Clinical Clerkship Manual - acom.edu · 2015 – 2016 ACOM Clinical Clerkship Manual i TABLE OF CONTENTS Philosophy of Osteopathic Medicine ... Internal Medicine Pratik Shah

Clinical Clerkship Manual

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TABLEOFCONTENTSPhilosophyofOsteopathicMedicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1OsteopathicPledgeofCommitment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1OsteopathicPhysician’sOath. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Overview.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2DivisionsofClinicalResourcesandClinicalSciences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2ClinicalResourcesStaff/ClerkshipRegionalCoordinators. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2ClinicalSciencesFaculty/Staff. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3GeneralInformationandGuidelinesforClinicalClerkships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

ClerkshipManagementSoftwareChangeofAddressProfessionalDemeanorandTitlesAppearanceLiabilityInsurancePersonalInsuranceTobacco,Drug,andAlcoholUseInappropriateConductPropertyofOthersNeedle‐StickandBlood‐BornePathogenExposureEligibilityforClerkshipsAssignmentofCoreClerkshipsClerkshipScheduleChangesCoreClerkships

ClinicalClerkshipSites. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8LengthofClerkshipsHoursofDutyAttendanceNon‐ClinicalExperiencesHIPPA

CoreCurriculum.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11ClassificationofClinicalClerkshipsOMS‐IIIClerkshipsOMS‐IVClerkshipsNumberofClerkshipsThirdYearClinicalClerkshipsDescriptionsOsteopathicPrinciples&PracticeDuringThirdYearClinicalClerkshipsFourthYearClinicalClerkshipDescriptionsLocatingSelectiveorElectiveClerkshipsProceduresforApplyingforClerkshipsatMilitaryEducationProgramsLocatingClerkshipsatMedicalEducationProgramsParticipatinginOut‐of‐NetworkSelectives/ElectivesAdditionalOptionsforElectiveClerkshipsLimitsonClerkshipsConfirmationofClerkshipAssignmentsPatientCareActivities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

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MedicalRecords/Charting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Portfolio/MilestoneCompetenciesLog. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22GradingGuidelinesforClinicalClerkships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23AssignmentofGradesGradingScaleIncompleteClerkshipsAssignmentoftheFinalGradeFailureofaClerkshipGradeAppealsCOMLEXExams.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24COMLEXLevel1COMLEXLevel2‐CEandLevel2‐PEStudentEvaluations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24CompetencyBasedEvaluationStudentResponsibilityforPreceptor’sEvaluationsEvaluationProcessStudentEvaluationofthePreceptor/SitePost‐ClerkshipExams.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29OMS‐IIICOMATExamsOMS‐IVPost‐ClerkshipExamsGraduationRequirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30AdditionalPoliciesandGuidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31TipsonMakingtheMostofEachClinicalClerkship. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32ClinicalClerkshipCoreSiteList. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33ClinicalClerkshipCoreSiteMap.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34PolicyandStatementofNon‐Discrimination.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35AppendixA:LearningAgreement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36AppendixB:ClinicalSkillsNecessaryforGraduation.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37AppendixC:ACOMGuidelinesforStudentParticipationinClinicalSettings. . . . . . . . . . . . . . . . . . . . . . . . . . . 42AppendixD:COMATScoreReleaseProcess. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46AppendixE:ProcessforParticipatinginSelectives/Electives.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47AppendixF:SchedulingAuditionRotations&ApplyingforResidency. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48AppendixG:TermstoKnow.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52AppendixH:OMS‐IICompetencies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60AppendixI:ACOMPatient‐CenteredInterviewingEvaluation.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64AppendixJ:ClerkshipRotationEvaluations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Mid‐RotationEvaluationPreceptorEvaluationofStudentEnd‐of‐ClerkshipSurveyAnnualSiteSurvey

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PHILOSOPHYOFOSTEOPATHICMEDICINE

Osteopathicmedicinestressesacomprehensiveapproachtothemaintenanceofhealth.Therootsofosteopathicmedicaleducationlieintheemphasisitplacesonthemusculoskeletalsystem.Theinterrelationshipbetweenthisandotherbodysystemsisbasictohealthmaintenanceandthepreventionofdisease.FoundedbyAndrewTaylorStill,MD,DO(1828‐1917),osteopathicmedicineutilizesfourfundamentalprincipleswhichenabletheosteopathicphysiciantolookathealthanddiseaseinauniquemanner:

Thebodyisaunit;thepersonisaunityofbody,mind,andspirit. Thebodyiscapableofself‐regulation,self‐healing,andhealthmaintenance. Structureandfunctionarereciprocallyinterrelated. Rationaltreatmentisbasedontheabovethreeprinciples.

OSTEOPATHICPLEDGEOFCOMMITMENT

Ipledgeto:

Providecompassionate,qualitycaretomypatients; Partnerwiththemtopromotehealth; Displayintegrityandprofessionalismthroughoutmycareer; Advancethephilosophy,practice,andscienceofosteopathicmedicine; Continuelife‐longlearning; Supportmyprofessionwithloyaltyinaction,wordanddeed;and Liveeachdayasanexampleofwhatanosteopathicphysicianshouldbe.

OSTEOPATHICPHYSICIAN’SOATH

IdoherebyaffirmmyloyaltytotheprofessionIamabouttoenter.Iwillbemindfulalwaysofmygreatresponsibilitytopreservethehealthandthelifeofmypatients,toretaintheirconfidenceandrespectbothasaphysicianandafriendwhowillguardtheirsecretswithscrupuloushonorandfidelity,toperformfaithfullymyprofessionalduties,toemployonlythoserecognizedmethodsoftreatmentconsistentwithgoodjudgmentandwithmyskillandability,keepinginmindalwaysnature'slawsandthebody'sinherentcapacityforrecovery.

Iwillbeevervigilantinaidingthegeneralwelfareofthecommunity,sustainingitslawsandinstitutions,notengaginginthosepracticeswhichwillinanywaybringshameordiscredituponmyselformyprofession.Iwillgivenodrugsfordeadlypurposestoanyperson,thoughitbeaskedofme.

Iwillendeavortoworkinaccordwithmycolleaguesinaspiritofprogressivecooperation,andneverbywordorbyactcastimputationsuponthemortheirrightfulpractices.

Iwilllookwithrespectandesteemuponallthosewhohavetaughtmemyart.TomycollegeIwillbeloyalandstrivealwaysforitsbestinterestsandfortheinterestsofthestudentswhowillcomeafterme.IwillbeeveralerttofurthertheapplicationofbasicbiologictruthstothehealingartsandtodeveloptheprinciplesofosteopathywhichwerefirstenunciatedbyAndrewTaylorStill.

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Overview

ThismanualprovidesanoverviewofthecurrentpoliciesandproceduresofAlabamaCollegeofOsteopathicMedicine(ACOM)pertainingtothird‐andfourth‐yearclinicalclerkships.ACOMreservestherighttomakechangesatanytimeineducationalpolicies,schedules,trainingsites,evaluationprocedures,oranyotheraspectsoftheclinicaltrainingprogram.Changeswilloccur,asneeded,tomaintaineducationalrequirements,standards,orthequalityoftheprogram.Everyeffortwillbemadetonotifystudentsinatimelymannerwhenchangesareimplementedandneworrevisedpoliciesareinstituted.Changeswillbeeffectiveonthedateofthenotification.AnyconflictsregardingtheapplicationorinterpretationofthepoliciescontainedinthismanualwillberesolvedbytheDeanofClinicalSciences,whosedecisionisfinal.TheStudentHandbookistheprimarystudentguideandtheClinicalClerkshipManualisasupplementforusebyOMS‐IIIandOMS‐IVstudentswhileonclerkships.

DivisionsofClinicalResourcesandClinicalSciences

MissionandBasicProcedures

TheDivisionofClinicalResourcesisdedicatedtoprovidingstudentswiththehighestqualityclinicaleducationalopportunitiesandprovidingexceptionalservicetoeveryonewithwhomweinteract.Eachstudentisassignedtoacoresite,whichismanagedbyadirectorandcoordinator,andconnectedtoaregionalcoordinatorforthatgeographicalregion.Collectively,theschedulesandassignmentsarecoordinatedbythesepersonnel.Clinicalassignmentsarebasedonmultiplefactors,includingavailabilityofpreceptors.

TheDivisionofClinicalScienceswillprovidestudentswithawell‐integrateddidacticandexperientialcurriculumthatwillbroadenstudents’medicalknowledgeandtaskthemtoapplythatknowledgeinclinicalsettingscommontoclinicalcare.ACOMClinicalSciencesFacultywillserveasclerkshipchairsandasfacilitatorsforclerkshipdidactics.ACOMpreceptorswillassessstudentabilitiesatthePointofCare,onrounds,andduringotherclerkshipvenues.

OnlyclinicalclerkshipsscheduledthroughandconfirmedbytheDivisionofClinicalResourcesandapprovedbytheDivisionofClinicalScienceswillfulfilltherequirementsoftheclinicalcurriculum.Noclinicalclerkshipwillbeacceptedforcreditunlessapprovedandconfirmedinadvance.

Asyllabusforeachrequiredclerkship,includingdidactics,readingassignments,andgradingcriteria,willbeprovidedbytheClerkshipChair.ClerkshipChairswillalsoassignthefinalgrade.

DivisionHours

RegularhoursfortheDivisionsofClinicalResourcesandClinicalSciencesare8:00a.m.to4:30p.m.CentralTime,excludingdayswhentheACOMcampusisclosed.Itisrecommended,becauseofvaryingschedules,thatcommunicationbetweenstudentsandtheDivisionsismadeprimarilyviaemail.Alongwithemail,theACOMvoicemailsystemisactivetwenty‐fourhoursaday,includingweekendsandholidays.Voicemailmayanswercallsifstaffmembersareunavailable.Anemergencycallschedulewillbepublishedannually.

ClinicalResourcesStaff/RegionalCoordinators

TheClinicalResourcesstaffwillprovidestudentswithguidanceandassistanceinpreparingtheirclinicalclerkshipschedule.Allplansmustbesubmittedinwritingtotheassignedstaffmemberwhowillprepareafinal,confirmedplan.

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STAFFNAME POSITION PHONE EMAIL

WilBaker,PhDAssociateDeanofClinicalResources

334‐944‐4051251‐947‐6288 [email protected]

CherylGibson DirectorofClerkshipResourcesManagement 334‐944‐4028 [email protected]

LisaPitman,RN RegionalCoordinator–North

334‐944‐4074 [email protected]

LeighKincer RegionalCoordinator–Central


BeckyJordan,RNRegionalCoordinator–

South 334‐944‐4076 [email protected]

ClinicalSciencesFaculty/Staff

TheClinicalSciencesfacultyandstaffwillprovidestudentswithguidanceandassistanceinclerkshiprotationdidactics,grading,andgeneralcurriculumissues.

CLERKSHIPCHAIRS

CLERKSHIP CHAIR PHONE EMAIL

BehavioralMedicine BascomBradshaw,DO,MPH,MAS


EmergencyMedicine JohnT.Giannini,Jr.,MD 334‐944‐4055 [email protected]

FamilyMedicineElizabethHengstebeck,

DO 334‐944‐4026 [email protected]

InternalMedicine PratikShah,DO 334‐944‐4071 [email protected]

Obstetrics/GynecologyVancePowell,DO,FAODME,FACOOG 334‐944‐4059 [email protected]

Pediatrics HeathParker,DO 334‐944‐4049 [email protected]

SurgeryVancePowell,DO,FAODME,FACOOG 334‐944‐4059 [email protected]

Selectives/Electives StephenJ.Miller,DO,MPH,FACOFP


FACULTY/STAFF

NAME POSITION PHONE EMAIL

StephenJ.Miller,DO,MPH,FACOFP

AssociateDeanofClinicalSciences


KimberlyCummings,LPN ExecutiveAssistant 334‐944‐4024 [email protected]

AmandaGantClinicalSciencesCoordinator 334‐944‐4025 [email protected]

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GeneralInformationandGuidelinesforClinicalClerkships

ClerkshipManagementSoftware

ACOMusesE*Valuemanagementsoftwaretoscheduleclinicalclerkships,recordstudentevaluations,andmanagetheclinicalexperiencesofstudents.StudentsreceiveinstructionsfromtheirRegionalCoordinatorwithlogininformation,username,andpasswordtoaccesstheirclinicalschedule,reviewevaluations,andcompleteevaluationsoftheirpreceptorsandclerkshipsites.

ChangeofAddress

Itisimportantthateachstudent’sRegionalCoordinatorbekeptuptodateoncurrentcontactinformation.Failuretopromptlyreportachangeinmailingaddress,telephonenumber,orothercontactinformationcanresultinfailuretoreceiveinformationimportanttothesuccessfulcompletionofclinicalclerkships.Itistheresponsibilityofthestudenttosupplycurrentandtimelycontactinformation.

ProfessionalDemeanorandTitles

Allstudentsareheldtohighprofessionalstandardsregardingtruthfulnessinwordanddeedregardingacademicandclinicalmatters.Studentsareexpectedtoperformatthehighestlevelofprofessionalism.Anydeviationfromthatstandardasjudgedbytheclinicalsitemaybecauseforfailureofthatclerkship.ReportedviolationsofprofessionalismmayresultinreferraltotheStudentProgressCommittee.

Studentswillrefertothemselvesas“Firstname,Lastname,third/fourthyearmedicalstudentatAlabamaCollegeofOsteopathicMedicine”inaclinicalsetting.Asagroup,studentsarereferredtoas“MedicalStudents.”Studentswillrefertootherprofessionalsintheclinicalsettingbytheirappropriatetitle,suchas“Dr.Smith,”“Ms.Jones,”etc.Studentsarenevertorepresentthemselvesaslicensedphysicians.Ifastudenthasadoctoraldegreeinanyfield,thistitlecannotbeusedwhileinanyclinicalsettingwhetherinastudentenvironmentornot.Studentsmayexpecttobetreatedasprofessionalsbyallclinicalpersonnelatalltimes,andinturnconductthemselvesprofessionally,ethically,andrespectfullyinregardtoallclinicandhospitalpersonnelandinteractions.Courtesyandaprofessionaldemeanoratalltimesareessentialtraitsforaphysician.

Appearance

Schoolofficialsandpreceptorsarethefinalarbitersofappropriatestudentappearance.Ifastudent’sappearanceisnotappropriate,studentsmaybeimmediatelyremovedfromclinicaldutiesandaskedtocorrecttheproblembeforecontinuingwithclinicalduties.Thefollowingrulesapplyatalltimeswhilethestudentisparticipatinginclerkshipactivities:

Thestudentwilldressinaneatandprofessionalmanner:o Conservativehairstyles,o Conservativemake‐upandjewelryo Neatlytrimmedmoustachesandbeardso Novisiblebodypiercingortattooso Clean,pressedwhitecoat

Professionalattireincludes:o Formen:dressshirt,dresspants,tie,closedtoedressshoesandsockso Forwomen:dressorskirtnotmorethan3inchesabovetheknee,ordressslacks,

conservativedressblouseorshirt,closedtoedressshoesandpantyhoseorsockso Noperfume,cologne,orscentedbodysprays

Thestudentwillmaintainacriticalawarenessofpersonalhygiene. AwhitestudentclinicjacketdisplayingtheACOMpatchandanACOMnamebadgeisrequiredatall

timesbyallstudentswheninaclinicalenvironment.

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SomefacilitiesmayrequirestudentstowearordisplaytheirsitespecificnamebadgeorIDinadditiontothatrequiredbytheschool.

Foractivitieswhereaninstitutionrequires“scrubs”orotheralternativeorprotectiveattire,thealternativeattirewillbeprovidedbytheinstitution,remaintheinstitution’sproperty,andremainattheinstitutionatalltimes.Scrubsarenottobewornawayfromortravelingtoandfromtheclinicaltrainingsiteandaretobereturnedtothetrainingsiteuponcompletionoftheclerkship.

Theaboverequirementsapplyfromthefirstdayoftheclerkshiptotheendoftheclerkship,unlessthepreceptorspecificallyrequestsdeviationfromtheabove.

IfanaffiliatedhospitalorclinicalsitehasadresscodethatdiffersfromACOM’sstandards,thestudentwillfollowthedresscodeofthetrainingfacility.

LiabilityInsurance

TheCollegeprovidesliabilityinsurancecoverageforstudentsonapprovedclinicalclerkshipswhiletheyaredirectlyunderthesupervisionoftheassignedpreceptorordesignee.TheCollege'sliabilitycoveragedoesnotapplytounsupervisedstudentclinicalactivity.AnyclerkshipnotofficiallyscheduledthroughtheClinicalResourcesDivisionandapprovedbytheClinicalSciencesDivisionwillnotberecognizedforofficialcredittowardgraduationrequirements.

PersonalInsurance

Studentsarerequiredtohavepersonalhealthinsurancewhileonclinicalclerkships.Studentsmaybeaskedtoshowevidencetotheclinicaltrainingsitethathealthinsuranceisinplace.

Tobacco,Drug,andAlcoholUseUnlawfulmanufacture,distribution,dispensation,possession,oruseofacontrolledsubstancebyanystudentoftheAlabamaCollegeofOsteopathicMedicinewhileheorsheisonCollegeproperty,involvedinCollegeactivities,oratanyclerkshipsite,isprohibited.TheCollegewilltakedisciplinaryactionagainstastudent,groupofstudents,orstudentorganizationforanyviolationofthispolicy.Astudentorstudentorganizationmayalsobedisciplinedfor,andisdeemedinviolationoftheCodeofEthicsandHonorfor,theunlawfulpossessionorconsumptionatanyclerkshiprotationsiteofalcoholicbeverages,publicdrunkenness,orviolationofstateorlocallawsregardingalcoholuseorpossession.Useofanytobaccoproductornonprescriptionnarcoticisprohibitedatanyclerkshiprotationsite.StudentsarealsorequiredtoadheretotheTobacco,Drug,andAlcoholpolicyoftheirclerkshiprotationsitewhileintrainingatthatsite,anditwillsupersedeACOM’sclerkshippolicyonlyifitsmorerestrictive.SeeACOM’sStudentHandbookathttp://www.acomedu.org/wp‐content/uploads/2014/12/2014‐2015‐ACOM‐Student‐Handbook.pdfformoreinformation.AnydisciplinaryactionstobetakenandthedisciplinaryprocedurestobeappliedforthefairadjudicationoftheallegedviolationswillbeinaccordancewithpoliciesandprocedurespublishedintheStudentHandbook.InappropriateConductTheStudentHandbookprovidesadditionalinformationaboutappropriatestudentconduct,andtheStudentProgressCommitteewilladdressissueswhichariseregardingstudentconduct.

PropertyofOthers

Studentswillnottaketemporaryorpermanentpossessionofhospitalorpreceptorproperty(books,journals,food,scrubs,etc.)withouttheowner'sexpressedpermission.Suchitemsshouldbereturnedatthecompletionoftheclinicalclerkship.

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Needle‐StickandBlood‐BornePathogenExposure

Ifastudentexperiencesaneedlestick,puncturewound,accident,orsharpinjury,orisotherwiseexposedtobodilyfluidsofapatientwhileonaclinicalclerkship,thestudentshould:

1. Immediatelywashthearea,scrubbingskinwithsoapandwater.2. Immediatelyreporttheincidenttotheattendingphysicianorotherappropriatesupervising

physicianconcerninghis/herwhereaboutsandwell‐being.Promptreportingisessential.Insomecases,post‐exposuretreatmentmayberecommendedandshouldbestartedassoonaspossible.

3. Seekpost‐exposureservices.Clinicalsiteswillhaveapolicyinplaceforblood‐bornepathogens,withapointofcontact.Thestudentshouldfollowthepolicyofthetrainingsite.Ifonacoreclerkship,contacttheCoreSiteCoordinatorforinstructions.Ifonanon‐coreclerkship,contactthenursingsupervisororemployeehealthservice.Iftheexposureoccursafterhoursorifthestudentcannotlocateapersontoguidethem,heorsheshouldgoimmediatelytotheemergencydepartmentandidentifyhimself/herselfasastudentwhohasjustsustainedanexposure.

4. ContacttheDivisionofClinicalResourceswithin24hoursforinstructionregardingreportingtheincident,handlingcostsforpost‐exposuretreatment,etc.

EligibilityforClerkships

1. OnlyACOMstudentscurrentlyenrolledasOMS‐IIIorOMS‐IVstudentswillbeallowedonclinicalclerkships.Tobeeligibletobeginclinicalclerkships,studentsmustsuccessfullycompletetheentirecourseofstudyforyeartwoandhaveachievedapassingCOMLEX1score.Tobeeligibletobegin4thyearclerkships,studentsmustsuccessfullycompleteallcomponentsof3rdyearclerkships.Inaspecialcircumstance,suchasanincompletegrade,thestudentmaybegin4thyearclerkships,butaholdwillbeplacedonthestudentrecorduntilallthirdyearrequirementsaremet,whichmayhindersubsequentregistration.

2. StudentswhopassLevelIafterthetermhasbegunmustenrollinaminimumof4credithours(atleastoneclerkship)inordertomeettheenrollmentrequirementsassociatedwithFederalStudentLoandisbursements.Formoreinformation,pleasecontacttheOfficeofFinancialAid.

3. StudentsmusthavecurrenttraininginBasicLifeSupport(BLS),AdvancedCardiacLifeSupport(ACLS),OSHA,HIPAA,UniversalPrecautionsandsteriletechnique.Trainingintheseareaswillbeprovidedoncampusbeforetheendofyeartwo.AttendanceismandatoryatsessionspertainingtothesetopicsprovidedatACOMandatanyclinicalclerkshipsiteatwhichtheyarerequired.

4. StudentsareresponsibletokeepacopyofBLSandACLScertificationcardsandpresenttotrainingsitesuponrequest.Itistheresponsibilityofthestudenttorecertifyintheseareasbeforethecertificationexpirationdate.Studentsareencouragedtolocateandregisterforrecertificationcoursesthreemonthsinadvanceoftheexpirationdatetoensurethatcertificationisnotinterrupted.Manycorehospitalsandotherclinicalclerkshipsitesroutinelyofferrecertificationclasses,oftenfreeofchargetostudents.

5. Studentsmusthavepersonalhealthinsuranceandprovideproofofinsurancetoclinicalsiteswhenrequested.

6. Thefollowingdocumentationisrequiredbymostclinicaltrainingsites.StudentsmustprovidetheDivisionofClinicalResourceswiththesedocumentsbyApril15oftheirOMS‐IIyear.

a. Requiredimmunizationsandtitersdemonstratingimmunity:

Immunizations:HepatitisBseriesMMRboosterTdaPboosterVaricellaBooster

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SerumTiterstoproveimmunity:VaricellaIgGtiterMeaslesIgGtiterMumpsIgGtiterRubellaIgGtiterHepatitisBSurfaceAntibodytiter

IfdocumentationoftheaboveimmunizationsandtitersisnotcurrentandonfilewiththeDivisionofClinicalResourcesbeforeclerkshipsbegin,thestudentwillnotbeallowedtobeginclinicalclerkships.Itis,therefore,importantforstudentstocomplywiththeApril15deadlineforsubmissionofimmunizationandtiterdocumentationsothatdiscrepanciescanbeclearedpriortothestudent’sfirstscheduledclerkship.Ifyouhaveaninsufficienttiterresult,thesubsequentvaccinationandfollow‐uptiterisonyou.SAMCEmployeeHealthwillworkwithyou,butyouareresponsibleforcostsincurred.

b. Manyclerkshipsitesrequireanannualinfluenzavaccination,usuallybyDecember1ofeachyear.Studentsarestronglyencouragedtoobtaintheinfluenzavaccinationandkeepdocumentationonhandtoprovidetoclerkshipsitesuponrequest.

c. AnannualTBtestmustbecurrentandonfilebyApril15ofeachyear;chestradiographyisrequiredeverytwoyearsiftheTBtestisconsideredpositive.

d. UpdatedCertifiedBackgroundCheck:TheCertifiedBackgroundreportsubmittedforadmissiontoACOMwillnotmeetthisrequirement.AnupdatedreportmustbecompletedandonfilewiththeDivisionofClinicalResourcesbyApril15oftheOMS‐IIyear.

e. Ten‐PanelDrugScreen:ThedrugscreencompletedforadmissiontoACOMwillnotmeetthisrequirement.AnupdateddrugscreenmustbecompletedbetweenFebruary1standApril1standonfilewiththeDivisionofClinicalResourcesbyApril15oftheOMS‐IIyear.

f. StudentswillreceiveinstructionsfromtheDivisionofClinicalResourcesregardingprocedurestoobtainanupdatedcriminalbackgroundcheckanddrugscreen.

g. CertifiedBackground.comwillberesponsiblefortrackingandinterpretingresultsforconductedbackgroundchecksanddrugtests,inadditiontoreportsofphysicalexaminationsandimmunizationssubmittedbyACOMstudents.

Someclinicaltrainingsitesmayrequiredocumentationinadditiontothatlistedabove.Studentsshouldpaycloseattentiontoclerkshiprequirementswhenapplyingforplacementatnon‐ACOMsites.Studentsmustadheretoandcompletefacility‐specificorientationand/ortrainingrequirementsateachclerkshipsite,evenifrepetitiveofrequirementsmetatACOMorpreviousclerkshipsites.Forexample,studentsmayberequiredtoattendHIPAAtrainingateachoftheirtrainingsites.

AssignmentofCoreClerkships

CoresitesandclerkshipsareassignedbytheDivisionofClinicalResources.Beforecompletionofthesecondyear,studentsranktheirtopchoicesforcoresites.Usinga“scheduleoptimization”(lottery)process,theDivisionofClinicalResourceswillassigncoresitesbased,totheextentpossible,onthestudent’stopchoices.Therewillbeaone‐to‐twoweektradingperiodaftercoresitesareassignedwhenstudentswillbeallowedtoswitchtheircoresiteassignmentwithotherstudents,afterwhichscheduleswillbesetandfinalized.Afterthetradingperiodends,studentswillnotbepermittedtochangecoresites.

ClerkshipScheduleChanges

Studentsmayrequestchanginganelectiveorselectiveclerkshipwith60days’noticetotheDivisionofClinicalResources.Thestudentshouldsendtherequest,withareasonforthechange,byemailtohis/herregionalcoordinator.Eachrequestwillbeconsideredonacase‐by‐casebasis.

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CoreClerkships

CoreclerkshipswillbecompletedduringtheOMS‐IIIyearatanassignedcoresite.Coreclerkshipsmayrequirethestudenttoworkwithavarietyofinstructorsatvariouslevels,includinginterns,residents,andattendingphysicians.Thefollowingareguidelinesfortheclinicalclerkshipexperience:

Thestudentisclinicallyresponsibletothepersontowhomhe/sheisassignedatthattime. Studentswillcomplywithallrulesandregulationsatthecoresiteandanyinstitutiontowhichthey

areassigned.o Ifassignedtoahospital,clinic,orotherinstitution,theinstitutionwilldefinewhatbenefitsthe

studentswillhavewhileattheinstitution(e.g.discountedorfreemeals,lodging,etc.)andunderwhatcircumstancesthestudentswillhaveaccesstothosebenefits.

o Theinstitutionisresponsiblefordeterminingthedegreeofstudentinvolvementatthatinstitutionincludingaccesstothefacilityandareaswithinthefacility,clinicalaccesstopatients,accessandcontributiontothemedicalrecord,andobservationandparticipationinprocedures.

o Eachstudentshouldhaveaccesstothehospitallibraryorlearningresourcescenterinthesamecapacityasphysiciansandhousestaffattheinstitution.

Studentswillconductthemselvesduringtheclerkshipasthoughtheywereguestsinsomeoneelse'shome.Conductotherwisemayresultindisciplinaryactionbythehospitaland/orACOMincludingdismissalfromtheclerkshipand/orreferraltotheStudentProgressCommittee.

Studentswillreturnanyborrowedpropertybeforetheendoftheclerkship,includingsurgicalgarb,librarymaterials,textbooks,pagersorotheritems.

ClinicalClerkshipSites

ACOMprovidesclinicaltrainingexperiencesprimarilyinAlabama,althoughexcellentsitesareavailableinotherlocations.StudentswillreceivethehighestqualityclerkshipexperiencesthroughtheframeworkestablishedbytheAlabamaMedicalEducationConsortium(AMEC).Since2005,medicalstudentsfrompartnerschoolshaveservedtheirthirdandfourthyearclerkshipsinthecoresitessetupbyAMECandmanagedbycoresitedirectors(physicians)andcoordinators.Thisenrichedandexpandingclinicalnetwork,coupledwithmaturecoresitemanagement,addsvaluetotheclinicalclerkshipexperienceforACOMstudents.

TheDivisionofClinicalResourcesassignsstudentstospecificcoreclerkships.ThesemandatedlearningexperiencesareatsiteswithpreceptorswhoprovideACOMwithtrainingopportunitiesandfromwhomtheschoolgetsqualityassessmentsofstudentsthroughouttheirclinicaltraining.

Studentswillcompletethesespecificcoreclerkshipsoverthecourseoftheirthirdyearoftrainingatassignedcoresites.Theseeducationalexposuresoccurinapractical,clinicalenvironmentdesignedtodevelopexpertiseinpatientdiagnosisandmanagement.Inadditiontooutpatientexperiencesathospital‐basedclinics,free‐standingclinics,andphysicians’offices,studentswillbeprovidedwithinpatientclinicalexperiencesathospitalsandmedicalcenters.

Duringthethirdyear,thestudentwillbeassignedtoacoresite.Eachsitewillbecenteredonacarefullyselectedhospitalwithsufficientresourcestoprovidethethirdyearcurricularplan.Thefourthyearcurriculumisintendedtobuildonthefoundationalexperienceprovidedinthethirdyear.Fourthyearexperiencesareinsettingswheremoredemandsforindependencecanbeexpectedoftheseniormedicalstudent.Flexibilityisprovidedbythreeclerkshipsofelectivetimeinthethirdyearanduptoeightclerkshipsofelectivetimeinthefourthyeartogivestudentsampleopportunitytopursuetheirspecialinterests.

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AcurrentlistofACOMclerkshipsitestowhichstudentswillbeassignedcanbefoundattheendofthisdocument.Theseclinicalclerkshipsaredirectedtowardareasofmedicinethatareimportantintheprimarycarepractice.

Formalclinicalaffiliationagreementsareinplacewiththesetrainingsites.Studentsareexpectedtocomplywiththepolicies,procedures,andgeneralrulesofthetrainingfacilityatwhichanyclerkshipiscompleted.Theinstitutionisresponsiblefordeterminingthedegreeofstudentinvolvementatthatinstitution,includingaccesstothefacilityandareaswithinthefacility,clinicalaccesstopatients,accessandcontributiontopatients’medicalrecords,aswellasobservationandparticipationinprocedures.Eachstudentshouldhaveaccesstothehospitallibraryorlearningresourcescenterinthesamecapacityasphysiciansandhousestaffattheinstitution.

LengthofClerkships

Theminimumlengthofaclerkshipisfour(4)consecutiveweeksatthesamesitewithasinglephysicianorahospitalresponsibletotheschoolforthestudent'seducationduringtheclerkship.Aclerkshipmaynotbe"split"unlessbyapprovalbytheAssociateDeanofClinicalSciencesatleastfourweekspriortothescheduledonsetoftheclerkship.

HoursofDuty

Eachclinicaltrainingsitesetsitsownschedule.Nightcall,weekendcoverage,andholidayassignmentsareatthediscretionofthetrainingsite.

Clerkshipsbeginat7:00a.m.onthefirstMondayoftheclerkshipblockandendat7:00p.m.onFridayevening26dayslater.Deviationfromthesehoursisatthediscretionofthesupervisingphysicianpreceptor. Studentsmaynottakecallorremainonserviceafter7:00p.m.onthelastFridayoftheclerkship.Ifthesupervisingphysiciandeviatesfromtheclerkshipplanandhasplannednumerous"daysoff"suchashis/herpersonalvacation,thestudentshouldcontacttheclerkshipchairforadviceandcounsel.

Atypicalworkweekis60–72hoursperweek.Theworkweekshallbelimitedtoaminimumof45hoursandamaximumof80hours,averagedoverthefour‐weekperiodoftheclerkship.Studentsmaynot“compress”theirclerkshipschedule,workingextrahourssomeweeksinordertocompletetheclerkshipinlessthanfourweeks.

Themaximumdurationofanyworkperiodwillbe24hoursandmustbefollowedbyaminimumof12hoursoffduty.Nostudentshallberequiredtobeoncallorperformnightdutyafteradayshiftmorethanonceeverythreedays.

Studentsshallbegivenaminimumoftwodaysoffevery14days.Thisrequirementmaybemetbygivingastudenteveryotherweekendoff,butthisisatthediscretionofthesupervisingphysician.

Departurepriortothescheduleddeparturedatewillbeconsideredanunexcusedabsenceandmayresultinfailureoftheclerkship,unlessapprovedbythesupervisingphysicianandtheclerkshipchair.

Onthefinalweekendoftherotation,thestudentmustbegivenadequatetimetotraveltothenextclerkshiprotationsite.ItisintendedthatSaturdayandSundayarealltraveldays,andthatallstudentassignmentsarecompletedbythefinalFridayoftheclerkshiprotation.

Attendance

Onehundredpercentattendanceisexpectedatallclinicalclerkships.Anyabsenceduringscheduledclerkshipworkhours,foranyreason,mustbearrangedwithandexcusedbythepreceptorandreportedtotheregionalcoordinatorinadvance.Thestudentmustreporttheabsencetotheirregionalcoordinatorinadvance.Ifonacoreclerkship,thestudentmustalsonotifytheSiteCoordinator.

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Anyabsenceduringclerkshipworkhoursmustbemadeupbythestudentinaccordancetoaplanpre‐approvedbythepreceptor.

Extendedabsenceswillnotbeexcusedfortraveltoelectiveclerkshipsand/ormedicalmissionwork.Studentswillusetheweekendbetweenclerkshipsfortraveltimetothenextclerkship.Ifastudentneedsadditionaltimetotraveltoageographicallydistantclerkship,thisshouldbediscussedwiththesupervisingphysicianofthecurrentclerkshipandthestudent’sregionalcoordinatorassoonastheneedisknown.

Anabsencefromaclerkshipwillbeexcusedonlyunderextremecircumstances.Studentscannotbeabsentfromanyclerkshipexperiencewithoutpermissionfromthesupervisingphysician.AbsencefromaclerkshipinexcessofthreedaysoranyunexcusedabsencewillbereviewedbytheAssociateDeanofClinicalSciencesandmayresultinrepetitionorfailureoftheclerkship.

Thestudentmaybeexcused,withpriorapprovalfromthestudent’sregionalcoordinator,forCOMLEXUSAexaminations.OnedayofexcusedabsenceisallowedforCOMLEXLevel2CE.StudentsareencouragedtoscheduletheNBOME/COMLEXexamatatestingcenterincloseproximitytotheirtrainingsite.OnedayofexcusedabsenceisallowedfortheCOMLEXLevel2PEexam.Theseabsencesmustbeasawrittenrequestinadvancetothestudent’sregionalcoordinator.Studentsshoulddiscusswiththesupervisingphysicianonthefirstdayoftheaffectedclerkshiptheirneedforreleasetimefortesting.Studentswishingtotakeadditionaltimeforlicensureexamstudyorreview,maybeapprovedtodosobytheAssociateDeanofStudents,butwillberequiredtotakealeaveofabsenceandmakeupthetimepriortograduation.

ShouldastudentreceiveanoticeforJuryDuty,he/shemayobtainaletterfromtheClinicalResourcesDivisiondescribingaclinicalstudent'sdutiesandobligationsandverifyingthestatusof"fulltimestudent,"whichshouldsufficeforexcusalfromjuryduty,butdoesnotexcusethestudentfromjuryduty;onlyajudicialofficialhastheauthoritytoexcusethestudentfromservingonajury.TheClinicalResourcesDivisionwillworkwiththestudentindividuallytoensurethatsuchrequestsareprovidedinatimelyandaccuratemanner.

ACOMmaintains,andthestudentmustrecognize,thatfulfillmentoftheacademicprogramistoppriorityandthatitisthestudent’sresponsibilitytofulfillallcourseandclerkshiprequirements.

ACOMdoesnotspecificallyallowtimeofffortheUSMLEexamorforinterviewsforpostdoctoralpositions.Withapprovalfromthesupervisingphysician,timemissedmaybemadeupbytakingnightcallorweekendcall.

Ifapersonalhealthproblemorfamilymedicalproblempreventsastudentfrommeetingtheassignedresponsibilities,thestudentshouldimmediatelycontacttheirregionalcoordinator.Awrittenphysician'snotemustbepresentedtoallinvolvedpartiesforanyabsenceexceeding24hours.Alllosttimeisexpectedtobemadeupwithnightorweekendduty,atthedirectionofthesupervisingphysicianorSiteDirector.

Dishonestytoapreceptorortheschool(suchasportrayingoneselfas"ill"whenthatisnotthecase)isinappropriatebehavior.Shouldastudentdecidetotaketimeawayfromaclerkshipforreasonsotherthanthoselistedaboveorbefoundtobedishonestlyportrayinghis/herreasonforbeingawayfromaclerkship,the"unexcusedabsence"policywillapply.Inaddition,thecircumstancesregardingtheabsencemaybereferredtotheStudentProgressCommittee.Violationsofstudentconductcanresultinadverseconsequencesuptoandincludingsuspensionand/ordismissal.RefertotheStudentHandbookregardingstandardsofconductandtheStudentProgressCommittee.

Non‐ClinicalExperiences

Itisimportantforstudentstoobserveandparticipateinnon‐clinicalexperiencessuchastumorboard,journalclub,orhospitalcommitteesinordertounderstandandappreciatethefullspectrumofactivitiesinwhichphysiciansareinvolved.Studentsareexpectedtoparticipateinasmanynon‐clinicalexperiencesasareapprovedbythepreceptor.

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HealthInsurancePortabilityandAccountabilityAct(HIPAA)

StudentswillabidebytherulesestablishedbyHIPAAwithafocusonmaintainingprivacyofProtectedHealthInformation(PHI).Thisincludesprohibitionofdiscussingpatientinformationinaninappropriatemannerorsetting.

CoreCurriculum

ACOMentrustsitsvariousclinicaltrainingsites,SiteDirectors,andSupervisingPhysicianstotrainstudentsforexcellenceinclinicalpractice.Thepreceptorsandclinicaltrainingsiteswillimplementthecurriculuminamannerthatbalancesthelearningneedsofthestudentsandtheeducationalresourcesavailableatthesite.Toenhancelearning,preceptorsandsitesareencouragedtouseavarietyofteachingtechniques,includingobservation,monitoredparticipation,videoandaudiorecordings,computers,readings,individualdiscussions,andpresentationsbystudents,faculty,andothers.Specificcurricularexpectationsareoutlinedinthecurriculumsyllabusforeachoftherequiredclerkships.

Theclinicalyears(3rdand4th)willconsistofclinic,hospital,andoffice‐basedtraining.AllfacultyareapprovedbyACOMbasedoninterestanddedicationtoteachingaswellastheevaluationoftheCurriculaVitae(CV)andbackgroundchecks.TheclinicalcurriculareflectthemissionofthecollegethroughplanningandevaluationintheAcademicPlanningandEvaluationCommitteeforCurriculum(APECC)andtheinputandreviewoftheDean’sCabinet.

Entryintoanythirdyearcourserequiressuccessfulcompletionoftheentirecourseofstudyofthesecondyear.Duringthethirdyear,thestudentwillbeassignedtoacoresite.Eachsitewillcoordinatewithclinicsandhospitalswithina50‐mileradiuswithsufficientresourcestoprovidethethirdyearcorecurricularplan.ThecoreexperiencewithinthesitewillconsistofthefollowingREQUIREDclerkships:onemonthofBehavioralMedicine,twomonthsofInternalMedicine,onemonthofGeneralSurgery,onemonthofObstetrics/Gynecology,onemonthofPediatrics,andonemonthofFamilyMedicine.Theremainderoftheyearisdesignatedforselectivesandelectives.

Thefourthyearcurriculumisintendedtobuildonthefoundationalexperienceprovidedinthethirdyear.TheonlyrequiredclerkshipisEmergencyMedicine.Fourthyearexperiencesareinsettingswheremoredemandsforindependencecanbeexpectedoftheseniormedicalstudent.Electiveswillallowstudentstotraveltolocationsforclerkshipsintheirchosenspecialtyinpreparationforapplicationtoresidencyprograms.

Ateachcoresite,therewillbeaCoreSiteDirectorandCoreSiteCoordinator.TheCoreSiteDirectormanagesthecoresiteanditsoperation,aswellasdirectinginteractionwiththeCollegeregardingstudentperformance.TheCoreSiteCoordinatormanagestheday‐to‐dayactivitiesofstudents,suchaspreceptorassignment,evaluations,lectures,andpost‐clerkshipexams.TheCoreSiteCoordinatorwillcontactthestudentbeforecoreclerkshipsbeginregardingstudentexpectations,housing,orientationactivities,andotherpertinentinformation.

ClassificationofClinicalClerkships

Clinicalclerkshipsareclassifiedasrequiredcore,selectiveorelective:

a. RequiredCoreClerkships:RequiredcoreclerkshipsareassignedbytheDivisionofClinicalResourcesandcannotbechangedbythestudent.

b. SelectiveClerkships:Studentswillcompletetwoselectiveclerkshipsduringthethirdyear:onemedicalselectiveandonesurgicalselective.Selectivesmustbeperformedinahospitalsetting.SelectiveclerkshipsmustbechosenfromtheselectiveclerkshipslistapprovedbyACOM.ThepreceptorforaselectiveclerkshipmaybeamemberoftheACOMClinicalFacultyoradjunct

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faculty,orafacultymemberofanaffiliatedmedicalschool.Ifastudentwishestocompleteaselectiveclerkshipwithaphysiciannotontheapprovedfacultylist,thatphysicianmustfirstreceiveapprovalthroughtheDivisionofClinicalSciences

c. ElectiveClerkships:Studentswillcompletethreeelectiveclerkshipsduringtheirthirdyearanduptoeightelectiveclerkshipsduringtheirfourthyear.Electivescanbeinanyspecialtyandatanymedicalfacility.Preceptorsforelectiveclerkshipsmaybeanylicensed,practicingphysicianapprovedbytheDivisionofClinicalSciencesandisnotrequiredtobeamemberoftheACOMClinicalFaculty.Studentsareencouragedtoscheduleelectiveclerkshipsinavarietyofclinicalpracticeareasforbroad‐basedclinicalexposure.Studentsmaynotcompletemorethantwoelectiveclerkshipswiththesamesupervisingphysicianoverthecombinationofthethirdandfourthyear.

OMS‐IIIClerkships

a. CoreHospitalClerkships:ClerkshipsarecompletedduringtheOMS‐IIIyear.

b. StudentshavetheoptiontocompleteselectiveclerkshipsatlocationsotherthanatACOMcoresitesprovidedtheclerkshipsareapprovedbytheDivisionofClinicalSciences60daysinadvance.

Clerkships CourseNumbers #of4WeekRotationsCore:BehavioralMedicine DOCLIN801 1Core:InternalMedicineI DOCLIN 802 1Core:InternalMedicineII DOCLIN 803 1

Core:Obstetrics/Gynecology DOCLIN 804 1Core:GeneralSurgery DOCLIN 805 1

Core:Pediatrics DOCLIN 806 1Core:FamilyMedicine DOCLIN 807 1

*Selectives DOCLIN 810‐839 2**Electives DOCLIN 840‐899 3TOTAL 12

*SelectivesmustbechosenfromdesignatedspecialtiesapprovedbytheAssociateDeanforClinicalSciences.Formonthone,studentschoosefromamedicinespecialty,andformonthtwo,studentschoosefromasurgicalspecialty.Ifastudentchoosestofulfilltheclerkshipwithaphysiciannotontheapprovedlist,he/shemustfirstreceiveapprovalthroughtheDivisionofClinicalSciences

SelectiveChoices:(CoursenumbersDOCLIN810‐839willbeassigned)

MonthOne‐Medicine:GeneralInternalMedicine DOCLIN810Gastroenterology DOCLIN811Cardiology DOCLIN812Nephrology DOCLIN813Pulmonology DOCLIN814Hematology/Oncology DOCLIN815Rheumatology DOCLIN816Neurology DOCLIN817

MonthTwo‐Surgery:GeneralSurgery DOCLIN818Orthopedics DOCLIN819ENT DOCLIN820 Ophthalmology DOCLIN821Urology DOCLIN822Urogynecology DOCLIN823GynecologicalSurgeryDOCLIN824

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ElectiveChoices:(CoursenumbersDOCLIN840‐899willbeassigned)

**Electivesshallnotbewiththesamephysicianformorethantwomonthsforthecombinationofthe3rdand4thyears.

GeneralInternalMedicine DOCLIN840Gastroenterology DOCLIN841Cardiology DOCLIN842Nephrology DOCLIN843Pulmonology DOCLIN844Hematology/Oncology DOCLIN845Rheumatology DOCLIN846Neurology DOCLIN847Allergy/Immunology DOCLIN848CriticalCareMedicine DOCLIN849InfectiousDiseases DOCLIN850AdolescentMedicine DOCLIN851EmergencyMedicine DOCLIN852Endocrinology DOCLIN853

Pediatrics DOCLIN854OB/GYN DOCLIN855SportsMedicine DOCLIN857GeneralSurgery DOCLIN861Neurosurgery DOCLIN862Otolaryngology DOCLIN863Anesthesiology DOCLIN864VascularSurgery DOCLIN865Orthopedics DOCLIN866ENT DOCLIN867Ophthalmology DOCLIN868Urology DOCLIN869

Radiology DOCLIN873Dermatology DOCLIN874Women’sHealth DOCLIN875BehavioralHealth DOCLIN876FamilyMedicine DOCLIN877OMM DOCLIN878Geriatrics DOCLIN879PM&R DOCLIN880OccupationalMedicine DOCLIN881InternationalMedicine DOCLIN882AddictionMedicine DOCLIN883Pathology DOCLIN884FQHC DOCLIN885

SAMPLESTUDENTSCHEDULE‐ThirdYear

OMS‐IVClerkships

a. EmergencyMedicine:OMS‐IVstudentswillcompleteafour‐weekemergencymedicineclerkshipattheircoresiteoranaffiliatedsite.

Fall2015SemesterCourses

CreditHours

Spring2016SemesterCourses

CreditHours

Summer2016SemesterCourses

CreditHours

ElectiveI 4 SelectiveII 4 ElectiveII 4InternalMedicineI 4 FamilyMedicine 4 ElectiveIII 4InternalMedicineII 4 OB/GYN 4 SelectiveI 4 Pediatrics 4 GeneralSurgery 4 BehavioralMedicine 4 TOTAL 20 TOTAL 20 TOTAL 8

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Clerkships CourseNumbers #of4WeekRotationsCore:EmergencyMedicine DOCLIN903 1

**Electives DOCLIN 940‐999 9TOTAL 10

ElectiveChoices:(CoursenumbersDOCLIN940‐999willbeassigned)

**Electivesshallnotbeinthesamespecialtyformorethanfourmonthsforthecombinationofthe3rdand4thyears.Studentsmaynotpreceptwiththesamephysicianformorethantwomonthsforthecombinationofthe3rdand4thyears.

GeneralInternalMedicine DOCLIN940Gastroenterology DOCLIN941Cardiology DOCLIN942Nephrology DOCLIN943Pulmonology DOCLIN944Hematology/Oncology DOCLIN945Rheumatology DOCLIN946Neurology DOCLIN947Allergy/Immunology DOCLIN948CriticalCareMedicine DOCLIN949InfectiousDiseases DOCLIN950AdolescentMedicine DOCLIN951EmergencyMedicine DOCLIN952Endocrinology DOCLIN953

Pediatrics DOCLIN954OB/GYN DOCLIN955SportsMedicine DOCLIN957GeneralSurgery DOCLIN961Neurosurgery DOCLIN962Otolaryngology DOCLIN963Anesthesiology DOCLIN964VascularSurgery DOCLIN965Orthopedics DOCLIN966ENT DOCLIN967Ophthalmology DOCLIN968Urology DOCLIN969

Radiology DOCLIN973Dermatology DOCLIN974Women’sHealth DOCLIN975BehavioralHealth DOCLIN976FamilyMedicine DOCLIN977OMM DOCLIN978Geriatrics DOCLIN979PM&R DOCLIN980OccupationalMedicine DOCLIN981InternationalMedicine DOCLIN982AddictionMedicine DOCLIN983Pathology DOCLIN984FQHC DOCLIN985Hospice&PalliativeCare DOCLIN999

SAMPLESTUDENTSCHEDULE‐FourthYear

Fall2015SemesterCourses CreditHours

Spring2016SemesterCourses CreditHours

ElectiveI 4 EmergencyMedicine 4ElectiveII 4 ElectiveVI 4ElectiveIII 4 ElectiveVII 4ElectiveIV 4 ElectiveVIII 4ElectiveV 4 ElectiveIX 4TOTAL 20 TOTAL 20

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NumberofClerkships

Studentswillcomplete22clinicalclerkshipsinthethirdandfourthyear,eachofwhichisrepresentedasacourseonthestudent’stranscript.Twelveclerkshipsarecompletedduringthethirdyearandtenclerkshipsarecompletedduringthefourthyear.

ThirdYearClinicalClerkshipDescriptions:

DOCLIN801)BehavioralMedicine:Fourweeksfocusingontheevaluation,intervention,andmanagementofthepsychiatricpatient.Emphasisisplacedonthemedicalstudentlearningthetriageandcommunityintegrationoftreatmentmodels,treatingthepatientinthesettingclosetohomeratherthantheinpatientpsychiatrichospital.Thismonthwilloffertheintegrationofthepsychiatrictreatmentmodelwiththegoalofcommunitytreatmentandplacementforthementallyillpatient.

DOCLIN802)InternalMedicineI:Fourweeksoftraininginclinicandhospitalsettingsleadingtoafoundationalunderstandingofgeneralmedicalproblemsintheadultmaleandfemalepatients.ThisprecedesandrepresentsarequirementforInternalMedicineII.

DOCLIN803)InternalMedicineII:FourweeksoftrainingwiththesameobjectivesasIMI.IncreasestheconsolidationofeducationalgoalsbyprovidingcontinuityofenvironmentandfacultyfoundinIMI.

DOCLIN804)Obstetrics/Gynecology:Fourweeksoftrainingintheinpatientoroutpatientsettingtoobtainacceptablecompetencyforamedicalstudentinthecareofmedicalandsurgicalissuesrelatedtothefemalegenitourinarysystem.Thiswillincludetheevaluationandcareofthepregnantpatientforprenatal,deliveryandpost‐natalperiod.

DOCLIN805)GeneralSurgery:Fourweeksoftraininginthehospitalsettingunderthesupervisionofahospital‐basedgeneralsurgeon(s).Thiswillincludetheevaluation,surgicalintervention,consultation,andfollow‐upoftheadultmaleandfemalepopulation.

DOCLIN806)Pediatrics:Fourweeksofclinicaltrainingintheoutpatientand/orinpatientsetting.Thestudentwilllearntotakeanappropriatehistoryformaleandfemalepatientsfrombirthtoadulthood.Emphasiswillbeplacedonpreventivehealthmanagementforevaluationofgrowthmilestones,aswellasimmunizationstrategies.Identificationoftheacutelyillpatientwillbeintegratedintotheexperience.

DOCLIN807)FamilyMedicine:Fourweeksoftrainingwithafamilyphysicianstudentswillworkwithafamilyphysicianinordertogainamorecompleteperspectiveoftheuniquenessoffamilymedicineandfurthertheirlearningofclinicalknowledgeandskillsetsnecessarytopracticemedicineinavarietyofoutpatientandinpatientsettings.

DOCLIN810‐839)Selectives:TherearetwoSelectiveClerkshipsthatarerequiredinthethirdyear:oneinmedicine,theotherinsurgery.TheymustbedoneinahospitalsettingwithpreceptorsthatareapprovedbytheDivisionofClinicalSciences.Eachstudentwillbeassignedtoonephysician/physiciangrouptofollowandworkwithfacultythroughouthis/herscheduleofclinicalactivity.AllselectiveclerkshippreceptorswillbeapprovedbytheAlabamaCollegeofOsteopathicMedicine’sDivisionofClinicalSciences..TheDivisionofClinicalResourceswillofferapre‐approvedsetofclerkshipsitesfromwhichthestudentsmaychoosetherequiredselectiveclerkships,butstudentswillnotbelimitedintheirchoicetoonlythesesites.Siteevaluationsarecollectedandreviewed.

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DOCLIN840‐899)ElectivesElectivesmaybecompletedinanydiscipline,withanylicensedpracticingphysicianapprovedbytheDivisionofClinicalSciencesandarenotrequiredtobecompletedwithamemberoftheACOMclinicalfaculty.

OsteopathicPrinciples&PracticeDuringThirdYearClinicalClerkships

Duringallclerkshiprotations,studentswillworktoincorporateosteopathicstructuraldiagnosisandtreatmenttechniquesinallhospitalandoutpatientareas.Studentswillpre‐round;attendrounds,andpostroundatthediscretionofthepreceptor.Studentswillalsoobserveandparticipateinpatientcareatthediscretionofthepreceptor.Studentswillcompletethegradingelementsofthisexperienceduringtheircoreclerkshiprotations.Pleasenote:ThisisNOTaclerkship.Thisisacurricularrequirementthatwillrunthroughoutthelengthofthethirdyear.CompletionisrequiredinorderforstudentstostarttheirOMS‐IVyear.Formoreinformation,pleaseconsulttheOPPforClerkshipssyllabus.

FourthYearClinicalClerkshipDescriptions

DOCLIN903)EmergencyMedicine:Fourweeksoftrainingwithaprerequisiteofsuccessfulcompletionoftheentirethirdyearoftrainingpriortoentry.Studentswillbeeducatedintheinitialevaluationandstabilizationoftheacutelyillortraumatizedpatient.EducationofthetriageprocessattheentryintotheEmergencyDepartmentisincludedintheexperience.

DOCLIN940‐999)ElectivesElectivesmaybecompletedinanydiscipline,withanylicensedpracticingphysicianapprovedbytheDivisionofClinicalSciencesandarenotrequiredtobecompletedwithamemberoftheACOMclinicalfaculty.

LocatingSelectiveorElectiveClerkships

a. Ifthestudentfindsaselective/electiveclerkshipthat(s)hewouldliketodowithintheACOMnetwork,(s)heshouldcontacther/hisRegionalCoordinatorbyemailtorequesttheclerkship.ThemajorityofACOMpreceptorsareclinicianswithbusypractices,sotheymaynotalwaysbeavailableatthetimeforwhichtheclerkshipisrequested.

b. PersonalorProfessionalContactsIfastudentisinterestedincompletingaclerkshipwithaphysicianwhoisnotanACOMcredentialedpreceptor,butwhoisinterestedinacceptingstudentsforclinicalclerkships,thatstudentmayrequestapprovalfromtheDivisionofClinicalSciences.

Forelectiveclerkshipswithanewpreceptor,thestudentshouldsendthephysician'sname,practicename,telephonenumber,ande‐mailtotheAssociateDeanofClinicalSciences.

Forselectiveclerkships,thephysicianmaybecredentialedasamemberoftheACOMClinicalFaculty.

AffiliationAgreements:AstudentwhorequestsaclerkshipwithaphysicianwhoisnotacredentialedACOMpreceptormustdetermineiftheclinicorhospitalwherethepreceptorpracticeswillrequireanaffiliationagreementandwhatsupportingdocuments(immunizations,certificateofinsurance,etc.)shouldbeprovided.Thisinformation,alongwithcontactinformation(name,address,telephonenumber,andemailaddress)fortheclinicorhospitalmustbeprovidedtothestudent'sRegionalCoordinatoratleast120daysinadvanceoftheclerkshipstartdate.

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ApplyingforClerkshipsatMedicalEducationProgramsAphysicianwhoholdsafacultyappointmentwithanotherschoolofmedicineisnotrequiredtobecomeamemberoftheACOMClinicalFaculty.

Studentsmayapplyforclerkshipsatothermedicalschoolsandgraduatemedicaleducationprograms.Theseclerkshipsareoftenusedto"audition"forGMEprograms.Eachtrainingsitewillhaveitsownapplicationguidelinesandprocesses,whichtypicallycanbefoundontheinstitution'sorprogram'swebsite.Pleasenotethattheapplicationprocesswillvarywithdifferentprogramsandcanbetime‐consuming.Someprogramswillallowstudentstoapplyforaclerkshiprotationonline,whileotherswillrequirethesignatureoftheAssociateDeanofClinicalSciencesbeforeprocessingtherequest.StudentsmustcompletetheirportionoftheapplicationandforwardittohisorherRegionalCoordinator,alongwithachecklistofallitemsthatthehostprogramrequiresforacompletedstudentpacket.Iftheapplicationiscompletedonline,theapplicationchecklistmustbeforwardedtotheRegionalCoordinator.Ifthereisanapplicationfee,acheckshouldbeincludedwiththeapplication.TheRegionalCoordinatorwillforwardthecompletedapplicationpacket,alongwiththesupportingdocuments,suchasimmunizationrecordsandcertificateofliabilityinsurance,tothehostprogram.Studentsareresponsibleforsecuringhousingandforallcostsassociatedwiththeseclerkships.Clerkshipsatmedicaleducationprogramsshouldberequestedatleast120daysinadvancetoallowtimetocompletethenecessaryprocesses.Applicationsreceivedlessthansixtydayspriortothestartdateoftheclerkshipmaynotbeapproved.Inthatsituation,thestudentmaybeplacedatanalternativeclerkshipsiteatthediscretionoftheDivisionofClinicalSciences.

(Note:ActiveDutyMilitaryclerkshipswillfollowtheseproceduresaswell.)

LocatingClerkshipsatMedicalEducationPrograms:

StudentswillbeprovidedalistofpotentialresidencysitesbyMay1ofeachyearforthepurposeofschedulingauditionrotations.Studentswillfinditextremelyusefultoperformauditionrotationsatresidencyprogramstowhichtheyareinterestedinapplyingforresidency.Itisstronglyrecommendedthateachstudentperformauditionrotationsinatleastthree(3),ifnotfour(4),residencyprogramsinwhichtheyareinterested.TheusualauditionrotationseasonopensinJuneoftheOMS‐IIIyearandconcludesinlateNovemberoftheOMS‐IVyear.Studentsmayfindthefollowingwebsiteshelpfulinlocatingclerkshipsatmedicaleducationprograms:

AOAOnlineOpportunitiesdatabasehasinformationaboutosteopathicresidencyprograms.Mostprogramsacceptvisitingstudentsforclerkships.Informationcanbefoundatthefollowingaddress:http://www.opportunities.osteopathic.org/

FRIEDAOnlineisanonlinedatabasemaintainedbytheACGMEofaccreditedGMEprograms.http://www.ama‐assn.org/ama/pub/education‐careers/graduate‐medical‐education/freida‐online.page

AAMC‐MemberProgramhttp://www.aamc.org/students/medstudents/electives

VisitingStudentApplicationService(VSAS)SomeprogramsrequirestudentstoapplythroughVSAS.Detailscanbefoundathttps://services.aamc.org/20/vsas/

Studentsmayalsocontactprogramsdirectlyorreviewtheirwebsite(s).

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ParticipatinginOut‐of‐NetworkSelectives/Electives

a. StudentResponsibilities Studentidentifiespreceptororresidencyprogramandgetstentativeapprovalforclerkship

frompreceptor/program. Studentrequestsapprovalviae‐mailfromtheAssociateDeanofClinicalSciences.Approval

requestshouldincludethecompletedOutofNetworkRequestform,whichliststhefollowinginformation:preceptor’snameandCV;practicenameandcontactinformation,includingtelephoneande‐mailaddress;plusforwardthee‐mailthestudentreceivedfrompreceptor/programindicatingapprovalforclerkship.

b. DivisionofClinicalSciences TheAssociateDeanofClinicalSciencessendsapprovalviae‐mailtostudentandcopies

RegionalCoordinator

c. DivisionofClinicalResources RegionalCoordinatorusesinformationfromtheOutofNetworkRequestformtomake

initialcontactwiththepreceptor/program.Additionalinformationcanbeaccessedathttp://opportunities.osteopathic.org/search/search.cfmorhttp://www.ama‐assn.org/ama/pub/education‐careers/graduate‐medical‐education/freida‐online.page

RegionalCoordinatorconfirmsandprovidestheinformationasrequiredbythepreceptor/program/institution.Theestablishmentofcommunicationwiththehostinstitution/agencywillstarttheclockforexchange,reviewandapprovaloftheclerkshipactivity.IfapprovalfrombothACOMandthehostinstitutionisnotsecuredby60daysfromthestartdate,theprobabilityofcompletingthenecessaryrequirementsintimetostarttheclerkshipissignificantlydecreased.

Ifanaffiliationagreementisrequired,thestudentDOESNOTnegotiateit–theRegionalCoordinatordoes.

d. KeyAssumptionstoGuideandDirectOut‐of‐NetworkActivities RequestforapprovalforelectiveclerkshipsmustbereceivedatACOM120dayspriorto

requestedclerkship. ParticipationinanelectiveclerkshipwillbeatthefinaldiscretionoftheACOMandthehost

institution. Studentsmustpayanyapplicationand/orregistrationsfeesandmeetanyadditional

requirementsofhostagency/institutionasnotedinVisitingStudentApplicationServiceorpresentedbytheprogram.

Allapplicationsandsupplementalmaterialsmustbecompleted90dayspriortothestartofaclerkship.

AcompletedsubmissiontoACOMorthehostinstitutiondoesnotguaranteeapprovaloracceptance.

AdditionalOptionsforElectiveClerkshipRotations

Studentsmayconsiderthefollowingoptionswhenplanningelectiveclerkships:

a.InternationalStudies:OMS‐IVstudentswhoareingoodstandingmaycompleteuptotwointernationalclerkshipsinvolvingtheclinicalcareofpatients.Theprimarysitesupervisorforinternationalclerkshipsmustbealicensedphysicianqualifiedtopracticewithinthehostcountry.Studentswillberesponsibleforobtainingtheappropriatevisaandimmunizationsorotherprophylaxisrequirements.Internationalclerkshipsmustbeapprovedatleast60daysinadvance

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bytheDivisionofClinicalSciences.Theguidelines/applicationforinternationalclerkshipcanbeobtainedfromtheDeanofStudents.

b.ResearchElective:StudentswhoareingoodstandingmaycompleteuptotworesearchelectiveswithpriorapprovalbytheDivisionofClinicalSciencesandwithsponsorshipbyanACOMon‐campusfacultymemberoranACOMadjunctclinicalfacultymember.Aresearchelectivemayinvolve,butisnotlimitedto,thefollowing:clinicalinvestigation,policystudies,orhealthservicesresearchandmaybelaboratory‐based,practice‐based,orboth.Researchelectivesmustbeapprovedatleast60daysinadvancebytheDivisionofClinicalSciences.Guidelines/ApplicationsfortheresearchelectivecanbeobtainedfromtheDivisionofClinicalResources.

d.Off‐CycleClerkships:IfanOMS‐IVstudentisacceptedforanelectiveclerkshipatatrainingsitethathasaclerkshipscheduledifferentfromACOM,thestudentmustfirstaskifthatsitewillaccepttheACOMclerkshipschedule.Siteswilloftenaccommodatevaryingstudentschedulesinordertorecruitapplicantsfortheirresidencyprograms.IfthetrainingsitewillnotaccommodatetheACOMclerkshipschedule,theDivisionofClinicalScienceswillreviewthestudent’srequestforalternateschedulingonacase‐by‐casebasis.

LimitsonClerkships

a. Throughoutyears3and4,thestudentwillnotbepermittedtocompletemorethanfiveelective/selectiveclerkshipsinthesamespecialty.Forexample,astudentwhoisinterestedincardiologycoulduseamedicalselectiveincardiologyandthenuptofourelectiveclerkshipsincardiology.

b. Studentsmaynotcompletemorethantwoelective/selectiveclerkshipswiththesamepreceptor.c. Studentsmaycompleteonlyoneclerkshipwithapreceptorwhoisamemberofthestudent’s

family.Aclerkshipcompletedwithafamilymembermustbeanelectiveclerkship.d. Guidelinesonstudentparticipationinclinicalactivitieswhileonclerkshiprotationsareincludedin

thisdocumentasAppendixC.Theyaremeanttoberecommendationsforpoliciesconcerningstudentinvolvementintheclinicalsettingatallclerkshiprotationvenues.

ConfirmationofClerkshipAssignments

Itistheresponsibilityofthestudenttocontacteachsite7dayspriortoarrivaltoconfirmtheclerkship,obtaininstructionsregardingstarttime,dresscode,housingarrangementsandtoreceiveanyspecialinstructionsorassignmentsfortheclerkship.Itisrecommendedthatthesecontactsbemadeatleast2weeksinadvance.Thestudentshouldsendaletterofintroductionand/oraCV,andaphotographbeforestartingtheclerkshipasawayofintroducingthemselves(somesiteswillrequiretheseitems).Foranyclerkshipoccurringatacoresite,itisveryimportanttoworkwiththeSiteCoordinatortoconfirmtheclerkshipandcoordinateclerkshipdetails.Somecoresitesaskthatstudentsnotcontactpreceptorsdirectly,buttoarrangeclerkshipsthroughtheSiteCoordinator.ThestudentshouldconferwiththeCoordinatorattheircoresitetodeterminethebestmethodtoconfirmclerkshipsatthatsite.

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PatientCareActivities

Theclinicalsitewilldefinethedegreeofstudentinvolvementinpatientcareactivitiesatthatfacility.Studentsmustcomplywithallofthegeneralandspecificrulesandmedicalethicsestablishedbythehospital,clinic,orfacilityatwhichtheyarebeingtrained.

Amedicalstudentisnotlegallyorethicallypermittedtopracticemedicineorassumeresponsibilityforpatientcare.Astudentmaybeinvolvedinassistinginthecareofapatient,butonlyunderthesupervisionofalicensedphysician.Theattendingphysicianisresponsibleforthemedicalcareofthepatient.Astudentmaynotadministertherapyorperformprocedures,exceptunderthesupervisionofalicensedphysiciantowhomthestudenthasbeenformallyassigned.

MedicalRecords/Charting

Policiesregardingdocumentationbymedicalstudentsinmedicalrecordswillvaryamonghospitalsandclinics.Somesitesallowstudentstowritefullnotesandordersdirectlyintothepatient'schart.Inthiscase,thesupervisingphysicianmustalsodocumentthehistoryofpresentillness,anyrelevantphysicalexaminformation,aswellasanassessmentandplan.Studentnotesarenevertoserveastheattendingphysician'snotes.Somesiteshaveseparatepagesinthechart,oftenbrightlycolored,setasideforstudentdocumentation.Thisallowsthestudenttopracticetheirdocumentationskills,butwillnotbecomeapartofthepermanentmedicalrecord.Thesenotesshouldalsobereviewedandsignedbythesupervisingphysician.Ifdictationorcomputerizedentrybystudentsisallowed,thosenotesmustalsobereviewedandsignedbytheattendingphysician.Studentsareresponsibleforproactivelyobtainingcharting/documentationinstructionsfromthepreceptororsitecoordinatorateachclerkshipsite.Thestudentmustalwayssignanddateallentriesintothemedicalrecordbynameandeducationalstatus,suchasJohnSmith,OMS‐III.

Portfolio/MilestoneCompetenciesLog

StudentsmustrecordclinicalthinkingandproceduralskillswitnessedbytheirpreceptorsinthePortfolio/MilestonesCompetenciesLoginthePxDxsectionofE*Value.Eachskillwillbelistedas"performed,""assisted,"or"observed."Studentsshouldaccessthelogdailywhileoneachclinicalclerkshipinordertorecordandverifyeachclinicalskill.Studentsmustmakesuretheyareaccuratelyloggingtheirexperienceswitheachsymptom/problemandclinicalskillduringtheirOMS‐IIIyear.DoingsoisimportantbecauseACOMwillgeneratealetteronthestudent’sbehalfforauditionrotationsandresidencyapplicationsthatspeakstothestudent’scompetencyintheseareas.Iftheportfolioisincomplete,thenthiscompetencylogisincomplete,andpotentialResidencyProgramDirectorswillnotbeabletoseeatruepictureofthestudent’sabilities.Studentgradeswillnotbeinfluencedbythenumberofclinicalskillsrecorded,butthelogwillserveasamethodforstudentstotracktheirperformanceofcommonskillstypicallyencounteredduringclinicalclerkships.Assuch,thislogwillbecomeanimportantassettothestudentwhenapplyingforresidency.Inaddition,thelogwillserveasatooltoassistACOMtoevaluatetheclinicalexperiencesreceivedbystudentsatvarioustrainingsites.

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GradingGuidelinesforClinicalClerkships

AssignmentofGrades

AgradeforeachclerkshipwillbeassignedbytheClerkshipChairs.Detailscanbefoundintheclinicalsyllabusforeachclerkship.Theelementsrequiredforeachcoreclerkshipincludeapost‐clerkshipCOMATexamination,evaluationbytheSupervisingPhysicianorCoreSiteDirector,attendanceandparticipationatgrandroundsorotherconferences,clerkshiprotationdidactics,casestudies,andquizzesororalexams.Studentswhodonotreceiveapassingscorewillberequiredtoremediatecertainportionsoftheclerkship.Thefinalgradewillbeassignedandapprovedwithin14daysofthecompletionoftheclerkship.Alettergradeisassignedforeachclerkship.Studentsmustscore70%orhigheroneachgradingelementtopasstheclerkship.

GradingScale

Theacademicstatusorgradingofmedicalstudentperformanceisdeterminedattheendofeachsemester.Gradesaredeterminedthroughaveragingscorescollectedthroughassignment(s)scores,quiz(s),practicalresults,evaluations,andCOMATexams.Eachclerkshiphasasyllabuswhichwillexplainindetailhowthegradesarecalculated.GradesshallbeassignedtoindividualstudentsonthebasisoftheClerkshipChair’sjudgmentofthestudent’sscholasticachievementusingthegradingsystembelow:

QualityofPerformance Grade OtherGradingSymbols GradeExcellent A Incomplete IGood B AdministrativeWithdrawal AW

Satisfactory C Withdrawal WFailure F

ClerkshipChairswillreportanumericgradetotheregistrar.AlettergradeofA,B,C,orFwillbeassignedtothescoreforthecoursebyregistrarbasedonthefollowingscale:

A=90‐100%B=80‐89%C=70‐79%F=<70%

TheminimumsatisfactorygradeforeachelementofacoreclerkshipisC.GradesofA,B,C,andFwillbefactoredintotheGPAcalculation.GradesofI,AW,andWwillnotaffectGPA.

IncompleteClerkships

"AgradeofIncomplete(I)maybeassignedifthestudent’sdidacticworkinaclerkshiprotationisincompleteorifthestudentwillberequiredtotakearemediationexam.TheAssociateDeanofClinicalScienceswillestablishadeadlineofnotmorethan90daysforthestudent’scompletionand/orremediationofremainingcoursework,andthegradeofIncompletewillbereplacedoncethestudenthascompletedallassignedcourseworkorremediation.AstudentwhofailstocompleteallcourseworkbythedeadlinewillbeassignedagradeofF."

AssignmentoftheFinalGrade

ThefinalgradeforeachstudentwillbeassignedbytheClerkshipChair.TheClerkshipChairsreservetherighttousetheirdiscretiontomodifyastudent'sgradebaseduponstatedcriteriaand/orcircumstancesinadditiontothosereferencedinthisdocument.Studentsmustscore70%orgreaterforeachrequiredgradingelement.

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FailureofaClerkship

Astudentwhofailsaclerkshipwillberequiredtorepeatandpassthatclerkshippriortograduation.Thismayresultinthestudentnotbeingabletograduateasscheduled.AnystudentwhofailsaclerkshiprotationwillbereferredtotheStudentProgressCommittee.GradeAppeals

QuestionsregardingaclerkshiprotationgradearetobedirectedtotheClerkshipChaironly.Studentsarenevertocontactthesupervisingphysicianwhoevaluatedthem.RefertotheStudentHandbookforproceduresonhowtoappealaclerkshiprotationgrade.

COMLEXExams

TheCOMLEX‐USAseries,administeredbytheNationalBoardofOsteopathicMedicalExaminers(NBOME),isanexaminationsequencewiththreeLevels.Whileallexaminationlevelshavethesametwo‐dimensionalcontentstructure,thedepthandemphasisofeachlevelparallelstheeducationalexperiencesofthecandidate.ThisprogressivenatureoftheCOMLEX‐USAexaminationsensurestheconsistencyandcontinuityofthemeasurementobjectivesoftheosteopathicmedicallicensingexaminations(www.nbome.org).

StudentsmusttakeandpassCOMLEXUSALevel1,COMLEXUSALevel2‐CEandCOMLEXUSALevel2‐PEtomeetgraduationrequirements.StudentswhofailCOMLEXLevel1or2maybeplacedonadministrativeleaveofabsenceandrequiredtoparticipateinexampreparationcoursesorprograms.Examinationdateswillbeprovidedtothestudents.AstudentwhofailsaCOMLEXexamwillremainingoodstandingwiththecollegeuntildeemedotherwisebyrecommendationoftheStudentProgressCommitteetotheDean.Multipleattemptsoneachexamareallowed;however,pleasenotethatmanystatelicensureboardsmayhavelimitsonthenumberofexamstakeninissuingmedicallicenses.

COMLEXLevel1

StudentsarerequiredtotakeCOMLEXUSALevelIassoonaspossiblefollowingcompletionofthesecondyearandtheymusttakeitnolaterthanJune30th.StudentsarenotallowedtostartclerkshipsuntiltheyhaveachievedapassingscoreonCOMLEXLevelIexam.

COMLEXLevel2‐CEandLevel2‐PE

PassageofStep2CognitiveEvaluation(CE)andStep2PerformanceEvaluation(PE)isrequiredforgraduation.PassingscoresmustbedocumentednolaterthanMarch1oftheyeargraduating.InitialattemptsatStep2examsmustbescheduledbyJuly1oftheyearprecedinggraduation.

StudentEvaluations

CompetencyBasedEvaluation

AStudentEvaluationwillbecompletedbythesupervisingphysicianatthecompletionofeachclerkship.Theevaluationwillbebasedonthestudent'sbehaviors,knowledge,andskillsobservedbythepreceptorandothermembersofthehealthcareteamineachofthefollowingcorecompetencies:

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OSTEOPATHICPHILOSOPHYANDOSTEOPATHICMANIPULATIVEMEDICINEOMMKnowledge:Articulatesanddemonstratesanunderstandingoftheosteopathicapproachtopatientcare.OMMTreatment:DemonstratesanabilitytoformulateanOMMtreatmentplan.

MEDICALKNOWLEDGEProfessionalKnowledge:Demonstrateseffectiveuseofmedicalknowledgenecessaryforpatientcareandaccessesinformationthroughconsultationsand/orliteraturesearches.

PATIENTCAREHistoryTaking:Obtainsrelevantinformationandperformsacompleteandaccuratehistory.PhysicalExamandDocumentation:Performsacompleteandaccuratephysicalexaminationandprovidesaccurateandmeaningfuldocumentation.Diagnosis:Synthesizesclinicalfindingsand/orlaboratorydatatoformulateanappropriatedifferentialdiagnosis.TreatmentPlan:Writesanappropriatetreatmentplan.SkillsandProcedures:Usesinstrumentsandperformssimpleprocedurescorrectly.

INTERPERSONALANDCOMMUNICATIONSKILLSInterpersonalCommunicationandInteraction:Demonstrateseffectivelistening,questioning,andnarrativeskillstocommunicatewithpatients,families,andotherhealthcareprofessionals,beingsensitivetocultural,religious,andlanguageissues.PresentationSkills:Organizesandreportscasepresentationinformationinalogicalandmeaningfulformat.

PROFESSIONALISMMotivationandProfessionalism:Demonstrateswillingnesstolearnandacceptinstruction;maintainsprofessional,respectful,andcooperativerelationshipswithothers(preceptors,staff,patients,andfamilies).

PRACTICE‐BASEDLEARNINGANDIMPROVEMENTDiagnosticandTherapeuticEffectiveness:Usesreliableandcurrentinformationindiagnosisandtreatment;demonstratestheabilitytoextractandapplyevidence;makesself‐improvementsasneeded.

SYSTEMS‐BASEDPRACTICEKnowledgeofHealthcareDeliverySystems:Understandsthebasicbusinessapplicationsinamedicalpractice;showsoperationalknowledgeofhealthcareorganizations;understandstheroleofthestudentasamemberofthehealthcareteam;attendsandparticipatesinlocalmeetings.LocalHealthcareAdvocacy:Understandslocalhealthcareneedsandchallenges;makesappropriateuseoflocalmedicalresourcesonbehalfofpatients.

AtACOMthesecompetenciesaredefinedwithinthefollowingstandardsstatements,asarticulatedinthetableonthenextpage(s).

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Graduate Characteristics ACOM Program Educational Outcomes AOA

Comp EPA

Knowledge: Medical Expert

1 To integrate information about normal structure and function of living systems with an emphasis on humans.

OPP MK

2 To relate to the normal state the variations in structure and function that lead to disease. OPP MK

3 To comprehend biochemical and physiological analytic methods, including techniques, application, pitfalls, and interpretation.

MK

4 To categorize, describe, and use various therapeutic methods including osteopathic manipulative medicine in their application to human illness.

OPP PC

5 To possess a clinically useful understanding of the elements of diagnostic reasoning. OPP PC 2

6

To identify those urgent, life-threatening, or painful human conditions that require immediate and specific interventions, including the initiation of appropriate initial therapy for those with life-threatening vascular, pulmonary, or neurologic conditions; the recognition and outline of initial management for patients requiring critical care; and/or the plan for and initiation of management strategies to relieve pain and ameliorate the suffering of patients.

OPP; PC MK

4, 1,10

7 To interpret and apply the scientific method in the acquisition of new knowledge, the interpretation of published knowledge, and the application to problem solving in the laboratory and clinical settings.

OPP PBLI

8 To employ mathematical and epidemiological principles in the application of fundamental methods of data reduction and analysis to clinical problems.

PBLI 7

9 To know the cardinal ethical principles and their application in medicine. P

10 To describe the elements of social structure and to use this information in the understanding and management of human behavior and illness.

OPP PC

11 To describe the basic elements of State and national health care system, its funding, and the effects of these factors on individual and community health.

SBP

12 To demonstrate awareness of the financial, political, and other situations that pose potential and real conflicts of interest to the practice of medicine and to strive to avoid such entanglements.

SBP

Skills: Culturally

Aware Communicator

13 To collect and record in a concise, reliable, and cohesive fashion the key elements of a clinical history including elements of mind, body and spirit.

OPP ICP PC 1

14 To perform and record accurately the findings observed in a physical assessment. OPP ICP 1

15 To collect, perform, and/or interpret essential laboratory assessments and diagnostic procedures.

OPP PC 3

16 To use electronic resources for self-education, the education of others including patients and their families, and for direct patient care.

OPP PBLI

17 To formulate a comprehensive list of diagnostic considerations based upon integration of historical, physical, laboratory findings and diagnostic modalities including imaging ability to formulate an appropriate therapeutic response to it.

OPP PBLI PC 2

18 To demonstrate a step-wise process of diagnostic refinement through the application of clinical reasoning.

OPP ; P 2

19

To communicate, by oral and written means, knowledge, knowledge interpretation, and recommendations to a wide range of audiences, including patients, patients’ families, peers, instructors, and other health care professionals, being responsive to and mindful of the needs and cultural background of the audience.

OPP; ICP 5,6,9

20 To demonstrate self-education through the use of a comprehensive range of educational modalities.

OPP; P

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Behaviors: Dutiful

Scholar, Manager, and Collaborator

21 To provide a precise, timely, and comprehensive approach to patient care and its documentation.

OPP SBP 1, 2, 3, 4

22 To exhibit compassion in dealings with patients without regard to ethnicity, gender, financial situation, social condition, or incapacity.

OPP; PC: P

23 To conduct all interpersonal communications and activities, including those with colleagues, staff members, patients, families, and teachers, with dignity, appropriateness, and cultural awareness.

OPP; PC 9

24 To use the highest ethical principles in interpersonal relationships and in professional activities, including direct patient care and research. To employ the cardinal ethical principles and their application in medicine.

MK

25 To use the principles of self-initiated learning in approaching new challenges. OPP; P

Attitudes: Professional

Health Advocate

26 To be respectful of others and of their beliefs, opinions, and privacy. OPP; P

27 To be scrupulously honest in all matters of professional life. P

28 To provide compassion in matters that deal with the life, health, suffering, and dying of individuals under his/her care.

OPP; PC; P;SBC;IPC

29 To assume responsibility when appropriate with one’s position, training, and experience and to defer responsibility to those with higher qualifications when necessary or other members of the healthcare team appropriate.

P; IPC

30 To maintain curiosity that will promote full inquiry and problem resolution in all professional matters contributing to the whole interprofessional team of patient care.

P; IPC

31 To work with patients and their families in a respectful and confidential manner that is appropriate to their educational level and preserves their dignity.

P

32 To demonstrate advocacy for the interests and needs of the patient and place those interests and needs above one’s immediate needs.

OPP SBP

AOA (American Osteopathic Association) Competency Legend:

OPP Osteopathic Principles and Practices

MK Medical Knowledge

PC Patient Care

ICP Interpersonal and Communication Skills

P Professionalism

PBL Practice Based Learning and Improvement

SBP System Based Practice

AAMC (Association of American Medical Colleges) EPA (Core Entrustable Professional Activities for Entering Residency) Legend:

EPA 1 Gather a history and perform a physical examination

EPA 2 Develop a prioritized differential diagnosis and select a working diagnosis following a patient encounter EPA 3 Recommend and interpret common diagnostic and screening tests EPA 4 Enter and discuss patient orders/prescriptions EPA 5 Provide documentation of a clinical encounter in written or electronic format EPA 6 Provide an oral presentation/summary of a patient encounter EPA 7 Form clinical questions and retrieve evidence to advance patient care EPA 8 Give or receive a patient handover to transition care responsibility to another health care provider or team

EPA 9 Participate as a contributing and integrated member of an interprofessional team EPA 10 Recognize a patient requiring urgent or emergent care, initiate evaluation and treatment, and seek help

ThePreceptorEvaluationoftheStudentisalistofobservablebehaviorsdirectlyreferencingtheseProgramEducationalOutcomes.

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StudentResponsibilityforPreceptor’sEvaluations

Itistheresponsibilityofthestudenttoensurethatpreceptors’evaluationsaresubmittedtotheDivisionofClinicalResourcesatthecompletionofeachclerkship.TheClinicalResourcesstaffwillassistwithobtainingtheevaluationifapreceptorisneglectfulincompletingtheevaluationform,buttheresponsibilityrestswiththestudent.Ifastudenthasdifficultyingettinganevaluationsubmitted,heorsheshouldinformhisorhercoresitecoordinatorattheendoftheclerkship.Themoretimethatpassesafteraclerkshipiscompleted,themoredifficultitbecomestoreceiveanaccurateevaluation.Thestudent'stranscriptwillnotbecompleteuntilallevaluationshavebeenposted.ApplicationforGraduateMedicalEducation(GME)programscannotbesubmittednordiplomasissuedwithoutacompletetranscript.

PreceptorsmaycompleteanonlineevaluationthroughtheE*Value.Ininstanceswhenapaperevaluationisrequestedbythepreceptor,onewillbesenttothetrainingsite.Studentsmayalsogiveacopyoftheevaluationtothepreceptor.Theevaluationcanbefaxed,mailed,orsentbyemailtotheDivisionofClinicalResources.PleasenotethatevaluationsreceiveddirectlyfromstudentswillnotbeacceptedbytheDivisionofClinicalResources.Theevaluationmustbereceivedfromthepreceptorortrainingsite.

PreceptorsforCoreClerkships:ThecoordinatorateachcoresitewillworkwiththeDivisionofClinicalResourcestoupdatepreceptorinformation.Thepreceptorlistedforacoreclerkshipmaynotbetheprimarypreceptor,butthesupervisingphysicianwhooverseesthecoreclerkship.Thestudentshouldaddressanyconcernsregardingthepreceptorlistedforcoreclerkshipswithhis/herSiteCoordinatorbythesecondweekoftheclerkship.

IndividualPreceptors:ThestudentshouldalsomakecertainthattheDivisionofClinicalResourceshasacorrectemailaddressforthepreceptor,orthepersonwhoshouldreceivetheemailnoticethatanevaluationisdue(suchasapracticemanager).Thisinformationshouldbereceivedbythestudent'sRegionalCoordinatorbythesecondweekoftheclerkship.

PreceptorsatMedicalEducationPrograms:WhenonaclerkshipatanothermedicalschoolorGMEprogram,thestudentshouldconsultwiththemedicaleducationcoordinatoratthatprogramregardingtheirproceduresforpreceptor’sevaluations.Evaluationproceduresmayvaryateachsite.Insomecases,onepreceptormaycompletetheevaluationonline.Inothercases,studentsmayworkwithmultiplepreceptorswhocontributetotheevaluation.Inthiscase,thecoordinatororsupervisingphysicianatthehostsitewillcombinetheinputreceivedfromallevaluatorsandsubmitoneoverallevaluationtotheDivisionofClinicalResources.

Pleasenote:aresidentphysicianmaynotqualifyasapreceptor;therefore,aresidentmaynotsubmitaPreceptorEvaluationofStudentformtoACOM.

Itistheresponsibilityofthestudenttodeterminetheevaluationprocessatthehostsiteandprovidethatinformation,alongwiththenameandcontactinformationofthepreceptorofrecord,totheDivisionofClinicalResources.Thisinformationshouldbereceivedbythestudent'sRegionalCoordinatoratACOMbythesecondweekoftheclerkship.

EvaluationProcess

a. Theevaluationprocessshouldbeginduringthefirstweekoftheclerkship.StudentsshouldmeettheirpreceptoratthebeginningoftheclerkshiptodiscussexpectationsforclinicalandacademicperformanceandcompleteaLearningAgreement(SeeAppendixA).Thisprovidesthestudentwiththeopportunitytobecomefamiliarwithandmeetpreceptorexpectationsandavoidbeingsurprisedbytheevaluationattheendoftheclerkship.Studentsshouldnothesitatetorequestclarificationofanythingthatisnotmadeclearbythepreceptor.ThestudentshouldprovidethepreceptorwithacopyoftheMid‐ClerkshipEvaluationForm.Ifthepreceptordoesnothaveacopyoftheclerkshipsyllabus,thestudentshouldprovideacopyatthebeginningoftheclerkship.

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b. Twoweeksintotheclerkship,thestudentshouldaskforaninformalmid‐clerkshipevaluation.ThestudentshouldreviewtheMid‐ClerkshipEvaluationFormwiththepreceptor,discussareasofcompetencythatwillbeevaluatedattheconclusionoftheclerkshiprotation,andaskfortheirinputonhisorherperformancetodateandspecificrecommendationsforimprovement.Thisisnotintendedtobeaformalevaluationandthestudentisnotrequiredtosubmitthemid‐clerkshipevaluationformtoACOM.Thestudentisencouragedtomakenotesandtokeeptheformforhisorherrecords.

c. ItistheresponsibilityofthestudenttoensurethatevaluationformsarecompletedandsubmittedonlineorturnedintotheSiteCoordinatorortheOfficeofClinicalSciencesatthecompletionoftheclerkshiprotation.StudentsshouldinformtheOfficeofClinicalResourcesofanydifficultyinobtaininganevaluationbythepreceptorattheendofthatclerkshiprotation.

d. Thecommentssectionoftheevaluationformisdesignedtoidentifythestudent'sstrengthsandareasforimprovement.CommentsmayalsobeusedascontentfortheMedicalStudentPerformanceEvaluationfortheresidencymatchprogram.Studentsareencouragedtoinformthepreceptorabouttheimportanceofmakingspecificcommentsabouttheirclinicalperformance.

StudentEvaluationofthePreceptor/Site

Studentsarerequiredtocompleteevaluationsregardingtheirclerkshipexperience.Studentfeedbackreceivedfromtheevaluationswillassistintheoverallassessmentandimprovementofclinicalclerkshipsandfuturefacultydevelopmentprograms.Inordertoassistcoresitestoimprovestudentexperiences,asummaryofstudentcommentswillbereportedanonymously,inredactedform,tothosetrainingsitesandpreceptorsonanannualbasis.Thefollowingevaluationsaretobecompletedwithinsevenbusinessdaysfollowingthecompletionfortheclerkship.

ForRequiredClerkships:

1. EvaluationofPreceptor:Providesfeedbackthatcanbeusedtoassessandimprovetheteachingofuptothreepreceptorsforeachclerkship.

2. EvaluationofSite:Providesfeedbackthatcanbeusedtoassessandimprovelearningopportunitiesandthelearningenvironmentofspecificclerkshipsites.

3. AcademicSurvey(CoreClerkshipsonly):Providesfeedbackthatcanbeusedtoassessandimprovetheclerkshipsyllabus,learningmaterials,assignments,activities,andtheinstructional/supporteffortsoftheclerkshipchair.

ForSelective/ElectiveClerkships:

1. EvaluationofClerkship:Providesfeedbackthatcanbeusedtoassessandimproveselectiveandelectiveclerkships.

Post‐ClerkshipExams

OMS‐IIICOMATExams

OMS‐IIIstudentscompletingcoreclerkshiprotationsinBehavioralMedicine,InternalMedicineII,OB/GYN,GeneralSurgery,PediatricsandFamilyMedicinewilltaketheCOMAT(ComprehensiveOsteopathicMedicalAchievementTests)subjectexaminationprovidedbytheNationalBoardofOsteopathicExaminers(NBOME).Therearenopost‐clerkshipexamsforIMI,selectiveorelectiveclerkships.Beforebeginning

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clerkships,studentswillreceiveinstructionsfromtheDivisionofClinicalResourcesonhowtodownloadtheNBOMEbrowserandrunasystemscheckontheircomputersinordertoaccessCOMATexams.AmandatoryOPPCOMATwillbeadministeredbytheendofthe3rdyear.StudentshavetheoptiontotaketheEmergencyMedicineCOMATanytimepriortotakingtheCOMLEX2CEexambyfollowingtheinstructionsbelow.

COMATexamsareadministeredonlineonthelastdayoftheclerkshipinaccordancewithNBOMEguidelines.TheexamsareproctoredbytheClinicalSiteCoordinatorortheirdesigneeateachcoresite.StudentswillreceiveinstructionsfromtheSiteCoordinatorregardingthetimeandplacetoreportfortheexam.COMATexamsmustbetakenonthedaythattheyarescheduled.Pleasenote:studentsmustinformboththeirSiteCoordinatorandtheClinicalSciencesCoordinatorregardingwhentheywouldliketotaketheOPPexamandtheEmergencyMedicineexamatleasttwo(2)weekspriortotheanticipatedexamdate.COMATexaminationstructure,contentoutlinesandpracticeexamsforeachsubjectcanbefoundathttp://www.nbome.org/comat.COMBANK2hasbeenpurchasedforyouruseinpreparingforeachCOMAT.ItisstronglyrecommendedthatyoumineCOMBANKbydisciplineforpracticequestions,whichwillgreatlyhelpyouprepareforeachCOMAT.

OMS‐IVPost‐ClerkshipExams

Therearenopost‐clerkshipexamsforcoreEmergencyMedicine,selective,orelectiveclerkships.

GraduationRequirements

AmedicalstudentwhohasfulfilledalltheacademicrequirementsmaybegrantedthedegreeDoctorofOsteopathicMedicineprovidedthemedicalstudent:

1. Hascompliedwithallthecurricular,legal,andfinancialrequirementsofACOM;2. Hassuccessfullycompletedallcourseworkrequirementsinnomorethansixyears;3. Attends,inperson,theceremonyatwhichtimethedegreeisconferred;4. HastakenandpassedCOMLEXLevel1,Level2‐CE,andLevel2‐PEadministeredbytheNational

BoardofOsteopathicMedicalExaminers(NBOME);and5. Hasdemonstratedtheethical,personal,andprofessionalqualitiesdeemednecessaryforthe

successfulandcontinuedstudyandpracticeofosteopathicmedicine.

StudentswhosegraduationdateisdelayedwillbeallowedtowalkacrossthestagewiththeirincomingclassaslongastheywillbeabletofinishtheirclerkshipsbeforeDecember31ofthegraduationyear.TowalkacrossthestagetheymusthavepassedCOMLEXLevel1andbothpartsofCOMLEXLevel2.

TheDivisionofStudentServiceswillkeepaprogressingchecklisttoconfirmacademicmilestonesandapprovepromotionfromoneyeartothenextforeachstudent.TheRegistrarwillconfirmanddateeachmilestonetodocumentthestudent’sprogressfrommatriculationtograduation.TheAssociateDeanofStudentswillconfirmeachstudent’schecklistand,uponcompletion,willpresentqualifyingstudentstotheACOMfacultyforavotetorecommendeachstudenttotheBoardofDirectorsforgraduation.ThedegreeofDoctorofOsteopathicMedicinewillbeconferredbytheBoardofDirectorsuponthosestudentswhohavefulfilledallacademicrequirementsofACOM.

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AdditionalPoliciesandGuidelines

ContacttheappropriateclerkshipsiteorACOMClinicalResourcesstaffwhenyouhavequestions. Readallpolicies/proceduresandcourse/clerkshipsyllabiandmakesureyouunderstandallclerkship

requirementsbeforebeginningaclerkship. Beproactive–youareresponsibleforyourschedule;youshouldknowwhatisexpectedofyou,

completeallforms,evaluations,etc.ontimeandrespondpromptlytophonecalls,e‐mails,andanyothercorrespondence.

Adheretotimeframes,especiallyforschedulechanges,absences,etc. Seekpermissioninadvancetobeabsentfromyourclerkshipforanyreason. Clinicalclerkshipsinmedicalschoolareafull‐timecommitment.Non‐clerkshipactivitiesmustnot

supersedeorconflictwithyourclinicaldutiesandacademicassignments. Failureofthestudenttofollowallspecifiedpoliciesmayresultinapproachingagraduationdatewith

requirementsunfulfilled,whichwouldimpacttheabilitytoparticipateincommencement,on‐timegraduation,and/ordateofbeginningpost‐graduatetraining.

Forissuesarisingatacoresiteregardingin‐housematters,workwithlocalstaffusingappropriateprocedurestoresolvetheissuelocally.

Ifadviceisneededregardingclerkshiporotherrequirements,seekthatfromappropriatestafforfaculty;wedonotrecommendseekingclarityfromclassmatesornon‐ACOMaffiliatedcoresite,hospital,orotherpersonnel.Remainfullyawarethatnoallowancescanbemadeforreceivingincorrectadvicefrominappropriatesources.

Duringclinicalclerkships,studentsareconsideredtobepartofthepatientcareteamattheapplicabletrainingsite;assuch,thestudentisaprofessional‐in‐training,hasduties,responsibilities,andalevelofexpectationregardingperformancethatissignificantlydifferent,oftenhigher,thanduringthefirsttwoyearsofmedicalschool.Studentbehavioristobeabovereproachatalltimes.

Sexualharassmentofanykindwillnotbetolerated.Ifastudentfeelsthatheorsheisbeingsubjectedtosexualharassmentbyanytrainingsitepersonnelsuchaspreceptor,hospitalstaffmember,oranyotherpersonassociatedwiththeclerkship,he/sheshouldimmediatelycontacttheirregionalcoordinator.Allreportsandallegationsofsexualharassmentwillbetakenveryseriously.Bythesametoken,studentsmustneverengageinactivitythatcouldbeconsideredbyotherstoconstitutesexualharassment.Studentsshouldrefrainfromdevelopingrelationshipswithpreceptorsorothertrainingsitepersonnelthatgobeyondwhatwouldbeconsideredatypicalprofessionalrelationship.

Studentsareimmediatelyaccountabletotheirassignedclinicalpreceptor(s)forcarryingoutallpatientcareandacademicassignmentsinatimely,professional,andhighqualitymanner.ThestudentisalsoaccountabletotheDirectorofMedicalEducationorSiteSupervisorforbeingawareofandcomplyingwithgeneralandsite‐specificpolicies/procedures,inadditiontothoseofACOMingeneralandthismanual.

Studentswhoareillorexperienceanemergencysituationthatrendersthemunabletofulfillclerkshiprequirementsandwhichnecessitatesabsencemustpersonally(notbyemail)contacttheclinicalsupervisors/preceptorandcoresitecoordinatorandtheirACOMRegionalCoordinator.

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TipsonMakingtheMostofEachClinicalClerkship(takeninpartfromtheAmericanAcademyofFamilyPhysiciansDivisionofMedicalResources)

Befamiliarwithandabletoapplythecorecontentoftheclerkshipspecialty.Beforeyourclerkshipbegins,taketimetoreviewoneortworelevanttextbooksandotherprimaryresourcesandgooveranynotesyoumayhave.Besuretodrawonthisbodyofknowledgeasyoudemonstrateyourdiagnosticskills.

Readasmuchasyoucanabouttheillnessesofthepatientsyouareseeing.Monitoryourpatients'chartsdaily.Researchpatientproblemsusingjournals,referencemanuals,andinternetsources,suchasUpToDate.Askyourpreceptortorecommendresourcestoenhanceyourunderstanding.

Beateamplayer.Gettoknowyourpatientcareteam–whotheyare,whattheydo,andhowyourroleinteractswiththeirs.Truestandoutsevenlyshareresponsibility,arewell‐liked,andcommunicateeffectivelywithotherteammembers.

Dressprofessionally,beontime,andbeenthusiastic.Attitudeandappearancecount.Takeextracareonyourclerkshipstolookyourbest.Unlessyouknowthatscrubsareacceptableattire,donotwearthem.Makesureyourstyleofdressisappropriateforthesetting.Showingupearlyorstayinglatecanalsoscoreyoupoints–aslongasyouarebeingproductiveandlearningintheprocess(notjust"hangingout").Finally,ineverythingyoudo,showenthusiasm.

Establishalearningagreementwithyourpreceptoratthebeginningofeachclinicalclerkship.Thisexerciseaffordsyouandthesupervisingphysicianatouchstoneforyoutolearntheclinicaldecision‐makingandproceduralskillsyouwantfromtheclerkship.Agreeingongoalsandunderstandinghowinformationwillbetaughtensuresthatyourclinicalexperienceisvaluable.

KeepyourmilestonesinPxDxuptodateforeachclerkship.Recordsuchthingsasthenumberofpatientsyouseeeveryday,thetypesofillnessesyourpatientshave,anyofyourmedical"firsts"(i.e.,thefirstphysicalyouperform,thefirstbabyyoudeliver,etc.),andanyexpectationsyouhavefortheclerkshipbeforeyoubegin.Thiswillhelpyourememberyourexperiencesandprocessyourfeelings.Whenitistimetochooseaspecialty,PxDxwillhelpyoureconcileyourexperienceswithyourexpectationsandgoals.

Learntoaskenoughquestionstosatisfyyourhungerforknowledgewithoutmonopolizingprecioustime.Althoughyoudon'twanttostifleanimportantquestion,itisnecessarytomakethemostoflimitedtimewithpreceptors.Payattentiontootherhealthprofessionals,aswellasotherstudents,andlearnfromallofthem.

Maximizetimespentwaitingduringclerkships.Sinceyouneverknowwhenyouwillhaveextratime,don'tgoanywherewithoutsomethingtoread.Keepingjournalarticlesorreferencematerialswithyouwillaffordyoutheopportunitytostudy,readuponapatient,orprepareforyournextsetofrounds.

Duringdowntime,resisttheurgetoengageinexcessivenon‐clerkshiptasks,suchastexting,websurfing,orpersonalphonecalls.Yourpreceptormayinterpretthisasboredom,distractionordisinterest.Instead,checkoutonlineresources,completeclerkshipassignments,readaboutyourpatients,orprepareforotherdidacticsorthepost‐clerkshipexamination.

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ClinicalClerkshipCoreSiteList(currentasofDecember,2015)

HOSPITAL CORESITELOCATIONSOUTHERNREGION

DWMcMillan Brewton,ALSoutheastAlabamaMedicalCenter Dothan,AL

SouthBaldwinHospital Foley,ALAltaPointeHealthSystems Mobile,AL

SpringhillMedical Mobile,ALMobileInfirmary Mobile,ALFranklinClinic* Mobile,AL

GulfCoastHospital PanamaCity,FLBaptist&WestFlorida Pensacola,FL

CapitalRegionalMedicalCenter Tallahassee,FLTroyRegional Troy,AL

CENTRALREGIONNortheastAlabamaRegional Anniston,AL

St.Vincent’sEast Birmingham,ALSamford/Brookwood Birmingham,ALCahabaMedicalCare* Centreville,ALJacksonHospital Montgomery,AL

CoosaValleyMedicalCenter Sylacauga,ALNORTHERNREGION

DecaturMorganHospital Decatur,ALElizaCoffeeMemorial Florence,AL

GadsdenRegionalMedicalCenter Gadsden,ALMarshallMedicalCenter Guntersville,AL

Crestwood Huntsville,ALHelenKellerHospital Sheffield,AL

*FederallyQualifiedHealthCenter(FQHC)site

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ClinicalClerkshipCoreSiteMap(currentasofDecember,2015)

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POLICYANDSTATEMENTOFNON‐DISCRIMINATION

TheAlabamaCollegeofOsteopathicMedicinedoesnotdiscriminateonthebasisofage,race,color,sex,gender,sexualorientation,religionorcreed,nationalorethnicorigin,ordisabilityinitsprograms,activities,hiring,ortheadmissionofstudents.

Thispolicyappliesinrecruitmentandadmissionofstudents,employmentoffacultyandstaff,andscholarshipandloanprograms.Thispolicyisalsofollowedintheoperationofallotherprograms,activitiesandservicesoftheCollege.

(TherevisedstatementabovewasapprovedbytheBoardofDirectors,AlabamaCollegeofOsteopathicMedicine,May13,2014)

ACOMsubscribestotheprinciplesandadherestotherequirementsofstateandfederallawpertainingtocivilrightsandequalopportunity,inaccordancewiththerequirementsofTitleVIoftheCivilRightsActof1964,asamended;TitleIXoftheEducationAmendmentsof1972;Section504oftheRehabilitationActof1973,asamended;andtheAgeDiscriminationActof1975,asamended.

EvidenceofpracticesinconsistentwiththispolicyshouldbereportedtotheDirectorofHumanResources,whoisthedesignatedcoordinatorofACOM’snon‐discriminationprogram.InquiriesregardingcompliancewiththesexdiscriminationprovisionsofTitleIXmayalsobedirectedtotheAssistantSecretaryforCivilRights,DepartmentofEducation,Washington,D.C.

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APPENDIXA:LEARNINGAGREEMENT

ACOMLearningAgreementforClerkshipRotations

Todevelopasetofmutually‐agreed‐uponlearningobjectives,studentsandpreceptorsshoulddiscussthequestionsbelowonthefirstorseconddayoftheclerkshiprotation.

Student:________________________________________ Preceptor:__________________________________RotationDiscipline:___________________________ Site:________________________________I.Whatskillsorknowledgedoesthestudenthopetolearninthisclerkshiprotation?(Thissectionmaybecompletedpriortomeeting.)

1._____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

II.Whatskillsorknowledgedoesthepreceptorthinkthestudentmostneedstolearninthisclerkshiprotation?

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

III.Basedonthetwosetsofgoalsabove,whatspecificlearningobjectives*dothestudentandpreceptoragreeshouldbeaccomplishedinthisclerkshiprotation?(Pleaselistatleastthree)

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

*Pleasenotethatlearningobjectivesneedtodescribewhatthestudentwillbeabletodooncompletingtheclerkshiprotation.Pleaseuseobjectiveswithinthisclerkshiprotationsyllabus.

IV.Whatactivitieswillmosthelpthestudentaccomplishtheabovelearningobjectives?

1.__________________________________________________________________________

2.__________________________________________________________________________

3.__________________________________________________________________________

SIGNATURES

Student:

Preceptor:

Date:

Studentsarerequiredtosubmitthisdocumentelectronicallyontheappropriatesoftwareplatformandstronglyencouragedtokeepthesignedlearningagreementfortheirrecords.

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APPENDIXB:CLINICALMILESTONESLIST

CLINICALMILESTONESNECESSARYFORGRADUATION

I. RequiredSymptoms/Problems:StudentsmustcompletethefollowingmilestonesintheirE*Valueportfoliosinordertograduate.

o AbdominalMassOrPaino AbnormalECGo AbnormalSerumLipidso AcidBaseDisorderso AcuteIllnessInAnInfant/Childo AllergicReactionso Anemia/Palloro BackPaino BreastDisorderso ChestDiscomfort/AnginaPectoriso Women’sHealth,Contraceptiono Diarrhea/Constipationo Dizziness/Vertigoo DifficultySwallowingo DomesticViolenceo Dyspnea/Breathlessnesso EarPain,HearingLoss/Deafnesso ElectrolyteDisorderso EyeRedness/Paino Fallso Fatigueo Fever/Chillso Fractures/Dislocations/JointInjurieso GaitDisturbanceso GastrointestinalBleedingo GeneticDisorderso Headacheo Hemoptysiso Hyperglycemia/DiabetesMellituso Hypertensiono Immunocompromise/Immunodeficiencyo ImpairedConsciousness,MemoryDisturbances,Dementiaso Jaundice(Adult&Infant)o JointPain,Non‐Traumatico Leukocytosis/Leukopeniao Lymphadenopathyo MoodDisorders,Anxiety/Depressiono Murmur/AbnormalHeartSoundso Numbness/Tingling/Paresthesias,PainfulLimbo PapAbnormalityo PelvicMass,Pain/Dysmenorrhea,AlteredMenses,VaginalBleeding‐Abnormalo PeriodicHealthExamination/Growth&Developmento Pregnancy/Deliveryo PreventiveHealthCare/CancerScreening/STIScreeningo PsychoticPatient/DisorderedThoughto RenalFailure:AcuteOrChronic

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o Rhinosinusitis(Rhinorrhea/Sneezing/NasalCongestion/SinusCongestion)o ScrotalMass/Paino Seizures(Epilepsy)o SexualDysfunction/Contraceptiono Shock/Hypotensiono SkinLesionso SleepDisturbanceso SoreThroato SpeechAndLanguageAbnormalities/Dysphonia/Hoarsenesso SubstanceAbuse/DrugAddiction/Withdrawalo SuicidalBehavior/Preventiono Syncope/Pre‐Syncope/LossOfConsciousnesso ThromboembolicDisorderso UrinaryDisorder/Incontinence/IncompleteEmptying/Frequencyo Vaginal/PenileDischargeo VisualDisturbance/Losso Vomiting/Nauseao Weakness/Paralysiso WeightGain/Obesityo WeightLosso Wheezing/Cougho Women’sHealth,Contraception

II. ThePortfolioProcess:EachofthehealthconcernslistedinPartIabovehasfivecategoriesofcompetencythatstudentsmustself‐check.

o Thefivecategoriesstudentsmustself‐checkareasfollows: Performanaccuratefocusedorcompletemedicalhistoryandphysicalexambasedon

thepresentingcomplaintandappropriatetotheclinicalsetting. Formulateadifferentialdiagnosisappropriatetothepatientandclinicalsetting. Orderandaccuratelyinterprettestsandproceduresinordertonarrowthedifferential

diagnosistoaworkingdiagnosis. Accuratelydescribeorperformprocedurestodiagnoseandtreatthepatient’sproblem. Craftatreatmentplanappropriatetothepatient’sproblemandsituation.

III. RecommendedSymptoms/Problems:Studentsshouldbeabletodiagnoseandtreatthehealth

concernslistedbelow,buttheyarenotrequiredtologtheseintotheirE*Valueportfolios.

o AbnormalLiverFunctionTestso AbnormalitiesOfWhiteBloodCellso AttentionDeficit/LearningDisorder/SchoolFailureo BehaviorDisordero BleedingTendency/Bruisingo Burnso CardiacArrest/RespiratoryArresto Cyanosis/Hypoxiao DepressedNewborno DevelopmentDisorder/DevelopmentDelayo Diplopiao EatingDisorders

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o Edema/Anasarca/Asciteso FailureToThriveo FetalDistress/Non‐ReassuringFetalStatuso HairandNailDisorderso HeadInjuries/BrainDeath/TransplantDonationo Hematemesiso Hematuriao HirsutismandVirilizationo Infertilityo InvoluntaryMovementDisorders/TicDisorderso IssuesOfDyingPatients/DeliveringBadNewso Limp/PaininLowerExtremityinChildreno Menopauseo Mouth/OralDisorderso NeckMass/Goitero PersonalityDisorderso Poisoningo Polycythemia/ElevatedHemoglobino PregnancyLosso Prematurityo PelvicRelaxation/PelvicOrganProlapseo Proteinuriao Prurituso PupilAbnormalitieso SexualMaturationo SexuallyConcernedPatient,GenderIdentityDisordero SuddenInfantDeathSyndromeo SpinalInjurieso Splenomegalyo Strabismusand/orAmblyopiao TallStature,ShortStatureo Tinnituso Torticollis

IV. Procedures:StudentsarerequiredtologproceduresintotheirE*Valueportfolios.

o AirwayManagement(specifytypeinnotessection,i.e.nasotracheal,oropharyngeal,etc.)o APGARandDubowitz/BallardAssessmento Arterialpuncture–forbloodgases(ABG)o Arthrocentesiso BreastExamo CaesareanSectiono Calculatemedicationdosagebyweightandwriteaprescription;signedbyphysiciano CardiacultrasoundandDopplerstudieso Casting/Splinting,Elbowo Casting/Splinting,Knee/Ankleo Casting/Splinting,LowerExtremityo Casting/Splinting,Other(SpecifyinNotesSection)

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o Casting/Splinting,Shouldero Casting/Splinting,ThumbSpicao Casting/Splinting,UpperExtremityo Casting/Splinting,Wrist/Hando Colposcopyo DigitalRectalExamo Ear,EvaluationandTreatment–CerumenRemovalo Ear,EvaluationandTreatment,EACforeignbodyremoval/wickinsertiono Echocardiographyo EKGInterpretationo Electroencephalogramo Endoscopy(specifytypeinnotessection)o Episiotomyandrepairo Eye,EvaluationandTreatment–EvaluationofCornealAbrasiono Eye,EvaluationandTreatment–Evaluationofforeignbodywithlideversiono Eye,EvaluationandTreatment–sliplampuseo Eye,EvaluationandTreatment–Tonometryo Eye,EvaluationandTreatmentofconjunctivalforeignbodyo Eye,EvaluationandTreatmentofcornealforeignbodyo FemalePelvicExam,BimanualExam(enterspecificpathologyfoundinnotessection)o FemalePelvicExam,PAPSmear(enterspecificpathologyfoundinnotessection)o H&PPrevention/HealthMaintenanceo Herniaexaminationo HistoryandPhysical–Complete/Comprehensiveo Injection–Sub‐Q/Intradermal,IM(specifyinnotessection)o IntravascularAccess,CentralLine(specifylocationinnotessection)o IntravascularAccess,CentralLine/Subclaviano IntravascularAccess,Intraosseouso IntravascularAccess,Peripheralo LumbarPunctureo MaleGenitalExamo MentalStatusExamo Mouth/DentalEvaluationandTreatment–regionalDentalBlocko Mouth/DentalEvaluationandTreatment–TreatmentofAphthousUlcerso Mouth/DentalEvaluationandTreatment–treatmentofDrySocketS/PExtractiono NasogastricTubePlacemento NewbornManagement,UncomplicatedDeliveryo NewbornManagement–NewbornResuscitationo Nose,EvaluationandTreatment–foreignbodyremovalo Nose,EvaluationandTreatment,EpistaxisControl(specifymethodusedinnotessection)o OfficeEncounter,ChronicComplexCareo OfficeEncounter,RoutineAcuteProblemo OsteopathicManipulationTreatment(OMT)o OsteopathicStructuralExamo OtherProcedures(specifyinnotessection)o Paracentesiso PerformOPPautonomicso PerformOPPlymphatics

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o PeritonealLavage,Diagnostico Pre‐NatalCareo ProvideHealthPromotion/DiseasePreventiono PsychiatricAssessment(describeinnotessection)o PulmonaryFunctionTestso Removesuturesorstapleso ResuscitationTeamMember(specifyroleinnotessection,i.e.Leader,Compressor,etc.)o SkinLesionExcisiono StressTestingo SurgicalAssist(specifytypeinnotessection)o Suturing,extremities(indicatetypeofanesthesiainnotessection)o Suturing,Face(indicatetypeofanesthesiainnotessection)o Suturing,Hand/digits(specifytypeofanesthesiainnotessection)o Thoracentesiso Thoracostomy,TubeorNeedle(specifyinnotessection)o Ultrasound,bedside–FAST(FocusedAssessmentwithSonographyforTrauma)o Ultrasound,OtherthanFAST(specifyincommentssection)o UrinalysisbyDipsticko UrinaryCatheterInsertiono VaginalDelivery–Spontaneous/Induced/VacuumExtraction/Forceps(specifyinnotessection)o VaginalDelivery,Spontaneouso Venipunctureo VisionScreeningo WellChildDevelopmentExamo X‐RayStudies(specifytypeinnotessection,i.e.chest,abdominalseries,etc.)

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APPENDIXC:ACOMGUIDELINESFORSTUDENTPARTICIPATIONINTHECLINICALSETTING

ACOMGUIDELINESFORSTUDENTPARTICIPATIONINTHECLINICALSETTING

TheseMedical Student Patient Care Duties' represent aminimummandatory regulations to beconsideredbyapolicymakingbodyatyourhealthcareorganizationgiventhelocalstandardofcareandapplicablestateandfederalrules,regulations,andlawstotheextentsuchareapplicable.Ifyourhospitalpolicyismorerestrictive,thenACOMstudentsmustadheretoyourpolicyasyoudirect.Totheextenttherecommendationsthatfollowarenotapplicabletoorappropriateforyourhealthcareorganization given the local standardof care and/orbecause applicable state and federal rules,regulations, and laws are more restrictive, it is advisable to document the analysis and finalconclusionsandmodifytheserecommendedguidelinesaccordingly.

MedicalStudentPatientCareDutiespermittedandprohibitedI. Definitions:

DirectPhysicianSupervision:

Thephysicianmustbepresentintheirofficesuiteoronhospitalgroundsandimmediatelyavailabletofurnishassistanceanddirectionthroughouttheperformanceofthefunction/procedure.Itdoesnotmeanthatthephysicianmustbepresentintheroomwhenthefunction/procedureisperformed.

PersonalPhysicianSupervision:

Thephysicianmustbeinattendanceintheroomfrombeginningtoend,withoutinterruption,duringtheperformanceofthefunction/procedure.

LimitedPhysicalExam:

Thisincludessuchcomponentsasthehead/neck,skin,chest,cardiac,abdominal,neurologicandmusculoskeletalexams;thisspecificallyexcludesgenitourinary,breastandrectalexams.

II. ScopeofDutiesPermitted:

MedicalStudentswillbesupervisedbyACOMcredentialedattendingphysicianswhileonACOMclerkshiprotations.Eachstudent’sessentiallearningtaskwhileonclerkshiprotationsistoimprovetheabilitytodothefollowing:

Performanaccuratemedicalhistoryandphysicalexambasedonthepresentingcomplaintandappropriatetotheclinicalsetting.

Formulateadifferentialdiagnosisappropriatetothepatientandtheclinicalsetting. Orderandaccuratelyinterprettestsandproceduresinordertonarrowthedifferential

diagnosistoaworkingdiagnosis. Accuratelydescribeorperformprocedurestodiagnoseandtreatthepatient’sproblem. Craftatreatmentplanappropriatetothepatient’sproblemsandsituation. Workwithpatientsandmembersofthehealthcareteamethicallyandprofessionally.

Bystudentyear,thescopeofdutiesmedicalstudentsmayperforminordertocompletetheabovelearningtasksare:

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FirstYearStudents:FirstYearStudentsarepermittedtoperformthefollowingfunctionsonly:

Observationandfollowonly HistorytakingunderPersonalPhysicianSupervision

SecondYearStudents:SecondyearStudentsarepermittedtoperformthefollowingfunctionsonly:

AllfunctionspermittedforFirstYearStudents,asstatedabove Historytakingunderdirectphysiciansupervision LimitedPhysicalExaminationunderpersonalphysiciansupervisionuntilphysiciandetermines

competency,afterwhichstudentmayperformLimitedPhysicalExaminationunderdirectphysiciansupervision;

ThirdandFourthyearStudents:ThirdandFourthYearstudentsarepermittedtoperformthefollowingfunctionsonly:

AllfunctionspermittedforFirstandSecondyearStudents,asstatedabove

Underdirectphysiciansupervision,may‘round’onpatients,toincludeo Gatheringlab,radiology,nursingandotherinformation/resultso Obtaininghistoryo PerformingLimitedPhysicalExamo Developinginterimassessmentsandrecommendations

Forgenitourinary,breastorrectalexam,studentmayperformexamunderpersonalphysiciansupervision,ifthesupervisingphysiciandeterminesthestudent’sreadinessandagender‐appropriatechaperoneispresent,asindicated.

Underdirectphysiciansupervision,maywritestudentnotesregardingE/Mservicesorprocedures:

o Ifsuchstudentnotesaretobeplacedinthepatientchart,theymustbeclearlylabeledasstudentnotesandco‐signedbythesupervisingphysicianwithin48hours;thesestudentnotesarejustthat–studentnotes.Theyarenottheprogressnoteforthepatientandneverstandaloneassuch.

o Ifsuchnotesarestrictlyfortheeducationalexperienceofthestudentandwillnotbeplacedinthechart,theymustnotusepatientidentifiersandshouldbeshreddedasconsistentwithhospitalHIPAApolicies.

Maywriteordersonthechartwhichmustbeimmediatelyreviewedandcountersignedbysupervisingphysicianbeforeanyactionistakenbasedonthoseorders.

Thefollowingproceduresmaybeperformedby3rdor4thyearmedicalstudentsonlyif(a)thesupervisingphysiciandeterminesthestudent’sreadinesstostarttoperformtheprocedureunderpersonalsupervision,and(b)thesupervisingphysicianhastheappropriateprivileges,competencyandteachingproficiencytoperformandeducatemedicalstudentsintheirperformance,and(c)uponobtainingappropriatepatientconsent.

o Thefollowingproceduresmustbeperformedunderthepersonalsupervisionofthephysicianuntilthephysiciandeterminesthestudentiscompetenttoperformtheprocedureunderdirectphysiciansupervision:

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PerforminsertionofIVsordrawblood–stickattemptslimitedtotwo(2)perpatient

OcularExamwithSlit‐Lamp Warttreatment InsertionofFoleycatheter

o Thefollowingproceduresmustalwaysbeperformedbythestudentunderpersonalphysiciansupervision:

AirwayManagement(i.e.nasotracheal,oropharyngeal,etc.) APGARandDubowitz/BallardAssessment Arterialpuncture–forbloodgases(ABG) Arthrocentesis BreastExam CardiacultrasoundandDopplerstudies Casting/Splinting,Elbow Casting/Splinting,Knee/Ankle Casting/Splinting,LowerExtremity Casting/Splinting,Other Casting/Splinting,Shoulder Casting/Splinting,ThumbSpica Casting/Splinting,UpperExtremity Casting/Splinting,Wrist/Hand Colposcopy Ear,EvaluationandTreatment–CerumenRemoval Ear,EvaluationandTreatment,EACforeignbodyremoval/wickinsertion Echocardiography EKGInterpretation Electroencephalogram Episiotomyandrepair Eye,EvaluationandTreatment–EvaluationofCornealAbrasion Eye,EvaluationandTreatment–Evaluationofforeignbodywithlideversion Eye,EvaluationandTreatment–Tonometry Eye,EvaluationandTreatmentofconjunctivalforeignbody IntravascularAccess,Peripheral IntravascularAccess,Central LumbarPuncture Mouth/DentalEvaluationandTreatment–TreatmentofAphthousUlcers NasogastricTubePlacement NewbornManagement,UncomplicatedDelivery NewbornManagement–NewbornResuscitation Nose,EvaluationandTreatment–foreignbodyremoval Nose,EvaluationandTreatment,EpistaxisControl OsteopathicManipulationTreatment(OMT) ProvideHealthPromotion/DiseasePrevention PsychiatricAssessment PulmonaryFunctionTests Removesuturesorstaples ResuscitationTeamMember(specifyrolei.e.Leader,Compressor,etc.) SkinLesionExcision SurgicalAssist Suturing,extremities(indicatetypeofanesthesia) Suturing,Face(indicatetypeofanesthesia)

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Suturing,Hand/digits(indicatetypeofanesthesia) Ultrasound,bedside–FAST(FocusedAssessmentwithSonographyfor

Trauma) Ultrasound,OtherthanFAST UrinalysisbyDipstick UrinaryCatheterInsertion VaginalDelivery,Spontaneous WellChildDevelopmentExam X‐RayStudies(i.e.chest,abdominalseries,etc.)

Theabovenotwithstanding,dutiesandactivitiesofstudentsmustnotconflictwithhospitalpolicies.III.ScopeofDutiesProhibitedMedicalStudentsarestrictlyprohibitedfromperforminganyandallfunctionsthatarenotspecificallypermitted.Additionally,medicalstudentsarespecificallyprohibitedfromperformingthefollowing:

Giveverbalortelephoneorders. Writeordersregardingend‐of‐life,suchasDNR

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APPENDIXD:COMATSCORERELEASEPROCESS

COMATSCORERELEASEPROCESS

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APPENDIXE:PROCESSFORPARTICIPATINGINSELECTIVES/ELECTIVES

PROCESSFORPARTICIPATINGINSELECTIVES/ELECTIVES

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APPENDIXF:SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY

SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY:OMS‐IIIDETAILEDTIMELINE

June TakeCOMLEXLevel1July BeginCORERotationsOctober–March ContinueworkingonyourCurriculumVitae(CV)

Evaluationyourcompetitiveness–compareboardscorestodisciplineminimums,lookatprogramrequirements,etc.

December–April BeginrequestingLettersofRecommendation(LoRs)andinformauthorsofthenewLoRprocessforERAS

Researchresidencyprogramsandrequestinformationand/orapplicationmaterial(AOAOpportunities,AMA’sFREIDA,PCOMMedNet)

WriteyourPersonalStatement(s) VisittheERASWebsitetofamiliarizeyourselfwiththetimeline,homepage,and

otherimportantinformationJanuary Begincontactingprograms(Non‐VSAS)regardingauditionrotationavailability

andimportantdatesEarlyFebruary VSASauthorizationswillbeissuedMarch–December SeasonopensforCOMLEXLevel2‐PEMarch BeginapplyingforVSASawayauditionrotations(ifapplicable)April–June PutfinaltouchesonyourCVandPersonalStatement

CompleteyourResidencySelectionFactSheet;meetwithpreceptorsandchosenadvisorstodiscussyouroptions

May ERAStokensaredistributedthroughemail MyERASsiteopenstoapplicantstoregisterandbeginworkingontheir

applicationsJune/July TakeCOMLEXLevel2‐CEJuly AuditionRotationseasonbegins

DeadlinetosubmitMSPEQuestionnaire

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SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY:OMS‐IIIVISUALTIMELINE

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SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY:OMS‐IVDETAILEDTIMELINE

July–December AuditionRotationseasoncontinuesJuly15 NMS/AOAMatchRegistrationOpens

ERASPostOfficeopens MaybeginapplyingtoAOA‐accreditedresidencyprogramsonly

EarlySeptember MayscheduleanappointmenttoreviewMSPEoncampusSeptember15 NRMPopensforregistrationfortheallopathicmatch

Applicantscanbegintoapply/transmittheirERASapplicationstoACGMEresidencyprograms

September–January ResidencyprograminterviewsOctober1 MedicalStudentPerformanceEvaluation(MSPEs)arereleasedtoprogramsNovember1 RecommendeddatebywhichstudentsshouldberegisteredfortheAOAMatchLateNovember Instructionsforsubmittingrankorderlistsandobtainingmatchresultsare

providedtoNMSregisteredstudentsandprograms NRMP(allopathic)ApplicantRegistrationDeadline–afterthisdateyouwillhave

topaya$50lateregistrationfeeJanuary UrologymatchresultsareavailableMid‐January FinaldateforsubmissionofstudentandprogramRankOrderListtoAOAMatch.

NoAOARankOrderListsorregistrationfortheMatchwillbeacceptedafterthisdate.

February NMSOsteopathicMatchResultsreleasedtoallparticipants DOScramble–beginningat12:00ETonthisdate,studentswhodidnotmatchto

apositionandprogramswithpositionsavailablemaycontacteachotherinordertofillavailablepositions

LateFebruary NRMPLateRegistrationDeadline NRMPRankOrderListDeadline

Mid‐March NRMPMatchResultsreleased SupplementalOfferandAcceptanceProgram(SOAP)begins

March–April SendResidency/StateLicensingFormsthatneedtobesignedbyACOMandrequestsforgraduationverificationletterstotheDepartmentofStudentServices

SendthankyouletterstoyourpreceptoradvisorsandLoRauthorslettingthemknowwhereyoumatchedandhowmuchyouappreciatetheirsupport

Mid‐May GraduationJune/July ResidencyOrientation(ProgramDependent);BeginResidency

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SCHEDULINGAUDITIONROTATIONS&APPLYINGFORRESIDENCY:OMS‐IVVISUALTIMELINE

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APPENDIXG:TERMSTOKNOW

TERMSTOKNOW

AA AnAffiliationAgreementisbetweenaninstitutionandanotherentityforpurposes ofprovidinganeducationalopportunityforstudentsgenerallyinasupervisory situation.

AACOMTheAmericanAssociationofCollegesofOsteopathicMedicineisanon‐profitorganizationthatsupportstheUnitedStates'collegesofosteopathicmedicine andservesasaunifyingvoiceforosteopathicmedicalresources.http://www.aacom.org/

AAFP TheAmericanAcademyofFamilyPhysiciansisthenationalassociationoffamily doctors.http://www.aafp.org

AAMC

TheAssociationofAmericanMedicalCollegesisanon‐profitorganizationbased inWashington,DCandestablishedin1876.ItadministerstheMedicalCollege AdmissionTest.TheAAMCoperatestheAmericanMedicalCollegeApplication ServiceandtheElectronicResidencyApplicationServicewhichfacilitatestudents applyingtomedicalschoolsandresidencyprograms,respectively.https://www.aamc.org/

ACGMETheAccreditationCouncilforGraduateMedicalEducationisresponsiblefortheAccreditationofpost‐MDmedicaltraining(residency)programswithintheUnited States.http://www.acgme.org/acgmeweb/

ACLS AdvancedCardiacLifeSupport

ACOM AlabamaCollegeofOsteopathicMedicine

AHEC AlabamaHealthEducationCenters

AllopathicMedicine

Thesystemofmedicalpracticewhichtreatsdiseasebytheuseofremedieswhich produceeffectsdifferentfromthoseproducedbythediseaseundertreatment.M.D.spracticeallopathicmedicine.

ALOMATheAlabamaOsteopathicMedicalAssociationisanon‐profitprofessional organizationcomprisedofosteopathicphysicians,residents,interns,andmedical students.http://aloma.org/

AMA AmericanMedicalAssociationhttp://www.ama‐assn.org

AMEC AlabamaMedicalEducationConsortiumhttp://www.amecdo.com

AOATheAmericanOsteopathicAssociationisthemainrepresentativeorganizationforosteopathicphysiciansintheUnitedStates.http://www.osteopathic.org/

AOAOpportunitiesDatabase

Awebsitededicatedtoosteopathicmedicalinternshipsandresidencies.The ProgramSearchfeatureisusedbyosteopathicmedicalstudents,internsor residents,hospitalsorotheragencies/organizationslookingforprogram informationinpreparationfortheOsteopathicMatchwhichisscheduledyearlyin earlyFebruary.http://www.opportunities.osteopathic.org/index.htm

ArchivalList ListofpreceptorskeptbytheACOMClinicalResourcesdepartmentwhichtracks thestatusofallpreceptors,whetheractive,inactiveorother.

ATLS AdvancedTraumaLifeSupport

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AuditionRotation Electiveclerkships(rotations)duringthe3rdand4thyearsatsiteswithresidency

programsinwhichastudentisinterested.

BLS BasicLifeSupport

CAF ReferstotheCommonApplicationFormthatiscompletedaspartoftheERAS applicationprocess.

ChartRoundsReviewofahospitalizedpatient'scurrentrecordsbyagroupofhealthcare professionals.Chartroundscanbeundertakenforavarietyofreasonssuchas assessmentofpatientprogress,planningofinterventions,oreducationofstaff.

Clerkship A4‐weekperiodoftraininginamedicalcoreorspecialty.

CME ContinuingMedicalEducation

COCA

TheAOACommissiononOsteopathicCollegeAccreditationservesthepublicbyestablishing,maintaining,andapplyingaccreditationstandardsandprocedures toensurethatacademicqualityandcontinuousqualityimprovementdelivered bythecollegesofosteopathicmedicine(COMs)reflecttheevolvingpracticeof osteopathicmedicine.ThescopeoftheCOCAencompassestheaccreditation ofCOMs.http://www.osteopathic.org/inside‐aoa/accreditation/predoctoral%20accreditation/Pages/default.aspx

COI CertificateofInsurance

COMAT

ComprehensiveOsteopathicMedicalAchievementTest(shelfexam);nationallystandardizedexaminationmodulesusedtoassessstudents,includingforthe purposesofevaluatingresourcesequivalencyacrossclinicalclerkshipsites. Exam willbeadministeredatthecompletionofcoreclerkships,generallyonthelast day,inaproctoredsetting.http://www.nbome.org/comatmain.asp

COMLEX‐USA

TheCOMLEX‐USAComprehensiveOsteopathicMedicalLicensingExamination seriesisdesignedtoassesstheosteopathicmedicalknowledgeandclinicalskills consideredessentialforosteopathicgeneralistphysicianstopracticemedicine withoutsupervision.http://www.nbome.org/comlex‐cbt.asp?m=can

COMLEXLevel1

Candidatesareexpectedtodemonstratebasicscienceknowledgerelevantto medicalproblems.Level1emphasizesthescientificconceptsandprinciples necessaryforunderstandingthemechanismsofhealth,medicalproblemsand diseaseprocesses.Level1,takeninone‐day,isaproblem‐andsymptom‐basedassessment integratingthebasicmedicalsciencesofanatomy,behavioralscience, biochemistry,microbiology,osteopathicprinciples,pathology,pharmacology, physiologyandotherareasofmedicalknowledgeastheyarerelevanttosolving medicalproblems.Theexaminationconsistsoftwofour‐hourtestsessions,each containingquestionsrelatedtodiverseclinicalpresentationsandprinciples. The examisadministeredataregionaltestingcenter.~ACOMstudentsarerequiredtotaketheCOMLEXLevel1assoonaspossible aftercompletionoftheirsecondyear. ItmustbetakenpriortoJune30. Students arenotallowedtostartclerkshipsuntiltheyhaveachievedapassingscoreonthe COMLEXLevel1.A3‐digitstandardscoreof400ora2‐digitstandardscoreof75isrequiredtopass theexamination.

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COMLEXLevel2‐CE(CognitiveExamination)

Candidatesareexpectedtodemonstrateknowledgeofclinicalconceptsand principlesinvolvedinallstepsofmedicalproblem‐solvingasdefinedby Dimension2.Level2‐CEemphasizesthemedicalconceptsandprinciples necessaryformakingappropriatemedicaldiagnosesthroughpatienthistoryand physicalexaminationfindings.Level2‐CE,takeninone‐day,isaproblem‐basedandsymptom‐based assessmentintegratingtheclinicaldisciplinesofemergencymedicine,family medicine,internalmedicine,obstetrics/gynecology,osteopathicprinciples, pediatrics,psychiatry,surgery,andotherareasnecessarytosolvemedical problemsasdefinedbytheLevel2‐CEblueprint.Asimilarproblem‐symptombasedapproachisusedinLevel2andinLevel1.Theexaminationconsistsoftwo four‐hourtestsessions,eachcontainingquestionsrelatedtodiverseclinicalpresentationsandprinciples. Theexamisadministeredataregionaltesting center.~ACOMstudentsarerequiredtopasstheCOMLEXLevel2CEforgraduation. PassingscoresmustbedocumentednolaterthanMarch1ofthegraduation year. StudentsareallowedonedayexcusedabsenceforCOMLEXLevel2CE.A3‐digitstandardscoreof400ora2‐digitstandardscoreof75isrequiredtopass theexamination

COMLEXLevel2‐PE

(PerformanceEvaluation)

TheLevel2‐PEisaone‐dayexaminationofclinicalskillswhereeachcandidatewillencountertwelvestandardizedpatientsoverthecourseofaseven‐hour examinationday.TheexaminationtakesplaceatNBOME’sNationalCenterfor ClinicalSkillsTestinginConshohocken,Pennsylvania(borderingPhiladelphia, Pennsylvania).~ACOMstudentsarerequiredtopasstheCOMLEXLevel2PEforgraduation. PassingscoresmustbedocumentednolaterthanMarch1ofthegraduation year. StudentsareallowedonedayexcusedabsencetotaketheCOMLEXLevel2PE.Traveldaysmustbemadeup.

COMLEXLevel3

Candidatesareexpectedtodemonstrateknowledgeofclinicalconceptsand principlesnecessaryforsolvingmedicalproblemsasindependentlypracticing osteopathicgeneralistphysicians.Level3emphasizesthemedicalconceptsand principlesrequiredtomakeappropriatepatientmanagementdecisions. Level3, takeninone‐day,isaproblem‐basedandsymptom‐basedassessment integratingtheclinicaldisciplinesofemergencymedicine,familymedicine, internalmedicine,obstetrics/gynecology,osteopathicprinciples,pediatrics,psychiatry,surgery,andotherareasnecessarytosolvemedicalproblems.Level3, likeLevel2‐CEandLevel1,isproblem‐basedandsymptom‐basedinpresentation. Theexaminationconsistsoftwofour‐hourtestsessions,eachcontainingquestionsrelatedtodiverseclinicalpresentationsandprinciples.The testisgenerallytakeninthefirstyearofresidency.A3‐digitstandardscoreof350ora2‐digitstandardscoreof75isrequiredtopass theexamination.

COMSAE

ComprehensiveOsteopathicMedicalSelf‐AssessmentExaminationisaself‐ assessmentexaminationforosteopathicstudentsandresidentstogaugethe baseoftheirknowledgeandabilityastheypreparetotakeaCOMLEX‐USA cognitiveexamination. Thispre‐testisadministeredtoACOMstudentsfourtimes priortotheactualCOMLEXLevel1test.http://www.nbome.org/comsae.asp

CoreClerkshipsThebasicclerkshipsthatallstudentsmustcomplete. Inthirdyear,thisincludes familymedicine,behavioralmedicine,internalmedicine,pediatrics,general surgery,andobstetrics/gynecology. Infourthyear,theonlycoreclerkshipis emergencymedicine.

CoreSiteConnections

ReferstoinitialmeetingsbetweenCoreSiteCoordinators(CSC)andstudents assignedtotheirsites.

CRNA CertifiedRegisteredNurseAnesthetist

CRNP CertifiedRegisteredNursePractitioner

CSC CoreSiteCoordinator

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CSD CoreSiteDirector

CV Acurriculumvitaeisawrittenoverviewofaperson'sexperienceandother qualifications.

Dean’sLetter SeeMSPE

Didactics Instructionbylecture,textbook,discussionboards,andjournalclubs.

DifferentialDiagnosis

Theprocessofweighingtheprobabilityofoneconditionversusthatofothers, possiblyaccountingforapatient'ssituation.Thedifferentialdiagnosisofrhinitis(a runnynose)includesallergicrhinitis(hayfever),theabuseofnasaldecongestants andthecommoncold.

DischargeSummary

Adocumentpreparedbytheattendingphysicianofahospitalizedpatientthat summarizestheadmittingdiagnosis,diagnosticproceduresperformed,therapy receivedwhilehospitalized,clinicalcourseduringhospitalization,prognosis,and planofactionuponthepatient’sdischargewithstatedtimetofollowup.

DO DoctorofOsteopathicMedicine

ElectiveClerkships Electiveclerkshipsarechosenbythestudentsbasedontheirinterests.

EMR(EHR) ElectronicMedicalRecordsorElectronicHealthRecords

ERAS

TheElectronicResidencyApplicationServiceisproducedbyAAMCtotransmit residencyapplications,lettersofrecommendation,Dean’sLetters,transcripts,and othersupportingdocumentstoresidencyprogramdirectorsviatheInternet.https://www.aamc.org/services/eras/

E*Value Softwareusedtomanage3rdand4thyearclerkships.

EVOS E*ValueOptimizationSchedulingTool

FERPA TheFamilyEducationalRightsandPrivacyActof1974. Definestheprivacyrights ofstudentsinacademicsettings.

FREIDA

FellowandResidencyElectronicInteractiveDatabase. FREIDAOnlineisa databasewithmorethan7,800graduatemedicaleducationprograms accreditedbyACGMEaswellasmorethan200combinedspecialtyprograms.http://www.ama‐assn.org/ama/pub/education‐careers/graduate‐medical‐education/freida‐online.page?

FQHC FederallyQualifiedHealthCenters

FSMBTheFederationofStateMedicalBoardsisanationalnon‐profitorganization representingthe70medicalandosteopathicboardsoftheUnitedStatesandits territories.http://www.fsmb.org/

GME GraduateMedicalEducation. Anofficesponsoringandmanagingresidency andfellowshipprogramsaccreditedbytheACGME.

GrandRounds

Aformalmeetingatwhichphysiciansdiscusstheclinicalcaseofoneormore patients.Grandroundsoriginatedaspartofresidencytrainingwhereinnew informationwastaughtandclinicalreasoningskillswereenhanced.Grandrounds todayareanintegralcomponentofmedicaleducation.Theypresentclinical problemsinmedicinebyfocusingoncurrentorinterestingcases.Theyarealso sometimesutilizedfordisseminationofnewresearchinformation.

H&P Shorthandforhistoryandphysical,theinitialclinicalevaluationandexaminationofthepatient.

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HCAHPS

TheintentoftheHospitalConsumerAssessmentofHealthcareProvidersand Systemsinitiativeistoprovideastandardizedsurveyinstrumentanddata collectionmethodologyformeasuringpatients'perspectivesonhospitalcare. PriortoHCAHPStherewasnonationalstandardforcollectingorpubliclyreporting patients'perspectivesofcareinformationthatwouldenablevalidcomparisonsto bemadeacrossallhospitalstomake"applestoapples"comparisons. Alsoknown astheCAHPS®HospitalSurvey,orHospitalCAHPS.http://www.hcahpsonline.org/home.aspx

HCHCA TheHoustonCountyHealthCareAuthorityistheumbrellaorganizationwhich ownsACOMandSAMC.

HIPPA TheHealthInsurancePortabilityandAccountabilityActof1996whichdefinesthe privacyrightsofpatientsandhealthcareinformation.

ICD‐10

ICD‐10isthe10threvisionoftheInternationalStatisticalClassificationofDiseases andRelatedHealthProblems(ICD),amedicalclassificationlistbytheWorld HealthOrganization(WHO).Itcontainscodesfordiseases,signsandsymptoms, abnormalfindings,complaints,socialcircumstances,andexternalcausesofinjury ordiseases.

IRB

Aninstitutionalreviewboard,alsoknownasanindependentethicscommittee (IEC),ethicalreviewboard(ERB)orresearchethicsboard(REB),isacommittee thathasbeenformallydesignatedtoapprove,monitor,andreviewbiomedical andbehavioralresearchinvolvinghumans.”

IT(IS) InformationTechnology(InformationSystems)

JournalClub Aformofeducationinwhichagroupofphysiciansdiscuss,analyze,andreviewa limitednumberofarticlesfrommedicaljournals,oftenonaweeklyormonthly basis.

LearningAgreement

Adocumentthatthestudentandpreceptorcreatetogetheratthebeginningof aclerkshiptodefinelearninggoals.

LetterofGoodStanding

Officialdocumentfromtheschoolthatstatesthatastudentisingoodacademic standingandhasnoissuespreventingthestudentfromstartingclerkships.

Locumtenens Alocumphysicianisaphysicianwhoworksintheplaceoftheregularphysician whenthatphysicianisabsent,orwhenahospital/practiceisshort‐staffed.

LoR LetterofRecommendation

LRC LearningResourceCenter

TheMatch

DuallyreferstotheAOAmatchwhichisadministeredbytheNMSandthe ACGMEmatchwhichisadministeredbytheNRMP. Osteopathicstudentsmay registerforbothmatchprocesses,butifastudentismatchedintheAOAmatch (inFebruary),theyaredroppedfromthesubsequentNRMPsothatthereisno possibilityofmatchingintwoprograms.

MatchDay Thedatewhenstudentsfindoutiftheyhavematchedtoaresidencyprogram.

MD AbbreviationforDoctorofMedicine

MOA(MOU)AMemorandumofAgreement(MemorandumofUnderstanding)orcooperative agreementisadocumentwrittenbetweenpartiestocooperateonanagreed uponprojectormeetanagreedobjective.

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MSPE

TheMedicalStudentPerformanceEvaluation(formerlyknownastheDean's Letter)isacomprehensiveassessmentofmedicalschoolperformancegenerally through3rdyearofmedicalschool. Includesgradecomparisongraphs,class rankfortopquartilestudentsforyears1‐2andpreceptorcommentsfrom clerkships.

NALS NeonatalAdvanceLifeSupport

NATMATCHTheNationalMatchingServicesInc.specializesinthedevelopmentand administrationofMatchingPrograms. NATMATCHistheserviceusedinthe osteopathicmatch.https://natmatch.com/

NBMETheNationalBoardofMedicalExaminersisanindependent,not‐for‐profit organizationthatservesthepublicthroughitshigh‐qualityassessmentsof healthcareprofessionals.http://www.nbme.org/

NBOME

TheNationalBoardofOsteopathicMedicalExaminersistheleadingassessmentorganizationfortheosteopathicmedicalprofession.Itsmissionistoprotectthe publicbyprovidingthemeanstoassesscompetenciesforosteopathicmedicine andrelatedhealthcareprofessions.TheNBOMECOMLEX‐USAexaminationseries providesthepathwaytolicensureforosteopathicphysiciansintheUnitedStates.http://www.nbome.org

NMS TheNationalMatchingServicesspecializesinthedevelopmentand a dministrationofMatchingPrograms. NMSadministerstheAOAMatch.https://www.natmatch.com/

NRMP

TheNationalResidentMatchingProgramwhichisanationalprocesstomatch medicalstudentsandotherapplicantswithhospitalstoobtaininternshipsand residencies.ApplicantssubmitaconfidentiallisttotheNRMPrankingtheirdesired placeofresidency.Participatinghospitalsalsoenteraconfidentiallistofthose mostdesiredapplicants. Onauniformdate(mid‐March),alloftheapplicants andhospitalsareinformedoftheresultsofthematch.http://www.nrmp.org

Off‐CycleStudent Astudentwhohashadaninterruptionintheirclerkships.

OGME OsteopathicGraduateMedicalEducation

OMM(OMT)OsteopathicManipulativeMedicine(OMM),alsoknownasOsteopathic ManipulativeTreatment(OMT),isacoresetoftechniquesofosteopathyand osteopathicmedicinedistinguishingthesefieldsfromallopathicmedicine.

OPP OsteopathicPrinciplesandPracticesisthetitleoftheclasswherestudentslearn OMM(OMT).

OPTI

AllOGMEprogramsarepartofanOsteopathicPostdoctoralTrainingInstitution. EachOPTIisacommunity‐basedtrainingconsortiumcomprisedofatleastone collegeofosteopathicmedicineandonehospitalandmayincludeadditional hospitalsandambulatorytrainingfacilities.http://www.osteopathic.org/inside‐aoa/Education/OGME‐development‐initiative/Pages/what‐is‐an‐opti.aspx

OSHA

TheOccupationalSafetyandHealthAdministrationisanagencyoftheUnited StatesDepartmentofLabor.OSHA'smissionisto"assuresafeandhealthful workingconditionsforworkingmenandwomenbysettingandenforcing standardsandbyprovidingtraining,outreach,educationandassistance".https://www.osha.gov/

PA PhysicianAssistant

PALS PediatricAdvancedLifeSupport

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PE PerformanceEvaluation.SeeCOMLEXLevel‐2PE

PersonalStatement

Consistsofinformationaboutthestudent’sprofessionalbackground,academic andclinicalqualifications,howthedecisionwasmadetopursuemedicine, chosenspecialty,andcareergoals.

PGY PostGraduateYear

PreliminaryYear Oneyearpositioninagivenfield(e.g.InternalMedicineorSurgery)usually precedingtraininginanotherspecialty.

PRN Abbreviationforprorenata,aLatinphrasemeaning"asneeded."

RC RegionalCoordinator

ROL RankOrderList

SAMC SoutheastAlabamaMedicalCenterhttp://www.samc.org/

SARHA

TheSoutheastAlabamaRuralHealthAssociatesisaprivate,non‐profit corporationestablishedin1983toensuretheavailabilityofqualitymedical servicestoallresidentsofsoutheastAlabama. SARHAcurrentlyprovidesprimary andpreventivehealthservicestotheresidentsofBarbour,Coffee,Crenshaw, Dale,Geneva,Henry,Houston,Pikeandsurroundingcounties.http://www.sarhaonline.com/

Scramble TheperiodaftertheAOAMatchinwhichstudentswhoarenotmatchedintoa programcan“scramble”tofindanavailableslot.

SEAMED SoftwareusedbyACOMstudentstoaccesscurricularinformation.

SelectiveClerkships

StudentsinthethirdyeararerequiredtotakeoneMedicineSelectiveandone SurgicalSelective. Therearechosenfromadefinedlistofcourses.

ShelfExam SeeCOMATorUSMLE

SOAP TheSupplementalOfferandAcceptanceProgramisaprocessforunmatched studentsintheNRMPmatchtofindresidencyprograms.http://www.nrmp.org/residency/soap/

SOAPnote TheSOAPnote(anacronymforsubjective,objective,assessment,andplan)isa methodofdocumentationemployedbyhealthcareproviderstorecordnotesin apatient'schart.

STAT AbbreviationfortheLatinwordstatim,"immediately."

TransitionalYear Oneyearpositionwithrotationsthroughvariousdisciplines(e.g.InternalMedicine, Surgery,etc.);alsoprecedestraininginotherspecialties.

TraditionalRotating

Internship(TRI)

TheTRIprogramsinvolveaone‐yearcommitmentbetweenthestudentandthe institutionforanOGME‐1internshipprogramonly.

USMLE

TheUnitedStatesMedicalLicensingExaminationissponsoredbyFSMBandNBME,resultsofUSMLEarereportedtomedicallicensingauthoritiesintheUnitedStates anditsterritoriesforuseingrantingtheinitiallicensetopracticemedicine.USMLE’sthreestepsassessaphysician’sabilitytoapplyknowledge,concepts,and principlesthatareimportantinhealthanddiseaseandthatconstitutethebasis ofsafeandeffectivepatientcare. Allopathicmedicalstudentsarerequiredtotakethisexam. Osteopathicstudentsareencouragedandmayberequiredto taketheUSMLEiftheyintendtoapplyforallopathicprograms.http://www.usmle.orgCurrentminimumpassingscoresare: Step1:192Step2CK: 209Step3:190

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USMLEStep2CK ClinicalKnowledgeExam(MDEquivalenttoCEExam)

USMLEStep2CS ClinicalSkillsExam(MDEquivalenttoPEExam)

VCU VideoConferencingUnit

VMR VirtualMeetingRoom

VisitingStudent Astudentwhois“away”fromtheirhomeprogramwhiletakingelectiveclerkships.

VSAS

TheVisitingStudentApplicationService(VSAS®)isanAAMCapplication designedtostreamlinetheapplicationprocessforsenior"away"electivesThis servicerequiresstudentstosubmitjustoneapplicationforallinstitutions, effectivelyreducingpaperwork,miscommunication,andtime.AllCOCA accreditedAACOMmembercolleges,withrisingfourthyearclasses,areVSAS homeschools.StudentsinaccreditedschoolsmayuseVSAStosubmit applications. ~ACOMStudentswillhaveaccesstoVSASbeginninginMarchof thirdyear.http://www.aamc.org/students/medstudents/vsas/

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APPENDIXH:OMS‐IICOMPETENCIES

OMS‐IICOMPETENCIESBytheendoftheirsecondyear,ACOMstudentsarefullycompetentintheareaslistedbelow,as

demonstratedthroughcoursework,especiallywithinthePrimaryClinicalSkillsandFoundations ofModernHealthcarecourses.

Competencies Description Performedand/or EvaluatedinSimulatedEnvironment

Professionalism&Lifelong LearningAppearance,attire,andbehavior

Demonstratesprofessional appearance, attire,andbehaviorduringallstandardizedpatientencounters,simulationsessions,andallotherworkplaceenvironments

Evaluated duringastagingprocess prior tostandardizedpatientencountersandsimulationsessions.AssessedinFMHCcourseaswell.

Medicalethics Understandandcritically analyze medical ethicsterms(beneficence,non‐maleficence,autonomy,informedconsent)andissues

CompletedMedScapesurvey regarding “Top 20MedicalEthicalDilemmasPhysiciansFace”andAnalyzedimportantcasesinsmallgroupenvironment

Properuseofsocialmedia Demonstrateproperuse of social media Small grouparticlepresentations and discussion

Self‐reflection Demonstratestheabilitytoself‐reflectinanaccurateandmeaningfulmanner

CompletedafterformativesessionsinpreparationforOSCE’s;Createdpersonalmedical oathinFMHCcourse

Teamwork Demonstratestheability to work as a teamwithotherstudents

Simulationsessions

CommunicationSkillsPatient‐centeredcommunication

Utilizesspecificpatient‐centered skills in everypatientencounter

Performed andevaluatedduring standardizedpatientencounters

Adaptingtothepediatricinterview

Utilizesspecificpatient‐centered skills that areappropriatetothepediatric patient

Performed andevaluatedduring standardizedpatient encounters

TheHistory and Physical ExaminationFocusedhistoryandphysicalexamappropriateforthepatient’schiefconcern

Performsanaccurate and efficient focusedhistoryandphysicalexamincludingaHPI,PMFSH,andROS

Performed andevaluatedduring standardizedpatientencounters.Studentscompletedapproximately26standardizedpatientencountersperformingafocusedhistoryandphysical exam.

Comprehensivehistoryandphysicalexam

Performsacompleteand accurate history andphysicalexamasappropriateforthepatientincludingaHPI,comprehensivePMFSHincludingasexualandreproductivehistory,completeROS,andhead to toe physical exam

Performed andevaluatedduring standardizedpatientencounters.Studentscompleted3comprehensivehistoryandphysicalexamonastandardizedpatient.

Theadolescentinterview Performsanappropriateadolescentmedicalinterview

Thepediatricswell‐childhistoryandphysicalexam

Utilizesappropriateresources to plot a growthchart,determineapediatricpatient’simmunizationsneeds,andprovideanticipatoryguidance

Students completedapproximately 3 history andphysicalexamsonpediatricstandardizedpatientencountersincluding infants,toddlers,andolderchildren.

Preparticipationphysicalevaluation

Performsapreparticipation physical evaluationundersupervision

Performed onlocalathletes at event held atACOM

AdvancedMedical Interviewing SkillsRespondingtostrongemotions

Demonstratesappropriate techniques tomanagingapatientexhibitingstrongemotionsincludingtheuseofstatementsdemonstratingempathy,respect,support/partnership


Communicating withdepressedoranxiouspatients

Demonstratesappropriate techniqueswhencommunicatingwithpatientswhoaredepressedoranxious


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Communicatingwithpatientsabouttobacco,alcohol,andsubstanceuse

Demonstratesappropriate techniques tocommunicatewithpatientsabouttobacco,alcohol,andsubstanceuseincludingtheadministrationandinterpretationofvalidatedtools


Advancedirectives Demonstratestheability to discuss advanceddirectiveswithapatient

Performed skillsusingroleplaying

Givingbadnews Demonstratesappropriate techniqueswhencommunicatingwithpatients about bad news

Performed skillsusingroleplaying

Communicatingneartheendoflife

Demonstratesappropriatetechniqueswhencommunicatingwithpatientswhoareneartheendoflife

Performedskillsusingroleplaying

Physical ExamSkillsGeneralobservation Demonstratestheabilitytomakeaccurateand

meaningfulobservations regarding patientsPerformedandevaluatedduringstandardizedpatient encounters

Mentalstatus Demonstratestheability to evaluate the mentalstatusofapatientincludingtheadministrationandinterpretationofvalidated tools


Vitalsigns Obtainsaccuratevital signs and interprets theresults


Skin,Hair,andNails Performsanaccurate and thorough examinationoftheskin,hair,andnails


HEENT Performsanaccurateandthoroughexaminationofthehead,eyes,ears, nose, and throat

Performedandevaluatedduringstandardizedpatient encounters

Neck Performsanaccurate and thorough examinationoftheneck


Lymphnodes Performsanaccurate and thorough examinationofthelymphnodes


Chestandlungs Performsanaccurate and thorough examinationofthechestlungs


Cardiovascularandperipheralvascular

Performsanaccurate and thorough examinationofthecardiovascularandperipheralvascularsystems


Abdomen Performsanaccurate and thorough examinationoftheabdomenincludinganevaluationforperitonealsigns


Anus,rectum,andprostate(tasktrainers*andstandardizedpatients)

Performsanaccurate and thorough examinationoftheanus,rectum,andprostateincludingfecaloccultbloodtestingwhen indicated


Musculoskeletalincludingorthopedicmaneuvers

Performsanaccurateandthoroughexaminationofthemusculoskeletalsystemincludingtheappropriateuseoforthopedicmaneuvers

Performedandevaluatedduringstandardizedpatientencounters

Breast(tasktrainers*andstandardizedpatients)

Performsanaccurate and thorough examinationofthebreasts


Screeningneuroexam Performsanaccurate and thorough examinationofneurologicalsystemincludingtheevaluationofthecranialnerveswithafundoscopicexam,motorandsensoryexam,DTR’s,andevaluationofcoordinationandgait


Femalegenitaliaandpelvicincludingspeculumandbimanual(tasktrainers*andstandardizedpatients)

Performsanaccurate and thorough examinationofthefemalegenitalia


Rev.1/25/16



Malegenitalia(standardizedpatients)

Performsanaccurate and thorough examinationofthemalegenitalia


OMMStructuralscreeningexam Incorporatesandosteopathic structural

screeningexamefficientlyintothephysicalexamPerformed andevaluatedduring standardizedpatientencounters

Treatment Providessafeandeffective osteopathicmanipulativetreatmentintheappropriatepatient


Procedural SkillsBasicandadvancedairwaymanagement

Describesbasicandadvanced airwaymanagementtechniquesanddemonstratestheseskillsonatasktrainer*.

Performed usingtasktrainers*

Bladdercatheterization(tasktrainer*)

Demonstratestheappropriate technique forperformingabladdercatheterizationonamaleandfemalepatient


Castingandsplinting Demonstratestheappropriate technique forcastingandsplintinganextremity

Lumbarpuncture(tasktrainers*)

Demonstratestheappropriate technique forperformingalumbar puncture


Nasogastrictubeinsertion Demonstratestheappropriatetechniqueforperforminganasogastric tube insertion

Performedusingtasktrainers*

Steriletechnique Demonstratestheappropriate use of steriletechnique

Suturing Demonstratestheappropriatetechniqueforsuturingawound

Performedusingtasktrainers*

VascularincludingIVandIApuncture(tasktrainers*)

Demonstratestheappropriate technique forperforminganintravenousandintra‐arterialpuncture


EKGinterpretation Demonstrateabilityto accurately read andinterpretEKGresults.

Assessed intheCardiovascular System course.

Chestx‐rayinterpretation Demonstrateabilityto accurately read andinterpretachestx‐ray.

Assess in theRespiratorySystem course.

Written&Oral CommunicationSOAPnotes Documentsthesubjective, objective, assessment

andplanportionsofapatient’snoteaccuratelyandconcisely

Performed andevaluatedduring standardizedpatientencounters.Studentscompletedapproximately26SOAPnotesincludingformulationofadifferential diagnosis.

Oralcasepresentation Providesanaccurate and concise oral casepresentation


ClinicalReasoningDifferentialdiagnosis Utilizeselectronicresources to create an

appropriatedifferentialdiagnosisbasedonapatient’spresentingproblems

Performedduringsimulation debrief sessions.AlsoassessedinFMHCcourse.

InformationMasteryResearching&evaluatingavailableresources

Demonstrateshowto access and criticallyanalyzejournalarticles,PubMed,andotherreferencesources.

Participatedinjournalclub small groupexperience

Point‐of‐careresources Demonstratestheappropriate use of point‐of‐careresourcestoanswerclinicalquestionsincludingDynamed,Epocrates,PEPID,andUpToDate

Performed duringsmallgroup sessions

Rev.1/25/16



Life Support CoursesBasicLifeSupport(BLS) CertificateofsuccessfulcompletionthroughAHA

approvedprogramAdvancedCardiacLifeSupport(ACLS)

Certificate ofsuccessfulcompletion through AHAapprovedprogram

Guidelines for HealthcareProfessionalsInfectioncontrol Demonstratestheappropriateuseofuniversal

precautionsforpreventingthetransmissionofbloodborneinfections.

CompletedOSHA‐approvedtrainingmoduleandsubsequentassessment

Isolationprecautions Demonstratestheappropriate use of isolationprecautionstopreventthetransmissionofinfectionssuchastuberculosisandMRSAinhealthcaresettings.

CompletedOSHA‐approved trainingmodule andsubsequentassessment

Childabusereporting Certificate verifyingunderstanding of properchild abuse reportingprocedures

Legaljurisprudence Demonstrateunderstanding of legal issues in themedicalprofession

Assessed in FMHCcoursethrough small groupcasepresentations

HIPAA Demonstrateunderstanding of laws andguidelinesassociatedwithHIPAA

Assessed in FMHCcoursethrough small groupcasepresentations

*Mosttasktrainersarelifelikemodelsofbodyparts,suchasanarmorpelvis.Alltasktrainershavetheabilityto breakdownaspecificskillintoitsindividualstepsasnewskillsaretaughtandlearned.

Rev.1/25/16


APPENDIXI:ACOMPATIENT‐CENTEREDINTERVIEWINGEVALUATIONACOMPatient‐CenteredInterviewingEvaluation

Tothestudent:Pleaseaskacorepreceptororthatpreceptor’sresidenttoobserveyourperformanceofahistoryandphysicalandgiveyoufeedbackusingthisrubricasaguide.

Student:________________________________________ Preceptor:__________________________________

Role:___________________________ Date:________________________________

StepOne:SetstheStagefortheInterview Signature:___________________________________

KeyElements: (Preceptor) Washeshandsonenteringroom Welcomesthepatient(demonstratesgenuineinterestinpatientasaperson) Usesthepatient’snameandasksforpreferredwayofbeingaddressed Introducesselfandidentifiesrole(firstandlastname,medicalstudent/studentphysician)

MeetsExpectations DoesNotMeetExpectations StepTwo:Elicitschiefconcernandsetstheagenda

KeyElements: Indicatesthetimeavailable Obtainsalistofallissuesthepatientwantstodiscuss(“Whatbringsyouintoday?”,“Isthere

anythingelseyouwouldliketodiscuss?”)

MeetsExpectations DoesNotMeetExpectations StepThree:Beginstheinterviewwithanopen‐endedquestionorrequest

KeyElement: Startswithopen‐endedrequest/question(“Tellmeabout…”,“Tellmemore…”)

MeetsExpectations DoesNotMeetExpectations

StepThreecont’d:UsesnonverbalencouragementKeyElements:

Smile Openbody Forwardlean Touch(referstotheuseoftouchwhenrespondingtofeelingsandemotions;handshakesand

physicalexaminationdonotmeettheintentofthisitem) Eyecontact Nod

MeetsExpectations DoesNotMeetExpectations StepFour:Elicitsthepersonaland/oremotionalcontext

KeyElements: Elicitspersonalcontext(psychologicalandsocialcontextofthesymptom) Elicitsemotionalcontext(“Howareyoudoingwiththis?”,“Howhasthisaffectedyou

emotionally?”)


Rev.1/25/16


StepFourcont’d:RespondstofeelingsandemotionsKeyElements:

Statementsthatdemonstrateempathy:“Icancertainlyunderstandwhyyouwouldbeupsetunderthecircumstances.”“Anyonewouldfinethisdifficult.”“Yourreactionsareperfectlynormal.”“Thiswouldbeanxiety‐provokingforanyone.”“Icanunderstandwhyyouaresoangry.”“Icanseethatthisisupsettingforyou.”“Thisishardtotalkabout.”

Statementsthatdemonstraterespect:“I’mimpressedbyhowwellyou’recoping.”“Iadmireyourresilience.”“Irespectthefactthatyouhavecontinuedworkinginspiteofyourpain.”

Statementsthatdemonstratesupport/partnership:“IwanttohelpyouinanywaythatIcan.”“Nomatterwhathappens,IwilldowhateverIcantoassistyou.”“Let’sworktogether.”“Together,wecanworkoutsomesolutionsthatmayhelp.”

MeetsExpectations DoesNotMeetExpectations StepFive:Transitiontothemiddleoftheinterview

KeyElements: Ensurespatient’sreadinesstotransition(“Ifitisokaywithyou…”) Indicatesthatboththecontentandstyleoftheinterviewwillchange(“Iwouldliketoswitch

gearsandaskyousomemorespecificquestions.”) Brieflysummarizesthepatient‐centeredportionoftheinterview

MeetsExpectations DoesNotMeetExpectations StepSix:PhysicalExamination

KeyElements: Performsosteopathicstructuralexaminationinconjunctionwithaccuratephysicalexamination

appropriatetopatient’sclinicalsituation Offersspecificosteopathicmanipulativetreatmentaspartofarationaltreatmentplan

MeetsExpectations DoesNotMeetExpectations StepSeven:Endoftheinterview

KeyElements: Orientsthepatienttotheendoftheinterview Summarizestheinformationobtainedduringthevisit Acknowledgesrelationshipwithpatientandofferssupportbeforesayinggoodbye(“Itwasnice

meetingyouandIlookforwardtoworkingtogether…”) Washeshandsbeforeleavingtheroom

MeetsExpectations DoesNotMeetExpectations Professionalism

KeyElements: Appearanceandattire(grooming,clothing,whitecoat,etc.) Interactionwithpatient(attitude,demeanor,behaviorintheexamroom) Inappropriatebehaviororconductasreportedbystaffi.e.showinguplatetostaging,

attemptingtobypassstaging,notfollowinginstructions,etc.


Studentsarerequiredtosubmitthisdocumentelectronicallyontheappropriatesoftwareplatformandstronglyencouragedtokeepacopyfortheirrecords.

Rev.1/25/16


APPENDIXJ:CLERKSHIPROTATIONEVALUATIONS

AlabamaCollegeofOsteopathicMedicine

**Mid‐RotationEvaluation**

Pleasecompletethisevaluationatthemidpointoftheclerkshiprotation.Yourcooperationismostappreciated.

SectionI–CoreCompetencies:

Pleaseprovidefeedbackregardingtheperformanceofthismedicalstudent.Yourresponseswillhelpthestudentimprovebyidentifyinghis/herstrengthsandweaknessesPleasenote:Itisextremelyrareforastudenttohavemorethan2or3“ExceedsExpectations.”Foreachoftheseselected,pleaseincludecommentsinthefollowingNarrativeCommentssectionsexplaininghowthestudentExceedsExpectationsinthatcategory.

GraduateCharacteristic Goal(s)

ObservableBehavior(s)

ExceedsExpectationsofanOMS‐IIIstudent

MeetsExpectationsofanOMS‐IIIstudent

DoesNotMeet

ExpectationsofanOMS‐IIIstudent

NotRelative

toPractice

Knowledge,ClinicalSkills,Behaviors,&Attitudes

1,13,14,17,19,21

Performsaneffectivehistoryandphysicalappropriatetothepatient’sclinicalsituation ☐ ☐ ☐ ☐

Canpresentaconcise,accurateoralreport ☐ ☐ ☐ ☐Knowledge,ClinicalSkills,Behaviors,&Attitudes

3,5,8,15,21

Utilizeslabandimagingappropriatelytoidentifycauseofapatient'sproblem(s) ☐ ☐ ☐ ☐


3.4,5,7,15,17,18,21,30

Createsanappropriatedifferentialdiagnosisbasedonthepatient'sproblems ☐ ☐ ☐ ☐Usesclinicalpathwaysandalgorithmswhenappropriate ☐ ☐ ☐ ☐

Usesstructuraldiagnostictechniqueswhenappropriate ☐ ☐ ☐ ☐

Knowledge&ClinicalSkills

1‐6,8,15,17

Demonstratesprioritizationofcriticalfindingsandlababnormalitiesinordertoappropriatelyaddressapatient'sproblems

☐ ☐ ☐ ☐

Accuratelyaddressestheacuityofillnessforanindividualpatientandcraftsanappropriatetreatment. ☐ ☐ ☐ ☐


4,6,7,8,20,25

Canreference,interpret,andapplyknowledgeresourcesinordertoaddressapatient’sclinicalproblem(s). ☐ ☐ ☐ ☐


9,24,25,27

Demonstrateshighethicalstandardswithempathy,honesty,andprofessionalism ☐ ☐ ☐ ☐

Demonstratesabilitytoself‐reflectappropriately ☐ ☐ ☐ ☐Knowledge&ClinicalSkills 10,11

Demonstratesunderstandingandcompassionofsocialissuesandutilizesthisinpatientcare ☐ ☐ ☐ ☐


11,12,22,24,26,28

Treatsallpatientsfairlyandcompassionatelyregardlessofhealthstatus,financialstanding,culturalbackground,orbeliefsystem

☐ ☐ ☐ ☐


7,16,22,28

Demonstratesappropriateuseofavailableelectronicresourceswhileconsistentlyapproachingthepatientinapersonable,compassionatemanner.

☐ ☐ ☐ ☐

Behaviors&Attitudes

23,27,29

Conductsallinteractionswithstaff,faculty,etc.withthesamelevelofrespectandhonesty,asappropriatetostudent’sroleonthehealthcareteam

☐ ☐ ☐ ☐


11,31,32

Demonstratesagenuineinterestinlearningaboutthepatient'sclinicalandbiopsychosocialsituation,andthenapplieshealthcareandcommunityresourcesappropriately

☐ ☐ ☐ ☐

Rev.1/25/16


SectionII–NarrativeComments:

Whatarethestudent’sparticularstrengths?Inwhatareasdoesthestudentneedtoimprove?PLEASElistanydeficitsthatthestudentshouldaddressimmediately.

SectionIII–NarrativeCommentsfortheStudent’sMedicalStudentPerformanceEvaluation(MSPE)FormerlyknownastheDean’sLetterofEvaluation

Whatcommentswouldyouliketoincludeinthestudent’sMSPE(Dean’sLetterofEvaluation)?SectionIV–GutCheckAtthispoint,whatlettergradedoesyour“gut”tellyouthisstudentdeserves? A B C F________________________________________________________ __________________________________PreceptorSignature Date________________________________________________________ __________________________________StudentSignature Date

ThankyouforthetimeandhardworkyoudevotetowardtheeducationofACOMstudents.Yourfeedbackishighlyvaluabletotheprogram.

Rev.1/25/16


APPENDIXG:CLERKSHIPROTATIONEVALUATIONS

AlabamaCollegeofOsteopathicMedicinePreceptorEvaluationofStudent

Pleasecompletethisevaluationwithin3daysofthestudent’slastdaywithyou.Thestudentmayneedthisevaluationcompletedinordertobeeligibleforcertainelectiverotations.Yourcooperationismostappreciated.

SectionI–CoreCompetencies:

Pleaseprovidefeedbackregardingtheperformanceofthismedicalstudent.Yourresponseswillhelpthestudentimprovebyidentifyinghis/herstrengthsandweaknesses.Pleasenote:Itisextremelyrareforastudenttohavemorethan2or3“ExceedsExpectations.”Foreachoftheseselected,pleaseincludecommentsinthefollowingNarrativeCommentssectionsexplaininghowthestudentExceedsExpectationsinthatcategory.

GraduateCharacteristic Goal(s)

ObservableBehavior(s)

ExceedsExpectationsofanOMS‐IIIstudent

MeetsExpectationsofanOMS‐IIIstudent

DoesNotMeet

ExpectationsofanOMS‐IIIstudent

NotRelative

toPractice


1,13,14,17,19,21

Performsaneffectivehistoryandphysicalappropriatetothepatient’sclinicalsituation ☐ ☐ ☐ ☐

Canpresentaconcise,accurateoralreport ☐ ☐ ☐ ☐Knowledge,ClinicalSkills,Behaviors,&Attitudes

3,5,8,15,21

Utilizeslabandimagingappropriatelytoidentifycauseofapatient'sproblem(s) ☐ ☐ ☐ ☐


3.4,5,7,15,17,18,21,30

Createsanappropriatedifferentialdiagnosisbasedonthepatient'sproblems ☐ ☐ ☐ ☐Usesclinicalpathwaysandalgorithmswhenappropriate ☐ ☐ ☐ ☐

Usesstructuraldiagnostictechniqueswhenappropriate ☐ ☐ ☐ ☐


1‐6,8,15,17

Demonstratesprioritizationofcriticalfindingsandlababnormalitiesinordertoappropriatelyaddressapatient'sproblems

☐ ☐ ☐ ☐

Accuratelyaddressestheacuityofillnessforanindividualpatientandcraftsanappropriatetreatment. ☐ ☐ ☐ ☐


4,6,7,8,20,25

Canreference,interpret,andapplyknowledgeresourcesinordertoaddressapatient’sclinicalproblem(s). ☐ ☐ ☐ ☐


9,24,25,27

Demonstrateshighethicalstandardswithempathy,honesty,andprofessionalism ☐ ☐ ☐ ☐

Demonstratesabilitytoself‐reflectappropriately ☐ ☐ ☐ ☐Knowledge&ClinicalSkills 10,11

Demonstratesunderstandingandcompassionofsocialissuesandutilizesthisinpatientcare ☐ ☐ ☐ ☐


11,12,22,24,26,28

Treatsallpatientsfairlyandcompassionatelyregardlessofhealthstatus,financialstanding,culturalbackground,orbeliefsystem

☐ ☐ ☐ ☐


7,16,22,28

Demonstratesappropriateuseofavailableelectronicresourceswhileconsistentlyapproachingthepatientinapersonable,compassionatemanner.

☐ ☐ ☐ ☐

Behaviors&Attitudes

23,27,29

Conductsallinteractionswithstaff,faculty,etc.withthesamelevelofrespectandhonesty,asappropriatetostudent’sroleonthehealthcareteam

☐ ☐ ☐ ☐


11,31,32

Demonstratesagenuineinterestinlearningaboutthepatient'sclinicalandbiopsychosocialsituation,andthenapplieshealthcareandcommunityresourcesappropriately

☐ ☐ ☐ ☐

Rev.1/25/16


SectionII–NarrativeComments:

Whatarethestudent’sparticularstrengths?Inwhatareasdoesthestudentneedtoimprove?PLEASElistanydeficitsthatthestudentshouldaddressimmediately.

SectionIII–NarrativeCommentsfortheStudent’sMedicalStudentPerformanceEvaluation(MSPE)FormerlyknownastheDean’sLetterofEvaluation

Whatcommentswouldyouliketoincludeinthestudent’sMSPE(Dean’sLetterofEvaluation)?SectionIV–GutCheckWhatlettergradedoesyour“gut”tellyouthisstudentdeserves? A B C F________________________________________________________ __________________________________PreceptorSignature Date________________________________________________________ __________________________________StudentSignature Date

ThankyouforthetimeandhardworkyoudevotetowardtheeducationofACOMstudents.Yourfeedbackishighlyvaluabletotheprogram.

Rev.1/25/16




End‐of‐ClerkshipSurvey

Pleasecompletethissurveyby3pmonthelastdayofeachcorerotation.

StudentEvaluationofSite:

1. Whatarethemainstrengthsatthisclerkshiprotationsite?

2. Whatarethegreatestchallengesatthisclerkshiprotationsite?

3. Whatelsewouldyouliketoseeatthisclerkshiprotationsite?

4. Whatcommentscanyouofferaboutyourworkingand/orlivingexperiencesatthisclerkshiprotationsite?

StudentEvaluationofPreceptor:

5. Whatwereyourpreceptor’sgreateststrengths?

6. Whatwerethechallengesyouandyourpreceptorfacedregardingyourlearningneeds?

7. Describethequalityoftheorientationprovidedbyyourpreceptor.Whatwasdiscussed?

8. Whatwasthevolumeofpatientsforwhichyoucared?

9. Wasthescopeofpatientproblemsadequatetomeetthegoalsandobjectivesoftheclerkshiprotation?

Rev.1/25/16


10. Wereyouropportunitiestoperformpatientcare/procedures/documentationatthelevelyouneededinordertolearn?Explain.

StudentEvaluationofClerkshipRotation:

11. WereyouabletomeettheeducationalobjectivesthatyouandyourpreceptoragreedtoinyourLearningAgreement?

12. Whatdidyoulikemostaboutthisclerkshiprotation?Explain.

13. Whatwerethegreatestchallengesyoufacedduringthisclerkshiprotation?

14. Doyouhaveanyothercommentsaboutthedesign/implementationofthisclerkshiprotation?

StudentEvaluationofOsteopathicOpportunities:

15. Didyouincorporatecomponentsoftheosteopathicstructuralexamintothediagnosesofyourpatientsthisrotation?Explain.

16. DidyouperformOMTonanyofyourpatientsthisrotation?Explain.

StudentEvaluationofLibraryAccess:

17. Pleaseratetheeaseofuseinaccessinglibraryresourcesinthefollowingvenues:

NeedsImprovement Adequate Good Excellent

a) Atthebedside ☐ ☐ ☐ ☐

b) Onrounds ☐ ☐ ☐ ☐

c) Withpreceptors ☐ ☐ ☐ ☐

d) Afterhours ☐ ☐ ☐ ☐

Rev.1/25/16


18. Pleaseratetheusefulnessofaccessedinformationinmeetingclerkship/patientcareobjectivesinthefollowingvenues:

NeedsImprovement

Adequate Good Excellent

a) Atthebedside ☐ ☐ ☐ ☐

b) Onrounds ☐ ☐ ☐ ☐

c) Withpreceptors ☐ ☐ ☐ ☐

d) Afterhours ☐ ☐ ☐ ☐

19. Pleasetelluswhichdeviceyouusemostfrequentlytoaccessrelevantclinicalinformationinthefollowingvenues:

Other(pleasespecify)

ComputerMobilephone

iPadmini

e) Atthebedside ☐ ☐ ☐ ☐

f) Onrounds ☐ ☐ ☐ ☐

g) Withpreceptors ☐ ☐ ☐ ☐

h) Afterhours ☐ ☐ ☐ ☐

20. Whatarethemostfrequentbarrierstoaccessingclinicalinformation?

21. Whataresomesuggestionsforimprovingaccesstolibraryinformationneededduringclerkships?

Thankyouforyourparticipation.Yourfeedbackhelpsusworkcontinuouslytoimproveyoureducationalexperience.

Rev.1/25/16




AnnualSiteSurvey

PleasecompletethissurveybyJune1.

CoreSite:___________________________________________________________

Pleaseratethefollowingaspectsofyourcoresitefacility: NeedsImprovement

Adequate Good Excellent

1. Howwouldyouratetheteachingatthissite? ☐ ☐ ☐ ☐2. Howwouldyouratethelodgingatthissite? ☐ ☐ ☐ ☐3. Howwouldyouratetheareasforroundsatthissite? ☐ ☐ ☐ ☐4. Howwouldyouratetheareasforindividual/group

studyatthissite?☐ ☐ ☐ ☐

5. Howwouldyouratethevideoconferenceareaatthissite? ☐ ☐ ☐ ☐

6. Howwouldyourateyouraccesstorequiredtechnologywhileatthissite?

☐ ☐ ☐ ☐

7. Howwouldyouratethesupportyoureceivedfromthecoresitecoordinator?

☐ ☐ ☐ ☐

8. Howwouldyouratethissiteoverall? ☐ ☐ ☐ ☐

Pleaseanswerthefollowingquestionsregardingyourcoresitefacility:

9. Whatstrengthsdidyounoticeregardingthecoresiteadministration?10. Whatchallengesdidyoufacewhenworkingwiththecoresiteadministration?

11. Whatstrengthsdidyounoticeregardingtheworkareasforrounds/meetings/study?

12. Whatchallengesdidyoufaceregardingtheworkareasforrounds/meetings/study?

13. Describeanynoteworthyexperiencesregardingaccessortechnology.

14. Whatweretheoverallstrengthsofthisclerkshiprotationsite?

Rev.1/25/16


15. Whatweretheoverallchallengesofthisclerkshiprotationsite?16. Howwouldyouratethissiteoverall?

Pleaseanswerthefollowingquestionsregardingyour overalleducationexperienceatthissite:

17. Pleaseprovideanyfeedbackyouhaveregardingpreceptorsatthissite,sitedirector,and/orsitecoordinator.

18. Pleasedescribetheopportunitiesyouhad forlearningatthissite(journalclub,tumorboard,grand

rounds,etc.).

Pleaseanswerthefollowingquestionsregardingyoureducationallocation(s):

19. Didyouspendanyofyourcorerotationsinaneducationallocation?Ifso,listthembelow.20. Whatstrengthsdidyounoticeregardingtheeducationallocation(s)?

21. Whatchallengesdidyoufacewhenworkingattheeducationallocation(s)?

22. Howwouldyouratetheeducationallocation(s)overall?

Thankyouforyourparticipation.Yourfeedbackhelpsusworkcontinuouslytoimproveyoureducationalexperience.