Longitudinal Integrated Clerkship

1. Longitudinal Integrated Clerkship Christine Ford, EdD

2. What is an LIC? Longitudinal integrated clerkships (LICs) have the following common core elements: • Medical students participate in the comprehensive care of patients over time • Medical students have continuing learning relationships with these patient’s clinicians • Medical students meet, through these experiences, the majority of the year’s core clinical competencies across multiple disciplines simultaneously. (Consortium of Longitudinal Integrated Clerkships, 2007)

3. Traditional Block Clerkships • Rotations are consecutive • 4-8 weeks each • NBME • Weekly didactics • Numerous faculty preceptors

4. McGovern Medical School LIC • Integrated primary care experience with Internal Medicine, Family Medicine, Pediatrics, OB-Gyn, and Geriatrics • 28 weeks long • Begins with 4 week inpatient IM immersion • 24 week ambulatory experience • Takes place at LBJ • 10 students

5. Clerkship Order for LIC Students

6. LIC Objectives In addition to meeting the established objectives for the Internal Medicine, Family Medicine, Geriatrics, Pediatrics, and OB-Gyn clerkships, LIC students will also: • Recognize the complexity of the health system • Advocate for patients within the health system • Define the social determinants of health and address them effectively with their patients • Recognize the role of quality improvement and safety in health care • Reflect on their developing professional identity • Demonstrate confidence in counseling patients on common ailments and preventive measures • Collaborate for patient care with other members of the healthcare team

7. Multiple Dimensions of Continuity Patients Faculty Peer Learners Practice Setting Pedagogy

8. Benefits of LICs for students, clinicians, and community (Greenhill & Walters, 2014)

9. Didactics • Weekly sessions/workshops • Guest speaker on wide variety of topics • Core teaching • Reflection • Supplemental content • Simulations (extra) • Online cases • Access to didactics from traditional clerkship

10. Patient Cohort • Acquired early in the experience • Patient lists kept on EMR • Patient mix with various diagnoses • Follow clinic visits, surgeries/procedures (Ob/Gyn)

11. Feedback/Evaluation • Regular meetings with faculty mentors • Multiple midpoint evaluations • Feedback cards and EPA forms

12. Exams and Grades Exams • Internal Med – Week 8 • Ob/Gyn– Week 13 • Pediatrics—Week 18 • Family Medicine—Week 24 Grades • Separate grade for each discipline • Same main grade components: national exam, clinical evaluations, online cases, simulation and SPs, didactic attendance

13. LIC Team Faculty Discipline Leads • Internal Medicine: Robby Wesley • Family Medicine: Bal Reddy • Pediatrics: Amalia Guardiola • OB-Gyn: Sara Holcombe • Geriatrics: Cristina Murdock OEP Staff • Christine Ford • Dawn Morvant

14. Sample Student Schedule

15. Application Process • Applications open today- due December 2 • Available on OEP website • Statement of interest • Tolerance for ambiguity survey • Good academic standing • Interviews December 11 • Determine participants by late December/early January* *Pending successful Step 1 performance

16. 2019 LIC Students • Heba Ahmad • Kylie Anthony • John-Paul Bach • MunirBuhaya • Isabella Ciuffetelli • Cynthia Coots • Monica Herbst • Isabella Taglialatela • Ayana Taylor