The Family and Community Medicine Year 3 Clerkship is designed to introduce students to the depth and breadth of family medicine, and the critical role it plays in the delivery of health care in the United States.  Students will be exposed to a wide variety of material, some seen in other clerkships and rotations, but in the context of the core overriding principle of family medicine, continuity of care.

In the pre-week, students will be exposed to preventive care and screening tests in addition to health topics and medical procedures frequently encountered in an outpatient family medicine office.  By the end of the week, students will be able to confidently address routine health maintenance visits and many common outpatient conditions.

The clinical weeks will be spent in a single family medicine office, giving the students the opportunity to experience the breadth of diagnoses and visit types seen in family medicine in addition to continuity of care.  Individual learning topics and case assignments will guide students through several areas of study during the rotation.

The post-week is designed to review and synthesize the core concepts learned throughout the rotation in order to successfully complete the NBME Shelf Exam and OSCE. It will also provide students with time to debrief the rotation and discuss difficult experiences in a non-judgmental environment.

The 8-week third year Medicine clerkship offers a variety of internal medicine clinical experiences.  Students will be assigned to either Borgess Medical Center or Bronson Methodist Hospital as their "home base" facility.  Students will immerse themselves 
with 1 week of ambulatory internal medicine, 
2 weeks of academic medicine, 1 week of hospitalist medicine, 1 week of nights, and 1 week in a subspecialty (e.g. palliative care, renal, cardiology or infectious disease). During these clerkships students immerse themselves into the clinical environment, taking on specific responsibilities as a valued member of the healthcare team, while being supervised at 
all times.   The WMed third year curriculum includes a number of innovations designed to optimize the students’ experience and provide an excellent foundation for future growth as a clinician. Two of these innovations are the Preparatory Week and the Summary and Assessment Week that flank each six-week clinical experience. The Preparatory Week is designed to optimally prepare the student to excel in the specific clinical setting for the discipline. The Summary and Assessment Week focuses on synthesizing the key knowledge and skills learned during the clerkship and include formative and summative assessments. During both these weeks, one day is dedicated interdisplinary activities in which students from all clerkships join together for a joint educational experience in an overarching topical area.

Advances and Perspectives in Medicine and Health provides students in the professional health-related sciences both exposure to and an opportunity for involvement in current topics that influence the practice, quality, and delivery of health care. The course consists of a series of events that includes seminars, workshops, plays, demonstrations, simulations, and conferences that are distributed throughout the academic year. Topics covered in the series of events include ethics, professionalism, communication, health policy, health disparities, delivery of care, biomedical/translational/clinical/community-based research, bioengineering, business and legal aspects of health care, health informatics, and global health. For some events, there are opportunities to participate in interprofessional discussion groups that include students from other health profession programs, as well as health care professionals. Students develop critical thinking skills and raise awareness to cross-disciplinary aspects and integration of health care teams, through attendance and reflection of the events in this course.

The Women’s Health Year 3 Clerkship is intended to be a comprehensive, challenging, and rewarding experience addressing essential clinical aspects of obstetrics and gynecology organized in an eight week block.  The Preparatory Week includes a variety of activities to assure success during the subsequent clinical component.  The six-week Clinical Experience affords students a wide range of clinical opportunities to develop the requisite knowledge and skills in Women’s Health.  The final eighth postweek is designed to crystalize principles to accomplish oral and written components for evaluation. 

The following components make up the Clinical Experience:

OB/Gyn Preceptorship – 3 weeks

Maternal & Fetal Medicine (Bronson) –  1 week 
(6 days)

Labor and Delivery (Night Float) –  1 week 
(5 nights)

Gynecologic Surgery –  1 week (5 days)

During the Clinical Experience weeks, students will be expected to complete Independent Study modules covering various topics relating to the particular clinical component.  The Summative and Assessment week is intended to review and synthesize essential clinical concepts, review and assess important clinical skills, and prepare for and successfully complete the NBME Shelf Exam.

The third year Core Pediatric and Adolescent Clerkship will provide the student with broad exposure to both the inpatient and ambulatory aspects of general pediatric care.  There are four components to the clerkship.

Preparatory Week

We will begin by defining the expectations and reviewing important procedural components and resources that students will be expected to utilize throughout the rotation.  Week one will focus primarily on the Well Child Care, Fluids and Electrolytes, and issues unique to the newborn and adolescent period.  Additional didactic teaching will include orientation to Bronson Children’s Hospital and EPIC, the role of parent and how it effects the doctor/patient relationship in caring for children. 

We will spend time on Thursday developing critical thinking skills and discuss differential diagnosis in the child.

We will utilize CLIPP cases in CBL events and other teaching resources in small group discussions.  

We plan to utilize the Sim Center to practice pediatric technical skills and practice clinical skills with newborn and adolescent cases. 

All students will gather on Tuesday and Wednesday afternoon for plenary sessions involving the entire third year class. 

Three weeks of Ambulatory Pediatrics

Placements are in the community or the WMed General Pediatric Clinic.

Main tasks of the rotation are accomplished through observation of doctor patient, doctor family and doctor staff interactions, and when appropriate, patient and family interviewing and physical examination.  Discussion of cases with the medical students may not always occur at the time of patient care in the private practice setting, but students will have an opportunity to learn through teaching that is directed to the patients and their caregivers.

Goals of the ambulatory component are:

Introduce the learner to the basis for well child care (growth, development, nutrition, safety, anticipatory guidance) and how these tasks change throughout maturation

Introduce the learner to common pediatric illness and disease processes

Utilizes COMSEP’s national pediatric third year curriculum

Content is supplemented by CLIPP cases and independent learning

Three weeks of Inpatient Pediatrics

One week of inpatient pediatrics days (7a-6p).

One week of inpatient evenings (2p-midnight).

One weekend inpatient call day (7 am – 6 pm, Saturday or Sunday of inpatient days week).

One week of caring for the newborn – this experience will include the following elements:   

Time spent on the mother baby unit involved in patient care during the daytime (3 days)

Time spent on night call, working with the supervising resident. (2 nights) 
 Goals of the inpatient component are as follow:

Introduce the learner to common conditions and how to recognize when inpatient care is required.

Instruct the learner on the transition from fetus to newborn and normal infant physiology.

Enhance development of differential diagnostic skills.

Improve history taking and physical examination skills.

Familiarize the learner with working as part of a healthcare team.

Provide knowledge of what is required for safe discharge from the inpatient setting.

Utilize COMSEP national pediatric third year curriculum.

Content is supplemented by CLIPP cases and independent learning.

Synthesis and Assessment Week

The week will begin with OSCE assessments on Monday morning.

Consolidation of diagnostic and management skills and relate pediatric clinical content to basic science principles.  Methods may include CLIPP cases, CBL format and/or case reviews focusing on management of common pediatric illnesses.

All students gather on Tuesday and Wednesday afternoon for Plenary sessions.

Summative cognitive assessment, NBME Pediatric Shelf Test, on Friday afternoon, beginning at 1 pm.

The four Profession of Medicine courses during Foundations of Medicine and the two Profession of Medicine courses during the third-year include a coordinated curriculum, Principles of Profession of Medicine, that includes all areas of health systems science, as well as additional components that provide a well-rounded undergraduate medical education. The components of Principles of Profession of Medicine include the following:

• Medical Ethics and Humanities
• Leadership
• Scientific Method, and Clinical and Translational Research
• Evidence-based Medicine
• Quality Improvement and Patient Safety Science
• Cultural Competence
• Social Determinants of Health
• Health Equity
• Health Advocacy
• Population Health
• Preventive Medicine
• Palliative Care
• Law, Health Care Policy, and Health Care Financing
• Biomedical Informatics
• Health Literacy
• Information Literacy
• Complementary and Alternative Medicine

In addition, the four Profession of Medicine courses during Foundations of Medicine include two additional components, Clinical Skills and Active Citizenship in Community Health.

• Clinical Skills teaches medical students interpersonal and communication skills, physical examination skills, simple procedures, and health record documentation, which provides a solid foundation for success in the third-year clerkships.
• Active Citizenship in Community Health integrates structured learning with service learning activities to facilitate student participation. Service learning is an instructional technique in which students participate in a community service activity, in this case with academic objectives that are part of the Profession of Medicine courses. Students gain relevant, hands-on experience while improving the health of the communities we serve. The curriculum addresses social determinants of health, cultural competence, and preventive health.

The seventh Profession of Medicine course (PROF 9340) is a capstone review of medical ethics during the spring of the fourth year of medical school.

The four Profession of Medicine courses during Foundations of Medicine and the two Profession of Medicine courses during the third-year include a coordinated curriculum, Principles of Profession of Medicine, that includes all areas of health systems science, as well as additional components that provide a well-rounded undergraduate medical education. The components of Principles of Profession of Medicine include the following:

• Medical Ethics and Humanities
• Leadership
• Scientific Method, and Clinical and Translational Research
• Evidence-based Medicine
• Quality Improvement and Patient Safety Science
• Cultural Competence
• Social Determinants of Health
• Health Equity
• Health Advocacy
• Population Health
• Preventive Medicine
• Palliative Care
• Law, Health Care Policy, and Health Care Financing
• Biomedical Informatics
• Health Literacy
• Information Literacy
• Complementary and Alternative Medicine

In addition, the four Profession of Medicine courses during Foundations of Medicine include two additional components, Clinical Skills and Active Citizenship in Community Health.

• Clinical Skills teaches medical students interpersonal and communication skills, physical examination skills, simple procedures, and health record documentation, which provides a solid foundation for success in the third-year clerkships.
• Active Citizenship in Community Health integrates structured learning with service learning activities to facilitate student participation. Service learning is an instructional technique in which students participate in a community service activity, in this case with academic objectives that are part of the Profession of Medicine courses. Students gain relevant, hands-on experience while improving the health of the communities we serve. The curriculum addresses social determinants of health, cultural competence, and preventive health.

The seventh Profession of Medicine course (PROF 9340) is a capstone review of medical ethics during the spring of the fourth year of medical school.

The goals of the third year medical student clerkship in Psychiatry is designed to provide the student with a broad clinical experience. 
The students will participate in clinical experiences in the inpatient unit at Borgess 
and the outpatient PTSD clinic at the Battle Creek VA.