information contained in the section “Paragraph to be included in the Student’s MSPE” to check for accuracy. It will not be possible to amend the content after the 30 day time period; this final paragraph will be directly imported in the MSPE and will not be changed by the Associate Dean of Student Affairs.

28. Clerkship MSPE Example Internal Medicine (12 weeks) Score: 2.97, Pass Chelsea’s Internal Medicine attendings made the following comments about her: “Chelsea had a solid performance during this rotation and I am sure she will go on to do well.” “Student was very engaged during rounds, would read about her patient’s issues and overall did a very good job on Medicine.” “Chelsea was a valuable member of the Internal Medicine team during her first third-year clerkship.” “Chelsea was easy to work with. She seemed to really care about her patients. She was a hard worker and sought out responsibility.” “Excited about patient care and medicine. Took responsibility for patients and would call consultants. Very helpful.” “Organization, willingness to learn, works well with team (are her strengths).”

29. ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III) Cumulative (year-long) performance on individual clinical competencies required for passing the clerkships – Clinical Knowledge – Professionalism – Patient Care Scores (0-4 scale) taken directly from Clerkship Final Grade Form

30. Clinical Knowledge Score

31. Pass 3.65 3.79 3.81

32. ACADEMIC PROGRESS: Track Curriculum (Phase IV) Grades and narrative from any courses that have a grade submitted prior to deadline. A list of fourth year courses schedule to be completed

34. SUMMARY Chelsea is a caring professional who is dedicated to her profession and to community advocacy. As of the submission of this letter, she has successfully completed the University of Utah School of Medicine curriculum. Based on all aspects of Mary’s educational experience, she has demonstrated competency in all of the general domains established by the medical school and is prepared to enter residency. She is considered to be an excellent candidate for your residency program.

35. AOA Calculation and Class Description Calculated at the completion of Phase III – Step 1 score10% – Phase I and II40% – Phase III50% No class rank is every released or made public Descriptors are used instead of class rank or quartiles/histograms

36. Summary Descriptor Descriptors of summary performance – “Outstanding, Excellent, Very Good, Good” Describe the criteria needed to achieve each level Provide relative percentages for top descriptor only (“Outstanding”)

37. Preliminary Descriptor Criteria Large list of potential inclusion points Only fair to use data that were disclosed would be on the MSPE – Not fair to include end of 2 nd year OSCE for example. – Discussed with class leaders and removed Includes Phase II honors, Phase III grades, score and exams, Step 1 score, Step 2 score Should not be based on a ranking or average – i.e. “5 out of 7 clerkship honors” rather than “top 10%”

38. Journal Club First Clerkship Block – Or second clerkship block for those starting clerkships block 2 Rooms – HSEB 2908 – Surgery – HSEB 2912 – Pediatrics – HSEB 2929 – Internal Medicine – HSEB 2931 – Ob/Gyn – HSEB 2949 – Psychiatry – HSEB 2962 – Family Medicine © 2012 University of Utah School of Medicine

39. Resident Panel Participants © 2012 University of Utah School of Medicine