End of Clerkship Requirements

Preamble

Your clinical clerkships are the first steps into the medical profession where you quickly learn that the patient is your teacher and the hospital is your classroom.  Daily clinical activities are your exam. This paradigm is not limited to medical school; this will be the scenario for the remainder of your training and the rest of your career.  You also discover that care is delivered by a team of health professionals closely working together with a common goal.   You are an essential part of this team.

As physicians-in-training on the medical service, you are the primary caretaker of more than a handful of patients.  Each patient gives his/her time and story, the precious resource for the interesting history and the springboard for the erudite discussions in your write-ups.  These patients will school you in the pathophysiology of disease and in the principles of clinical medicine.   Their afflictions will foster your intellectual curiosity and development, as well as your growth as a humanistic physician.

Philosophy of the clerkship

Your role on this clerkship expands your understanding of being a student.  Your experiences teach you important lessons not found in textbooks.  Daily, you see human suffering on the wards.  You learn empathy and compassion.  Your patients depend on you and the care you provide.  You learn responsibility.  On more than one occasion you are asked questions that you are unable to answer.  You learn humility.  But, you are also comforted by your patients and your team because they recognize that you are doing the best that you can.

In the pre-clinical medical training, your responsibility was to assimilate a fairly defined body of information for the next series of exams.  In your clinical training, especially in medicine, your responsibility is to your broader learning.  The information you encounter is endless. But more importantly, your responsibility is your commitment to your patients.  Unfortunately, this commitment is too often clouded near the end of the clerkship.  Clinical responsibilities fall by the wayside.  The patient case load for each student dwindles to zero at the beginning of the last week on service.  No new patients are followed after a long call.  The focus narrows on the exam, the perceived endpoint of the medicine rotation.   This behavior is contrary to that which is endorsed by the house staff and faculty.  Therefore, standards have been articulated to re-emphasize the importance of the clinical aspects of the clerkship and encourage professionalism.

On-going standard of care