Year 3 Clerkship

The UBC Year 3 Medical School curriculum consists of the following clerkships:

  • Internal Medicine, 8 weeks
  • Surgery, 8 weeks
  • Pediatrics, 8 weeks
  • Obstetrics & Gynecology, 6 weeks
  • Psychiatry, 6 weeks
  • Emergency Medicine, 4 weeks
  • Orthopedics, 2 weeks
  • Anaesthesia, 2 weeks
  • Dermatology, 1 week
  • Ophthalmology, 1 week
  • Elective, 2 weeks

 

In addition, there are several Integrated Community Clerkships where the above distribution of clinical experiences are delivered in an integrated fashion over a full year continuum.

During the Emergency Medicine clerkship, students have the opportunity to perform multiple primary clinical assessments and manage patients under the direct supervision of an attending faculty member on a wide range of ambulatory and non‐ambulatory patients. The mix of presentations varies depending on the assigned site, but this variation does not affect the learning objectives. Students are required to complete on line logging of a prescribed set of core clinical encounters and clinical procedures. A hard copy log book is provided for formative logging of a wider scope of potential encounters/procedures that can be covered during the EM Clerkship. As a part of their patient management, students will interpret lab tests, ECG’s, and imaging tests under the supervision of an attending physician.

The emphasis for students is to hone their clinical skills through multiple patient assessments rather than on learning specialized “emergency medicine” material per se. The clinical skills to be practiced include: a) defining the “emergent presenting problem” or list of multiple problems, b) data gathering skills using a “directed” history and physical exam c) clinical reasoning skills to generate a differential diagnosis list for each presenting problem, and d) therapeutic reasoning skills eg formulating a plan of investigation in order to narrow down the differential diagnosis in order to arrive at the diagnosis, and a treatment plan.

Students can choose to spend 2 weeks of their Pediatric Clerkship in a Pediatric Emergency Department setting. That experience is organized through the Department of Pediatrics.

The Core Teaching Sites involved in the delivery of the Year 3 Clerkship are listed below. Unfortunately we are unable to offer students a choice of site in Year 3.

Vancouver Fraser Medical Program

  • Vancouver General Hospital & UBC Urgent Care Centre
  • St. Paul’s Hospital
  • Royal Columbian Hospital & Eagle Ridge Hospital
  • Lions Gate Hospital
  • Richmond Hospital
  • Burnaby General Hospital
  • Surrey Memorial Hospital
  • Mount St. Joseph’s Hospital
  • Peace Arch Hospital
  • Chilliwack (ICC Site)

Northern Medical Program

  • Prince George Regional Hospital
  • Terrace (ICC Site)
  • Fort St. John/Peace Liard (ICC Site)

Island Medical Program

  • Victoria General & Royal Jubilee Hospitals
  • Cowichan Regional Hospital (Duncan) (ICC Site)

Southern Medical Program

  • Kelowna General Hospital
  • Royal Inland Hospital (Kamloops)
  • Trail (ICC Site)
  • Vernon (ICC Site)

Schedule

Site-specific shift schedules and reporting information are sent to students by email by the Discipline-Specific Site Leader (DSSL) or his/her designate approximately one week preceding the clerkship. All students are required to complete 17 clinical shifts during the 4 week clerkship. An attempt will be made to balance shifts at different times of the day. Shifts missed for any reason (negotiated or unanticipated) MUST all be made up at a time negotiated with the DSSL or designate. Appropriate documentation must be submitted to the Year 3 Office as per the Year 3 Absence Policy found in the Policies & Procedures Manual.

Orientation

A site-specific Orientation will take place on the first day of the clerkship, at a time arranged by the DSSL or designate.  Students should read the first 2 chapters of the UBC Year 3 Core Content Manual PRIOR to their Orientation.

Core Content Manual & Seminars

All students are expected to read the entire UBC Year 3 EM Core Content Manual posted on the UBC Medicol site during the 4 week clerkship.  www.med.ubc.ca/medicol

Students are required to attend a series of Core Content, small group, case-based seminars, led by Emergency Physicians.  Attendance at seminars is MANDATORY, unless a student has worked the overnight shift prior to the seminar and is scheduled to work again on the night of the seminar date.  Attendance is taken. Seminar reading packages are posted on the UBC Medicol site, and must be reviewed by students PRIOR to the session.

Logging

In order to be promoted to Year 4, all Year 3 students must have completed and logged specific mandatory clinical encounters and procedures on their One45 online log. The Emergency Medicine Clerkship provides an unparalleled opportunity to sign-off on many of these requirements. Students are encouraged to proactively seek out opportunities for procedures and clinical encounters.

Observation

Students are encouraged to look for opportunities to ask their supervising Emergency Physician to observe them taking a history or doing a physical exam (either before, after, or during a shift). The goal is for 2 histories and 2 physicals to be observed over the course of the clerkship.

Please click on the following link to download the UBC Emergency Medicine Clerkship Objectives:

Emergency Medicine Clerkship Objectives

Formative

Students receive feedback and coaching on their clinical performance on a daily basis, following each shift. If feedback isn’t spontaneously forthcoming, the onus is on the student to prompt their preceptors for feedback (at an appropriate time, when he/she is not otherwise occupied).

Students are encouraged to ask their preceptor to observe at least 2 histories & 2 physical exams over the 4 weeks in order to provide feedback on their technique.

Students with academic or professionalism difficulties will be given a “mid”-rotation assessment if at all possible (ie if the problem(s) are evident during the first half of the clerkship, and schedules permitting).

A mid-rotation online practice multiple choice test is under development and will be made available at a later time.

Summative

Clinical assessment comprises 75% of the final grade. It is based on a) the daily encounter cards b) verbal and c) written submissions by the student’s preceptors to the Discipline Specific Site Leader. The DSSL completes an End of Clerkship Assessment on One45. All comments on the EOC form are formative, and do not appear on the Medical School Performance Record.

A 50 question, online multiple-choice test comprises 25% of the final grade.

Students must log all items on an online list Year 3 “must see, must do” clinical encounters and procedures by the end of Year 3.  Many of these items are available during the EM Clerkship.

At the completion of each shift, students are asked to complete a brief online teacher assessment on One45 (please see the link below). This is best done during the 30 minutes allocated to “wrap up” at the end of each student’s shift. Students are reminded of the heavy clinical load in most ED’s which means that formal didactic teaching is often impossible during patient care. Students are asked to take this into consideration when assessing “teaching”. We encourage students to learn from other types of teaching, such as role-modeling, the ongoing feedback they receive on their patient assessments and clinical presentations, teaching around cases (ie interpretation of tests and images), and the brief clinical pearls that are imparted.

At the completion of each academic half-day, students are similarly asked to complete an online assessment of their seminar faculty teacher (on One45).

Teacher Assessment Form

The purpose of collecting teacher assessments is to enable continuous improvement of our teaching program, and to provide faculty with feedback on their teaching skills.

Students are assured their teacher assessments will not be accessible to faculty until some time after the completion of their clerkship, and long after their assessment has been submitted. Students are required to complete all 17 of their shift and seminar faculty assessments before their end-of-clerkship assessment will be released.