1. Practical clinical experience is an integral part of each OSU College of Osteopathic Medicine (OSU-CHS) clerkship program and directs the clerkship program. The courses (rotations) are conducted at OSU-CHS affiliated “core” teaching hospitals located in Tulsa, Oklahoma City, Enid, Tahlequah, and Durant, Oklahoma. OSU-CHS requires successful completion of rotations for graduation.
2. The chairman of the OSU-CHS department of internal medicine coordinates the course and the department arranges assignments and additional course responsibilities.
3. Two rotations (courses I-CLME 9115 and II-CLME 9125) in clerkship medicine are assigned. Each rotation is a four-week clinical experience designed to develop patient-related cognitive and decision-making skills. The teaching physician for each service directs patient care responsibilities, reading assignments, and educational activities. Students are encouraged to observe, evaluate and participate in discussions of patient care.
4. Students are expected to dress appropriately. Men should wear a shirt, tie, and slacks. Women should wear slacks or a dress. A white physician’s jacket with OSU identification should be worn at all times. Scrubs are acceptable in the Intensive Care Unit and the GI Center.
5. Students are expected to identify themselves to patients and hospital personnel as medical students, not as graduates or licensed physicians.

1. Medicine clerkship is designed to acquaint third-year medical students with care of acutely-ill, hospitalized patients. Case discussions, clinical pathology conferences, didactic lectures, and bedside teaching accompany patient care.

1. One hundred percent (100%) attendance is required on all rotations. An excused absence must be obtained from the attending and approved by the course coordinator prior to any absence. Students are expected to make up all absences due to short-term illness, accident, or personal matters (e.g., intern interviews, etc.). Make-up arrangements are made with the service director. Additionally, attendance is mandatory at Morning Report, Grand Rounds, Tumor Board, and Clinicopathologic Conference.

1. Morning Report: Conducted from 7:15-8:15 a.m., Monday, Tuesday, Thursday, and Friday. Consists of case presentations and various lectures.
2. Student Book Club: A review of current literature supervised by an Internal Medicine Attending or Resident on Friday from 3:00-5:00 p.m.
3. Clinical Rounds: Conducted following Morning Report, Monday through Friday. The length and involvement of rounds are determined by type of service and the service director. Many services provide experience in an office setting.
4. Tumor Board: Held third Tuesday of every month from 12:00-1:00 p.m.
5. Grand Rounds: Held every Wednesday from 12:00-1:00 p.m.

The didactic portion of the course is structured around seven (7) of the major subspecialties in internal medicine. Each week consists of two (2) journal articles and a “topics” list to help guide your study within each section. There is an additional topics list that covers areas that do not fit neatly into the seven (7) groups.

The core curriculum lecture schedule is as follows:

Week 1 – Cardiology (Chest pain and heart failure)
An Algorithm for the Diagnosis and Management of Chest Pain in Primary Care, Heart Failure, and Secondary Prevention of Atherothrombotic Events After Ischemic Stroke

Heart Failure

Week 2 – Nephrology (Chronic kidney disease and sepsis)
Approach to the Patient with Sepsis, and Diagnosis and Management of Chronic Kidney Disease

Diagnosis and Management of Chronic Kidney Diseases

Week 3 – Gastroenterology (Inflammatory bowel disease and ascites)
Ascites – Diagnosis and Management, and Inflammatory Bowel Disease

Inflammatory Bowel Disease

Week 4 – Pulmonology (COPD and pneumonia)
Pulmonary Topics, COPD, and Recent Advances in Community-Acquired Pneumonia – Inpatient and Outpatient

Recent Advances in Community-Acquired Pneumonia - Inpatient and Outpatient

Week 5 – Endocrinology (Diabetes 1 & 2)
Current Antihyperglycemic Treatment Guidelines, Algorithms for Patients with Type 2 Diabetes, and Overview of Newer Agents – Where Treatment is Going

Overview of Newer Agents - Where Treatment Is Going

Week 6 – Neurology (Stroke and seizure disorders)
Neurology Topics and Seizure Disorders and Stroke

Secondary Prevention of Atherothrombotic Events After Ischemic Stroke

Week 7 – Rheumatology (Rheumatoid arthritis 1 & 2)
Diagnosis and Differential Diagnosis of Rheumatoid Arthritis, Overview of Treatment

Rheumatoid Principles

Additional Topics

There is an exam at the end of each month that covers only the articles listed above. The first test is given at the end of the first month (dates to be announced monthly) and covers the first six (6) articles (through week 3). The second test is given at the end of the second month and covers the last eight (8) articles (week 4 through week 7). In addition to the internal medicine monthly exam, students will take the NBOME shelf examination for internal medicine at the end of the second month. Dates for that exam are determined by OSU-CHS and will be announced during the rotation.

Another component of the course is self-directed learning through structured cases. There are 36 online cases through MedU focused on internal medicine. Each month the student is to choose 12 cases to complete for a total of 24 cases during the two months. The student may choose to do more than the 24 cases but only 24 are required to complete the rotation. The course coordinator will be checking for completion at the end of each month. You may log into the website using your Okey username and password. The web address is www.med-u-org. Select the SIMPLE link for internal medicine cases.

In addition to participation on rounds and didactics, you will also be expected to give a morning report case presentation. The presentation consists of a 3-5 minute summary of a patient’s initial presentation to the hospital. The case is to be reviewed with the resident on service. Further details will be provided during your rotation.

1. At the completion of each rotation, the attending physician on each service determines overall performance. Input is gathered from residents, interns and other supervising physicians. The final evaluation, with comments, is determined by careful assessment of medical knowledge, diagnostic acumen, decision-making, professionalism, and interaction with other members on the service.
2. Overall Evaluation is a Percent as Follows:
   

   A	90-100%	Excellent
   B	80-89%	Good
   C	70-79%	Satisfactory
   D	65-69%	Marginal
   U	64% and below	Unsatisfactory

   
   
3. Grades for Each Month’s Rotation are determined as Follows:
   1. The written test is worth ten percent (10%) and covers the Journal Articles.
   2. The clerkship evaluation is worth ninety percent (90%) and is determined by performance during rotation, presentations at Morning Report, participation on the service, and completion of cases from the SIMPLE series.
   3. Beginning April 7, 2010 – The site evaluation is a course requirement, and must be completed within seven (7) calendar days after the completion of the rotation. A decrease of one letter grade will be implemented for failed compliance.
4. Grade Grievances: Directed to the course coordinator or chairman of internal medicine.