Third-Year Medicine Core Clerkship

Committed to a Supportive Learning Environment

At BIDMC, students learn and see a broad spectrum of internal medicine in a supportive and collaborative setting conducive to education. Every effort is made to ensure that each student is given the opportunity to thrive to the greatest extent possible.

Clerkship Objectives & Expectations

Twelve-Week Program

Students at the Beth Israel Deaconess Medical Center are introduced to the whole range of experiences that internists encounter on the general and subspecialty medical wards and in the primary care and subspecialty ambulatory clinics.

Eight Weeks on the Inpatient Services

To acquire the skills necessary to evaluate and manage common problems in internal medicine, students spend eight weeks on our general medicine firms, subspecialty services, and emergency department admitter services. A special effort is made to give students varied experiences.

Whenever possible, students see the patients first, with adequate time allocated to take complete histories, to perform complete physical exams, to discuss patients' problems with the intern and resident, to write complete admission notes, and to seek out information about patients' problems in relevant textbooks and peer-reviewed literature.

Four Weeks in the Ambulatory Setting

In addition to the time on the wards, each student spends four weeks in the ambulatory setting. During this part of the course, students are paired with a primary care faculty continuity preceptor with whom the student works two half-days per week. Additionally, students rotate through several medical subspecialties and dermatology. As much as possible in all of these sessions, students have the opportunity to perform problem-oriented histories and physical exams, review encounters with faculty preceptors, develop differential diagnoses, and devise evaluation and treatment plans.

This comprehensive, balanced experience prepares students to handle medically diverse issues in various medical settings, in preparation for subsequent clerkship rotations and ultimately internship.

Skills Acquired During Clerkship

During the clerkship, students work on taking a thorough history, performing a detailed and accurate physical exam, formulating a thoughtful differential diagnosis, designing a plan to evaluate their patients' clinical problems and developing skills to present their patients' problems to the medical team. These experiences aim to foster growth in each student's clinical judgment while consolidating the development of sophisticated approaches to both simple and complex medical problems. By the end of the 12-week clerkship, students are expected to possess a broad working knowledge and a thorough understanding of the pathophysiology and therapies of common problems in internal medicine.

Emphasis on Total Care of the Patient

Great emphasis is placed on the total care of the patient. With this in mind, it is anticipated that students acquire sensitivity to the whole spectrum of a patient's encounter with illness, including psychological as well as medical aspects of the patient's care.

Clerkship Teaching

Core Faculty Preceptors

Students work with Core Faculty preceptors during both the inpatient and ambulatory portions of the clerkship. Their inpatient Core Faculty preceptor works with them longitudinally throughout the clerkship, serving as a clinical coach. They perform varied direct observations to build clinical skills, provide feedback on documentation, lead case-based clinical reasoning sessions, and assist with goal setting and professional development. Their ambulatory Core Faculty preceptor works with them in a unique urgent care teaching clinic that affords students the opportunity to work up and present new chief concerns. Additionally, the ambulatory Core Faculty preceptors lead an ambulatory-specific case-based clinical reasoning conference.

Didactic Conferences

Students participate in a wide array of teaching sessions to advance their clinical knowledge. The required Core I Clerkship Core Curriculum sessions are interactive, case-based teaching sessions run by the clerkship directors and core faculty on key internal medicine topics. In the Core I Clerkship Leadership Sessions, key leaders of the department teach and support the students. In addition, students participate in simulation sessions in the Shapiro Simulation and Skills Center and in a Value Added Medical Education curriculum through which students advance their knowledge while providing patients with needed support.

Through the Department of Medicine, students also participate in several conferences including the residency program's noon conference which covers a broad spectrum of topics in internal medicine and other disciplines germane to the practicing internist. A weekly Firm Conference, conducted by a Firm Chief, brings together students, residents and faculty to discuss patient cases addressing challenging diagnostic, evaluative and medical management issues. Students have the opportunity to attend Medical Grand Rounds and General Medicine Grand Rounds which cover a range of timely and clinically-important topics, and the Morbidity and Mortality Conference (M&M) which reviews a case containing medical errors, complications or unintended outcomes to improve the quality of care provided to patients at BIDMC.