Clerkships

Due to space limitations, required clerkships are open to SUNY Downstate College of Medicine students only.

MEDI 3000: Transition to Clerkships — July 2, 3 and 5, 2012

Course Director: Robin Ovitsh, M.D. (Telephone 718 270-1625)

Prerequisites: Satisfactory completion of first & second years of medical school

• The Transition to Clerkships course is the required introduction to the third year clerkships.

At the end of the Transition to Clerkships course, the student will:

1. Be able to describe the continuum of care for the patient from hospital admission through discharge and follow-up.
2. Recognize his or her role in the patient’s care at various points in that continuum.
3. Identify the components of professionalism for physicians.
4. Understand his or her performance will be evaluated not only for knowledge, but also for skills and attitudes, which demonstrate the student’s commitment to the code of professionalism.
5. Be alert to the challenges of adapting one’s learning habits in the clinical setting and of protecting one’s own well being; is aware of strategies and resources for successfully meeting those challenges.

MEDI 3111: Medicine Clerkship — 8 weeks (8 credits)

Course Director: Samy McFarland, M.D.

Interim Clerkship Coordinator: Kate Schulz UHB 6-511 (718) 270-2390

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 40

Clerkship Description: Students will be introduced to clinical medicine; will develop skills and knowledge needed to evaluate patients; will learn the principles underlying therapy; and, will develop an appreciation of their role as a member of a health care team, a sense of responsibility for the well-being of their patients, and an understanding of the effort and dedication required of a care-giver.

NERU 3201: Neurology Clerkship — 4 weeks (4 credits)

Course Co-Directors:

• Brian Anziska, M.D. (718) 270-2502
• Lisa Merlin, M.D. (718) 270-3957

Clerkship Coordinator: Roxanne Deshong (718) 270-2945

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number if Students: 30

Clerkship Description: The clerkship provides experience in the physical examination, assessment, work-up and management of patients with acute and chronic neurological conditions. Students are assigned patients for whom they assume responsibility under the supervision of resident and attending neurologists. Students participate in weekly clinical conferences and outpatient clinics, and are introduced to the use of neurological tests, such as EEG, EMG, CT scans, MRI scanning, cerebral MR angiography, and lumbar puncture.

OBGY 3301: Women’s Health Clerkship — 6 weeks (6 credits)

Course Director: Ishola Adeyemo, M.D. (718) 270-3117

Clerkship Coordinator: Takiya Swaby UH B3-485 (718) 270-2076

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 29

Clerkship Description: Practical experience, full-time. Seminar sessions for the entire group are held on Mondays at SUNY Downstate Health Sciences University. Attendance at all formally scheduled academic activities is required. Students work-up and deliver patients, and assist at operations and deliveries. Participation in the outpatient service is concurrent with inpatient experience. Lectures and preparatory materials are available on-line.

PEDS 3401: Pediatrics Clerkship — 6 weeks (6 credits)

Course Director: Laura Bruno, M.D., UH B4-461 (718) 270-2994

Clerkship Coordinator: Joyce Smith (718) 270-4560

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 28

Clerkship Description: The pediatric clerkship is designed to provide students with the basic knowledge and skills necessary to evaluate and manage patients from birth through adolescence. The clerkship objectives, course requirements and expectations of students are presented and discussed at orientation on the first day of the clerkship. Students will spend approximately 2-3 weeks in an in-patient setting and 2-3 weeks in a combined nursery/ambulatory setting. Considerable effort has been made to develop a program which enables students to become fully engaged in the clinical work and involved in the care of patients. Students will be expected to share the responsibility for covering the topics designated as the Core Curriculum in Pediatrics in weekly meetings with their preceptors, and with attendings and residents in all of the clinical sites to which they are assigned. Attendance at preceptor meetings, and at the weekly student lectures is required.

The students must perform satisfactorily throughout the clerkship and fulfill all of the objectives in knowledge, skills, and attitudes defined for the course. The final grade in Pediatrics will be based on the evaluations submitted by preceptors, attendings, and residents who supervised the students' clinical performance during the clerkship, on the quality of three written case reports submitted by students, and on the results of students' performance on the National Board shelf examination in Pediatrics taken at the conclusion of the clerkship.

PSYH 3501: Psychiatry Clerkship — 6 weeks (6 credits)

Course Director: Thomas Brouette, M.D. (718) 270-3224

Clerkship Coordinator: Mashanda Ellison (718) 270-1402

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 30

Clerkship Description: Students work on either of two settings: An inpatient psychiatric unit in evaluating and treating patients with metal illness, or as a member of the consultation-liaison team assessing medical and surgical patients for acute Psychiatric issues. For both of these settings, most students will also work a half day in an outpatient Psychiatric clinic.

SURG 3601: Surgery Clerkship — 8 weeks (8 credits)

Course Director: Robert Schulze, M.D.

Co-Clerkship Coordinators: Jillian Telford and Darryl Wilson UH B8-338 (718) 270-1982

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 40

Clerkship Description: A brief orientation period on the first day is followed by 8 weeks of clinical clerkship. A more detailed written handout of course requirements and expectations will be distributed on the first day of the clerkship. The following is an overview of the clerkship.

Four of these 8 weeks are spent on general surgery service at the University Hospital/Kings County Hospital Center, Long Island College Hospital, the Brooklyn Veterans Administration Medical Center, Staten Island University Hospital, or Lenox Hill. The other four weeks are spent in a surgical subspecialty service. The student must follow patients throughout their illnesses and take an active part in the therapy, including the performance of minor technical procedures, assisting at operations and following results. Rounds and teaching conferences are held throughout the week. These are conducted at the bedside, and are directed at exposing the student to common clinical problems.

The student is expected to attend rounds in the service to which he or she is assigned. A preceptor in the ward guides each student through the clerkship. At the end of the clerkship, the student is given a written examination. The solving of clinical problems is stressed throughout all phases of the clerkship

By the end of the clerkship the student will have:

1. acquired the knowledge, skills and attitudes necessary to care for the surgical patient.
2. gained an understanding of the process of surgical decision making as it relates to all aspects of the patient’s illness.
3. gained an understanding of the pre-, peri- and post-operative care of the patient.

These goals will be accomplished through didactic lectures, small group sessions, seminars, and ward participation. Emphasis will be placed on the clinical, rather than the technical aspect of surgery. Your final grade in surgery is based on a final written exam (National Board shelf exam); and evaluation by both preceptors and SUNY Downstate chief residents where appropriate.

Primary Care I Clerkships (select either PRIM 3811 or FAMP 3812)

PRIM 3801: General Primary Care I — 4 weeks (4 credits)

Course Director: Paul Harris, M.D. (718) 270-4627

Clerkship Coordinator: Cheryl Hoyte HSEB E-145 (718) 270-2257

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 25-27

Clerkship Description: Students spend six consecutive weeks in a functioning clinical ambulatory care setting with direct patient care responsibility. At least 40 percent of time is spent in continuity of care, 10-20 percent in acute care, and the remainder in subspecialty and gynecology ambulatory clinics. Psycho-social issues are addressed in the context of patient care with preceptor supervision and psychiatric input. Students have a wide variety of affiliated institutions from which to choose.

The experience focuses on ambulatory/primary care issues in clinical medicine, pediatrics and family practice. Students expand existing skills in medical interviewing, and physical diagnosis while developing additional skills in differential diagnosis, health care maintenance, patient counseling and follow-up. During the course, students are responsible for assuming the role of "student" physician under the supervision of an attending preceptor. In addition to direct patient care responsibility, small-group case discussions and topic reviews of particular importance to primary care form the core of the teaching.

Students are required to present an in-depth review of one Primary Care topic during the course. There will be formal evaluation of the student's performance by attending preceptors based on observation of patient encounters, record keeping, and presentations. Students will be required to evaluate the course and sites. In order to obtain Honors, students are required to conduct a special project in ambulatory or community health, in addition to performing at an honors level.

Students will spend one afternoon a week back at the SUNY Downstate campus taking ECM III, which is considered to be an integral part of Primary Care I. The final grade for Primary Care I will include performance in the ECM III component. There is also a standardized patient experience.

FAMP 3812: Family Practice Clerkship — 4 weeks (4 credits)

Course Director:

• Gloria Mtomboti, M.D. (718 270-3064; 917-760-0787);
• Family Practice Center (Suite B), Out-Patient Department, University Hospital

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 10

Clerkship Description: Students spend 6 consecutive weeks participating in a variety of activities designed to expose them to the challenge of providing primary care to non-hospitalized patients. The clinical activity in the Family Practice Clerkship gives students the opportunity to assume the role of primary "student" physician in an office-based setting. The main goal of this experience is to develop basic clinical and procedural skills for common presenting problems in each of six core areas: Adult Health, Child Health, Women's Health, Geriatrics, Behavioral Medicine, and Preventive Medicine and Well Care. In this supervised experience, students work one to one with physicians, physician assistants, and resident physicians in the care of children, families, and adults with a range of acute and chronic problems. Certainly, many of these patients will have serious medical illnesses that merit intensive diagnostic testing, pharmacologic treatment, and referral.

This experience challenges students to review, utilize, and improve their clinical skills in medical interviewing, physical diagnosis, laboratory assessment, including skills in the interpretation of tests, reviewing X-rays and reading EKG's. In addition, students develop new skills and knowledge in areas such as preventive medicine, patient education and counseling, occupational and rehabilitative medicine, nutrition, and emergency care. Some students are exposed to home care for the older patients, and learn aspects of clinical geriatrics that will be new to them. Some will see ambulatory substance abusing patients, who may be more open to rehabilitative efforts.

One day a week students meet with the various faculty and student colleagues to review and discuss a series of common primary care problems. Through lectures, workshops, and assigned readings, students explore a variety of subjects relevant to the practice of Family Medicine. Included are topics such as diabetes, hypertension, cardiovascular disease, contraception, osteoarthritis, back pain, growth and development in pediatric populations, depression, dementia, vaginitis, dermatology, adolescent medicine, occupational medicine, Family Practice as a career, managed care, medical and legal implications of proper documentation, working cross culturally, evidence-based medicine, EKG stepwise approach, time management, patient education, and periodic health screening. Students are also provided the opportunity to work weekly with faculty and student colleagues on an interactive case-based computer learning experience.

Students’ success in the clerkship is evaluated in a variety of ways. Preceptors at the clinical sites rate each student with whom they work on the degree to which the students accomplished each goal related to the precepting experience. Logs of clinic cases and procedures kept by each student are also evaluated to determine the degree to which students experienced the breadth of cases representing the goals of the clerkship. Each student will also be evaluated on a five-minute oral presentation at the end of the Clerkship on a topic using an evidence based medicine approach.

Complementing this series of evaluations of performance, each student has multiple opportunities to evaluate the various aspects of the program.

PRIM 4003: Primary Care II Clerkship Geriatrics/Palliative Care — 4 weeks (4 credits)

Course Director: Paul Harris, M.D.

Clerkship Coordinator: Cheryl Hoyte HSEB E-145 (718) 270-2257

Prerequisites: Satisfactory completion of first & second years of medical school; Primary Care I; passing Step 1 USMLE

Maximum Number of Students: 24

Clerkship Description : The curriculum ensures a foundation for competent compassionate care of older patients. It is focused on acquiring proficiencies in the attitudes, knowledge and skills needed for elder care. The goals include:

1. An appreciation of the heterogeneity of the aging population in terms of values, ambition, capabilities and personalities
2. An understanding of the importance of optimizing function for older patients, rather than an exclusively disease focused approach
3. An empathy towards issues related to death and dying including the principles of palliative care
4. A recognition of the essentially interdisciplinary nature of caring for the biopsychological needs of older patients.

• Proficiency in knowledge will encompass an overview of the basic science of normal and abnormal aging as well as the essentials of clinical geriatrics. Knowledge and experience will be gained of the common geriatric syndromes including altered mental status, iatrogenesis, mobility including falls, sensory deficits, failure to thrive, sleep disorders, pressure ulcers, incontinence and non-specific presentation of disease. Risk reduction and preventive care will be emphasized. Also, emphasis will be placed on health promotion and disorder prevention of importance to the elderly as well as the ethical, legal, humanistic and financial aspects of geriatric care including advanced directives, decision-making capacity and end-of-life care.
• The skills to be learned focus on geriatric assessment using standardized methods for assessing physical, cognitive, emotional and social functions as appropriate. These include screening for mental status, depression, functional status including mobility assessment, activities of daily living and instrumental activities of daily living.
• There is no final examination in this clerkship. Grading is pass, high pass, honors or fail. To achieve honors, an honors project is required.
• The Clerkship includes a lecture series on Palliative Care with emphasis o n the EPEC Curriculum, a site visit to Calvary Hospital and direct clinical experiences at the individual sites. A palliative care website is available for student participation and will be an additional requirement for completion of this segment.

ANES 3901: Anesthesiology Clerkship — 2 weeks (2 credits)

Course Director: Constance H. Hill, M.D.

Clerkship Coordinator: Karen A. King (718 270-3765) UH RM B3-338

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 13

Clerkship Description: The anesthetized patient provides an excellent model for students to learn how to recognize and treat individuals whose respiratory, cardiovascular and central nervous system have been electively depressed. Students will be able to apply basic science principles to understand the pathophysiology of the patient with CNS, Cardiovascular and respiratory depression. Students will become knowledgeable of the risks and hazards of anesthesia and the problems unique to the specialty. Students are expected to take an active part in the perioperative care of patients presenting for surgery and anesthesia.

• Students are expected to attend Grand Rounds, Morning Conference and Visiting Professor lectures. A student lecture series has been designed to enhance the clinical operating room experience. Hospital sites include State University Hospital, Kings County Hospital, Long Island College Hospital, Maimonides Medical Center and Staten Island University Hospital.
• Grading is based on clinical evaluations and an oral case presentation.

EMED 3701: Emergency Medicine Clerkship — 2 weeks (2 credits)

Course Director: Charlene An, M.D.

Clerkship Coordinator: Marcella Coma (718 245-2975)

Prerequisites: Satisfactory completion of first & second years of medical school; passing Step 1 USMLE

Maximum Number of Students: 18

Clerkship Description: Students will have the opportunity to evaluate patients as they initially present with a variety of acute illnesses and injuries. A major goal of the clerkship is that students learn the importance of establishing priorities in the care of acutely ill patients. Particular emphasis is placed on assessing and stabilizing respiratory, circulatory and basic metabolic functions. In their work with emergency medicine residents and faculty, students will develop the ability to acquire a chief complaint driven history, physical examination and differential diagnosis. Students will be introduced to the appropriate use and analysis of laboratory and radiological data, and will be able to perform some basic emergency procedures under close supervision. Finally, students will learn to rapidly establish an alliance with patients and their families as they cope with the emotional trauma of emergencies, critical illness, and death. In addition, students will be exposed to the unique medical needs of an inner city population - including primary and preventive care.

The Clerkship is given throughout the year. Medical students registered for the course will be scheduled for a total of nine 8-hour shifts over the two week period – four night shifts and five day shifts.

A total of nine 8-hour clinical shifts 1 written examination at the conclusion of the course.