Scheduling of Clerkship/Courses for Years 3 and 4

1. Practical Information Scheduling of Clerkship/Courses for Years 3 and 4 Faculty Advisor, Clinical Mentor Responsibilities

2. Scheduling of Clerkships Core Objectives for Scheduling of clerkships • Outline requirements to start rotations in Year 3 • Describe requirements for graduation from Medical School • List all required clerkships with number of weeks/credits needed for graduation • Describe requirements for elective credits needed for graduation and what constitutes “hands-on” credits • Outline approximate dates (if available) for RPAP application, scheduling lottery, and Transition Day • List four main responsibilities of a Faculty Advisor and two responsibilities for Clinical Mentors

3. Beginning of Year 3 or 4 (Intersession) Next to Last or Last Monday (May) or First Monday (June)? Required clerkshipsYear 3 (Medicine I) Residency Information day March-April, Year 3 Career selection – residency Spring, Year 3 Summer,Year 4 Overview of Important Dates — Years 3, 4

4. MSPE (Dean’s letter) Late Spring, Summer to Aug 1--Year 4 Submit Applications September 15--Year 4 ERAS, letters – complete Oct 1(submit)--Year 4 Clinical Competence June-October--Year 4 Assessment (CCA)-OSCE Residency interviews Regular Match: Nov. thru early Jan (December)--Year 4; Early Match: Sept?,October- November--Year 4 Overview of Important Dates — Years 3, 4

5. USMLE Step 2 CK, CS Before February 1 (CK) orDecember 31 (CS), Year 4 Match DayThird Friday of March, Year 4 Transition to residency During Graduation week Graduation First Friday of May, Year 4 Overview of Important Dates — Years 3, 4

6. Important Upcoming DatesClass of 2015 EventDate RPAP Application - Submitted November, December 2012 - Interviews Jan (D), Jan (TC) - Selection February, 2013 Select/Schedule Clerkships March 11-15, 2013 5:30-10:30 pm Faculty Advisors Approve Schedules March18-March 31, 2013 Transition Course/Days (Required) April 3, 2013 • Must register for USMLE Step 1 exam before access to on-line scheduling system • Must take USMLE Step 1 exam before end of Period 2 (Year 3)-mid August

7. Curriculum Requirements for Graduation • Required Course/Clerkships – Must pass ALL Required Courses/ Clerkships in Years 3 and 4 • Must pass all Year 1 and 2 Courses before entering into Year 3 • Must have 76 Credits for Graduation (Maximum of 85 Credits for non-RPAP, 95 Credits for RPAP Students-may do more upon request) • 56 Credits – Required Clerkships • 20 Credits – Elective (at least 8 “hands-on”) • Must pass USMLE Step I, Step II CK and Step II CS Board Examinations and CCA to graduate

8. Required Courses/Clerkships Years 3 and 4 Courses Length MED 7500 (Medicine I)6 weeks MED 7500 (Advanced Medicine/Medicine II)6 weeks ADPY 7500 (Psychiatry)6 weeks OBST 7500 (Obstetrics/Gynecology)6 weeks PED 7501 (Pediatrics)6 weeks

9. Required Courses/Clerkships Years 3 and 4 Courses Length SURG 7500 (Surgery) 6 weeks FMCH 7600/ Dept-7700 or 7701 8 weeks Family Medicine Clerkship (FMCH 7600) 4 weeks Primary Care Selective—Clinics in Family Med (UCAM), Medicine, Pediatrics, Med/Peds 4 weeks (Sequential, non-sequential) NEUR 7510 (Neurology) (adult) 4 weeks EMMD 7500 (Emergency Medicine) 4 weeks Medicine or Surgery pre-requisite

10. Required Courses/Clerkships Years 3 and 4 Courses Length Surgical Specialty Selective(s) (4-week block) 4 weeks 4 weeks in one or 2 weeks in two of four: (sequential, non-sequential) Neurosurgery (7200) Otolaryngology (ENT) (7200) (general, pediatrics[?]) Urology (7200) (general) Orthopaedic surgery (7200) (general, pediatrics, sports) TOTAL 56 1 week = 1 credit

11. Required Clerkships – Twin Cities, Duluth Campuses • Both • Medicine I • Obstetrics/Gynecology • Surgery • Pediatrics • Family Medicine Course, Primary Care Selective Clinics • Orthopaedic Surgery • Neurology • Emergency Medicine • Twin Cities only • Medicine II • Psychiatry • Neurosurgery • Otolaryngology • Urology

12. Clerkship SchedulingSuggestions/Hints--Career Specialty Dependent

13. Scheduling of Clerkships—On Call 6 Weeks Medicine I-10:00pm Pediatrics-Call Medicine II-10:00pm Ob/Gyn-Call Psychiatry-no call Surgery-Call 4 Weeks Emergency Medicine (Block hours including nights) Neurology-site specific call Surgical Specialties (NSG, OTO, Ortho Surgery, Urology) One (four weeks) or Two (two weeks each)-no or minimal call 8 Weeks Family Medicine Course (4weeks), Primary Care Selective Clinic(4 weeks) -no call TOTAL: 56 Weeks = 56 Credits Be careful scheduling clerkships that have back to back overnight call Note—Sub-internships (electives)— Overnight Call is common

14. Curriculum PlanningSchedulingElectives in Years 3 and 4 • 20 weeks (20 credits) = electives (over 180 courses) • 8 weeks direct patient interaction or “hands-on” in Twin Cities, Duluth or Greater Minnesota (hospital, clinic/office)—U of Minnesota • Does NOT include radiology (except interventional), laboratory medicine, research, elective away for credit, international rotation, military rotations • 12 weeks available for research • Can NOT earn credits and be paid • 6-12 weeks available for Elective Away for Credit including international electives (flexible) • RPAP/MetroPAP students • 2-8 weeks for electives • Hands-on requirement waived

15. Subinternships (late Year 3, early Year 4) Dermatology Anesthesiology Radiology Ophthalmology Cardiology Research Sports medicine International medicine Family medicine rotations Indian Health Service Elective away Laboratory - data interpretation Common Electives (over 180 available)

16. Curriculum PlanningSchedulingYear 3 and 4 Medical Students • 23 weeks of Free Time • Leave time in fourth year for residency interviews, USMLE Step 2 exams, electives away, international rotations) • Medical education • Research • Special projects • Other • Two weeks vacation

17. “Tracks” or Pathways-Flexibility Second degree-Flexible MD RPAP or MetroPAP (36 credits total): Required courses (all students) - 22 credits (D, TC): Medicine I (before RPAP) – 6 weeks-D, TC Advanced Medicine/Medicine II – 6 weeks-TC Psychiatry – 6 weeks-TC Neurology – 4 weeks-D, TC

18. Rural Physician Associate Program (RPAP) • 35-40 students (plus 2-4 students-MetroPAP) per year, spend 9 months with preceptor(s) in Greater Minnesota (North Memorial-Broadway Family Medicine) • Period 4 (Year 3) through Period 1 (Year 4) • Apply in November-December, Year 2 • Must take at least two required clerkships (12 credits stronglyrecommended, 10 credits if extenuating circumstances and permission of Director of RPAP and Lead Academic Advisor before RPAP/MetroPAP begins in October • Medicine Iplus second required clerkship (e.g.,Ob, Peds, Psych) • Lottery for Duluth students at Duluth sites – 12 students (Medicine I) • Contacts: Deann Dahl (Duluth), Genne Fritts; Kathleen Brooks, MD (MetroPAP) • Third elective rotation in Duluth (Deann Dahl), in Twin Cities (lottery) MUST OBTAIN CREDIT FOR ALL REQUIRED CLERKSHIPS TO GRADUATE MUST HAVE PASSING SCORE for STEP I “in hand” BEFORE RPAP BEGINS

19. RPAP • May opt out—24 credits (weeks) maximum*: • Family Medicine Clerkship/Primary Care Selective Clinic—8 weeks (all sites) • Surgery – 6 weeks (all sites) • Pediatrics* – 6 weeks (selected sites)-not MetroPAP • Ob/Gyn* – 6 weeks (selected sites, otherwise beforeRPAP) • Orthopaedics and/or Urology* – 2 or 4 weeks (selected sites) – both or one – counts as one opt out-not MetroPAP • Emergency Medicine* – 4 weeks (selected sites) *Note: Opt out courses dependent on site, educational experience and approval of RPAP director, preceptor, faculty advisor, Department Head and Lead Academic Advisor

20. Evaluation-Clerkships/Courses

21. Evaluation System - 2008 • Competencies • Patient care • Interpersonal and communication skills • Professionalism • Medical knowledge • Practice-based learning • Systems-based practice • Competence – overall (50-60% of grade) Rating scale Below expectations Meets expectations Above expectations Far exceeds expectations

22. Areas to Address or Discuss with Advisees Update — GRADES • Review evaluations - grades • Residency selection: grades/evaluations in required courses • Grading (required courses only)-annual • Honors: up to 30% • Excellent: 30-60% • Satisfactory: 20-30% • Evaluation (faculty of student; student of faculty, rotation) • Electronic • Linked to scheduling system

23. Keys to Success in Clinical Rotations/Clerkships • Demonstrate professionalism consistently • Be on time (early) • Be prepared (like Boy Scouts) • Be respectful to all • Be a team player • Be interested, collegial • Present accurate, concise histories, physical examinations, assessments, plans • Demonstrate passionate commitment to patients • Be motivated to learn • Participate actively in discussions on rounds • Know objectives, expectations of clerkship/course • Use correct books and know how to study • Seek and receive formative feedback • Demonstrate interest in lifelong learning

24. Years 3 and 4 Scheduling System • Accessible from any PC that has Internet access — available, flexible, fast, efficient and effective • Guards against favoritism when students select periods, sites for setting up their clerkship (lottery system) • Empowers students to design their own experience in medical school - FLEXIBILITY • Ensures that students schedule courses correctly (all required clerkships are to be scheduled before electives) • Provides staff an easy way to track students’ locations

25. Access to Course Scheduling www.meded.umn.edu Current Students, Years 3, 4 Course Registration Demonstration / Instruction

26. Scheduling-- LotteryMarch,11-15, 2013 • Number of groups: 10 • Students per group: 20-24 • Time period per group: 8 Min • 5:30-10:30 pm • March 11-15, 2013 • Number of rounds: 15 • Select one REQUIRED course per round 11 rounds • Select remaining electives 4-5 rounds

27. Clerkship Scheduling-Suggestions/Hints • Year 3 usually begins second to last or last Monday in May (May27,2013)-excludes 3 week intersession (May) • STRONGLY ENCOURAGE: take required clerkship(s) duringPeriod 1 and/or 2 of Year 3 (before or after taking Step I)- YOUDONOTneed to take USMLE Step 1 before taking clinical courses. • USMLE Step 1: • Take end of Year 2, early year 3 butMUST TAKEBEFORE end of Period 2 (early to mid-August) of Year 3 • To Take Step l exam after Period 2 has concluded: You need extenuating circumstances plus Faculty Advisor’s signature and permission of Lead Academic Advisor or Senior Associate Dean • MUST Register for Step I before access to scheduling system • MUST have score “in hand” to extend beyond 18 credits (weeks) in courses--cannot start course/rotation if 18 weeks falls within course. • MUSTpass all courses/clerkships plus USMLE Step I and Step II CK and CS exams and CCA to graduate

28. Scheduling for Years 3 and 4 • Take REQUIRED courses/clerkships in periods 1 and 2 of year 3 • Better site selection • Avoids problems at the end of 4th year • May assist in taking USMLE Step 1 examination • Stable numbers of students across periods is valuable to the sites and faculty for educational experiences • Goal--have a full complement of students in all the required clerkships during periods 1-2 • Lead Academic Advisor/Senior Associate Dean will consider exceptions for educational reasons/ personal emergencies (in writing)

29. Scheduling-- Suggestions/Hints Take Required Courses/Clerkships in Year 3 (AS MANY AS POSSIBLE): Attempt to have completed 42-44 required credits by start of Period 4 of Year 4 Career specialty selection--maximal information Take required clerkship(s) in Period 1and/or Period 2 of Year 3-strongly encouraged-do NOT need to take USMLE Step 1 first Allows time for interviews (Year 4)–mid-Nov.,December, early January (Oct, Nov-early Match) Grades, evaluations available for residency interviews (Year 4) Letters of recommendation are easier to obtain Allows you to take electives, research projects, electives away for credit (summer, fall), international health in Year 4--Flexibility Allows time for USMLE Step 2 CK, 2 CS preparation

30. Scheduling-- Step 2 CK, CS Exams • Take USMLE Step 2 CK and CS after most required courses are completed, but beforeFebruary 1 (CK) or December 31 (CS) of Year 4 • Medicine I & II(?), Pediatrics, Surgery, Ob/Gyn, Neurology/Psychiatry before 2 CK; Family Medicine Clerkship/Primary Care Selective (before 2 CS), Emergency Medicine (if possible, before 2CS) • Military students – mid-September, Year 4 • Take 2CK earlier (Aug-Oct) if to improve score compared to Step I exam score or required by program; questions-ask residency program director • MUST pass both exams 2 CK and 2CS to graduate • - Difficult tests – take seriously--prepare

31. Regular Match--Leave time for residency interviewing from mid-Nov thru mid-Jan (DECEMBER) of Year 4 Early Match--Leave time for residency interviewing in Oct-Nov of Year 4 (Ophthalmology, Urology) 0.5 day/week (3days per 6 weeks) off allowed in REQUIRED COURSES for interviewing, illness days– preceptor permission; NOT personal holidays NOT ALLOWED to take any required course/clerkship with or without shelf exam in latter part of Period 8 of Year 4 without permission from Senior Associate Dean or Lead Academic Advisor and Faculty Advisor Take elective away for credit (VSAS-Becka/Genne), subinternship in Summer/ Early Fall of Year 4 Take international elective late Year 4 Additional Clerkship SchedulingSuggestions/Hints

32. Additional Clerkship SchedulingSuggestions/Hints • CANNOT take same course/clerkskhip twice  University policy (unless failed course) • CANNOT vary length of course/clerkship predetermined for educational purposes • Encourage you to take required course(s) in Period 1 and/or 2 of Year 3 and throughout Year 3--DONOT need to take USMLE Step I first. • MUST take required courses, direct patient care or hands-onelectives at University of Minnesota Medical School (Twin Cities, Duluth, Greater Minnesota) • CANNOT take Med I and Med II back to back but can take surgical specialties and Fam med/Primary Care clinics back to back. • CANNOT receive retroactive credit for research, elective away — turn in forms at least six weeks early • Clinical Competence Assessment (CCA)-REQUIRED (Pass, Fail;June-Oct)-Year 4

33. Additional Clerkship Scheduling Suggestions/Hints • Adhere to cancel/add deadlines (8 weeks before each period begins) • No changes two weeks prior to the start of a course/ clerkship except in extreme emergencies • Do NOT plan to change schedule past the deadline to accommodate interview time in Year 4 — time is built into the schedule specifically for that purpose

34. Additional Clerkship SchedulingSuggestions/Hints • Research, elective away for credit • To receive credit for these courses, the course MUST be on your schedule prior to participation and the correct forms must be COMPLETED and filed with the Curriculum Office

35. Forms to be Downloaded for Completion www.meded.umn.edu • INMD application/evaluation (elective away for credit) • Research application/evaluation - elective • Change of advisor • ERAS

36. Please complete and submit the forms EARLY for electives away for credit, research and international rotations— retroactive credit will NOT be given

37. Student Swapping of Clerkships/Courses • Student run • Scott Davenport, R Egbert/G. Fritts, T. Thompson do NOTdo swaps • Will help with required clerkship swaps if difficulty encountered and if submit: • ID numbers of both students needed • Swap periods, sites, and course numbers for both courses • e-mail from BOTH students approving swap

38. Additional Clerkship Scheduling Suggestions/Hints Leave time in schedule for interviewing (Periods 4 (?) and 5 of Year 4)-0.5 day off per week for emergencies (includes interviewing) Do elective away rotations (you may need a letter explaining our school’s flexible scheduling) through VSAS (Rebecca/Genne) and sub-internships in summer,early fall of year 4 Take Step 2 early if you did not do as well as you would have liked on Step 1; questions ask residency program director Take Surgery before a surgical specialty if you want to enter that surgical specialty No required clerkships in Period 8, minimize in Period 5 (Dec) of Year 4 Enjoy rotations – work hard, be professional, be interested and committed, take responsibility and learn as much as you can.

39. Curriculum Changes for 2013-2014 • NO required courses in period 8 unless approved by faculty advisor and Drs. Watson or Thompson; minimize required clerkships in Period 5 of Year 4 • MetroPAP -3 or4 students • Clinical Competence Assessment (CCA), OSCE-Required in Year 4 • (June-October); Pass/Fail • FacultyAdvisor System for incoming Year 1 students in TC similar to Learning Communities in Duluth • Emergency Medicine—Remains Required Course • Scheduling (required clerkships)—Shorter time period:5:30-10:30pm- • four days.

40. Clerkship Scheduling – Lottery Hints • Clerkship, site of choice, period: Put in first-often Med I; put in OB # 1 or 2 if strong interest in Ob (2013) • Family Medicine Clerkship and Primary Care Clinic Selective replace Primary Care Clerkship (PCC); are both required courses; do NOT need to be sequential (similar to surgical specialties); • UCAM: Select FMCH 7600 and FMCH 7700 early (if strong desire to take UCAM-- sign up for it as the UC site and FMCH 7511 as elective (3rd month);Fam Med PCS (UCAM) • Grading at sites now more similar with more central oversight • Follow cancel-add deadlines. • Monitor the scheduling system for openings—multiple “hits” or changes; contact colleagues to switch (student run swap)

41. Clerkship Scheduling – Lottery Hints • Your schedule will NOT be perfect , but it will work out over time. • Come prepared with several schedules-required clerkships may be filled. • “You will get the courses you need to graduate”! • “You will get into your career specialty residency, despite your schedule”! • Take time off for interviews • “ALL WILL WORK OUT IN THE END”!!! Do NOT Stress Out

42. Important Upcoming DatesClass of 2015 EventDate RPAP Application - Submitted December 2012 - Interviews Jan (D), Jan (TC) - Selection February, 2013 Select/Schedule Clerkships March 11-15, 2013: 5:30-10:30pm Advisors Approve Schedules March 18-31, 2013 Transition Course/ Days (Required) April 3, 2013 • Must register for USMLE Step 1 exam before access to on-line scheduling system • Must take USMLE Step 1 exam before end of Period 2 (Year 3)-mid August

43. Important Decisions • Schedule - Years 3, 4 • RPAP, MetroPAP (late fall Year 2) • UCAM • Required courses/clerkships (56 credits) • Start in Period 1, 2; Year 3 • USMLE Step I exam (when take) • Career choice • 0.5 day/week off for emergencies only, not vacation day • Select periods, sites of educational experiences for clerkships/courses

44. Important Decisions-Year 3,4 • International rotation (4-12 credits) • Elective away • Flexible MD program • Free time — remember residency interviews (November-mid-January) • Research — critical inquiry (6-12 weeks) • Electives (20 credits) • Direct patient care or “hands-on”: 8 credits minimum • Sub-internships • Non hands on: radiology (except interventional), laboratory medicine, electives away, alternative medicine, research, international rotations

45. Important Decisions about Scheduling • Take required clerkships in Periods 1, 2 of Year 3 • Better site selection • Increased flexibility throughout Years 3, 4 • Take 42-44 credits (weeks) by start of Period 4 in Year 4 (mid-late September) if possible-STRONGLY RECOMMEND • Allows for improved career specialty selection • Allows for interviewing, seeking letter of recommendations-Year 4 • Grades, evaluations available for MSPE, interviewing • Allows for study for Step 2 CK, CS exams-Year 4 • Allows for research, international rotations in Year 4 • Allows for elective away for credit courses in Year 4 • NO required clerkships in latter part of Period 8 of Year 4 • Minimize Required clerkships in Period 5 of Year 4 (interviews)

46. Important Decisions for SchedulingYear 3, 4 – Medical School DONOT: • Delay taking required clerkships until mid or late Year 3 and Year 4 • Delay registering for required clerkships in Periods 1 and 2 of Year 3 • Register for required clerkships in Period 5 (interviewing) and Period 8 (Graduation) of Year 4 • Register for Medicine I and Medicine II back to back • Register for subspecialty elective(s) in a specialty without taking the core clerkship/course (e.g, cardiology before Med I) • Register for Emergency Medicine without taking Medicine I or Surgery • Delay discussion with clinical mentors past mid-late Year 3 about specific requirements (e.g. research, other projects, electives away, sub-internships) to match in highly competitive specialties

47. Scheduling LotteryMarch 11-15, 2013 Number of groups: 10 Students per group: 20-24 Time period per group: 8 Min 5:30-10:30 pm March 11-15, 2013 Number of rounds: 15 Select one REQUIRED course per round 11 rounds Select remaining electives 4-5 rounds

48. Resources to Help • Faculty Advisors • Fellow Students (Year 3 and 4)

49. Resources to Help • Ruth Westra, DO • Ted Thompson, MD • 612-626-2841 (telephone) • 612-273-1193 (fax) • thomp005@umn.edu (e-mail) Senior Associate Dean-- Kathy Watson, MD

50. Genne Fritts Rebecca Egbert Deann Dahl Ruth Westra 612-625-4692 mcand003@umn.edu 612-626-4281 rsegbert@umn.edu 218-726-7034 ddahl@d.umn.edu 218-726-8393 rwestra@d.umn.edu Four Very Important People