MD 803 – Obstetrics and Gynecology LIC
Clerkship
The Commonwealth Medical College
Academic Year 2012-2013
Approved, Year 3-4 Subcommittee of the CAC: May 30, 2012
Approved (as modified), Curriculum Action Committee: June 4, 2012
Contact Information
Education Director:
Regional Education Coordinators:
Brian D. Wilcox, M.D., Ph.D.
Harold Davis, M.D.
Scranton
Physicians Health Alliance
401 Adams Avenue
Scranton, PA, 18503
570-346-7338 570-650-2889
hdavis@tcmedc.org
Physicians Health Alliance
748 Quincy Ave, Suite 2A
Scranton, PA 18510
570-961-0855 570-309-7569
bwilcox@tcmedc.org
Regional Clerkship Directors:
2
Lisa C. Thomas, M.D.
Scranton
Hematology/Oncology Associates of
NEPA
1100 Meade Street
Dunmore, PA 18512
570-342-3675 ext. 228
lthomas01@tcmedc.org
Joseph P. Narins, M.D.
Wilkes-Barre
Wyoming Valley Family Practice
Residency Program
2 Sharpe Street
Kingston, PA 18704
570-552-8954 570-706-5522
jnarins@tcmedc.org
Mary Beth Sokach, DO
Wilkes-Barre
Exeter Twp Medical Center
RR 1, Box 301
Falls, PA 18615
570-388-6151 570-947-3680
msokach@tcmedc.org
Janice L. Schifferli, DO
Williamsport
699 Rural Avenue
Williamsport, PA 17701
570-321-2339 570-329-5521
jschifferli@tcmedc.org
Margrit Shoemaker, MD
Williamsport
1100 Grampian Boulevard
Williamsport, PA 17701
570-320-7848 570-419-0149
mshoemaker@tcmedc.org
Charles D. Lamade, MD
Williamsport
Women’s Health Care Associates, PC
777 Rural Avenue, 6th Floor
Williamsport, PA 17701
570-323-3671
clamade@tcmedc.org
Purpose of the Course Syllabus:
This syllabus is a guide for participation in the course; information is subject to change during the presentation
of the course. Any changes in the course will be announced during the classroom or clinical sessions and will be
noted in the course Blackboard website.
Learning Objectives for MD 803:
The Learning Objectives of the clerkship are based on the general MD Curriculum Program
Objectives that have been established by TCMC. These include:
1. Medical Knowledge: Students must demonstrate understanding of established and evolving
biomedical, clinical, epidemiological and social-behavioral sciences, and the application of this
knowledge to the care of obstetric and gynecologic patients. Students must demonstrate depth
of knowledge about the presentation and management of obstetric and gynecologic illness and
evidence-based knowledge that is the foundation of well-woman care.
2. Practice-Based Learning and Improvement: Students must demonstrate an ability to locate,
appraise and assimilate scientific evidence for improvement of OB/GYN patient care practices.
3. Interpersonal and Communication Skills: Students must demonstrate interpersonal and
communication skills that result in effective information exchange, therapeutic, ethically-sound
relationships and collaborative decision-making with patients, their families, and professional
colleagues.
4. Patient Care: Students must demonstrate patient care that is compassionate, appropriate, and
effective for the treatment of obstetric and gynecologic patients in the context of their families
and communities. Students will demonstrate and advocate for appropriate treatment of illness
and also the promotion of health maintenance, disease prevention and wellness as it pertains
gynecology and obstetrics.
5. Professionalism: Students must demonstrate a commitment to carrying out professional
responsibilities, adherence to ethical principles, and sensitivity to contextual issues in a diverse
female patient population. This includes demonstration of a commitment to continuous
learning, dedication to patient care, respect, compassion and integrity in all activities.
6. Systems-Based Practice: Students must demonstrate an awareness of, and responsiveness to,
the larger context and system of health care, as well as the ability to call on other resources in
the system to provide optimal health care to obstetric and gynecologic patients and their
families.
General Clerkship Description / Overview:
The Obstetrics and Gynecology 803 clerkship is one of the six core components of the third year longitudinal
integrated curriculum (LIC).
Students will spend one half day weekly with an OB/GYN clinician in his/her office and will care for a group
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of patients over the course of the year. Additional inpatient “bursts” and/or inpatient “on-call” experiences will
also be scheduled. Students will follow obstetric patients and gynecologic patients. Obstetric patients will be
followed through various settings including outpatient prenatal care visits, outpatient consultations, inpatient
antepartum care, labor, birth, and postpartum care. Gynecologic patients will be followed through well-woman
visits, gynecologic problem visits, emergency room visits, inpatients hospitalizations, preoperative care, surgery,
postoperative care and outpatient consultations. Students will all have a TCMC extension/voice mail and are
expected to discuss how they can be contacted by the supervising attending on any emerging issues.
Students are expected to possess the ability to take an accurate history and physical and formulate an initial
differential diagnosis from their clinical experiences in the first and second year courses “Profession of
Medicine, ” “Art and Practice of Medicine, ” and “Systems II: Reproduction”. They are also expected to
already possess professional attitudes and deportment in a clinical setting, appropriate to the third year student
level.
Clerkship Outcomes:
During the Obstetrics and Gynecology clerkship, third year students will:




Acquire basic medical knowledge about normal and abnormal pregnancy, gynecologic illness and wellwoman care.
Attain clinical skills, clinical knowledge and professional behaviors required to evaluate and care for the
gynecologic and obstetric problems of female patients and the health maintenance of female patients.
Gain knowledge of the evaluation, diagnosis and management of obstetric and gynecologic patients
encountered in the ambulatory setting, emergency department, operating room, and labor and delivery
suite.
Obtain the foundation for OB/GYN sub-specialty 4th year clerkships if desired.
Clerkship Schedule/Schedule of Learning sessions:
Students will be scheduled in an Obstetrics and Gynecology practice/office one half-day per week for the
duration of the third year integrated clerkship. They will work on an ongoing basis with a primary supervising
attending physician who will coordinate their activities and ensure adequate experience. Experiences with
additional OB/GYN providers are anticipated for some students depending on the schedule and practice
pattern of the supervising attending.
Students will see patients in the office, at scheduled specialty consultations in other offices, and in inpatient
settings depending on the needs of the patients. Gynecology experiences will include inpatient and outpatient
surgery and appropriate preoperative, hospital and outpatient follow-up care. Obstetric experiences will require
the longitudinal follow-up of at least three patients through the entirety of pregnancy, labor and birth, and
postpartum. Students are expected to visit any hospitalized patients they are following on one of the two
weekend days. In addition, students will attend regularly-scheduled formal didactic conferences during each
week.
Inpatient and “on-call” Experiences:
All students will obtain additional inpatient experiences by participation in “bursts” of inpatient care in the
Departments of Obstetrics and Gynecology at participating hospitals. In Scranton and Williamsport, students
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will be scheduled for two, 5-day inpatient bursts. In Wilkes-Barre, students will perform three, 3-day bursts.
Because of variations in patient volume and practice patterns at outlying hospitals, some students may be
assigned alternative inpatient experiences under the discretion of the Regional Education Coordinator for
OB/GYN. All students should obtain at least 9 days of inpatient experience.
Continuity Patients:
In the 3rd Year Longitudinal Integrated Clerkship, each student will develop a panel of at least 10 patients per
discipline as “continuity patients”. For the Obstetrics and Gynecology Clerkship, this will require at least 5
Obstetric continuity patients and at least 5 Gynecology continuity patients. Students are required to follow
these patients as they access the health care system. These patients are to be seen in the inpatient and outpatient
setting. They are to be followed through consultations and procedures. Following the cohort of continuity
patients is the PRIMARY ROLE of the M3 student. This longitudinal experience with patients and their
families is the central learning experience of the LIC.
Students, with the assistance of their preceptors, will develop a cohort of patients to follow throughout the year.
Students should not have all patients selected in the first few weeks of the year-long clerkship, but they should
have their cohort of patients selected no later than December, 2012.
The characteristics of a continuity patient will be different depending on the discipline. Here are some general
guidelines for the selection of these patients:
Internal Medicine: a patient with chronic medical problems or a newly diagnosed problem who will be followed
in the office, the hospital, and other locations over the year.
Family Medicine: a patient who will be followed-up during the year, and at least one of these patients are to be
seen in a home visit.
Obstetrics and Gynecology: a patient who will be followed through the course of her pregnancy (and ideally for
whom the student will be present for the delivery) or a non-pregnant patient who the student will follow
throughout the treatment and follow-up of a gynecologic problem or an operative and peri-operative course.
Surgery: a patient who the student will see preoperatively, in the operating room, and postoperatively.
Pediatrics: a well patient who the student will see at least more than once during the year or a child with a
chronic illness you will follow throughout the year.
Psychiatry: a patient who the student will participate in on-going care, including counseling sessions or a patient
with a newly diagnosed condition that will be followed throughout the year.
Patient Encounter Log:
The following patient encounter types and procedure requirements may be filled at any time during your yearlong experience in any clinical setting. The required obstetrics and gynecology patient encounters to be logged
are derived from the “APGO Medical Student Objectives, 9th Edition,” 2009, Association of Professors of
Gynecology and Obstetrics (APGO). Because this is a Longitudinal Integrated Clerkship in which you work and
learn simultaneously in the six core disciplines, the patient encounter types and procedure requirements listed in
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tables 1,2, and 3 may be filled at any time during your year-long experience in any clinical setting unless
otherwise specified in the specific encounter type.
Logging encounters is MANDATORY. Student logs are reviewed at 2 weeks, 1 month, 2 months, 3 months, 6
months, 9 months, and 12 months during the Longitudinal Integrated Clerkship. Students MUST complete all
required patient encounter types by seeing a patient with that designation in one of the six core disciplines
(IM—Internal Medicine, FM—Family Medicine, PED—Pediatrics, SURG—Surgery, OB—Obstetrics and
Gynecology, PSY—Psychiatry) or in alternative learning environment (ALT) such as the simulation center,
during educational sessions, on-line modules, or other learning methods. Experiences occurring in the
Emergency setting are to be logged under the core discipline that is most appropriate.
Tables 1,2 and 3 outline the requirements for all six disciplines. ALL encounters must be logged into the One45
system. The table below is a master list of all encounters. The first column is the specific encounter type; the
second column is the MINIMAL number of encounters required (remember ALL encounters MUST be
logged). Students must participate in at least this number of encounters to pass the clerkship. The next column
designated “L” means that these encounters are “logged only” unlike certain procedures and encounter types
which require “L/F”, “logging and feedback”. Students must choose (from a drop-down menu in One 45) one
of the following seven clerkships or alternative educational experiences appropriate to the encounter.
Just as busy clinicians must finish patient records to be in compliance with standards of practice, M3 students
are expected to be in compliance with logging. It is recommended that students will log their encounters at least
daily to maintain their record. Students who fail to log encounters or who fall behind in logging will be referred
to their Regional Clerkship Director (RCD) who may ultimately decide to make a referral to the Committee on
Academic and Professional Standards for a breach of professionalism.
Required Encounters / Procedures:
Table 3 is a summary of encounters/procedures that require faculty feedback. ALL of these encounters are to
be logged into One45 and MUST be entered into the Preceptor Feedback Book which you will receive. Students
will only receive credit for encounters that are either done under the direction of a faculty member or done
under direct observation (the first two columns are for student recordkeeping. EACH encounter/procedure
must have a check in either the “done with direction” or “does while observed” column and then certified with
the supervising faculty initials in the last column. Certifying faculty may include preceptors, advanced
practitioners, residents, nurses, or technicians (depending on the procedure). If an encounter does not have a
faculty initial next to it, it will not be counted for credit. ALL encounters/procedures MUST be completed and
certified by a faculty member to pass the clerkship. Logging is MANDATORY. Student logs are reviewed at 2
weeks, 1 month, 2 months, 3 months, 6 months, 9 months, and 12 months during the Longitudinal Integrated
Clerkship. . It is recommended that students log their encounters at least daily to maintain their record. Students
who fail to log encounters or who fall behind in logging will be referred to their Regional Clerkship Director
(RCD) who may ultimately decide to make a referral to the Committee on Academic and Professional Standards
for a breach of professionalism.
Whitespace:
An LIC requires initiative on the part of all medical students. While an LIC gives students the most true-to-life
experience of patient care, it also demands a high degree of responsibility. Most students feel somewhat
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disoriented for the first few months; this is expected. Many students express confusion with the concept of
whitespace. Some guidelines to how to use this protected educational time are provided below.
1. Whitespace is not vacation or “free-time”. It is time in which you are to follow your patients
who are hospitalized, having a procedure, or a consultation. It is time to make a home visit. It is
time to make rounds on patients. The first use of whitespace is to follow your patients.
2. The second use of whitespace is to fulfill the requirements of the clerkship. It is a time to seek
out encounters or procedures that are required. This does not need to be done during the first
two months. The LIC is not a race to complete encounter charts, but it is a method to learn the
practice of medicine over time. In fact, students will experience better educational outcomes if
required encounters are completed over time.
3. Whitespace CAN be used to pursue areas of interest, however, it is not just to be used observing
procedures or being a “fly on the wall”. Students should seek out active learning opportunities
whenever possible.
4. Whitespace CAN be used to read, study, or attend local educational sessions. This is probably
the least effective use of time. While students must set up a reading and study schedule, this is
better done during evenings and weekends.
Clinical Education Days (CED):
1. On Friday afternoons from 1:00 to 4:30 PM students are REQUIRED to participate in a
Clinical Education Day (CED). This is held at the regional campus and is sponsored by the Year
3 educational team. Please refer to the schedule posted on the portal.
2. Attendance is MANDATORY. Students may have no more than 2 unexcused absences during
the year. This is to maximize the learning experience for each student. Students missing any
activity for any reason must report this to the appropriate faculty and their Regional Educational
Specialist (REC).
3. Any student having more than 2 unexcused absences during the year will be referred to the
Committee on Academic and Professional Standards (CAPS) by his/her Regional Clerkship
Director.
Inpatient Experiences for the third year: “Bursts” and Emergency Medicine Shifts:
1. There will be seven one-week experiences during the third year in which students are relieved of duties
in the ambulatory setting and work in inpatient settings. The purpose of these “bursts” is for students to
gain a deeper understanding of the fields of inpatient medicine, surgery, anesthesia, and obstetrics and
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2.
3.
4.
5.
6.
gynecology. These bursts serve as the foundation of sub-internships in the fourth year and allow
exposure to the field of anesthesiology.
Inpatient Medicine x 2 weeks
Inpatient Surgery x 2 weeks
Anesthesia x 1 week
Obstetrics/Gynecologic Surgery x 2 weeks
Students are assigned to16 “shifts” in the emergency department during the year.
Learning Objectives for INPATIENT BURSTS in Obstetrics and Gynecology:
1. Students will understand the process of normal labor and delivery. They will obtain the medical
knowledge to provide optimal care and reassurance for the woman in normal labor and the timely
recognition and treatment of abnormal events. This includes, but is not limited to:
a) Understanding the signs and symptoms of true and false labor
b) Performing the initial assessment of the laboring patient
c) Performing and documenting an adequate admission history and physical
d) Understanding the stages of labor and recognizing common labor abnormalities
e) Understanding approaches to pain management in labor
f) Understanding the methods of monitoring of the mother and fetus
g) Performing, with supervision, normal vaginal delivery
h) Observing operative vaginal delivery and understanding the indications
i) Observing cesarean section and understanding its indications, risks and recovery
2. Students will demonstrate knowledge of, and the provision of normal postpartum care, reassurance of
the normal postpartum patient, and recognition of abnormal events. This includes but is not limited to:
a) Understanding the normal maternal physiologic changes of the postpartum period
b) The components of normal postpartum care including postpartum rounds and care notes
c) Understanding and providing appropriate postpartum patient counseling
3. Students will understand and demonstrate knowledge of medical and surgical conditions that may alter
the course of pregnancy, labor and delivery and the postpartum period. This includes an understanding
of the diagnosis, evaluation, and management of the following conditions:
a) Ectopic pregnancy
b) Spontaneous abortion
c) Medical and surgical comorbidities and their affect on pregnancy
d) Medical and surgical comorbidities and the effect of pregnancy on these conditions
e) Preeclampsia-eclampsia
f) Alloimmunization
g) Multi-fetal gestation
h) Fetal death
i) Abnormal labor
j) Third trimester bleeding
k) Preterm labor
l) Preterm rupture of membranes
m) Postpartum hemorrhage
n) Postpartum infection
o) Postpartum depression and anxiety
p) Post term pregnancy
q) Fetal growth abnormalities
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4. Students will demonstrate knowledge of obstetric procedures basic to the management and counseling
of the pregnant patient. This includes but is not limited to:
a) Preoperative evaluation, planning, history, physical exam and informed consent
b) Measures for the prevention of infection, deep venous thrombosis and other perioperative
complications
c) Essential components of postoperative care
d) Common postoperative complications
e) Communication of operative findings to the patient and family
f) Understanding indications, mechanisms and possible complications of obstetric procedures
including:
i.
Ultrasound
ii.
Amniocentesis
iii.
Intrapartum fetal surveillance
iv.
Induction and augmentation of labor
v.
Vaginal birth after cesarean delivery
vi.
Breech delivery
vii.
Cesarean delivery
viii. Postpartum tubal ligation
ix.
Newborn circumcision
5. The student will demonstrate knowledge of the evaluation and management of gynecologic problems
that frequently require diagnostic and therapeutic surgical procedures. This includes but is not limited to:
1. Preoperative evaluation, planning, history, physical examination and informed consent
2. Common measures for the prevention of surgical infections, deep venous thrombosis and other
perioperative complications
3. Essential components of post operative care
4. Common postoperative complications and management
5. Effective communication of operative findings and complications to the patient and family
6. Understanding common outpatient and inpatient gynecologic surgical procedures, their
indications and possible complications including:
i.
Foley catheter insertion
ii.
Electrosurgical excision of the cervix
iii.
Dilation and curettage
iv.
Hysteroscopy
v.
Gynecologic laparoscopy
vi.
Tubal sterilization
vii.
Hysterectomy and bilateral salpingo-oophorectomy
Reading List:
There is an integrated reading list as part of the Clinical Education Day schedule on the portal. There are
assignments directly related to the material covered that day as well as a list to round out the reading list for the
year.
Core weeks:
Attendance at ALL activities during core weeks is MANDATORY. Any student with an unexcused absence will
be referred to the Committee for Academic and Professional Standards (CAPS). Students with excused absences
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are REQUIRED to make-up any material missed during their absence. The core weeks for the 2012-2013
academic year are:
1. Monday, October 22, 2012 to Friday, October 26
2. Monday, April 1, 2013 to Friday, April 5, 2013
3. Monday, June 17, 2013 to Friday, June 21, 2013
Required / Recommended Texts
Title
Link to Resource
Required :
Obstetrics and Gynecology, 6th edition, (2010)
Charles RB Beckmann, Frank W Ling, et.al.
(Wolters / Lippicott /ACOG)
http://www.amazon.com/Obstetrics-GynecologyBeckman/dp/0781788072/ref=sr_1_5?
Case Files: Obstetrics and Gynecology, 2nd
edition (2006)Eugene Toy, Benton Baker III,
et.al. (Lange)
http://www.netlibrary.com.ezproxy.tcmedc.net/ListContent.
aspx?cc=Ebook
Recommended / Optional Learning Materials:
Blueprints: Obstetrics and Gynecology
(2008)Tamara L Callahan, Aaron B Caughey.
(Blackwell)
Obstetrics, Gynecology and Infertility:
Handbook for Clinicians, 6th edition
John D Gordon, Jan Rydfors, et.al., (Scrub
Hill Press)
Managing Contraception: (2010-2012) Mimi
Zieman, Robert A Hatcher, et.al.,
Obstetrics and Gynecology Recall (2007)
F John Bourgeois, Megan J Bray, Catherine H
Matthews (Wolters / Lippincott)
Blackboard Site:
OR
http://www.amazon.com/Case-Files-Obstetrics-EugeneToy/dp/0071402845/ref=sr_1_19?
http://www.amazon.com/Blueprints-Obstetrics-GynecologyTamarahttp://www.amazon.com/Obstetrics-Gynecology-InfertilityHandbookClinicians/dp/0964546779/ref=ntt_at_ep_dpi_1#_
http://www.amazon.com/Managing-Contraception-20072009-MimiZieman/dp/0979439507/ref=sr_1_1?s=books&ie=UTF8&qi
d=1280183138&sr=1-1
http://www.amazon.com/Obstetrics-Gynecology-RecallJohnBourgeois/dp/0781770696/ref=sr_1_1?s=books&ie=UTF8
&qid=1280183392&sr=1-1
http://my.tcmedc.net/
Agencies used in this clerkship include, but are not limited to:
1. Local health departments
2. Social service agencies
3. Area agencies
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4. Indigent care clinics
5. Visiting nurse organizations
6. Hospice organizations
Teaching & Learning Methods to be used in this course:
1. Direct Patient Care under Supervision – Students will work in clinical settings closely supervised by
attending faculty. Attendance at these sessions is MANDATORY. Any student with more than 2 unexcused
absences will be referred to the Committee for Academic and Professional Standards (CAPS).
2 Interprofessional Learning: Students will function in clinical settings as a part of an interdisciplinary team,
including physicians, nurses, office staff, cross-disciplinary hospital staff, and staff at community agencies.
3. Case-Based Learning: Students will participate in conferences where OB/GYN topics are covered in a
case-based format.
4. Independent Learning: Students are allocated time during the schedule for independent learning focused
on patient encounters. This includes uWISE (Undergraduate, Web-based, Interactive Self-Assessment,
www.APGO.org) assignments as alternative learning for less-common patient encounter types.
Required Clerkship Assignments:
Student Led Tutorial: Each student will lead two tutorial sessions. Topics will be assigned at the
beginning of the year.
Course Evaluation:
Thoughtful student feedback is vital to assuring a high quality curriculum and educational experience.
All students will be given an opportunity to provide constructive feedback to the clerkship coordinators,
Regional Campus Dean(s), and Clerkship Director(s) for the Obstetrics and Gynecology clerkship.
Numerical ratings by all students will be solicited at the end of the course through the Office of
Evaluation & Assessment using the student feedback evaluation form specifically designed for the
TCMC Obstetrics and Gynecology Clerkship.
Medical Knowledge Competency and Course Narratives:
Medical Knowledge competency is assessed at multiple points in the MD Curriculum based upon students’
performance on graded items defined in each course (such as examinations, practicals, standardized patients,
etc.). Unsatisfactory and satisfactory performance is determined based on the pass mark established at 70%.
The course narrative is prepared by the clerkship grading committee. The Education Director for the discipline
and the Regional Education Coordinators comprise this committee. This qualitative and quantitiative
assessment of the student’s progress toward Professional competency will be maintained as part of the student’s
academic record and will be sent to each student for review after the clerkship is completed.
Students who have recurring difficulties in Medical Knowledge or professionalism competencies will be referred
to the Office of Academic Affairs and/or CAPS for progress review. This referral can occur at any time in any
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course in the first 2 years of the program (MS1 and MS2) or during the clinical years (MS3 and MS4). Issues in
professionalism during the clinical years are usually addressed by the appropriate Regional Clerkship Director
Evaluation Methods:
Learner Evaluation:
Each student will receive a 60-day, a mid-clerkship, and final evaluation from the Regional Education
Coordinator. The final grade will be based on the College’s Standards and Procedures for the Evaluation of
Students and will utilize evaluations from the student’s faculty supervisor, and the Obstetrics and Gynecology
faculty leading case conferences and didactic activities. Students will complete the NBME Shelf examinations
during the last third of the rotation. In addition to the formulation of specific grades, narrative evaluations will
be prepared by the Regional Education Coordinator and the Education Director for Obstetrics and Gynecology
and provided to the Office of the Registrar, the student’s advisor, and reviewed by the Committee on Academic
and Professional Standards (CAPS). Final clerkship grades are assigned by the discipline-specific Grading
Committee.
NBME Practice Examinations:
All students will take two NBME practice examinations. The Clinical Science Exam will cover all of the six core
disciplines. Students will also choose a subject-specific exam to take. The results of these examinations will be
reviewed by the Year 3 educational team.
Friday, December 14, 2012: Clinical Science Exam
Friday, February 1, 2013: Student-Selected Subject Exam
NBME Shelf Exam Dates for the 2012-2013 Academic Year:
As outlined above, the results of the NBME shelf exams are a component of the student’s final grade for a
specific clerkship. The dates for the exams for the 2012-2013 academic year are as follows:
Wednesday, May 15, 2013: Family Medicine and Pediatrics
Thursday, May 30,2013: Surgery and Psychiatry
Friday, June 14, 2013: Internal Medicine and OB/GYN
To be announced: Make-up exam date
Students may only use the make-up exam date for an excused absence. Students may miss no more than two
scheduled exams, and may take no more than two shelf exams on a single day.
Grading:
All clerkship grades are determined by the discipline-specific grading committee. The Education Director and
the Regional Education Coordinators from each region comprise the committee. The committee will review all
of the materials that pertain to the specific clerkship and assign a specific grade.
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Clerkship grades may be Honors (H), Satisfactory (S), or Unsatisfactory (U). Honors will be given to those
students performing in the top 15%. Grades will be determined in the following manner:
Clinical Preceptor Evaluation – 40%
Performance in Case Conferences, Tutorials, Reflection and Inpatient Bursts – 20%
Performance on NBME “Shelf” Exam – 20%
Performance on OSCE’s-20% (done during the call back weeks)
A SATISFACTORY grade requires that students have a passing score on the NBME exam which is defined as a
score greater than two standard deviations below the national mean for the prior year. It also requires a mean
score of “4” or more on their faculty evaluation. Passing OSCE and TBL scores are also required. Students
MUST complete all of their clinical encounters/procedures as outlined. Any student not meeting these
requirements will receive the grade of UNSATISFACTORY. A clinical preceptor may recommend a student for
the grade of INCOMPLETE based on his/her assessment of the student’s performance over the year. Students
receiving a grade of UNSATISFACTORY or INCOMPLETE will be notified by the Education Director for
the clerkship and the student will be referred to the Committee on Academic and Professional Standards
(CAPS).
For clerkships with inpatient burst experiences, the grading committee will solicit feedback from the faculty
involved in the burst(s) and will take this into account when assigning a final clerkship grade. The grading
committee may choose to contact clinical preceptors to discuss a student’s performance over the year. The
committee may use this information to help in the assignment of a final clerkship grade. The individual clinical
preceptor may recommend a student for honors, but only the grading committee may assign a grade of HONORS.
An HONORS grade will be given to the top 15% of students in that discipline for that year. Students will be
considered as a class and not by region for this distinction.
The rationale for the top 15% of students receiving honors is to identify those students who have truly excelled
in a specific discipline. The grading schema for clinical clerkships is included in the TCMC Medical Student
Performance Evaluation (MSPE) letter sent to residency programs.
The grading committee will also finalize the clerkship narrative which will be included in the MSPE.
Work Hour Policy:
TCMC agrees with the AMA-MSS statement on medical student work hours, and believes that periods of rest
optimize learning. In keeping with the ACGME work hour restrictions for residents, TCMC’s policy is as
follows:

TCMC does not permit students to work greater than 80 hours in a week.

Call periods are limited to 16 hours.
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
Call is limited to no more than once every three nights.

Duty free periods between on-call should be at least 8 hours long.

Students should have at least 24 consecutive hours free of all assigned duty every seven days.

The on-duty time medical students spend delivering patient care services of marginal or no
educational value should be minimized.

Students will submit a monthly “hours on duty” form to their Regional Educational Specialist.
Absences:
There are no unexcused absences during the 3rd year. Students may take up to 7 days in excused absence time (if
a student is ill, he or she must obtain a written clearance from a health-care provider to return to clinical duties).
All absences must be reported to the Regional Educational Specialist and it is the student’s responsibility to
inform clinical preceptors of this time and to use whitespace as make-up time. Any student failing to notify
his/her clinical preceptor AND Regional Educational Specialist of an absence will be considered in breach of
professionalism, and will be referred to his/her Regional Clerkship Director and ultimately to the Committee
for Professional and Academic Standards (CAPS). Any other time off requested during the third year is covered
by the College’s Leave of Absence Policy.
Educational Conference Time:
TCMC encourages 3rd and 4th year students to attend and participate in educational conferences of medical and
scientific organizations and societies. Attendance at these meetings should follow the guidelines listed below:
1. Students may be absent from 3rd or 4th year clinical/educational responsibilities for a maximum of 3
days during each academic year.
2. Any absence greater than 3 days will be used against the student’s 1 week of personal time.
3. Students must apply to the Office of Academic Affairs, in writing, 30 days prior to the meeting. This is
required even if the student is not seeking funds to attend the meeting.
4. The Education Director for the discipline must approve of the absence.
5. Students must inform all preceptors and arrange for any makeup time at the discretion of the preceptor.
6. Students must prepare a brief (10-15 minute) oral presentation and present at the next Friday CED
session (between 1-1:30 PM) reviewing important topics learned at the meeting/conference. If the
student is presenting data at the conference, it is desirable that the oral presentation focus on feedback
received or new ideas learned regarding the research.
7. The TCMC Office of Academic Affairs has limited funds to defray the costs of attending such meetings.
Priority is given to students presenting data or co-authoring presentations. See the policy on
Scholarships to Attend Professional meetings.
Faculty Roles and Responsibilities:
14
Education Director – The Education Director (ED) is ultimately responsible for all content and activities
associated with the clerkship, including establishing the educational goals for the clerkship, organizing clinical
and didactic activities, and ensuring that these activities meet stated goals. The ED works in conjunction with
Clinical Chairs, Regional Deans, Regional Clerkship Directors, Regional Education Coordinators, and Clinical
Faculty to develop and deliver the educational content of the clerkship. In addition, the ED works to ensure
comparability for the clerkship at all sites and has responsibility for ongoing review and revision of the clerkship
experience. The ED serves as the chair of his/her respective grading committee and works with the Regional
Education Coordinators in assigning student grades for the clerkship.
Regional Education Coordinator: The Regional Education Coordinator (REC) is responsible for the
coordination of all local activities at his/her respective clinical regional campus, including the implementation of
the curricular goals and ensuring that all activities are fulfilling these goals. The REC is responsible for the
recruitment and evaluation of faculty in the region for the clerkship. The REC serves as a primary regional
contact for students in a specific clerkship. All RECs serve as members of their respective grading committees.
Regional Clerkship Director: The Regional Clerkship Director (RCD) works with the Regional Dean and
Education Directors to ensure that all clinical activities in the region are functioning in a coordinated fashion.
This individual is responsible for working with Regional Education Coordinators across the disciplines to ensure
that each student fulfills educational goals. The RCD serves as a primary contact for students assigned to a
specific region. The RCD mentors and motivates students, monitors their progress, and assists students
requiring remediation or counseling. The RCD has no role in assigning grades for any clerkship, but may
intervene in global student performance issues such as in the domain of professionalism.
Regional Education Specialist: The Regional Education Specialist (RES) is the primary, initial point of
contact for students to clarify scheduling issues, or address educational or logistical concerns. In addition, the
RES will interface with the individual disciplines to help ensure that objectives are being met, and in addition,
will act as an interface for Student Affairs functions. The RES, with the assistance of the Regional Campus
Manager, will produce schedules for each student’s activities.
Clinical Preceptor: The faculty for the clerkship will work with the student on a daily basis to collaborate with
the student in the care of the students’ patients. The faculty is the initial point of contact for the students, and is
responsible for reporting any issues a student may be having with meeting the learning objectives to the
Regional Clerkship Director. The faculty is responsible for ensuring a welcoming and supportive learning
environment for the student, identifying gaps the students may have, and helping to direct the student towards
resources for self-directed learning to fill these gaps. He/she is also responsible for setting the highest example
of professionalism and life-long learning for TCMC students.
Students: The student is responsible for attending all clinical sessions and didactic learning experiences as part
of the rotation as well as completing self-directed learning experiences and activities. The student is responsible
for notifying both the RES and the supervising attending if illness or a personal emergency prevents attendance.
Attendance at didactics and conferences is mandatory.
Clerkship/Faculty Evaluation:
Thoughtful student feedback is vital to assuring a high quality curriculum and educational experience. All
students will be given an opportunity to provide constructive feedback to the clerkship coordinators, Regional
15
Campus Dean(s), and Clerkship Director(s) for the Family Medicine clerkship. Numerical ratings by all students
will be solicited at the end of the course through the Office of Evaluation & Assessment using the student
feedback evaluation form specifically designed for the TCMC OB/GYN Clerkship.
Attendance Policy:
Students will be accountable and personably responsible for attending all clerkship activities. Attendance is
MANDATORY for all clerkship related activities (as outlined in the previous pages), Portfolio assignments, and
presentation delivered at the conclusion of the clerkship. Excused absence from scheduled learning activity
requires prior notification and approval of the agency clerkship coordinator and the Regional Campus Dean and
should be requested only for extenuating circumstances. Absences because of illness or family emergency will be
addressed on an individual basis by the Regional Campus Dean or Clerkship Director. Unexcused absences
from any clerkship activity will be reported to the Regional Campus Dean’s office where attendance records will
be maintained for review and appropriate action.
Attendance at all clinical and educational sessions is required. The only exception to this is if there are
conflicting patient care learning opportunities; in this case the student must prioritize the conflict and report in
to the affected faculty member. Punctuality is of extreme importance; appearing late to clinical experiences
and/or conferences is not acceptable and will affect the students’ grade.
Dress Code:
Attire should not detract from the educational atmosphere. Students are expected to dress professionally to
show respect to yourself and others. This includes patient encounters in the hospital or clinic. Neat, clean and
professional attire and a name tag are minimal requirements. Avoid dress or attire that could be potentially
offensive to the public, your peers, patients, and faculty.
General Standards:



TCMC ID badges are worn at all times.
Good personal hygiene is to be maintained at all times. This includes regular bathing, use of
deodorants/antiperspirants, and regular dental hygiene.
Scrubs may not be worn in ambulatory settings. They should only be worn in the Emergency
Room and Operating Room.
Check with your course or Clinical supervisor to learn of any other dress code requirements when you begin
each rotation.
Confidentiality:
Students are required to maintain standards of confidentiality in accordance with HIPAA.
Patient Care Responsibility:
In order to enhance educational outcomes, it is important that students ‘take ownership’ of their patients. This
means that students should feel that their contributions as a member of the health care team are meaningful and
important. Students should communicate frequently with their faculty preceptors and the patients they are
following; students should of course not be making medical decisions independently without guidance and
16
approval of faculty, but at this same time should see themselves as important contributors and completely
engaged as a member of the team. This will necessitate regular communication with the office and physician;
preferred modes of communication should be established at the outset of the year. Students should adhere to
important ethical guidelines on the care of patients, including boundary setting and the avoidance of
inappropriate relationships with patients.
Remediation Policy for Students Who Fail a Course or Clerkship:
If a student fails a clerkship, that student will be contacted by the appropriate Education Director prior to the
posting of grades to be informed of the need to remediate. The Education Director will refer the student to the
Senior Associate Dean for Academic Affairs, the Committee for Academic and Professional Standards (CAPS),
and the Center for Learning Excellence (CLE). The Education Director will notify the student in writing of
these referrals. The Education Director will notify the student in writing of these referrals. If the student is
determined to be eligible for remediation by CAPS, the Education Director will determine the appropriate
remediation and set the timeline for this remediation.
Social Justice Statement:
The Commonwealth Medical College is committed to social justice. The course director concurs with that
commitment and expects to foster a nurturing learning environment based upon open communication, mutual
respect, and non-discrimination. Our College does not discriminate on the basis of race, sex, age, disability,
veteran status, religion, sexual orientation, color or national origin. Any suggestions as to how to further such a
positive and open environment in this class will be appreciated and given serious consideration.
Disability Support Services:
If you are a person with a disability and anticipate needing any type of accommodation in order to participate in
this class, please advise the course director and The Director of the Center for Learning Excellence prior to the
commencement of the course. The Center for Learning Excellence coordinates all disability services and
requires three days notification in order to proctor and provide all testing accommodations. Failure to notify the
course director and Center for Learning Excellence 1 week before an exam that you will need accommodation
for your disability implies acceptance of conditions for that examination.
Code of Conduct and Professional Behavior:
All activities in this course are conducted under The Commonwealth Medical College Student Code of
Academic and Professional Integrity for the MD Degree Program. You signed and received a copy of this
Student Code when you enrolled at The Commonwealth Medical College. The full policy is in the Student
Handbook. The college, which includes the faculty and staff, expect students to behave appropriately and to
fulfill their academic and professional responsibilities.
Table 1: Continuity Patient Panels (Logging and Preceptor Certification)
REQUIRED CONTINUITY PATIENTS
Continuity Patient 1 -- Internal Medicine
Description/Diagnoses
Date of
Initial
Encounter
Patient
Initials
Faculty
Initials
17
Continuity Patient 2 -- Internal Medicine
Continuity Patient 3 -- Internal Medicine
Continuity Patient 4 -- Internal Medicine
Continuity Patient 5 -- Internal Medicine
Continuity Patient 6 -- Internal Medicine
Continuity Patient 7 -- Internal Medicine
Continuity Patient 8 -- Internal Medicine
Continuity Patient 9 -- Internal Medicine
Continuity Patient 10 -- Internal Medicine
OTHER Continuity Patient(s) -- Internal Medicine
Continuity Patient 1 -- Family Medicine
Continuity Patient 2 -- Family Medicine
Continuity Patient 3 -- Family Medicine
Continuity Patient 4 -- Family Medicine
Continuity Patient 5 -- Family Medicine
Continuity Patient 6 -- Family Medicine
Continuity Patient 7 -- Family Medicine
Continuity Patient 8 -- Family Medicine
Continuity Patient 9 -- Family Medicine
Continuity Patient 10 -- Family Medicine
OTHER Continuity Patient(s) -- Family Medicine
Continuity Patient 1 -- Pediatrics
Continuity Patient 2 -- Pediatrics
Continuity Patient 3 -- Pediatrics
Continuity Patient 4 -- Pediatrics
Continuity Patient 5 -- Pediatrics
Continuity Patient 6 -- Pediatrics
Continuity Patient 7 -- Pediatrics
Continuity Patient 8 -- Pediatrics
Continuity Patient 9 -- Pediatrics
Continuity Patient 10 -- Pediatrics
OTHER Continuity Patient(s) -- Pediatrics
Continuity Patient 1 -- Surgery
Continuity Patient 2 -- Surgery
Continuity Patient 3 -- Surgery
Continuity Patient 4 -- Surgery
Continuity Patient 5 -- Surgery
Continuity Patient 6 -- Surgery
Continuity Patient 7 -- Surgery
Continuity Patient 8 -- Surgery
Continuity Patient 9 -- Surgery
18
Continuity Patient 10 -- Surgery
OTHER Continuity Patient(s) -- Surgery
Continuity Patient 1 -- OB/GYN
Continuity Patient 2 -- OB/GYN
Continuity Patient 3 -- OB/GYN
Continuity Patient 4 -- OB/GYN
Continuity Patient 5 -- OB/GYN
Continuity Patient 6 -- OB/GYN
Continuity Patient 7 -- OB/GYN
Continuity Patient 8 -- OB/GYN
Continuity Patient 9 -- OB/GYN
Continuity Patient 10 -- OB/GYN
OTHER Continuity Patient(s) -- OB/GYN
Continuity Patient 1 -- Psychiatry
Continuity Patient 2 -- Psychiatry
Continuity Patient 3 -- Psychiatry
Continuity Patient 4 -- Psychiatry
Continuity Patient 5 -- Psychiatry
Continuity Patient 6 -- Psychiatry
Continuity Patient 7 -- Psychiatry
Continuity Patient 8 -- Psychiatry
Continuity Patient 9 -- Psychiatry
Continuity Patient 10 -- Psychiatry
OTHER Continuity Patient(s) -- Psychiatry
Table 2: Required Patient Encounters (Logging only)
Longitudinal Integrated Clerkship Requirements
REQUIRED PATIENT TYPES
Abdominal Aortic Aneurysm
Abdominal Pain
Abnormal labor
Abnormal Pap Smear
Abnormal uterine bleeding
Abrasion
Acute injury -- in a child
Acute Kidney Injury
Adenexal mass/cyst
Alloimmunization during pregnancy
Amenorrhea
1
3
1
2
2
1
1
1
1
1
1
log IM FM PED SURG OB PSY ALT
L
L
L
L
L
L
L
L
L
L
L
19
Anemia
Anorectal disease
Anxiety disorder
Appendicitis -- acute
Arrythmia
Asthma -- in a child
Autism screening
Back pain -- acute
Behavioral disorder
Biliary disease
Bipolar disorder
Bleeding Disorder
Bowel incontinence
Bowel obstruction
Breast Mass
Breast Pain
CABG -- patient management
Cancer Diagnosis
Cerumen impaction
Chest pain
Child sexual abuse
Chromosomal abnormality
Chronic back pain
Chronic Kidney Disease
Colorectal cancer
Colposcopy -- observe
Congestive Heart Failure
Conjunctivitis
Contraception counseling
COPD
Cough evaluation
Dehydration -- in a child
Delirium
Dementia
Dental disease
Dental review -- in a child
Depression -- follow-up
Depression -- geriatric patient
Depression -- initial diagnosis
Developmental delay
Diabetes
Diabetes -- initial diagnosis
Diabetes and pregnancy
Diabetes mellitus -- in a child
20
2
1
1
1
3
2
2
2
1
4
2
1
2
2
3
1
2
1
1
3
1
1
3
1
2
1
5
1
2
2
3
1
2
3
3
2
2
1
2
1
2
3
1
1
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
Diabetic foot ulcer
Diarrhea
Diet/Exercise counseling
Digestive Malignancy
Diverticular disease
Dizziness
Dysmenorrhea
Dyspnea Evaluation
Ear pain -- in a child
Eating disorder
Ectopic Pregnancy
Edema -- lower extremity
Electrolyte abnormality -- in a child
Endometriosis
Eye problem
Failure to thrive -- in a child
Fall risk evaluation
Family and Social Support Discussion
Fatigue
Fetal Death
Fetal Growth Abnormalities
Fever Evaluation -- in a child
Fever Evaluation -- in an adult
Fibroids
First Trimester Bleeding
Fracture or dislocation
Gastroenteritis -- in a child
GERD
GERD -- surgical evaluation
Geriatric patient in community
Geriatric patient in long-term care
Gestational Trophoblastic disease
GI bleed -- upper
Grief
Growth abnormality -- in a child
Gynecologic Malignancies
Headache -- in a child
Headache -- in an adult
Hearing screening -- in a child
Hernia
HIV/AIDS
Hospice patient
Hyperlipidemia
Hyperlipidemia -- initial diagnosis
1
3
2
2
1
3
1
3
2
1
1
3
1
1
2
1
2
2
3
1
1
3
3
1
1
3
2
3
1
1
1
1
2
1
1
1
2
3
2
3
1
3
1
3
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
21
Hypertension
Hypertension -- initial diagnosis
Immunizations
Infection, peripartum
Infertility patient
Injury prevention -- in a child
Intimate Partner Violence Screening
Ischemic heart disease
Kidney stones
Labor, normal
Lacerations
Lactation Consult, observation
Lead Exposure -- in a child
Leg pain -- in a child
Liver Disease
Lung Mass
Menopause/Perimenopause
Multifetal gestation
Multiple chronic illnesses
Neck mass evaluation
Neck pain -- acute
New diagnosis -- adult patients
Nutrition
Obesity -- in a child
Obesity -- in an adult
Obstructive uropathy
Osteoarthritis
Osteoporosis
1
3
10
1
1
2
5
2
1
3
1
1
2
1
1
1
2
1
3
1
2
3
2
2
3
1
1
2
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
Panic disorder
Pelvic floor dysfunction/prolapse
Pelvic pain, acute
Pelvic pain, chronic
Peripheral vascular disease
Pneumonia
Pospartum depression
Postmenopausal bleeding
Postpartum care -- routine
Postpartum hemorrhage
Postterm Pregnancy
Preconception care
Pre-eclampsia/eclampsia
Pregnancy -- advanced maternal age
Pregnancy -- First trimester care
Pregnancy -- Second trimester care
1
1
2
2
1
1
1
1
3
1
1
1
1
2
2
2
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
22
Pregnancy -- Third Trimester care
Pregnancy termination
Premature infant
Premature rupture of membranes (PROM)
Premenstrual Syndrome/PMDD
Preterm labor (PTL)
Prostate disease -- surgical evaluation
Psychosis, acute
Rash -- in a child
Rash -- in an adult
Rheumatoid Arthritis
Salivary gland malignancy
Schizophrenia
Seizure Disorder
Seizure disorder -- in a child
Severely disabled child
Sexual Assault
Sexually Transmitted Infection
Sore throat -- in a child
Spontaneous abortion
Sterlization counseling
Stroke, acute
Substance use/dependence
Suicide attempt, acute
Teen Pregnancy
Third trimester bleeding
Thyroid disorder
Thyroid disorder -- in a child
Traumatic injury -- management
Tuberculosis screening
Upper respiratory tract infection
Urinalysis interpretation
Urinary incontinence -- female
Urinary incontinence -- male
Urinary tract infection
Vaginal discharge
Vertigo
Vision screening -- in a child
Vomiting
Vulvar disease
OTHER ENCOUNTERS
2
1
2
1
1
1
1
2
2
3
1
1
2
1
1
1
1
3
2
1
2
1
2
1
1
1
1
1
1
2
2
3
1
2
1
3
1
2
3
1
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
L
23
Table 3: Required Encounters and Procedures (Logging and Preceptor Feedback)
REQUIRED ENCOUNTERS/PROCEDURES -feedback
Annual, well woman exam -- gynecology
Arterial Blood Gas Sampling
Breast examination
Cervical Culture
Cesarean Section Observation
Delivery Note
Disability Evaluation
EKG Interpretation
Fern and Nitrazine test
Foley catheter insert -- female
Foley catheter insert -- male
Follow-up Acute Problem - adult/pediatric patient
Follow-up Chronic Care -- adult patients
Gynecology Operative Note
Gynecology Preoperative Note
Gyneology Postoperative Progress Note
History and Physical -- Gynecology (complete)
History and Physical -- Obstetrics (complete)
History and Physical -- Psychiatry (complete)
History and Physical Inpatient -- Adult (complete)
History and Physical Inpatient -- Peds (complete)
History and Physicial -- Adult Outpatient (focused)
History and Physicial -- Surgical Eval (complete)
Home Visit
Hospital discharge -- of a child
Hospital discharge -- of an adult
Hysterectomy Observation
IV catheter (peripheral) insertion
Labor -- cervical check for dilation
Laparoscopic Gynecologic Surgery Observation
Nasogastric tube placement
Nutrition Evaluation (surgery patient)
Operative Vaginal Delivery Observation
Pelvic examination (speculum and bimanual)
Phlebotomy (diagnostic, peripheral)
Postpartum note -- operative delivery
Postpartum note -- vaginal delivery
Rectal Examination
School physical
24
obs
only
6
2
1
1
1
3
2
5
1
1
1
10
15
2
1
2
6
6
3
6
6
10
6
2
1
5
1
6
1
1
2
1
1
6
6
1
1
3
2
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
understand/explain
done
w/direction
does
while
observed
Faculty
Initials
Screening -- breast cancer
Screening -- cervical cancer
Screening -- colon cancer
Screening -- intimate partner violence
Screening -- prostate
Skin excision
Sports physical
Suturing (simple)
Suturing of vagina/perineal lac post vag delivery
Tubal ligation -- observe
Vaginal delivery with supervision
Vaginitis exam with KOH and wet prep
Well adult visit -- female
Well adult visit -- male
Well child visit -- 10-20 years
Well child visit -- 1-4 years
Well child visit -- 5-10 years
Well child visit -- birth to 1 year
OTHER PROCEDURES
6
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
L/F
25
Program Outcomes
The Commonwealth Medical College (TCMC) will educate aspiring physicians and scientists to serve society
using a community based, patient centered, interprofessional and evidence based model of education that is
committed to inclusion, promotes discovery and utilizes innovative techniques.
Competency & Student Learning Objectives and Examples of Outcome Measures:
The following are the general MD Curriculum Program Outcomes that have been organized by competency
domain established by TCMC and addressed in this course:
Students will develop basic knowledge of the pathophysiology, presentation, and treatment of commonly
encountered obstetric and gynecologic illnesses, prenatal care and well-woman care. The observable student
learning performance of knowledge, skills and behaviors achieved by the end of the course are as follows:
Clerkship Objectives
General
Objectives
Medical Knowledge
Knowledge & Skills Objectives
Demonstration of the ability to apply a
comprehensive basic science knowledge
foundation to clinical medicine.
Demonstrates an investigatory and analytic
approach to patient care practices.
Demonstrates good analytic skills and sound
judgment when making medical decisions
Obtain the necessary clinical skills to
address health maintenance needs on the
female patient.
Demonstrate a comprehensive knowledge
foundation of the clinically supportive
cognitive sciences
Obtain the necessary clinical skills to
diagnose and manage the health needs of
populations and communities.
Practice-Based
Learning and
Improvement
26
Demonstrates good knowledge of medical
interviewing techniques and understands
significance of physical examination
findings.
Locate, appraise and assimilate evidence
from scientific studies related to their
patients’ health problems; apply knowledge
of epidemiologic principles, appropriate use
of statistical methods, and proper study
design to appraise information on diagnostic
and therapeutic effectiveness
Instructional
Strategies
Evaluation
Methods
Direct patient care
under supervision, case
conferences, tutorials,
clinical rounds
Direct patient care
under supervision, case
conferences, tutorials,
clinical rounds
Direct patient care
under supervision, case
conferences, tutorials,
clinical rounds
Direct patient care
under supervision, case
conferences, tutorials,
clinical rounds
Faculty evaluations
NBME shelf
examinations,
OSCEs
Faculty evaluations
NBME shelf
examinations,
OSCEs
Faculty evaluations
NBME shelf
examinations,
OSCEs
Faculty evaluation
NBME shelf
exams, OSCEs
E-portfolio,
Course narrative
Case conferences,
tutorials, clinical rounds
Faculty evaluations
NBME shelf
exams, OSCEs
Faculty evaluations
NBME shelf
exams, OSCEs
E-portfolio, course
narrative
Faculty evaluations
NBME shelf
examinations,
OSCEs
Faculty evaluations,
OSCEs
E-portfolio, course
narrative
Direct patient care
under supervision, case
conferences, clinical
rounds
Direct patient care
under supervision, case
conferences, tutorials,
clinical rounds
Tutorials, clinical
rounds, case
conferences
Documentation
E-portfolio, course
narrative
E-portfolio, course
narrative
E-portfolio, course
narrative
E-portfolio, course
narrative
E-portfolio, course
narrative
General
Objectives
Interpersonal Skills
and Communication
Professionalism
Patient Care
Instructional
Strategies
Evaluation
Methods
Use information technology to manage
information, access on-line information, and
support self-education.
Tutorials
Faculty evaluations,
OSCEs
E-portfolio
Use information technology to manage
information, access on-line information, and
support self-education
Analyze clinical experiences and reflect on
personal practice patterns to initiate
practice-based improvement activities using
a systematic methodology
Facilitates the learning of students and other
health care professionals.
Clinical rounds, case
conferences
Faculty evaluations,
OSCEs
E-portfolio
Patient panel audit
Faculty evaluations
E-portfolio
Tutorials, clinical
rounds, case
conferences
Clinical care under
supervision
Faculty evaluations,
OSCEs
E-portfolio, course
narrative
Faculty evaluations,
patient evaluations
E-portfolio
Create and sustain a therapeutic and
ethically sound relationship with patients.
Clinical care under
supervision
Faculty evaluations,
patient evaluations
E-portfolio
Work effectively with others as a member or
leader of a healthcare team.
Clinical care under
supervision
Faculty evaluations,
patient evaluations
E-portfolio
Recognize that the need to learn and
develop professionally is continuous.
Conferences; faculty
role modeling
E-portfolio
Demonstrate a commitment to ethical
principles pertaining to provision or
withholding of clinical care, confidentiality
of patient information, informed consent,
and business practices.
Conferences
Health care team
and faculty
evaluations
Faculty evaluations
Demonstrate sensitivity and responsiveness
to patients and colleague’s culture, age,
gender, race, religion, and sexual
preferences.
Supervised clinical
experiences, tutorials
Faculty evaluations
E-portfolio
Demonstrate respect, compassion and
integrity; a responsiveness to the needs of
patients and society that supersedes selfinterest; accountability to patients, society
and the profession; and a commitment to
excellence and ongoing professional
development.
Clinical rounds,
supervised clinical care
OSCEs, faculty
evaluations
E-portfolio, course
narrative
Demonstrate caring, respectful and effective
communication skills when interacting with
patients and families.
Supervised clinical
experiences
Faculty and patient
evaluations, OSCEs
E-portfolio
Gather essential and accurate patient
information through history and physical
examination and collection of pertinent
data.
Supervised clinical
experiences, rounds
Faculty evaluations
E-portfolio
Formulate appropriate diagnostic and
therapeutic management strategies for
patients with common health problems
including emergent, acute or chronic across
the spectrum of disciplines based on patient
Supervised clinical
experiences, rounds,
case conferences
Faculty evaluations,
OSCEs, NBME
exams
E-portfolio
Knowledge & Skills Objectives
Use effective listening skills and elicit and
provide information using effective
nonverbal, explanatory, questioning and
writing skills.
Documentation
E-portfolio
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General
Objectives
Instructional
Strategies
Evaluation
Methods
Develops and implements patient
management plans that actively engage the
patient and caretakers.
Use information technology to optimize
patient care.
Supervised clinical
experiences, rounds,
case conferences
Supervised clinical care
Faculty evaluations,
OSCEs, NBME
exams
Faculty evaluations
E-portfolio
Perform competently appropriate medical
and invasive procedures considered essential
for entering any area of graduate medical
education.
Supervised clinical care
Faculty evaluations
E-portfolio
Promote standard health maintenance and
disease prevention.
Supervised clinical care,
conferences
NBME exams
E-portfolio
Work with other health professionals to
provide patient focused care.
Supervised clinical care
Faculty evaluations
E-portfolio
Understand how their patient care and other
professional practices affect other healthcare
professionals, the healthcare organization
and the larger society.
Clinical conferences,
reflective writing
Faculty evaluations
E-portfolio
Advocate for quality patient care and assist
patients in dealing with system complexities.
Clinical conferences,
supervised clinical care
Faculty and patient
evaluations
E-portfolio
Act as advocates for better health for
patients and the community by partnering
with health care managers and providers to
assess, coordinate and improve health
outcomes.
Supervised clinical care
Health care team
evaluations
E-portfolio
Know how types of medical practice and
delivery systems differ from one another,
including methods of controlling health care
costs and allocating resources
Practice cost-effective healthcare and
resource allocation that does not
compromise quality of care.
Supervised clinical care,
conferences
Faculty evaluations
E-portfolio
Supervised clinical care,
conferences
Faculty evaluations
E-portfolio
Knowledge & Skills Objectives
Documentation
information and preferences, current
evidence and clinical judgment, while
considering costs for the patient and the
system.
Systems-Based
Practice
E-portfolio
Every student will receive an MD Program Outcomes Evaluation (often referred to as Competency Evaluation)
that is based upon the established overall MD Program Outcomes for the MD Curriculum at TCMC. This is a
quantitative assessment that uses a scale of 1-9 for each competency item. The “Meets Expectations Criteria”
has a scale of 4-6 and the expectation is that third year MD students will attain a mean score of 6.0 or greater in
MS 3 and MS 4. This score is for MD program evaluation purposes only and is not calculated into the students’
final grade given for the course or used for any other student based evaluation purposes. It is reported in
aggregate for program review purposes only.
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