Internal Medicine Clerkship

Internal Medicine is an eight-week clerkship that includes six weeks of inpatient experience in which students care for hospitalized adult patients with a variety of medical problems and two weeks of ambulatory experience in which they develop skills to enable provision of primary care services. These experiences provide ample opportunity to gather histories, develop differential diagnoses, formulate assessments, and develop treatment plans for patients with a variety of diagnoses.

Internal Medicine (Inpatient) Clerkship Objectives

At the end of this rotation, the student should be able to do the following:

Inpatient Objectives:

Patient Care and Procedural Skills (PC)

1. Proposes and systematically interprets appropriate diagnostic studies including labs, ECGs and imaging. (PC5)
2. Develops safe, effective, and efficient evaluation and management plans based on evidence and patient preferences, including therapeutic decision-making principles (risk/benefit, cost, shared decision-making). (PC6)
3. Understands and demonstrates basic procedural skills under supervision (e.g., POCUS, bedside techniques). (PC7)
4. Counsels and partners with patients and families to address acute and chronic clinical conditions highlighting inclusivity and use of community resources. (PC8)
5. Organizes, coordinates and prioritizes patient care responsibilities. (PC9)

Medical Knowledge (MK) 

1. Demonstrates and applies knowledge of the pathophysiology, epidemiology, and natural history of diseases to common patient conditions listed in the Core Required and Recommended Medical Conditions for Internal Medicine. (MK1)
2. Understands the principles of diagnostic tests and treatments including indications, benefits, risks, and costs, and interprets results using test characteristics (sensitivity, specificity, predictive values) for clinical reasoning. (MK2)
3. Demonstrates knowledge of medical evidence, interpretation, critical appraisal and application to clinical questions. (MK3)

Interpersonal and Communication Skills (CS)

1. Communicates effectively with patients and caregivers using patient-centered language, empathy and active listening to enhance the therapeutic relationship. (IC1)
2. Communicates and collaborates effectively with health care team members to deliver high quality care and enhance system performance. (IC2)
3. Presents patient data clearly and concisely in oral and written formats, including structured case presentations and EHR documentation best practices. (IC2)
4. Demonstrates skills in educating patients, families, and other health professionals. (IC3)
5. Formulates and shares feedback constructively with others. (IC4)

Practice-Based Learning and Improvement (PL)

1. Acknowledges limitations, seeks feedback, and adapts behavior constructively, including coping strategies, mindfulness, and growth mindset. (PL1)
2. Sets SMART goals and employs strategies for improvement. (PL1)
3. Develops strategies to manage uncertainty in clinical reasoning such as using evidence-based medicine and medical knowledge resources to determine patient care decisions, incorporating PICO framework and critical appraisal. (PL2)

Systems-Based Practice (SP) 

1. Applies principles of public health and population health improvement to promote equitable care and reduce disparities. (SP1)
2. Recognizes risks and benefits of emerging technology and uses resources safely to optimize learning and patient care. (SP2)
3. Identifies opportunities for system-based quality improvement. (SP3)
4. Discusses strategies for cost-effective and high-value care. (SP4) 

Ambulatory Objectives:

At the end of this two-week block, the student should be able to do the following:

1. Demonstrate proper techniques for interviewing a patient to obtain a medical history and performing a physical examination in the ambulatory clinical setting. (PC1)
2. Formulate a comprehensive, ordered differential diagnosis. (PC2)
3. Present and document patient data gathered from interviews, physical examinations, and laboratory studies in a standardized format. (CS5)
4. Apply knowledge of the pathophysiology, epidemiology, and natural history of diseases to the diagnosis and management of common patient conditions in Internal Medicine. (MK8)
5. Identify basic concepts of preventive health care and population health/panel management, including patient education, immunization, and appropriate age-specific screening recommendations. (PC5)
6. Identify members of a primary care inter-professional care team and understand their roles and responsibilities.  (IP1)
7. Understand key USPSTF guidelines for clinical preventative services. (PL6)