Clinical Laboratory Sciences Program The Clinical Laboratory Sciences (CLS) Program (formerly Medical Technology) was initiated in 1978 by Tuskegee University, College of Arts and Sciences, with generous support from the then Tuskegee Veterans Administration Medical Center, currently, Central Alabama Veterans Health Care Systems. The Clinical Laboratory Sciences Program received its first accreditation in 1980 and maintains current accreditation. The Clinical Laboratory Sciences Program has been housed in the College of Arts and Sciences, School of Applied Sciences, School of Nursing and Allied Health, and currently College of Veterinary Medicine, Nursing and Allied Health. The Pre-Clinical Laboratory Sciences Program encompasses the freshman and sophomore years and prepares the student to meet the necessary prerequisite courses for the program. The maximum number of students accepted for each class is 12. Completion of all prerequisite courses does not guarantee students admission to the professional phase of the program. Students who do not gain admission to the professional phase of the program will have an opportunity to complete baccalaureate degree requirements in a related major. Counseling and advisement are available to assist students in meeting requirements of the program. Students admitted to the professional phase of the Clinical Laboratory Science Program must have completed all prerequisite courses, specific courses (CHEM, MATH, BIOL, HLSC, and ANPH designation) with a “C” or better, have maintained at least a 2.5 CGPA and completed the CLS program application process. Transfer students must be admitted to Tuskegee University before applying to the CLS program. 1 General Admission Policy for Allied Health Sciences Programs It should be noted that the mere completion of the prescribed admission requirement does not guarantee admission to the professional program in Allied Health. The candidate must also present evidence acceptable to the Committee on Admissions, that he/she exhibits the intellectual, moral and social traits which are considered desirable for a practicing professional. Selection is based on review of all data submitted and not merely on academic achievements. Students admitted to the Occupational Therapy Professional Curriculum will be required to complete a minimum of four academic semesters or equivalent quarters of prescribed course work. This includes applicants who have a conferred baccalaureate degree in another field at the time of admission. There is a minimum of 60-semester hours. This professional program has a limited space for enrollment of 20 students per class. Thus, not all students who qualify may have a chance to enter the professional programs during the given year. Students admitted to the Clinical Laboratory Science Professional Curriculum must have completed a minimum of four academic semesters or equivalent quarters of prescribed course work. Students from other colleges/universities must meet specified prerequisite requirements for acceptance. Limited space is available for 12 per class during a given year. This is a 2+2 Professional Program. In addition to completing the prescribed prerequisites for the two Allied Health Professional curricula, applicants are required to have: A minimum grade-point average of 2.50 on a 4.00 scale. Evidence of experience in relating to people from all situations of life. Maturity and problem-solving abilities. 2 Evidence of participation in health-care delivery is desirable (voluntary or employment). Application Procedures: Applications (inclusive of Transfer students) must be requested from the Office of Admissions, Tuskegee University, Tuskegee, Alabama 36088. Applications are returned to the Office of Admissions along with official copies of transcripts from all colleges/universities attended. Tuskegee University students must apply through the respective Allied Health Program Office. COURSE DESCRIPTIONS HLSC 0311. RESEARCH METHODS. 1st and 2nd Semester. Lect. 1, 1 credit. This course provides an overview of research methods, the research process, and how to conduct a literature review. Students will be required to develop and submit a research project. HLSC 0411. BASIC MANAGEMENT PRINCIPLES. Lect. 1, 1 credit. This course introduces the student to management skills applicable to the supervision of technological departments in health care facilities to include wage and salary administration, interpersonal relations, workload recording, cost analysis, quality assurance, and other issues related to entry level skills. Applications are specific to clinical laboratory sciences. Prerequisites: approval of instructor. 3 CLINICAL LABORATORY SCIENCES (CLS) The Clinical Laboratory Sciences (Formerly Medical Technology) area offers a basic professional program of education leading to the degree of Bachelor of Science in Clinical Laboratory Sciences. This program, accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), 5600 N. River Road, Suite 720, Rosemont, IL 60018; 773.714.8880 (Tel), 773.714.8886 (Fax), info@naacls.org, www.naacls.org; is designed to prepare the student in: The Natural Sciences (Biology, Chemistry, etc.) The Clinical Laboratory Sciences People orientation/patient care Accurate performance of complex analyses Assumption of responsibility Professional communication and management Clinical Laboratory Sciences is that branch of medicine concerned with the performance of laboratory determinations and analyses used in the prevention, diagnosis, monitoring, and treatment of diseases. Many of the laboratory tests involve life-and-death situations. Therefore, the profession requires and needs technologists who are precise, dependable, dedicated, and have a strong sense of responsibility. Practitioners of Clinical Laboratory Sciences are employed in hospitals, public health laboratories, sales (lab equipment and supplies), industry, reference lab, research, physicians’ offices, education, and other areas of health care. Clinical Laboratory Sciences graduates are 4 also qualified to undertake graduate education in research, medicine and other professional fields. Upon successful completion of the Tuskegee University Program, the Bachelor of Science degree is awarded. After graduation, graduates are eligible to take a national certification examination, administered by the American Society for Clinical Pathology (Board of Registry). This examination provides certification and a professional title: Medical Laboratory Scientist (certified by the ) American Society of Clinical Pathologists, i.e. MLS(ASCP tory Scientist). In those states requiring licensure (except for a few states), the national certification may suffice for employment purposes. The Clinical Laboratory Sciences student must possess the ability to: 1. Observe laboratory demonstrations in which biological (i.e., body fluids, culture plates, tissue sections, and cellular specimens) materials are tested for their biochemical hematological, immunological, microbiological, and histochemical components. 2. Characterize the color, odor, clarity and viscosity of biological, reagents, or chemical reaction products. 3. Employ a clinical grade binocular microscope to discriminate among fine structural and color (hue, shading, and intensity) differences of microscopic specimens. 4. Read and comprehend text, numbers, illustrations, and graphs displayed in print, on projection screen, and on a video monitor. 5. Move freely and safely about in a laboratory. 6. Reach laboratory benchtop and shelves, patients lying in hospital beds or seated in specimen collection furniture. 5 7. Travel to numerous clinical sites for practical experience. 8. Perform moderately taxing continuous physical work, often requiring prolonged sitting, in confined spaces, over several hours. 9. Control laboratory equipment (i.e., pipettes, inoculating loops, test tubes) and adjust instruments to perform laboratory procedures. 10. Use an electronic keyboard (i.e., computer keyboard) to operate laboratory instruments and to calculate, record, evaluate, and transmit laboratory information. 11. Read and comprehend technical and professional materials (i.e., textbooks, magazines and journal articles, handbooks and instructional manuals). 12. Follow verbal and written instructions in order to correctly perform laboratory test procedures. 13. Prepare papers, laboratory reports and take examinations within specified times. 14. Possess the emotional health necessary to effectively employ intellect and exercise appropriate judgment. 15. Be flexible, creative, and adapt to professional and technical change. 16. Recognize potentially hazardous materials, equipment situations, and proceed safely to minimize risk of injury to self, patients and nearby individuals. Upon graduation and initial employment, the clinical laboratory scientist/medical technologist should be able to demonstrate entry-level competencies in the following areas of professional practice: a. Reflecting ethical and moral attitudes and principles essential for gaining and maintaining the trust of professional associates, the support of the community, and the confidence of the patient and family; 6 b. Maintaining an attitude of respect for the patient and confidentiality of patients’ records and/or diagnoses; c. Developing and establishing procedures for collecting, processing, and analyzing biological specimens and other substances; d. Performing analytical tests on body fluids, cells, and other clinical substances; e. Integrating and relating data generated by the various clinical laboratory departments while making decisions regarding possible discrepancies; f. Confirming abnormal results, verifying quality control procedures, and developing solutions to problems concerning the generation of laboratory data; g. Making decisions concerning the results of quality control and quality assurance measures, and instituting proper procedures to maintain accuracy and precision; h. Establishing and performing preventive and corrective maintenance of equipment and instruments as well as identifying appropriate sources for repairs; i. Developing, evaluating, and selecting new techniques, instruments and methods in terms of their usefulness and practicality within the context of a given laboratory’s personnel, equipment, space, and budgetary resources. j. Demonstrating professional conduct and interpersonal skills with patients, laboratory personnel, other health care professionals, and the public; k. Establishing and maintaining continuing education as a function of growth and maintenance of professional competence; l. Providing leadership in educating other health personnel and the community; m. Exercising principles of management, safety, and supervision; n. Applying principles of educational methodology, and 7 o. Applying principles of current information systems. The Professional Program The professional phase of the program begins in the Fall semester of each year. The professional phase requires one summer session plus four regular semesters of study (clinical experience included). Clinical facilities are located at the Central Alabama Veterans Health Care System in Tuskegee and Montgomery and Columbus Regional Healthcare System in Columbus, Georgia, and other facilities as the need arises, approximately 40 miles away. Students are responsible for the expense of commuting daily to and from all clinical sites. All core curriculum and professional courses must be completed prior to clinical rotation. Senior students are required to spend 6 months at the clinical facilities. Students on clinical rotation must adhere strictly to the working hours (40 hours per week), rules and regulations and policies of the clinical facility. Any legitimate absence must be arranged officially and documented. No pre-professional core curriculum courses may be taken during the professional phase. Hepatitis-B Protection Policy Students who are admitted to the Professional Clinical Laboratory Science Program must show evidence of having received protective immunization for Hepatitis-B, or must sign a waiver acknowledging that he/she refuses the vaccine, but was aware of its availability. The vaccine is administered as a series of three (3) shots with the second shot given one month after the initial shot, and the third shot given six months later. Therefore, students applying to the Professional Program must arrange to complete the series no later than the beginning of the Fall Semester of the Junior Year. Students are responsible for their own immunizations. Ideally, students should present evidence of immunization to the Student Health nurse at the beginning of the Fall semester of the 8 Junior Year. For students who refuse the vaccine, a waiver must be signed at the time, and a copy must be placed in the student’s file in the Allied Health Office. For students who have not been vaccinated, or who do not have proof of vaccination, the vaccine is available through Tuskegee University’s Student Health by appointment. The cost of the vaccine will be included in the registration fee for that semester. Advanced Standing Individualized advance placement is available to graduates of accredited Medical Laboratory Technician or Clinical Laboratory Technician, MLT- or CLT, programs. Others with medical laboratory background and/or experience will be considered. Interested Clinical Laboratory Technicians should contact the CLS Program Director, Tuskegee University, Tuskegee, AL 36088. Background Checks All students must submit to a background check and/or drug test for each clinical site prior to commencing clinical rotation at the student’s expense. Application Procedures All applications must be requested from the Office of Admissions, Tuskegee University, Tuskegee Institute, Alabama 36088. Applications are returned to the Office of Admissions along with copies of transcripts from all colleges/universities. A letter of intent to enter the professional program and an autobiographical sketch should be mailed to the Clinical Laboratory Sciences Program Director, 71-270 Bioethics Building, Tuskegee University, Tuskegee, AL 36088. Students making application into the professional CLS Program may be required to take specified eligibility tests. 9 Applications must be submitted by the last Monday in January. Late or incomplete applications may be considered by the Admissions Committee only if vacancies still exist in class to be selected. Applications are reviewed in February. Interviews are scheduled for the month of March. Acceptance letters are sent out as close to April 15th of each year as possible. Professional program approximate total expense outside the University’s usual tuition and living expense include: liability insurance ($100); books ($1,000); uniforms, name tags ($100); transportation to clinical sites ($900). Hepatitis-B vaccine: $200-$300 (3 shots) – may be covered by some health insurance policies. Pre-Professional Program Pre-professional course planning should include the required courses as listed below. Electives should be selected for academic enrichment in Humanities and Biological/Behavioral Sciences. No grade below a “C” level will be accepted for pre-professional chemistry, mathematics, anatomy/physiology, and biology courses. (Suggested Curriculum) PRE-PROFESSIONAL PHASE FRESHMAN YEAR 1st Semester ENGL 101 Composition* MATH 107 Col Alg & Trig* HIST 103 World Civilization I PHED Physical Education CHEM 231 General Chem I* CHEM 233 General Chem I Lab* OREN 100 Growth & Develop Total Cr. 3 4 3 1 4 1 1 17 2nd Semester ENGL 102 Composition* BIOL 120 Organismic Biology* BIOL 121 Organismic/Lab* CHEM 232 General Chem II* CHEM 234 General Chem Lab* HIST 104 World Civilization II PHED Physical Education OREN 101 Growth & Develop Total Cr. 3 3 2 4 1 3 1 1 18 10 SOPHOMORE YEAR 1st Semester Cr. CHEM 320 Organic Chem I* 3 CHEM 322 Organic Chem Lab* 2 BIOL 230 Cell and Genetics* 3 BIOL 231 Cell and Geneti Lab* 1 SOCI 240 Intro to Sociology 3 HLSC 209 Health Care Systems* 2 ANPH 201 Human Anat/Physi I* 4 Total 18 2nd Semester Cr. CHEM 360 Biochem of Cell Reg* 3 CHEM 361 Intro in Biotechno* 1 CSCI 100 Intro to Computer 3 MUSC 208 Music Appreciation 1 ANPH 202 Human Anat/Physi II*4 HLSC 303 Medical Vocab* 2 ENGL 327 Public Speaking 3 Total 17 Successful completion of the above or the equivalent and a 2.5 CGPA are prerequisites for admission to the professional curriculum. PROFESSIONAL PHASE JUNIOR YEAR 1st Semester BIOL 301 General Microbiology* BIOL 303 General Micro Lab* HLSC 311 Research Methods* MEDT 330 Intro to Med Tech & Edu MEDT 320 Immunology/Serology MEDT 321 Serology Lab PSYC 270 Intro to Psychology PHIL 212 Intro to Humanities Total MEDT 422 MEDT 423 Cr. 3 1 1 3 3 1 3 3 18 2nd Semester MEDT 322 MEDT 323 MEDT 325 MEDT 326 MEDT 328 MEDT 329 MEDT 420 MEDT 421 HLSC 411 SUMMER SESSION Cr. Clinical Microbiology II 4 MEDT 428 Clinical Micro II Lab 1 MEDT 429 SENIOR YEAR 1st Semester Cr. MEDT 425 Clinical Chemistry II 3 MEDT 426 Clinical Chemistry II Lab 1 MEDT 432 Clinical Rotation 5 MEDT 331 Urinalysis & Body Fluids 3 MEDT 332 Urinalysis & Body Fl Lab 1 Total 13 2nd Semester MEDT 433 MEDT 434 MEDT 435 MEDT 436 Cr. Clinical Microbiology I 3 Clinical Micro I Lab 1 Clinical Chemistry I 3 Clinical Chem I Lab 1 Clinical Hematology I 3 Clinical Hemat I Lab 1 Immunohematology 3 Immunohem Lab 1 Clinical Lab Manag 1 Total 17 Hematology II Hematology II Lab Total Cr. 3 1 9 Clinical Rotation Clinical Rotation Clinical Rotation Senior Seminar Total Cr. 5 5 5 1 16 Clinical Rotation I (Chemistry) Clinical Rotation II (Microbiology) 11 Clinical Rotation III (Hematology, Coagulation & Urinalysis/Body Fluids) Clinical Rotation IV (Immunohematology & Serology) Clinical Rotations: A minimum of four weeks, 40 hours per week to be spent in each rotation at a clinical facility. The Clinical Laboratory Sciences Program is accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), 5600 N. River Road, Suite 720, Rosemont, IL 60018; 773.714.8880 (Tel), 773.714.8886 (Fax), info@naacls.org, www.naacls.org. *A grade of at least “C” required in these courses, and in all professional courses (HLSC and MEDT designation). Course Descriptions MEDT 0320. IMMUNOLOGY/SEROLOGY. 1st Semester. Lect. 3, 3 credits. This course is a study of the immunology concepts and principles to include the immune system, immune response, autoimmunity, antigen-antibody reactions, hypersensitivity, tumor immunology, tissue transplantation and hereditary immune dyscrasia. Prerequisite: Approval of Instructor. MEDT 0321. SEROLOGY LAB. 1st Semester. Lab 4, 1 credit. This course emphasizes the clinical application of antigen-antibody reaction, concepts and technique. The student is expected to demonstrate skills in performing, interpreting and reporting results. Corequisite: MEDT 0320. MEDT 0322. CLINICAL MICROBIOLOGY I. 2nd Semester. Lect. 3, 3 credits. This course focuses on pathogenic and saprophytic microorganisms pertaining to man; host resistance, biologic reactions and characteristics of cell-colony morphology. Identification techniques, sterility techniques, antibiotic sensitivity testing, mutants, mode of transmission are also covered. Emphasis will be on gram positive, gram-negative, anaerobic, and acid-fast microorganisms. Prerequisites: BIOL 301/303 and approval of instructor. MEDT 0323. CLINICAL MICROBIOLOGY I LAB. 2nd semester. Lab 4, 1 credit. This course emphasizes bacteriological techniques and methods; isolating and identifying 12 microorganisms; media selection and demonstration of psychomotor skills. The course will include streaking plates for isolation, determining colonial morphology, staining techniques, biochemical and serological reactions that lead to the identification of microorganisms and antimicrobial susceptibility. Corequisite: MEDT 0322. MEDT 0325. CLINICAL CHEMISTRY I. 2nd Semester. Lect 3, 3 credits. This course is designed to facilitate an understanding of the basic principles and practice of clinical chemistry. It focuses on procedures for obtaining reliable analytical data, and the diagnostic significance of biochemical metabolites in normal and pathologic states. The issue of lab safety is also covered. Prerequisites: CHEM 0320/0322, 0321/0323. MEDT 0326. CLINICAL CHEMISTRY I LAB. 2nd Semester. Lab 4, 1 credit. This course is designed to introduce the fundamental principles involved in providing clinical chemical data for the diagnosis and monitoring of treatment. Emphasis is placed on the development of skills in laboratory techniques used to obtain, process, and report accurate analytical data. The clinical significance of the data and their correlations with disease states are also covered. Corequisite: MEDT 0325. MEDT 0328. CLINICAL HEMATOLOGY I. 2nd Semester. Lect. 3, 3 credits. This course emphasizes the hematopoietic system during normal and abnormal states, includes anemia and leukemia, and the principles of the basic laboratory procedures. This course introduces the theory and practical application of routine and special hematology procedures, both manual and automated; red blood cells and white blood cells maturation sequences, and normal and abnormal morphology and associated diseases. MEDT 0329. CLINICAL HEMATOLOGY I LAB. 2nd Semester. Lab 4, 1 credit. This course emphasizes performance of basic phlebotomy, cell counts, hemoglobin determination, and 13 operation of the coulter counter. A high degree of proficiency is expected. Corequisite: MEDT 0328. MEDT 0330. INTRODUCTION TO MEDICAL TECHNOLOGY AND EDUCATION. 1st Semester, Lect. 3, 3 credit. This course focuses on the history of clinical laboratory science, professionalism, professional organization, certification, registration, licensure, entry level requirements, career advancement, mobility, and salaries, as related to the clinical laboratorian. Some overlapping from HLSC 209 will be included, to demonstrate interrelationships of the health professionals in “total patient care” and meeting current goals of the health care delivery system. Introduction to educational methodology and laboratory analysis are included. MEDT 0331. URINE AND BODY FLUIDS ANALYSIS. 1st Semester. Lect. 3, 3 credits. This course focuses on kidney physiology and function in health and diseased states; normal and abnormal constituents of urine, seminal fluids, feces, cerebrospinal fluid and other body fluids. MEDT 0332. URINE AND BODY FLUIDS LAB. 1st Semester. Lab 4, 1 credit. This course focuses on analysis and interpretation of body fluids, comparison of methods; and the development of skills in performing analysis within pre-determined limits of accuracy. Corequisite: MEDT 0331. MEDT 0420. IMMUNOHEMATOLOGY LAB. 2nd Semester, Lect. 3, 3 credits. This course involves the study of the theory and practice of a wide variety of procedures used in the following: donor selection, component preparation and use, and techniques used to detect antigen/antibody reactions which may adversely affect a patient receiving a transfusion. The topics to be covered include: donor screening, preparation of components, antigens and antibodies of the ABO, Rh and other blood group systems, pre-transfusion testing procedures, 14 hemolytic disease of the newborn, neonatal and obstetrical transfusion practice, autoimmune hemolytic anemias and adverse affects of transfusion. MEDT 0421. IMMUNOHEMATOLOGY LAB. 2nd Semester, Lab. 4, 1 credit. This course emphasizes the performance of blood grouping and typing, antibody detection and identification, compatibility testing, and other special procedures. Students are expected to perform the immunohematology procedures with a high degree of accuracy. Corequisite: MEDT 0420. MEDT 0422. CLINICAL MICROBIOLOGY II. Summer. Lect. 4, 4 credits. This course is a continuation of MEDT 0322. This course focuses on mycology, parasitology, virology, organs systems, quality control, and bioterrorism and the microorganisms involved in producing disease states in humans. MEDT 0423. CLINICAL MICROBIOLOGY II LAB, Summer, Lab. 4, 1 credit. This course is a continuation of MEDT 0323 with emphasis on the identification of microorganisms from specimens, infection control, quality control, and bioterrorism. Corequisite: MEDT 0422. HLSC 0311. RESEARCH METHODS. 1st Semester. Lect. 1, 1 credit. This course facilitates on understanding of research methods develop skills, knowledge and attitudes necessary for the critical reading and analysis of scientific literature related to health. HLSC 0411. CLINICAL LABORATORY MANAGEMENT. 2nd Semester. Lect. 1, 1 credit. This course introduces students to management skills applicable to clinical laboratory sciences, to including wage and salary administration, interpersonal relations, workload recording, cost analysis and other issues relative to entry level skills. Prerequisite: Approval of Instructor. MEDT 0425. CLINICAL CHEMISTRY II. 1st Semester. Lect. 3, 3 credits. This course is a continuation of MEDT 0325. It is designed to facilitate an understanding of advanced principles and practice of clinical chemistry. It focuses on the diagnostic significance of biochemical 15 metabolites in normal and abnormal states. The methods of acquisition and correlation of laboratory data with pathophysiology, along with the issues related to professional development are emphasized MEDT 0426. CLINICAL CHEMISTRY II LAB. 1st Semester, Lab. 4, 1 credit. This course is problem-based learning advanced course applied to the teaching of instrumentation techniques, principles, and clinical correlation of laboratory data. It is the continuation of 1MEDT 0326. Corequisite: MEDT 0425. MEDT 0428. HEMATOLOGY II. Summer. Lect. 3, 3 credits. This course is a continuation of MEDT 0328 plus emphasis on cellular abnormalities including lymphomas and the coagulopathies. MEDT 0429. HEMATOLOGY II LAB. Summer, Lab. 1, 1 credit. This course is a continuation of MEDT 0329 plus troubleshooting equipment and performing cytochemistries. Corequisite: MEDT 0428. MEDT 0432. CLINICAL ROTATION I. Chemistry. 5 credits. The course focuses on giving students practical experience in the clinical chemistry section of the hospital laboratory. Following the successful completion of this clinical rotation, the student should be able to demonstrate the entry level competencies of a Clinical Laboratory Scientist in this area of practice. MEDT 0433. CLINICAL ROTATION II. Microbiology. 5 credits. The course focuses on giving students practical experience in the clinical microbiology section of the hospital laboratory. Following the successful completion of this clinical rotation, the student should be able to demonstrate the entry level competencies of a Clinical Laboratory Scientist in this area of practice. 16 MEDT 0434. CLINICAL ROTATION III. Hematology, Coagulation, Urinalysis & Body Fluids. 5 credits. The course focuses on giving students practical experience in the clinical hematology, coagulation, urinalysis and body fluids sections of the hospital laboratory. Following the successful completion of this clinical rotation, the student should be able to demonstrate the entry level competencies of a Clinical Laboratory Scientist in this area of practice. MEDT 0435. CLINICAL ROTATION IV. Immunohematology & Serology. 5 credits. The course focuses on giving students practical experience in the clinical immunohematology section of the hospital laboratory. Following the successful completion of this clinical rotation, the student should be able to demonstrate the entry level competencies of a Clinical Laboratory Scientist in this area of practice. MEDT 0436. SENIOR SEMINAR. 2nd Semester. 1 credit. This course focuses on content review, and on the application of theories, concepts and practices learned in all courses. Emphasis is on case presentation, discussion of laboratory findings as related to pathological conditions; correlation of findings from each medical laboratory area with diagnosis, treatment, and monitoring of treatment. Completion of course requires a minimum score of 74% on a final comprehensive exit examination. Prerequisites: Completion of prescribed sequence of courses and approval of course coordinator. NOTE: Students cannot rotate within an area without completing both the lecture and lab courses with a minimum grade of “C”. Furthermore, students must maintain a “C” grade in ALL professional courses to continue in the program. One clinical rotation is scheduled 17 during the 1st semester and three clinical rotations are scheduled during the 2nd Semester. 18