2019 MD/PhD Medical Scientist Training Program Student Handbook

This handbook serves as an aid to students in the MD/PhD Medical Scientist Training Program. For additional details, see the MD student handbook or the handbook for your specific graduate program.

With questions about the MD/PhD program, contact program administrator Alison Smolinski at 717-531-1188 or als539@psu.edu.

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Pre-Matriculation Roadmap

Pre-Matriculation Overview Expand answer

Secure housing in the Hershey area prior to the start of the rotation

See on-campus student housing options here and off-campus options elsewhere in this handbook. Chances of securing on-campus housing options improve the earlier an application is submitted and the earlier a move-in-date is requested. Call the Housing Office at 717-531-5138 with questions about on-campus student housing contracts.

Select a Penn State lab to complete the pre-matriculation lab rotation

Students must reach out to Penn State faculty about research opportunities and identify a lab in which to complete a four-week research rotation during June, before medical school orientation, and contact the program administrator (Alison Smolinski, als539@psu.edu) with their selection. Students who wish to defer this lab rotation to a later time in order to complete another scholarly activity (e.g., completing ongoing research projects at their current institution) must seek approval from the program co-directors in advance. Additional information about lab rotations is provided elsewhere in this handbook.

Send final official undergraduate and graduate transcripts to the MD/PhD Program Office

Before July 1, students must send an original copy of their official transcript (showing conferred degrees) to the program administrator, Alison Smolinski, either via eVerify sent to als539@psu.edu or via mail to:

Alison Smolinski
MD/PhD Program Administrator
Penn State College of Medicine
500 University Dr.
Mail Code H172, Room C6802
Hershey, PA 17033

Complete the Pennsylvania Child Abuse Background Check paperwork, Criminal and Education Background Check and Fingerprint Registration Data Sheet

Paperwork will be completed along with the medical school class during July orientation.

Attend Wage Orientation with Human Resources for the pre-matriculation lab rotation

Wage orientation for all new MD/PhD students is usually the first Monday in June. The session will be scheduled by the program administrator, Alison Smolinski. Students must bring a valid form of identification (according to the I-9 Federal Employment Eligibility Form) to this orientation with HR. Attendance is mandatory for those completing a pre-matriculation lab rotation. This is a requirement specific to the MD/PhD appointment.

Complete the Medical Student Orientation Survey

This survey is administered by the Office of Medical Education in June. The survey contains the RSVP for the student and guests for the White Coat Ceremony, as well as the requested white coat size. This is a requirement for all MD students.

Schedule a physical exam/general health appointment with a medical provider

Students will need to have an up-to-date physical examination completed by a physician in the last 12 months, as well as a signed immunization record. The immunization record should be complete, signed and include copies of lab data (titers). See guidelines for required immunizations here. If vaccination regimens are in progress but not complete before arrival on campus, that needs to be documented by the physician. (This is the case with the Hepatitis B vaccine for many students). Send completed forms by the end of May to avoid $150 fine to:

Penn State College of Medicine
Office of Student Health, HP03
845 Fishburn Road
Hershey, PA 17033

Complete the Health History Form for new medical students

This is a requirement for all MD students. Send completed forms to Student Health at the address above by the end of May to avoid fines.

Complete the pre-registration form for health insurance

Students need to provide information and copies of their current medical insurance cards. Students will learn more about the insurances available in MD/PhD orientation. The current insurance provider for student insurance is United Healthcare. Enrollment fees and insurance premiums are paid 80 percent by the MD/PhD program, and students are responsible for the remaining 20 percent. Those with own insurance carrier who want to decline school-provided plans will need to fill out a waiver form. Insurance coverage is available for a spouse and children at a discounted cost. Students must also fill out an additional form if planning to acquire insurance coverage for family members; they are not automatically enrolled.

Pay medical school-associated fees at the Bursar’s Office or online on LionPath

MD/PhD students receive a tuition waiver for the medical school years. However, a fall semester tuition bill or student account statement will show three additional charges for which the student is responsible and which cannot be reimbursed. Students must pay the balance at the Bursar’s Office (Room C1607 at the College of Medicine in Hershey) or online on LionPath. Note that paying with a credit card incurs additional processing charges, so students are encouraged to pay with check or e-check. Additional fees are:

  • Activity Fee, approx. $35
  • Information Technology Fee, approx. $330
  • Disability Insurance Fee, approx. $50

Log in to LionPath to complete the Pre-Registration Activity and Financial Responsibility Agreement

The University requires students to update their contact information and financial information at the start of every semester. Log in to LionPath and the Pre-Registration Activity and Financial Responsibility Agreement (FRA) will appear in the to-do list at the top of the homepage. Medical students are automatically registered for medical courses for the fall semester following completion of the pre-registration activity and FRA. For the spring semester, students will be prompted by the University to update your information again, completing the same actions in LionPath. In the spring, students will be given direction for course enrollment by the Registrar’s office. Students will complete registration on their own through LionPath at that time. Students should take care of any bills and register at their earliest convenience. Those who encounter issues with bills or registration should contact the MD/PhD Program Office.

Consult the textbook list and medical equipment list

Refer to the lists provided elsewhere in this handbook before purchasing anything.

Pre-Matriculation Lab Rotation Expand answer

Rotations are done in order to gain research experience in different disciplines, learn multiple techniques and explore potential training environments and mentor-mentee relationships.

Students will have to complete three lab rotations, typically one rotation in the summer before M1 and two rotations during the summer between M1 and M2. Each rotation should be a minimum of four weeks. Students who complete a summer lab rotation before M1 will receive a Penn State College of Medicine faculty/staff ID badge to access lab facilities and will be compensated by the MD/PhD program with an hourly wage ($11.50 per hour) for up to a 40-hour workweek. Pay is dispensed biweekly over the course of the four-week rotation. Instructions for reporting time will be provided at orientation. Students who wish to defer the pre-M1 rotation to a later time in order to complete another scholarly activity (e.g., completing ongoing research projects at the current institution) must seek approval from the program co-directors.

Explore MD/PhD Medical Scientist Training Program faculty here. This list does not encompass all training opportunities at Penn State College of Medicine; also, rotations at University Park are limited to post-matriculation.

Students who have another Penn State laboratory or faculty mentor with research they are interested in being part of must contact the program co-directors for further guidance. These are intended to be four-week rotations with a firm end date of the last day of June to ensure enough time for the transition to medical school. Search the University faculty research directory here.

After finding potential labs in which to rotate, students must contact the faculty to inquire about research opportunities and projects available in their laboratory. Most investigators are enthusiastic about having MD/PhD students rotate and work in their labs. If someone doesn’t seem open to having a rotation student right now, it may be due to current funding status or they may be at capacity for personnel and space at that time. Students can always check back the following year to see if circumstances have changed. Those who have difficulty deciding on a rotation should reach out to any current MD/PhD Medical Scientist Training Program students, the program administrator or the program co-directors.

Once a faculty member has agreed to host you and you have decided to rotate, complete the Lab Rotation Permission Form found in Box.

Overview of Phase I Medical Coursework Expand answer

Medical courses are held every weekday from 8 a.m. to noon, with the afternoons dedicated to independent study and preparation for problem-based learning.

The Foundations of Patient-Centered Care course, clinical skills sessions, health systems patient navigation and Patients as Teachers project meetings occur occasionally in the afternoon and are scheduled irregularly. Attendance is only mandatory for some of the coursework during M1. Anatomy lab sessions, humanities small groups, problem-based learning sessions, team-based learning sessions, examinations and clinical skills classes are all mandatory.

For lectures that are held Mondays, Wednesdays and Fridays between 10 a.m. and noon, attendance is not mandatory and sessions are recorded and posted online on MediaSite.

All MD/PhD students are expected to maintain passing grades in all coursework.

See a calendar overview for all years of the MD program in Hershey here.

Overview of Problem-Based Learning Expand answer

Problem-based learning is a group-based learning component of all classes during the first two years of medical education at Penn State College of Medicine. Sessions sessions are mandatory, occurring for two hours three times a week all year.

Students are assigned to a group of eight peers to analyze medical cases and understand the pathophysiology of a particular disease, facilitated by a faculty preceptor. Discussion of patient cases enforces medical knowledge and promotes long-term retention. Grading is pass/fail and is largely based on participation and preparation for discussion.

In problem-based learning, learning how to find information and ask good questions is just as important as learning the material itself. As part of the College of Medicine philosophy for medical education, students will encounter patients and clinical scenarios in the future that may be complex or new.

Problem-based learning seeks to arm students with skills for the rest of their careers, such as humility to recognize what they don’t know, resourcefulness to find the answers and teamwork to deliver care to patients.

Textbook List for M1 Expand answer

Textbooks are expensive. Courses in medical school are an average of four to eight weeks long, so purchasing multiple books for each class can become a heavy financial burden.

Fortunately, Penn State College of Medicine MD/PhD students do not need to purchase every single book for all classes. Many texts are provided in an online PDF format through the Harrell Health Sciences Library website for free. Other core texts for classes are available in physical copies on course reserve in the library. See library textbook details here.

Alternatively, senior peers in the program are often willing to gift hand-me-downs or lend resources if asked. Consequently, the program recommends students check the library and consult with older students and the list below before investing in any resources.

Problem-Based Learning

  • Free Harrell Health Sciences Library clinical database resources
    • UpToDate – electronic clinical resource tool for physicians and patients
  • Dynamed – evidence-based medical content; electronic clinical resource tool
  • Robbins and Cotran Pathologic Basis of Disease by Kumar, Abbas and Aster
    • Three copies on course reserve in the library; ebook also available for free
    • Approximately $100 on Amazon (favorite resource for many MD/PhDs)

Anatomy

  • Free Harrell Healthy Sciences Library anatomy learning tools
    • Acland’s Video Atlas of Anatomy – videos of human anatomic structures narrated by Dr. Acland
    • Grant’s Dissector by Alan Detton – ebook; reference for in-class dissections
    • Atlas of Human Anatomy by Frank H. Netter – ebook
    • Netter’s Clinical Anatomy by John Hansen – ebook
    • Bone boxes – four bone boxes available for two-hour checkout at the library service desk for free.
  • BRS Gross Anatomy by Kyuong Won Chung: $9 used on Amazon
  • Rohen’s Photographic Anatomy Flashcards: $18 on Amazon
  • University of Michigan’s Online Anatomical Practical Quiz

Science of Health Systems

  • Health Systems Science by Skochelak and Gonzalo: Four or more copies available on course reserve

Foundations of Patient-Centered Care

  • The Medical Interview: Mastering Skills for Clinical Practice by John L. Coulehan: ebook available for free through the library
  • Seidel’s Guide to Physical Exam by Jane Ball: ebook available for free through the library

Scientific Principles of Medicine

  • Essential Cell Biology by Alberts, Bray, Hopkin: one copy available in the library for checkout
  • Textbook of Biochemistry with clinical correlates by Devlin: three copies on course reserve
  • Lippincott’s Illustrative Reviews of Biochemistry by Ferrier: ebook available for free through the library
  • Metabolism at a Glance by Salway: ebook available for free through the library
  • Basic and Clinical Pharmacology by Katzung: two copies on course reserve
  • Elsevier’s integrated review of Pharmacology by Kester, Vrana and Karpa: three copies on course reserve; one copy available for checkout in the library
  • Cellular and Molecular Immunology by Abul Abbas: ebook available for free through the library
  • Emery’s Elements of Medical Genetics by Turnpenny: one copy on course reserve in the library
  • Medical Physiology by Borno and Boulpaep: ebook available for free through the library
  • Janeway’s Immunobiology by Kenneth Murphy: one copy on course reserve in the library
  • Clinical Microbiology Made Ridiculously Simple by Mark Gladwin: one copy on reserve in the library
  • SketchyMicro: $160 for a one-year subscription

Musculoskeletal, Dermatology and Rheumatology

  • Essentials of Musculoskeletal Care by American Academy of Orthopaedic Surgerons, April Armstrong: one copy on course reserve in the library
  • Lookingbill & Mark’s Principles of Dermatology by James Marks and Jeffrey Miller: two copies on course reserve; one copy available for checkout in the library
  • Primer on the Rheumatic Disease by John Klippel: ebook available for free through the library
  • Textbook of Pediatric Rheumatology by Ross E. Petty: ebook available for free through the library
  • Robbins and Cotran Pathologic Basis of Disease by Kumar, Abbas, and Aster: three copies on course reserve in the library; ebook also available for free
  • First Aid for USMLE Step 1 2017: one copy available on course reserve, approx. $50 on Amazon (necessary purchase for all medical students taking board exam)
  • Pathoma: Fundamentals of Pathology by Dr. Husain Sattar; $84.95 for access to video lecture series and notes (necessary purchase for all medical students)

Hematology

  • Pathoma: Fundamentals of Pathology by Dr. Husain Sattar
  • Robbins and Cotran Pathologic Basis of Disease by Kumar, Abbas, and Aster: three copies on course reserve in the library, ebook also available for free
  • First Aid for USMLE Step 1 2017
  • Hoffbrand’s Essential Haematology by Hoffbrand: one copy available on course reserve

Cardiorespiratory

  • Pathophysiology of Heart Disease by Leonard S. Lilly: two copies available on course reserve
  • Pulmonary Physiology by Michael Levitzky: ebook available through Library
  • Principles of Pulmonary Medicine by Steven Weinberger: ebook available through library
  • Physiology by Linda Costanzo: ebook available through library
  • Basic and Clinical Pharmacology by Katzung: two copies on course reserve
  • Elsevier’s integrated review of Pharmacology by Kester, Vrana and Karpa: three copies on course reserve; one copy available for checkout in the library
  • Pharmacological Basis of Therapeutics by Louis Sanford Goodman: ebook available through library
  • Pathoma: Fundamentals of Pathology by Dr. Husain Sattar
  • Robbins and Cotran Pathologic Basis of Disease by Kumar, Abbas and Aster
  • First Aid for USMLE Step 1

Renal

  • Pathoma: Fundamentals of Pathology by Dr. Husain Sattar
  • Robbins and Cotran Pathologic Basis of Disease by Kumar, Abbas and Aster
  • First Aid for USMLE Step 1 2017
  • Basic and Clinical Pharmacology by Katzung: two copies on course reserve
  • High Yield Acid Base by J. Craig Longenecker: one copy available on course reserve
  • The Kidney at a Glance by O’Callaghan: one copy available for checkout
  • Medical Physiology: a systems approach by Raff: one copy available on course reserve
  • Renal Pathophysiology: The Essentials by Rennke: one copy available on course reserve
Medical Instruments Expand answer

All students should at a minimum be equipped with their own stethoscope by the end of July of their first year. The most commonly purchased stethoscopes are the Littman Cardiology III and Cardiology IV. These range in price from $150 to $200 depending on vendor, customization (name engravings) and length of tube.

Other popular options are Harvey Elite, ADC Cardiology and Littman Master Cardiology. The Penn State College of Medicine Gift Shop stocks and sells stethoscopes.

Options are also available at medical suppliers in the greater Harrisburg area, (e.g., Med Plus Uniforms and Scrubs) or online. New students may wish to buy their stethoscopes in a store instead of online to get a sense of length. All stethoscopes are essentially the same, so students are encouraged not to worry too much about this purchase.

An otoscope/opthalmascope diagnostic kit is considered required. However, this kit is expensive (more than $500) so not all students purchase their own. Students may opt to purchase the kit in conjunction with another student (splitting the cost) and then share the instruments.

Alternatively, students may be able to borrow a diagnostic kit from an older student or purchase a diagnostic kit from a graduating student.

Clinical advisers and clerkships/clinical rotations will have different recommendations on what to get, if at all (many clinics and patient rooms contain the equipment already). If purchasing, the Welch Allyn 92820 PocketScope Set sold by AllHeart.com meets all school criteria, is lightweight enough to carry in a white coat and comes with both an opthalmascope and an otoscope.

Finding Housing in Hershey Expand answer

University Manor East Apartments, Hershey, PA

  • On-campus housing with close proximity to classes, the hospital and other students, and cheapest rent for the area.
  • Landlord: Penn State
  • Contact information: 717-531-5138 or housing@pennstatehealth.psu.edu
  • Online: See details and apply
  • Details:
    • Due to overwhelming demand for accommodations, applicants are strongly advised to submit their applications to the Housing Office as soon as possible. Assignments are made on a first-come, first-served basis by the date of request for occupancy (move-in date).
    • MD/PhD students who request move-in dates at the end of May/early June, in time for a pre-matriculation lab rotation, usually have no problems getting housing. No money is required to apply for housing. A security deposit is required after receiving a housing assignment.
    • All apartments come equipped with an in-unit washer and dryer, refrigerator, oven and stove. The unit does not come with a microwave or dishwasher.
    • All apartments are unfurnished, but have carpeting in bedrooms and common areas.
    • Each apartment is allotted one assigned parking space, but overflow and additional parking is also available for both tenants and visitors. Parking is at no additional cost. Vehicles need only be registered with the University.
    • The University has a strict pet-free, smoke-free policy for campus housing.

Briarcrest Gardens, Hershey, PA

  • A popular off-campus housing option. Briarcrest is the closest off-campus housing from the medical center, an average of 0.8 miles or a 20-minute walk from campus.
  • Landlord: Horst Realty
  • Contact information: 717-533-9377 or info@briarcrestgardens.com
  • Online: See details

Rosedale Apartments, Hershey, PA

  • Another popular off-campus housing option. Rosedale is located 1.3 miles from the medical center, or about a 25-minute walk or short bike ride from campus.
  • Landlord: Boyd Wilson
  • Contact information: 717-533-6677 or rosedale@boydwilson.com
  • Online: See details

Roadmap for M1 Year

Overview of M1 Expand answer

July

  • Orientation for Medical School, Professions of Medicine Course and White Coat Ceremony

August

  • Individual Development Plan (IDP) Submission
    • IDPs are due annually on Aug. 1. The template is available in Box under information and student forms. Completed forms should be submitted to the program administrator (Alison Smolinski).

September

  • Meet with clinical adviser to discuss transition to medical school and academic progress.
    • MD/PhD students are assigned to the Waldhausen Society under clinical adviser Dr. Michael Katzman or Mortel Society under clinical adviser Dr. Gisoo Ghaffari.

October

  • Register for BMS 506B (Biological Basis of Human Health and Disease).
    • Contact Diane Gill in the Medical Student Affairs and Registrar’s Office at dgill@pennstatehealth.psu.edu to register for the first graduate course.

December

  • Meet with clinical adviser to discuss academic progress

January

  • Select summer lab rotations and submit dates and mentor choice to program administrator (Alison Smolinski).
    • Alison will schedule individual meetings with the program co-directors to review choices. Students should complete two rotations that are four weeks each, unless instructed otherwise by program leadership.

February

  • Foundations of Patient-Centered Care I standardized patient taped exercise.
    • The results of this formative exam are reviewed by the adviser in preparation for the spring OSCE.

April

  • Primary Care Preceptorship (PCMED 700).
    • Students must complete a one-week preceptorship course in a primary care setting (family medicine) over spring break. Students can work with the Family and Community Medicine office to coordinate an assignment in a physician office in the Hershey area or in a hometown community.
  • Foundations of Patient-Centered Care I Objective Structured Physical Exam (OSCE). I

June

  • Register for BMS 506A (Biological Basis of Human Health and Disease) for the fall of M2.
    • Contact Diane Gill in the Medical Student Affairs and Registrar’s Office at dgill@pennstatehealth.psu.edu to register for the upcoming fall semester in the second year.
Graduate Coursework for Year 1 Expand answer

Biological Basis of Human Health and Disease (BMS 506B)

  • Two credits in the spring semester.
  • This course meets 1 to 3 p.m. Mondays and is taught by Dr. Robert Levenson.
Medical Coursework for Year 1 Expand answer

Medical courses are held every weekday from 8 a.m. to noon, and afternoons are dedicated to independent study and preparation for problem-based learning. The Foundations of Patient-Centered Care course, clinical skills sessions, health systems patient navigation and Patients as Teachers site visits occur occasionally in the afternoon and are scheduled irregularly. Consult the calendar on DaVinci for the day-to-day schedule.

See the full course calendar here.

Yearlong Requirements for M1 Expand answer
  • Foundations of Patient-Centered Care Flex Days: Students will attend six clinic or flex day sessions with their clinical adviser, putting into practice clinical skills learned in Foundations of Patient-Centered Care. Flex sessions are scheduled in the afternoons based on the availability of the adviser’s clinical schedule.
  • Science of Health Systems (SHS 721) Patient Navigation: Students are assigned to a patient navigation experience with their MD cohort. Patient navigation scheduling is variable and dependent on site location/assignment, but should occur in the afternoon.
  • Patients as Teachers Project in Humanities (HMN 713): Students are paired with a peer in their MD cohort and assigned a patient in an hour radius of the medical center. Students participate in a minimum of four home visits over the course of the year, submit a final project in April and attend a patient appreciation dinner in May.
  • MD/PhD Program Research Mentor Talks: This lunch series is for M1s only, to identify potential research mentors and lab rotations. Students are provided with a $10 meal voucher to purchase lunch at Au Bon Pain or the hospital cafeteria. This occurs noon to 1 p.m. every Thursday from August through April, except Seminar weeks.
  • Medical School Portfolio: Update with problem-based learning feedback, clinical performance assessments, writings and content as specified by the Office of Medical Education.
  • Medical School Interprofessional Education Sessions: Two sessions occur per year in which students learn to work collaboratively in a team setting with nursing students, occupational therapy and physical therapy students in simulated clinical care scenarios. Scheduling is to be determined. Check DaVinci for the assigned time.
  • Mandatory MD/PhD Program Monthly Student Lunch Seminars: These occur noon to 1 p.m. the second Thursday of each month, except for July. All students must attend in person.
  • Mandatory MD/PhD Program Clinical Research Conference: These occur 5 to 6:45 p.m. the second Thursday of every other month, except for July. All students must attend in person.
  • Mandatory MD/PhD Program Student Retreats: These occur one weekend in March or early April in State College; dates announced based on venue and speaker availability and scheduling. Students are responsible for their own transportation to and from the event, but overnight accommodations and food are provided at no additional cost. Upcoming retreats are listed in the MD/PhD student calendar.
  • MD/PhD Responsible Conduct in Research Training: This annual training session focuses on ethics in biomedical research, with date announced based on speaker availability.
  • MD/PhD Interview Days for Prospective Students: MD/PhD interview days occur five times a year. Prospective student/applicant days begin on Sunday with student airport escorts, hosting, dinner at Houlihans and tours of housing, school and Hershey. Formal interview activities occur on Monday. M1s are required to attend Monday’s lunch with applicants and are strongly encouraged to become involved in hosting and Sunday activities. Reimbursement will be made for any meals or related expenses when hosting an applicant.
  • Travel/Vacation Policy: The Travel/Vacation Policy listed elsewhere in this handbook applies.
Overarching Concepts and Advice from Peers for M1 Expand answer

Phase I medical curriculum is pass/fail, so study hard, do your best and pass your classes. Make friends and get involved in student life, including wellness societies, specialty lunch lectures, clubs and volunteer projects like LionCare. Over the course of the year, continue to explore research opportunities through seminars, faculty lunch talks, networking with older students in the program and consultation with program leadership. Selecting lab rotations is an important process that requires time and doing your homework.

Roadmap for M2 Year

Overview of M2 Expand answer

August

  • Individual Development Plan submission.

September

  • Contact Medical Student Affairs to register for USMLE Step 1 board exam.
    • Contact Diane Gill in the Medical Student Affairs and Registrar’s Office at dgill@pennstatehealth.psu.edu to receive application and registration information.

October

  • Foundations of Patient-Centered Care II standardized patient taped exercise.
    • The results of this formative exam are reviewed by the adviser in preparation for the spring OSCE.
    • Register for required 1 credit graduate course, either MICRO 581 or GENT 582.

December

  • Meet with clinical adviser to discuss academic progress.

January

  • Meet with program leadership to discuss PhD mentor/lab.
    • Program administator Alison Smolinski will set up individual meetings with program co-directors.
    • For UP labs: Request form must be approved before end of M2 in March.
  • Submit PhD application in GRADS.

February

  • Foundations of Patient-Centered Care II Objective Structured Physical Exam (OSCE) II.
  • Communicate with program coordinator to secure approvals for PhD lab.
  • M2 ends; required graduate course ends; MD/PhD students receive seven weeks of dedicated study time for Step 1 and one week vacation after, before entering PhD lab or finishing up outstanding rotations.

May

  • Deadline for USMLE Step 1 board examination.
    • Students must schedule and complete their Step 1 exam prior to April 23 in order to enter their PhD lab July 1.
Graduate Coursework for Year 2 Expand answer

Biological Basis of Human Health and Disease (BMS 506A).

  • Two credits in the fall semester.
  • This course meets 1 to 3 p.m. Mondays and is taught by Dr. Robert Levenson.

Students must choose one of the following one-credit course options:

  • Genetics of Model Organisms: Molecular and Genetic Analysis of Signaling Pathways (GENET 582)
  • Immunology A: Basic Concepts in Innate and Adaptive Immunity (MICRO 581)
Medical Coursework for Year 2 Expand answer

See the full course calendar here.

Yearlong Requirements for M2 Expand answer
  • Foundations of Patient Centered Care flex days
  • Medical school portfolio
  • MD/PhD program monthly student lunch seminars
  • MD/PhD program clinical research conference
  • MD/PhD program student retreats
  • MD/PhD responsible conduct of research
Overarching Concepts and Advice from Peers for M2 Expand answer

M2 is part of the Phase I medical curriculum and is therefore pass/fail. During the second year, students should continue to focus on their studies and passing classes while becoming acquainted with USMLE study materials (First Aid, Pathoma, UWorld, Doctors in Training, Firecracker, NBME Practice Exams). M2 students should develop a study plan for boards early and are encouraged to reach out to the Cognitive Skills program for help planning a study schedule and identifying resources to prepare for this exam.

To ease the transition from medical school into graduate school, students must identify their doctoral thesis mentor before the boards studying period begins in February. Identifying a research mentor is one of the most critical decisions to make as an MD/PhD trainee. As such, it is important for students to reflect on rotation experiences and discern which lab is the best fit for them. Be sure to talk to former and current trainees in the lab, department employees, collaborating faculty and program leadership before reaching a decision. After a lab is selected, students should contact program administrator Alison Smolinski to communicate this choice. There is paperwork that needs to be signed by the potential mentor for the graduate assistant/fellowship appointment to be processed.

Roadmap for G1 Year

Overview of G1 Expand answer

March

  • Declare research lab (form required for those requesting to conduct PhD at UP.)
  • Registration opens for fall semester.
  • Core requirements:
    • BMS 591 Ethics (1)
    • BMS 801 Writing Grant Proposals for Biomedical Research (1)
  • Program-specific requirements:
    • Program-Specific Colloquium (1)

March through May

  • Pass USMLE Step 1.
    • Send Step Report to program administrator. Successful completion of Step 1 fulfills the candidacy requirement for the Biomedical Sciences graduate program, Neuroscience Graduate program, Bioinformatics and Genomics graduate program and MCIBS graduate program, and is necessary to begin dissertation research.
  • Choose Clinical Exposure Program mentor.

July 1

  • Begin dissertation research in chosen lab.
  • Apply to certificate or dual-title PhD programs (optional).
    • MD/PhD students have the option to apply to either the Graduate Certifiate in Applied Bioinformatics offered through World Campus or the Clinical and Translational Science Institute’s TL1 Program. Requirements for either program will need to be completed in addition to BMS requirements, and the decision to apply should be discussed with the MD/PhD program co-directors and the student’s mentor.

August

  • Orientation and Graduate Student Oath Ceremony.
  • Individual Development Plan submission.
  • Students must submit mentor information by Aug. 26 to BMS 597 course director. Use Canvas module for recording.
  • G1 students should identify a preceptor in preparation for registering for the required BMS 597: Introduction to Translational Medicine course in their fall semester of G2.

October

  • Registration opens for spring semester.
  • Core requirements:
    • BMS 590 Colloquium (1)
  • MD/PhD-specific requirements:
    • Statistics (2-3)
  • Program-specific requirements:
    • Program-Specific Colloquium (1)

December

  • Recommend members for doctoral committee to MD/PhD Medical Scientist Training Program co-directors.
    • The committee must include at least four members, one of whom must be a member of the MD/PhD Steering Committee. Requirements differ for those conducting research at UP (two College of Medicine faculty, one being a Steering Committee member). Official appointment of PhD doctoral committee will be approved by the Dean of the Graduate School following recommendation from the MD/PhD co-directors and the graduate program. Students must work with graduate program staff to initiate and submit the committee appointment form. The program administrator needs copy for the student’s file.

March

  • Registration opens for fall semester.
    • Students should register for zero credits of BMS 601 for the semester after successful completion of the comprehensive exam.

April and May

  • Schedule first committee meeting to review comprehensive exam-specific aims.
    • Contact committee members at least one month in advance to schedule meeting. Contact Kathy Shuey at kes6@psu.edu to schedule a room (or appropriate graduate program staff). MD/PhD program requires two committee meetings per academic year.

May to August

  • After successfully completing the comprehensive exam, students in their G2 year for AY 2019-2020 will register for 1 credit of BMS 597 – an MD/PhD-only course being piloted titled Introduction to Translational Medicine. (Fall 2019: BMS 597 section 3, class number 29590.) Students who are G2s in AY 2019-2020 will take 5 credits (1 credit per semester) of the course over 5 semesters (Fall 2019, Spring 2020, Fall 2020, Spring 2021, Fall 2021). This course is a prerequisite for the Advanced Translational medicine selective course (ATM-LS 700) in the M3 year. The course is for credit, pass/fail, and will utilize Canvas for tracking.
Biomedical Sciences Program Track Requirements Expand answer
  • 14 core requirement credits
    • BMS 591 Ethics (1)
    • BMS 801 Writing Grant Proposals for Biomedical Research (1)
    • BMS 590 Colloquium (1)
    • BMS 596 Individual Study: Research (2)
  • 2 Biomedical Sciences required credits
    • Colloquium (1) Fall Semester
    • Colloquium (1) Spring Semester
  • 6 MD/PhD required credits
    • BMS 506A Biological Basis of Human Health and Disease A (2)
    • BMS 506B Biological Basis of Human Health and Disease B (2)
    • Statistics (2-3)
  • 6 elective credits
  • CITI “Responsible Conduct of Research-Basic Course” module
Yearlong Requirements for G1 Expand answer
  • BMS weekly seminars (4 p.m. Tuesdays) and outside speaker seminars (4 p.m. Wednesdays)
    • Attendance is required at 75 percent of weekly student seminars and the four or five outside speaker seminars.
  • G1 students should identify a preceptor in preparation for registering for the required BMS 597: Introduction to Translational Medicine course in their fall semester of G2.
  • MD/PhD Program monthly student lunch seminars
  • MD/PhD Program clinical research conference
  • MD/PhD Program responsible conduct of research
  • MD/PhD Program student retreats
  • Roadmap for G2 and G3 Years

    Overview for G2 and G3 Expand answer

    March

    • Registration opens for fall semester.
      • Students must register for zero credits of BMS601 for the semester after successful completion of the comprehensive exam.

    May

    • The formalized Clinical Exposure Program has as a required course Introduction to Translational Medicine (BMS 597) for Fall 2019. This is a required course for MD/PhD students in the G2, G3 and fall of G4 years and is a prerequisite for the Advanced Translational medicine selective course (ATM-LS 700) in the M3 year. Students will register for 1 credit in Fall 2019, via LionPath. The course is for credit, pass/fail, and will utilize Canvas for tracking. Students in their G2 year for AY 2019-2020 will take 5 credits (1 credit per semester) of the course over five semesters (Fall 2019, Spring 2020, Fall 2020, Spring 2021, Fall 2021). Students in their G3 year for AY 2019-2020 will register for 1.0 credit per semester in Fall 2019 and Spring 2020. Students who consistently participated in CEP during the last academic year, as G2-G3, are required to register for 1 credit in Fall 2019 and 1 credit in Spring 2020. This will satisfy the pre-requisite and serve as eligibility to register for the Advanced Translational medicine selective during their M3 year. Students in G4+ who are planning on returning to M3 in February 2020 do not have to register for the course, and will be eligible to register for the Advanced Translational medicine selective during their M3 year. There is no additional tuition cost associated with this course. The rubric for the course will be distributed via Canvas once successfully registered. (Fall 2019 – BMS 597 section 3, class number 29590.)

    August

    • Individual Development Plan submission.

    October

    • Registration opens for spring semester.
      • Students must register for zero credits of BMS601 and one credit of Colloquium, BMS590.

    All year

    • Complete dissertation research.
      • Most of the G2 and G3 years are focused on completing thesis research. During this time, students will be expected to present their research at annual MD/PhD lunch seminars and Biomedical Sciences graduate research seminars.
    • Meet with doctoral committee every six months.
      • Students must meet with their committee every six months to assess their progress toward completing their dissertation research. Students may provide a progress report one week prior to their committee meeting. Following this committee meeting, committee meeting forms must be signed by committee members and submitted to graduate program staff. Students at UP, should copy Alison Smolinski on the email to graduate program staff.
    Yearlong Requirements for G2 and G3 Expand answer
    • BMS weekly seminars (4 p.m. Tuesdays) and outside speaker seminars (4 p.m. Wednesdays)
    • BMS seminar research presentation
      • Students in year G2 and up are required to present one research seminar per year during the Biomedical Sciences graduate student research seminar series.
    • MD/PhD Clinical Exposure Program (CEP)
      • Students in their G2 year for AY 2019-2020 will take 5 credits (1 credit per semester) of the course over five semesters (Fall 2019, Spring 2020, Fall 2020, Spring 2021, Fall 2021). Students in their G3 year for AY 2019-2020 will register for 1 credit per semester in Fall 2019 and Spring 2020.
    • MD/PhD Program monthly student lunch seminars
    • MD/PHD lunch seminar presentation
      • Students in year G2 and up are required to present one research seminar per year during the monthly MD/PhD lunch seminar series.
    • MD/PhD Program clinical research conference
    • MD/PhD Program responsible conduct of research
    • MD/PhD Program student retreats

    Roadmap for G4 Year and Beyond

    Overview for G4 and Beyond Expand answer

    Variable Time to Defense

    Discuss timeline to graduation with program leadership.

    • Students should speak with MSTP program personnel (coordinator Alison Smolinski, co-directors Dr. Robert Levenson and Dr. Leslie Parent). Becky Yockey, financial coordinator in Graduate Education, can be especially helpful in transitioning financial support from the graduate mentor back to the MSTP program. Dr. Leslie Parent can be particularly helpful in identifying and manipulating when the student can return to medical school.
    • Graduate Education
    • Medical Education – Diane Gill (dgill@pennstatehealth.psu.edu) is the registrar, and her office is located in the medical student Office of Student Affairs. She helps arrange all of the medical student clerkship schedules and is an important resource.

    Students must submit “Intent to Graduate” in Lionpath at the start of the semester they plan to defend their dissertation.

    Student should refer to graduation calendar deadlines on the Graduate School website. ETD uploads and thesis review are imperative.

    Students must request that the Office of Medical Education add them to the email list of the M2 class they plan to join.

    Students should coordinate medical school enrollment with Diane Gill.

    Phase II is typically scheduled in thre 15-week blocks, each of which is broken up into three one-month rotations, one two-week Career Exploration Elective and one week of exams. For MD/PhD students, there are re-entry points into M3 on a near-monthly basis from March to October. However, clerkship cohort blocks and sites are ranked and scheduled in December of the year prior. Diane Gill can help arrange the block schedule to fit the student’s timeline, but the timeline must be communicated to her by the start of December the year prior (at the latest), when she’s arranging everyone’s schedules. Students should complete all LionPath scheduling tasks on time. Presently, the transition to Phase II/M3 occurs for medical students at the end of February with Profession of Medicine II (a mandatory two-week clerkship transition course for all medical students). Students must participate in Profession of Medicine II in February even if they will not start M3 until five or six months later.

    12 Months to Defense

    Meet with dissertation committee at beginning of G4.

    Students must present academic accomplishments and dissertation research completed so far and express their desire to defend and return to M3 within a year from the date. Based on input from the adviser and committee, students will identify what further experiments they must complete for their dissertation. Studetns must ask the committee to verbally commit that completion of these experiments will be sufficient for graduation. Students should set an expectation for when they will return to medical school.

    Publish a first-author peer-reviewed manuscript.

    Students must have at least one first-author peer-reviewed manuscript accepted for publication before returning to M3. Students who have not yet published should:

    • Talk with their adviser about how the data generated can be best integrated and crafted into a manuscript, and to what journal they plan to submit.
    • Conduct any remaining experiments needed.
    • Draft a manuscript and make successive revisions with the feedback of co-authors.
    • Submit to a journal and realize that it can take up to four to five weeks to receive reviews.
    • Budget time to conduct additional experiments in response to reviewer concerns.
    • Revise and resubmit.

    Six months to defense

    Students should familiarize themselves with the Thesis and Dissertation Information page of the Penn State Graduate School website.

    Students must know the calendar deadline for registering their “Intent to Graduate” on LionPath, and the requirements for writing and submitting a dissertation. Students should use the calendar dates to work backward and plan how long the overall process is anticipated to take.

    Meet with Dissertation Committee in the middle of G4.

    Students will present the final results of their research to their committee and establish a formal date range for when they would like to defend. Students should address committee expectations for the dissertation. Questions for consideration: What does the committee expect research chapters are going to look like? Can the student insert publications verbatim as chapters? Is there a review article that can be used as an introduction or part of the discussion?

    Five months to defense

    Students should identify a date and time for the dissertation defense.

    Students should plan fro at least one month between their dissertation defense and returning to M3.

    The program recommends students send out a Doodle poll after the previous committee meeting to work this out. Once a date is set, students should work backward to determine how to schedule dissertation writing.

    Inform the Office of Graduate Education of the oral defense date.

    Students should contact the appropriate person to formally schedule the oral defense, reserve a room for the event, print out programs and provide the committee with the oral defense evaluation form on the day of your defense.

    Students shoudl also send the MD/PhD program administrator, Alison Smolinski, the announcement to be shared and saved in the student’s file.

    Four months to defense

    Begin to write the dissertation.

    First, students should re-read the “Thesis and Dissertation Guide” and “The Most Common Mistakes” PDFs on the Penn State Graduate School site. As long as the committee is comfortable with it, each of the student’s first-author publications can be inserted verbatim into the dissertation with minor formatting. Then, it remains just to write an introduction and discussion chapter. To insert publications into the dissertation, they must already be open access, or, if under copyright, the student needs to request permission online from the publishing company to use the manuscript in the dissertation. Studetns can refer to other MD/PhD students’ published dissertations online as a resource to understand what is expected. At the end of the day, the committee has a heavy hand in the dissertation.

    Whether experiments stop to allow for writing will dictate the strategy in writing the dissertation. The program recommends students set aside one to two hours of protected time each day to write, and to be consistent. Students should revise and receive feedback on the dissertation from their adviser before submitting it to other committee members. This is an academic exercise; the only people who will read this for content are the student, the adviser and other committee members.

    Two months to defense

    Prepare oral dissertation PowerPoint.

    This talk should last approximately 40 minutes, appeal to a broad audience and tell a story about the research and its contextual significance. Students should consider presenting a preliminary version as a Biomedical Sciences, Medical Scientist Training Program or departmental seminar and request feedback. Students should rehearse this talk and try to anticipate questions it may elicit.

    Five weeks to defense

    Email a polished draft of the dissertation to the committee for review.

    Students should state in the email that if there are major concerns with what they’ve submitted, the committee should let them know within three weeks from receipt. Otherwise, the student should expect to receive feedback for minor revisions after the oral defense.

    Submit a draft of the dissertation to the Graduate School for format review.

    This is done via the electronic Thesis and Dissertation (eTD) website. Students should receive feedback for formatting revisions within two to three weeks of submission.

    Day of defense

    Present and defend the dissertation.

    Students must pay the $95 dissertation fee and complete the online Survey of Earned Doctorates.

    This is done on the Penn State Graduate School portal.

    One month after defense

    Revise and submit the final written dissertation to the eTD website and all required forms to the Office of Theses and Dissertations.

    Students should obtain committee members’ signatures of approval on the Doctoral Signatory page. Materials that need to be submitted to the Office of Theses and Dissertations are: the doctoral signatory page, Proquest/UMI publishing agreement, standalone copies of the title page and abstract, any necessary copyright permissions, and the Survey of Earned Doctorates certificate of completion.

    Identify an MD/PhD residency adviser to assist in residency planning.

    This can be any Medical Scientist Training Program steering committee member who is an MD. The current list is available in Box on the Return to M3 permission form.

    Complete the Permission to Begin Clinical Clerkship form.

    This form requires the signatures of the student, their mentor and one of the MD/PhD Medical Scientist Training Program co-directors and should be submitted to the program administrator.

    Yearlong Requirements for G4 and Beyond Expand answer
    • BMS weekly seminars (4 p.m. Tuesdays) and outside speaker seminars (4 p.m. Wednesdays)
    • BMS seminar research presentation
    • MD/PhD clinical exposure program
    • MD/PhD Program monthly student lunch seminars
    • MD/PHD Program lunch seminar presentation
    • MD/PhD Program clinical research conference
    • MD/PhD Program responsible conduct of research
    • MD/PhD Program student retreats

    Roadmap for M3 Year

    Overview for M3 Expand answer

    The third year is composed of two weeks of Profession of Medicine II; eight required clerkships; four weeks of elective taken either as a single four-week elective or two two-week electives; and three two-week Career Exploration and Synthesis weeks.

    Required clerkships are:

    • Medicine (six weeks)
    • Surgery (six weeks)
    • Pediatrics (four weeks)
    • Obstetrics and Gynecology (four weeks)
    • Family and Community Medicine (longitudinally integrated clerkship)
    • Psychiatry (four weeks)
    • Neurology (four weeks)
    • Underserved Medicine (four weeks)

    See the full course calendar here.

    Third-Year Rotation Scheduling Expand answer

    During the M3 year, students will complete the core clerkships as well as at least one elective. Scheduling is done through LionPath.

    The Medical Education team will provide all needed information; older students are also a very good resource for tips on navigating through the system and the best way to order clerkships.

    The medical school has a series of lunch lectures in November/December that provide information on scheduling and site selection. The MD/PhD student will begin the scheduling process in mid-December of the G4 year.

    Site Selection

    After being assigned a specific cohort, students will rank choices for sites for each clerkship. All M3 and M4 MD/PhD student clerkship rotations are to be done at Penn State Health Milton S. Hershey Medical Center only.

    In addition, all M3 and M4 schedules must be approved and signed off by a MD/PhD residency adviser (Dr Leslie Parent, Dr. Diane Thiboutot or Dr. Mark Stahl). Students are required to choose from one of the three designated residency advisers for MD/PhD students and let Alison Smolinski know who they have chosen. Students should plan to meet with the adviser at least twice per year. The schedule signature is required because students are supported by either NIH grants or institutional funds or both.

    The order of M3 clerkships does not really matter. Students who are worried about starting with surgery because they later want to pursue a surgery residency can relax. The order of the M3 rotations will be in the Dean’s Letter, so residency programs will be able to see that surgery was done first, and programs will take that into account when looking at the surgery grade. Recommendations from acting internships also carry a lot of weight, so students are encouraged to focus on doing those early in M4, and to do well in them.

    Professions of Medicine II Expand answer

    As mentioned elsewhere in this handbook, the POM courses are built into the M3/M4 schedules. This course is mandatory attendance. Students cannot miss any of these classes; attendance is taken at every lecture and group activity.

    Third-Year Core Clerkships: Overview and General Advice Expand answer

    Core clerkships for M3 include Surgery A and B, Family Medicine, (Internal) Medicine A and B, Psychiatry, OB/GYN, Maternity and Newborn, Pediatrics and Neurology. Each of these clerkships has a final shelf exam. The grade is calculated slightly differently for each clerkship, but generally about half of the grade will be from the clerkship exam and the other half will be from the clinical evaluation by the attending on the clerkship service.

    What to buy to keep in the white coat

    • Blank notebook or notecards
    • Smartphone with useful apps (see the library for information on useful medical apps)
    • Maxwells or MD Pocket Medical Reference (pick one) – This is essential; these are small pocket-sized booklets containing useful information like normal lab values, dermatome maps, the structure of pre- and post-op notes, child immunization schedules, neuro exam landmarks, etc.
    • Pocket Medicine – Though focused on medicine, it is an extremely useful and compact resource for all the clerkships; most students and residents are seen carrying a copy
    • Yellow EKG card and calipers – This is a cheat sheet for reading EKGs, given during Professions of Medicine II.
    • Extra pens
    • Snacks (especially for Surgery) – You never know when your next meal is
    • Medical equipment

    How to do well in clerkships

    Students should understand they are here to learn, and are the least senior person. Clerkships are stressful. Embracing each one as an opportunity to learn about a new specialty and to further improve clinical knowledge will allow students to do well and create less stress. Students will make mistakes and are reminded not to take it personally if a resident criticizes or corrects them.

    Being low on the chain of command has some disadvantages. Students must not be unwilling to do grunt work, and should do anything and everything in their power to contribute. Students should show the attending physician or resident that they are a willing team player and that they are capable and eager to do whatever it takes to provide the best care for patients. Being cheerful and trying to make the residents’ job easier is important. Simply asking the residents “What can I do to help?” is one of the best ways to get a good experience on the rotation and a great evaluation at the end.

    There is also a big advantage to being low on the chain of command. Students are responsible for fewer patients than residents are. They also work shorter hours than the residents and take much less call. (Penn State guidelines say that sites should aim to have medical students work 40 to 60 hours per week so that time is available to study for shelf exams). Because of these factors, students can spend more time with their patients than the residents can. Students should take this opportunity to do really thorough work-ups and truly understand the diseases encountered.

    The first day

    All clerkships have an orientation on the first day. Those doing a rotation at a site other than Hershey will have an orientation in Hershey on the first day, and may have another orientation at the rotation site on the second day of the rotation. For Hershey orientations, students should check out the schedule on DaVinci. For other sites, students will usually get an email telling them where and when to arrive for orientation, but if the program does not initiate contact, students should contact them and find out who the attending or resident will be, and page them the night before to find out where/when to show up.

    Students must always dress in professional attire on the first day (even if in the surgery clerkship). The sites generally want students to be dressed professionally at all times unless they are in the OR. Students will be told when and where it is acceptable to wear scrubs.

    On the first day (especially at away sites), students will also need to find out details about logistics like parking and ID badges. Students should be sure to ask where the locker rooms are, and where it is safe to leave belongings while in the clinic or OR.

    On the first day, students should be sure to take note of:

    • Residents’ and attendings’ pager numbers
    • Phone numbers for the lab, radiology, pharmacy, etc.
    • The username and password for site’s workstation computers and electronic medical records

    What do you do during the day?

    There is no one answer to this question. The larger and more organized sites will tell students what is expected. The smaller sites may not have formal guidelines, in which case students should ask their resident directly “What can I do to help?” This handbook outlines some general guidelines for inpatient and outpatient clinical settings, but whatever the resident or attending tells the student to do trumps everything.

    Keeping track of patients

    Above all, students must be organized. Each student must find a system that works for them. They can keep a notebook with patients’ information in it, or carry notecards (one for each patient).

    Inpatient service

    Students will see many patients on inpatient services, but may be given two or three patients that will be exclusively theirs. Students not assigned any patients should take the initiative and take ownership of a few. Students will do rounds with the residents and attending each morning, but will want to do their own “pre-rounds” every day – arriving before the residents, seeing patients, doing a history and physical, tracking any changes from the day before (especially if there were complications), writing an updated SOAP note and leaving it in the chart before the resident sees that patient.

    Tips on writing notes

    • Students should read the residents’ previous notes to see what they should focus on and how to structure the note itself. Notes should always focus on the chief complaint and highlight any changes from previous days.
    • Students should talk with the resident about what might be best to include in the note.
    • Each student should photocopy their note to keep with them on rounds, leaving the original in the patient’s chart. The student can then refer to the note while presenting their patient on rounds.
    • Students should not neglect the assessment and plan portion of the note; residents will ask what the assessment is.
    • Students must have all your SOAP notes done before rounds. Some patients take longer than others, so students are advised to plan accordingly.

    The student will then go on rounds with the residents and the attendings and should have their copies of the SOAP notes in hand, present the cases to the team, and get feedback from the team on the presentation and the assessment/plan for each case.

    During the rest of the day, each student will probably team up with a resident and take care of patient-related tasks such as writing orders, following up on lab results, etc. Inpatient time can be feast or famine; some days will be busy, and others will be slow. Students should carry a small review book around in their white coat so that, if there is downtime, they can read or do practice questions.

    Students will probably have some call duty while on inpatient service; the amount depends on the site and the rotation. Being on call can be a great learning experience; students will often get a lot more personal attention from the residents on call than they would during the day. Residents will usually let the student do more on call. This is a great time to get some procedures done (putting in IVs, drawing blood, placing NG tubes, etc).

    Some clerkships require students to work at least one weekend. Many times, the student will be expected to attend Saturday morning rounds or conferences, but these usually don’t last beyond noon.

    Outpatient service

    On many clerkships, the student may be required to attend inpatient rounds in the morning and then go to an outpatient clinic for the rest of the day, or some days may be exclusively outpatient.

    In outpatient clinics, students will not have patients that they follow continuously, and they will likely not see the same patient twice. Students should show up at least 15 minutes before clinic officially begins. For each patient, the student should review the chart, see the patient by themselves first and do an interview, physical, create a plan and then present the case to the attending or resident. Then the student and the attending/chief will re-enter the room and discuss the plan with the patient. It is much harder to get any procedures done during outpatient time.

    Lectures

    Hershey and most other sites also have didactic lectures during the day for students and/or residents – these are mandatory attendance. Each student will get a schedule for these and be expected to attend. Residents/attendings know to excuse students from clinical duties for these lectures. When on inpatient service, students may want to eat during the lectures in case they don’t get another chance.

    Customizing your education

    Those interested in seeing a particular subspecialty on a core clerkship should ask the site clerkship director if it would be possible to arrange. For example, some sites do not require students to spend time on a reproductive endocrinology/infertility service during the core OB/GYN clerkship, so students who would like to spend a day or two in an infertility clinic should ask. The act of asking shows that a student is are interested in learning, and most sites will attempt to accommodate such requests.

    How do you study each night?

    Read! The material to be learned each night is a balance between patient-geared learning and shelf-exam-geared learning. Students who have a patient with a COPD exacerbation should read everything they can find about COPD (including the latest information from Up to Date) so that on rounds the next morning, they can answer any questions correctly. Knowing the latest recommendations from Up to Date is also a huge bonus on rounds. In fact, many attendings stay updated on the latest recommendations by asking the students. Students who formulate an assessment and plan around the latest evidence-based medicine are providing an honors-level report. This will impress the attending and residents, which will translate into more respect and less grunt work later.

    Students should be sure to spend a portion of each night learning material that will be on the shelf exam (consult review books for a list of topics).

    Clerkship exams

    Every core clerkship has an exam at the end. These are national exams, and the passing cut-off is usually around the 10th percentile for the nation (the student must pass the shelf to pass each clerkship). Each exam gives two and a half hours to answer 100 multiple-choice questions.

    The exams cover everything, not just the cases the student has seen. The clerkship training is less uniform than the M1/M2 classes – differences in attendings, sites and patient populations can give each student a totally different experience than other students on any particular clerkship. Students will need to do a lot of reading outside their patient cases. A popular strategy among students is to concentrate on specific patients during the week, and on the weekends study more generally for the shelf exam. Students should keep up with their studying, trying to do at least two hours of reading on average per night.

    Review books are popular for exam preparation. There are electronic versions of a lot of these circulating through the medical classes (Kaplan, 1st Aid, Appleton and Lange and Pretest, to name a few); students can ask an upperclassman for copies. A common trap is to rely on review books too heavily. Students should use review books to make sure they are covering all the topics, but should do most of their reading in Cecil’s, Harrison’s or similar references.

    More information about specific review books for the exams or the USMLE can be found in the specific sections for each elsewhere in this handbook.

    Attendance during M3 clerkships

    Attendance is mandatory during each clerkship. Students are only allowed to miss one day (excused absence) for the four-week clerkships and electives, and up to two days for the six- and eight-week clerkships. Planned absences must be cleared with the course director at least four weeks prior to the beginning of the course. Note that approval of absences is entirely at the discretion of the clerkship director. Excused absence is granted for severe illness, death of a family member or attending a scientific conference. Invalid excuses include family vacations, attending a wedding, etc. An unexcused absence may result in a failing grade for the clerkship. No absence will be excused (for any reason) from the shelf exams, Island courses and the TCM course.

    In some situations, it is possible to miss more than one day of a core clerkship to go to a scientific meeting. Students should ask the clerkship director ahead of time and offer to make up for any missed clinic duties, and the director may try to accommodate the request, especially if the student is presenting their own research at a conference. If it is an off-campus rotation, students should ask the director at your site, not the director at Hershey.

    Clerkship grades and evaluations

    For each clerkship, the student needs to be evaluated by a resident/attending as part of the grade and will receive both a written evaluation as well as a score for performance in the clinics. Comments from the written evaluation go into the Dean’s Letter verbatim. Students may sometimes choose who to give their evaluation form(s) to, but should keep in mind that when evaluating the student, the attending will ask for input from the residents. So students should be nice to all the residents in case they are consulted for the evaluation.

    Final grades are calculated slightly differently for each clerkship, but generally about half of the grade will be from the shelf exam, and the other half will be from the clinical evaluation by the attending on the clerkship service. Students must pass both the shelf and the clinical evaluation to pass the clerkship.

    For the highly competitive specialties, it is of paramount importance to do well in the core clinical clerkships. Students should try to get honors in as many clerkship as possible. This will not only afford for a good Dean’s Letter, but also an acceptance into Alpha Omega Alpha (AOA).

    Required procedures

    Students will be given a list of required procedures and patient encounters for M3 and must complete all of these procedures and log them in New Innovations. The general advice is to be proactive; no one will ask a student in the OR if they would like put in the Foley catheter, so students who see the nurse getting a Foley kit out should ask if they can put it in. Not only will the nurses let the student, but they will often help them through it, too. Getting the procedures done as early as possible (whenever opportunity permits), and keeping up with logging them in New Innovations every day, will provide the best experience. Procrastinating the logging until the end of the rotation will create hours of last-minute work for the student during the days when they want to be studying for the shelf exam.

    More general advice for clerkships

    • They resident/attending is always right. Do what they want, the way they want it, when they want it.
    • Look happy and interested, even if you are exhausted.
    • Don’t be late.
    • If you don’t know an answer, admit it. Never lie or make up information.
    • If you don’t know how to do something, ask.
    • Never answer a question that the attending asks the resident (even if the resident says they don’t know, don’t speak up unless you are asked to give an answer).
    • You will get yelled at once or twice during M3. It’s not always a resident or attending; you may be yelled at by a nurse, a patient or a patient’s parents. Be professional and learn from it.
    • Try not to get frustrated when a patient tells you something completely different than what they later tell the attending. Patients do this all the time. The attendings know that this happens a lot.
    • Phrases to engrain in your vocabulary:
      • “I’d like to do (this procedure), but I don’t know how. Would you show me?”
      • “I don’t know the answer, but I will find out.”
      • “What can I do to help?”
    Surgery Core Clerkship Expand answer

    Overview

    The surgery clerkship is composed of two halves that make up a total of six weeks. Each student has a general surgery experience (two weeks) as well as a subspecialty surgery experience (two weeks). In actuality, there are too many students for each individual to be on a general surgery, and thus many students will have their general surgery component on a subspecialty service. These surgical services that serve as the general component for the rotation vary, but typically include emergency general surgery, surgical oncology, endocrine, colorectal, vascular, transplant, trauma and pediatric surgery; students will be able to rank these choices when registering.

    For the subspecialty experience, each student will be sent an email a few weeks before the start of the rotation asking for rankings of choices for subspecialty electives. Students generally get their first and second choices for subspecialty. Surgery clerkship subspecialty electives include breast surgery, ENT, cardiothoracic, transplant, urology, plastic surgery, neurosurgery and orthopedics.

    Regardless of the service the student is assigned to, the goal should be to understand the fundamentals of surgery and become familiar with as many types of surgical patients and problems as possible during the rotation. For many students, this will be the last time that they will ever be in the operating room.

    Responsibilities as the Medical Student

    For the general portion of the Surgery rotation, medical students typically start the morning by pre-rounding on one or two patients and writing a daily SOAP note prior to rounding with the rest of the surgical team. Generally, students will follow patients that they saw in the operating room so that they are familiar with their operative course, complications, medical history and indication for operative management.

    When reading about patient cases, students should focus on the following:

    • Why is this patient going to the OR?
    • What is the disease process and relevant anatomy/physiology?
    • What are the treatments for this disease (both surgical and non-surgical)? What are contraindications for surgical treatment?
    • How do you manage this patient post-operatively? What are the post-op complications to watch for?

    The hours on the surgery clerkship can be longer than most other clerkships (typically 5 a.m. to 6 p.m., if not longer). The days start early because the surgical team needs to finish rounds prior to the first operative cases, which typically start around 7:30 a.m. most weekdays. For call duty, students at Hershey are required to take one night of overnight call per month (two call nights for the entire eight-week surgery rotation), but they may also work some daytime weekend shifts. Some other sites have overnight call once a week, but weekends are completely free. This is unlike surgical residency, which can have overnight call at most every third night. The idea of taking call as a student, though, is to provide a taste of what happens overnight. Additionally, it is beneficial to see various surgery consultations with the senior surgical residents in the emergency department when on call. This is also the time when students can get a lot of procedures completed.

    Surgical Recall and Lawrence’s Essentials of General Surgery have introductory chapters about OR chain of command, scrubbing in and etiquette in the OR. Students should read these before their first day in the OR. The expectations vary from service to service and between residents/attendings. Each student should ask their team how they do things and what they expect.

    Doing Well in the Surgery Clerkship

    The most important preparation each day is to pre-read the evening prior to surgical cases. The OR schedule is available online days in advance (the residents will show how to access this schedule), and students should know which cases they want to be involved with for the following day. If there is only one medical student on a particular service, that student can go to whichever cases they want. However, if there are multiple medical students on the service, they should try to decide ahead of time who is going to scrub in on which cases so that they can prepare the night before.

    Students should become familiar with the patient/case in the operating room prior to the beginning of the surgery. Many attending surgeons will expect that the student knows the patient’s past medical history and why they are having a particular procedure. Furthermore, knowing these things will allow students to learn a lot more during the actual time spent in the operating room.

    Shelf Exam

    As mentioned above, the surgery clerkship focuses on patient management, and the shelf exam reflects this. Students will do themselves a service by reading from a general medicine textbook, like Harrison’s. Keep in mind that the Shelf will not ask about types of suture knots, equipment, etc. Even though the hours can be long on surgery, the residents know that students have to be studying for the Shelf as well.

    Good resources for the shelf

    The following two books are provided to students to borrow for free during the surgery clerkship:

    • Lawrence’s Essentials of General Surgery
    • Surgical Recall – very helpful; students should carry it with them and skim it before each surgery. This is a favorite book by most students, by far.

    Also:

    • Kaplan Notes – The vignettes are especially useful. Read them at least once.
    • Pretest – Very good; best question book.
    • First Aid for Surgery – A good number of students use it and like it.
    • Blueprints – Less helpful; too general.
    • Appleton and Lange – An OK resource; many fewer students reported using it.

    Students should use Lawrence, Cecil’s, Harrison’s or Up-To-Date for specific reading about pathology leading to the surgeries.

    Other tips for the Surgery Clerkship

    Show up the first day wearing professional attire. Many sites do not want to see medical students in scrubs unless they are in the OR.

    Carry tape, scissors and gauze in the white coat pocket for changing dressings on rounds.

    Students may not get time to eat regular meals and should keep snacks in their white coat pockets.

    Students may wish to buy a pair of Dansko clogs for the OR. Some people like Crocs, as well.

    Pediatrics Core Clerkship Expand answer

    Overview

    The pediatrics clerkship combines inpatient and outpatient exposure to pediatric problems and diseases. The student’s time on the pediatric inpatient wards can be extremely rewarding because they will likely bond with certain patients and their families during the course of their hospital stay. In the outpatient setting, there is a lot of emphasis on the well-child check and developmental milestones, as well as preventative medicine such as immunizations and child safety. Depending on the site, students may also be exposed to sub-specialty clinics such as pediatric cardiology, gastroenterology, surgery, rheumatology, etc. Students will also be exposed to adolescent medicine and issues of confidentiality for minors.

    Responsibilities as the Medical Student

    Much like other clerkships, the student’s responsibilities will vary depending on whether they are on inpatient or outpatient service at the time. On outpatient days, students will interview patients and present cases to a resident or attending. On inpatient service, students will follow two or three patients a day, pre-round on them, write notes and participate in rounds. Many sites have family-centered rounds on the pediatric wards, during which the whole medical team will enter the patient’s room, and a student/resident will present the patient case with the family there; family members are encouraged to fill in holes in the history and ask questions. Presenting a case in front of the patient and their family can take practice, because it is important to minimize medical jargon and be careful with wording regarding the plan/prognosis.

    Doing Well in the Pediatrics Clerkship

    A large part of doing well in pediatrics involves interactions with the patient’s family. If the family doesn’t like a student, it will be evident to the attending. Additionally, the art of interviewing pediatric patients takes practice. When walking into a room, students should introduce themselves to the parent first and then the child. Address the child, ask them questions, engage them in whatever conversation possible in order to establish trust. This will make the physical exam go much more smoothly. If a child doesn’t like/trust a student, they may scream and kick and do whatever else is necessary to prevent them from doing a good exam.

    Shelf Exam

    Pediatric patients really aren’t just small adults, so students should not rely on adult medicine textbooks for all of their studying. The pediatrics Shelf typically emphasizes developmental milestones and preventative care.

    Good resources for the Shelf

    • Pocket Pediatrics – Great for carrying around in the white coat
    • Blueprints – Great overview for the clerkship
    • First Aid for the Pediatric Clerkship
    • Pretest – Useful question book
    • Case Files
    • Harriet Lane Handbook – good white coat quick-reference book
    • Appleton & Lange

    Other tips for the Pediatrics Clerkship

    • Carry a copy of the Vaccination Schedule Card and Well Child Development Milestones.
    • Some students carry stickers or cute Band-Aid in their white coats for giving to younger kids.
    • If parents, especially those of chronically ill children, yell, don’t take it personally.
    OB/GYN Core Clerkship Expand answer

    Overview

    The OB/GYN clerkship is six weeks long and includes a mix of outpatient, inpatient and surgery. It is this variety of day-to-day activities that attracts many physicians to the OB/GYN field. Most sites will give students at least some exposure to all aspects of OB/GYN, including routine well-patient visits, labor and delivery, maternal-fetal medicine (“high-risk” obstetrics), reproductive endocrinology and infertility and gynecologic oncology.

    Responsibilities as the Medical Student

    Responsibilities vary according to the service the student is on. In the outpatient clinic, students may be able to interview a patient and present the case to a resident or attending, much like any other clerkship. Gynecologic Oncology is very surgically-intensive, so students will likely spend most of their time in the OR. Experiences on labor hall can vary. Some sites/attendings will let students do a lot during a vaginal delivery, and others want students to just stand back and watch. Regardless of the student’s role during a birth or surgery case, they will want to follow those patients and pre-round on them.

    Students can get a lot of their required procedures done during OB/GYN, such as wet mounts, pelvic exams, urinalysis and rectal exams.

    Doing Well in the OB/GYN Clerkship

    Doing well in OB/GYN is similar to other clerkships. While on the surgery or gynecologic oncology service, students should do everything that a surgery clerkship would expect. While on the outpatient service, they should do everything that a medicine clerkship would expect. And don’t drop any babies.

    Shelf Exam

    The best advice is to read the Beckman textbook (it’s the same Beckman that is recommended for the reproductive block in M2). This textbook is not very long and is very readable. Students who read this book and do the UWise practice questions will do well on the Shelf.

    Good resources for the Shelf

    • Beckman – See above
    • UWise question database – A fantastic resource. This is a website that has more than 500 questions that are written in the same format as the Shelf questions, and that cover all of the pertinent topics. Students get access to this site for free and receive information on how to do so at orientation.
    • Blueprints – Many students have recommended this in the past
    • Pretest – Most students liked this book for questions, though they are not necessarily the same format as those on the shelf
    • Case Files
    • First Aid

    Other tips for the OB/GYN Clerkship

    • Carry a pregnancy wheel in the white coat.
    • Good procedures to get done during OB/GYN include IVs, Foleys and injections.
    Medicine Core Clerkship Expand answer

    Overview

    Medicine is an important clerkship even for students who don’t go into a medicine residency. Many competitive residencies (dermatology, ophthalmology) will want to see that the student did well in their core medicine clerkship. Medicine is eight weeks: four weeks are spent in an inpatient setting at Hershey or affiliate sites, and the other four weeks are spent doing two two-week outpatient selectives at Penn State Health Milton S. Hershey Medical Center.

    Students are often assigned to their first- and last-ranked selective choices for the outpatient medicine month, so those who really don’t want to rotate through a particular clinic may do well to rank it somewhere in the middle.

    Responsibilities as the Medical Student

    Medicine has very long hours in the inpatient weeks. Students may be given two or three patients as exclusively their. If none are assigned, students should take ownership of a few patients. In the busier locations like Hershey, students may be one of several students working with several residents, in which case they will have to be proactive in asking the team what they can do to help. Students will focus on patient management during medicine, and may not have time to do any of the required procedures because of spending so much time rounding while the nurses do procedures.

    Doing Well in the Medicine Clerkship

    Medicine is very centered around patient workup and case presentations, so each student should do thorough histories and physicals; learning how to give an organized, thorough presentation will impress the attending. Including everything in the case presentation is important unless the attending asks the student to skip it. For example, this means reporting all the vital sign values instead of saying “vital signs normal,” and reporting pertinent negatives on the physical exam instead of saying “rest of exam was unremarkable.” Students should not be wishy-washy in their assessment of a patient. After stating the facts, students should give a conclusion – sharing their opinion and showing that they are reasoning through the case. The students who do this get honors.

    Unfortunately, students do get tough or seemingly unfair questions a lot during rounds on medicine, depending on the site and the attending they are working with. Rounds are teaching sessions as much as they are patient care sessions. Students may be asked to give a complete differential for abdominal pain, or list 40 different reasons a patient could have hypokalemia. This means that, more than any other rotation, students must do extensive reading on their patients’ diseases and have a good understanding of physiology, pathology and pharmacology.

    Shelf Exam

    As mentioned above, the best bet for much of the reading will be Harrison’s or a similar text. However, students should be sure to consult a review book as well. The patient population will not be diverse enough to cover all the topics on the Shelf. This Shelf is difficult and covers a large range of subjects.

    Good resources for the Shelf

    • Internal Medicine Essentials for Clerkship Students, Version 2 – This book is written by the same people who write the Shelf exam questions. It is not extremely thorough, so students may need to use Harrison’s or a similar text as a supplement. The free PDF version of this book is available through the library.
    • MKSAP question database – Put together by the same people who write the Shelf exam, this database has several hundred questions. The latest version is Version 5, but the library has Version 4 available to students for free. Students should ask the library for the CD that has the program on it. The program recommends that students do all of these questions.
    • First Aid for Medicine
    • Pretest for Medicine
    • Case Files
    • Pocket Medicine – Very useful to carry in the white coat
    Family Medicine Core Clerkship Expand answer

    Overview

    The family medicine longitudinal clerkship has the most locations where students can do the clerkship, and thus a wide variety of experiences that they can have during this month. There are at least 20 different sites throughout Pennsylvania. The experience can vary from strictly outpatient experiences to a combination of outpatient and inpatient experiences; the people students will primarily interact with on a daily basis will vary as well. The locations that have both inpatient and outpatient requirements are Johnstown, Lancaster, Middletown, Lebanon and Altoona.

    Responsibilities as the Medical Student

    For outpatient experiences, students’ typical hours will be the hours of the clinic. Some offices have evening hours, but usually students aren’t required to work in the evenings. Students will most likely have one required or optional call at the sites where there is an inpatient requirement. For students in the MD/PhD cohort, this clerkship will take place toward the end of M3, so they should be pretty self-sufficient in interviewing/assessing/presenting patients. Students may be able to get a lot of their required procedures done during family medicine.

    Doing Well in the Family Medicine Clerkship

    This clerkship deals largely with the bread and butter of medicine, so reading up on common conditions (diabetes, hypertension, dyslipidemia, pharyngitis, etc.) is a good idea. This clerkship focuses more on preventative health measures than others, so students should ask patients if they are up-to-date on vaccinations (especially the flu vaccine), mammograms, pap smears, colonoscopies, etc.

    Shelf Exam

    This exam is not actually a Shelf exam; it is Penn State’s own test that is based on a series of computer cases, with more information on this delivered at orientation. Students who read the cases as they are supposed to will do fine on the exam.

    Good resources for the exam

    • Online cases – These are found online and are required for the rotation. Information is provided on these at orientation.
    • Blueprints – Pretty handy
    • Essentials of Family Medicine – Some students liked it; others didn’t. Helpful to read about specific clinical experiences.
    • NMS Family Medicine – A question-and-answer book that is pretty decent
    • Some students recommended using the same question books that were used for the medicine Shelf.
    Health Equity (Underserved Medicine) Clerkship Expand answer

    Overview

    The health equality clerkship is a program that requires Pennsylvania medical students to do a primary care rotation in an underserved area in the state. There are three geographical areas where students are sent: northwestern, northern central and southcentral portions of the state. Students may pick a region of choice, but should try to get a location as close to Penn State Health Milton S. Hershey Medical Center as possible within that region. Most students are sent far enough away from Hershey that they cannot commute every day, but luckily most sites will arrange housing for students.

    Exam

    This rotation does not have a Shelf exam, but Penn State has its own exam for it. The exam format will be like the IPA exams in M1/M2, so students probably don’t need to do any studying for it (especially if they have already had several other clerkships). This clerkship also has some extra assignments students must complete, including another patient project and several presentations. Students will get more information during M3, and will not be assigned to their specific location until a week or two before their health equity month begins. Some students have pretty relaxed experiences, and others are extremely busy for the whole month.

    Psychiatry Core Clerkship Expand answer

    Overview

    Psychiatry is four weeks long, and is a much more important clerkship than some students might think. In patient care, psychiatry is everywhere. Around one-third of inpatients will get confused, and students will need to determine if it is delirium, dementia, mental illness or simply old age. During this clerkship, students will gain exposure to thinking about the way people look and act when sick. They will also explore the sometimes-murky continuum of what qualifies as “normal” and “abnormal.” Since laboratory tests and scans cannot identify mental illnesses, a good physician learns to act as a diagnostic instrument by listening, examining, interacting, feeling and struggling with patients.

    The psychiatry clerkship may be a mix of inpatient and outpatient, with a fair amount of consults. A large number of hours in the weekday afternoons are dedicated to lectures and discussion groups on topics in psychiatry.

    Responsibilities as the Medical Student

    Typically, students will have one primary assignment in the inpatient psychiatric hospital setting or the consultation-liaison psychiatry service in the medical hospital, and then spend part of the day at substance abuse treatment groups, the inpatient consult service, an outpatient office and the electroconvulsive therapy suite. The hours on the psychiatry clerkship are generally 8 a.m. to 5 p.m., with one or two call nights during the month. Weariness comes more from the emotional toll of the work than from the amount of time spent on patient care. There is usually plenty of time to read and study.

    Doing Well in the Psychiatry Clerkship

    Students should be genuinely present, asking questions and remaining open to all answers that they may hear. They should make the effort to truly understand their patients and the meaning of human behaviors, and be curious rather than threatened. Also, students should find and print out a guide for how to write a psychiatry-specific H and P, because it is very different compared to other rotations.

    Shelf Exam

    The psychiatry Shelf is heavy on drugs and diagnosis. For drugs, studying should focus on specific drugs, not just classes. Students should learn the side effects and contraindications for each one. They will also need to essentially memorize parts of the DSM-IV, because the Shelf will ask them to make diagnoses based on very long clinical vignettes. Differentiating some of the diseases can be challenging.

    Good resources for the Shelf

    • The clerkship gives each student a copy of the DSM-IV manual and Psychiatry Case Files
    • First Aid – Most students polled used this text
    • Blueprints – Pretty good to supplement
    • Appleton and Lange
    • Pretest
    Third-Year Electives Expand answer

    Students have approximately two months of elective time during M3. Research electives count toward this requirement. Students can take a research elective if they need to finish thesis/paper revisions, or if they want to do research in another field; this can be a good idea for those who want to pursue a competitive residency but have never done research in that area.

    Students who take a research elective or start M3 late because of thesis delays will then have less time to explore different clinical electives.

    Roadmap for M4 Year

    Overview for M4 Expand answer

    See the full course calendar here.

    Phase 4 is tailored based on residency selection and individual interests, and includes acting internships, outside electives, humanities requirements, advanced basic science selectives and “Intern Boot Camp.”

    During M4, students have much greater flexibility in scheduling rotations than in M3. Required courses include neurology, humanities and two acting internships. Students have five months of elective time and are required to complete five electives total (including those in M3). Clerkships in M4 do not have Shelf exams (with the exception of neurology, which has an exam). Instead of spending their free time studying like they did in M3, during the M4 year, students will spending a lot of time on residency applications. M4 schedules must be approved by the residency adviser, including vacation blocks. M4 students are permitted one four-week vacation block. An MD/PhD vacation form should be completed prior to travel.

    When creating the fourth-year schedule, students should consider their timeline for residency application and interviews. Students will need to complete important electives and acting internships by August/September in order to get the relevant recommendations in time for residency applications. For the early Match, this timeline is even tighter. Also, students should consider when they will take Step 2 of the USMLE, as well as when peak residency interview months will be.

    Required Fourth-Year Clerkships Expand answer

    Acting Internships

    Acting internships are rotations where medical students act as first-year residents (interns). These essentially assess students’ ability to function as interns. During acting internships, students take on greater responsibilities and are given a set of patients for whom they are responsible. Students also round and take call just as the residents do, so the hours are usually pretty grueling.

    MD/PhD students will need to complete two acting internships during your fourth year: one surgical and one medical. Students should try to complete at least one of these as soon as possible so that they can use the recommendation for their residency application. Students who know they will be pursuing a surgical residency should be sure to complete the surgical acting internship by August/September and get a recommendation from it; the same goes for Medicine/Pediatrics residencies. A good recommendation from an acting internship is essential for the residency application.

    Humanities

    In order to graduate, students are required to fulfill one Humanities elective. Humanities is typically offered in September through November and February through April of M4 only. Each course has about 10 to 30 students, and the classes range from class discussions on end-of-life care to using art as a therapy for patients. Humanities courses are designed to be only half-time so that students can use the rest of the time for interviews or studying for Step 2.

    Attendance during M4 clerkships

    As in M3, attendance is mandatory during each M4 clerkship. Because it is the fourth year, students will have to worry about balancing their clerkship schedules with residency applications and interviews. During acting internships, students are allowed up to five days of excused absences (per month) for interviews. Because Humanities courses have classes only twice a week, students are expected to be able to work around the class schedule, and missing classes may put a grade in jeopardy.

    Unofficially, it is possible to negotiate with a clerkship director if the student will have to miss more than five days for residency interviews. There are few to no instances where a clerkship director has refused to excuse a student for an interview. Students should talk to their site-specific director for the rotation, not the Hershey director. Those who address the issue ahead of time and offer to make up the missed days will likely be able to work things out. Clerkship directors are especially lenient if the reason for missing days is to attend residency interviews in the same field. If applying to pediatrics residencies, then scheduling a pediatrics elective during an interview month may actually give more wiggle room. Students may have to make up for missed time by taking more call, or coming in on some extra weekends.

    Away rotations

    Doing rotations at other institutions is a great way to get a feel for how residency programs may vary within the same field as well as to evaluate a particular program. Doing an away rotation in the field to which the student is applying to shows how interested they are. Perhaps most importantly, away rotations can be a sort of extended interview for those who are particularly interested in a program, because if they know the student, that student will be more likely to be selected for an interview or ranked high on the Match list.

    Generally, it’s not essential that students do away rotations before submitting the ERAS application. Rank lists are submitted in mid-February, so any away rotations done up until February can help.

    Away rotation applications go through a web system called VSAS. In mid-M3, Diane Gill will activate each student’s VSAS access and send a password to get into the system. The student may then start filling out the application. Most schools participate in VSAS. The ones that don’t will have their own application process. Away rotations must be approved by the MD/PhD Residency Adviser.

    USMLE Step 2 Expand answer

    Step 2 of the USMLE has two components: Clinical Knowledge and Clinical Skills. Diane Gill in Student Affairs is the main contact person. Students will receive information in the mail or email explaining registration and locations for taking the exam. Details on exam fees are available here.

    Step 2 Clinical Knowledge (CK)

    The CK part of Step 2 is the written computer exam, much like Step 1. Step 2 CK is a one-day examination. It is divided into eight 60-minute blocks and administered in one nine-hour testing session. The number of questions per block on a given examination form will vary, but will not exceed 40. The total number of items on the overall examination form will not exceed 318. Students must take Step 2 by Dec. 31 of M4 in order to graduate from Penn State. Note that taking Step 2 before submitting residency applications is not necessarily required. Many residency programs will not wait to see an applicant’s Step 2 scores before they send out interviews.

    Deciding when to take Step 2 will depend on the type of residency to which the student is applying to as well as how competitive their Step 1 score is. If the Step 1 score is not great or just average, then the student will need to do well on Step 2 and have the scores back before submitting an ERAS application in order to be competitive for residencies.

    Many students even take a month of vacation during the summer after M3 to study for Step 2. Conversely, if the Step 1 score is very good, then that student could wait and take Step 2 later in the fall. But even for those who wait until the last possible day to take Step 2 (Dec. 31), residency programs will still receive Step 2 scores before they make their rank lists in February, so it is not an exam that can be ignored.

    In preparation for Step 2, most students use their review books from the Shelf exams, since the question formats are similar. Additionally, nearly all students recommend doing practice questions and full-length practice tests. Popular sources of practice questions are Kaplan and USMLE World.

    Step 2 Clinical Skills (CS)

    The CS component tests the student’s ability to complete a history, physical exam and assessment of patients. It is formatted much like the OSCEs that are taken at Penn State: Students will see standardized patients and do a complete workup of each one. Step 2 CS has 12 patient cases. The student will have 15 minutes for each patient encounter and 10 minutes to record each patient note. Students who do not use the entire 15 minutes for the patient encounter will have the remaining time added to the time they have to record the patient note. The testing session is approximately eight hours.

    Step 2 CS is not difficult. Students do not need to study for it, because experience in M3 clerkships will prepare them. Students should be sure to familiarize themselves with the format of the sessions and the structure of the patient notes that the test will require them to write; the OSCEs will help with this preparation. With that said, First Aid for Step 2 CS is an excellent review book for this test.

    Step 2 CS exams are only offered in certain locations around the United States. The closest site to Penn State is in Philadelphia. Students should schedule Step 2 CS as early as possible in order to get a spot in Philadelphia, because they fill up quickly. Those who are taking Step 2 CS elsewhere should expect to cover travel/lodging expenses for a day or two.

    Mentoring and Counseling During M3 and M4 Expand answer

    Dr. Leslie Parent, Dr. Raymond Hohl and Dr. Mark Stahl serve as the residency advisers for students in the MD/PhD program in M3 and M4. Any steering committee member with an MD may serve as a residency adviser. They advise students on arranging their clinical rotation schedules and applying for and seeking out residency programs. They help students explore the different types of residency programs that are available, including fast-track programs that provide clinical/research opportunities for physician scientists. Students and their residency advisers are required to meet at least once per year. Selections are indicated on the Return to M3 form, and recorded by the program office.

    Students who know what type of residency they will be applying to should find a mentor in that field. They should start by contacting the clerkship director for that program at Penn State; that person will help the student determine how competitive their application is and advise them on which particular programs to consider. The mentor may know which programs have the best research-track residencies. They can also give feedback on the personal statement. Advisers who are especially friendly may even call some program directors at other institutions to promote their advisees.

    The co-directors meet with students once or twice during M3 to discuss the transition to M3, and to review the student’s M4 schedule and plans for seeking out appropriate residency programs. During M4, the co-directors meet with students at least once to review their progress in the residency match process.

    M3/M4 is a very stressful time for students. Those who find that they need to talk to someone should contact Dr. Kelly Holder (kholder@pennstatehealth.psu.edu) of the Office of Student Mental Health and Counseling and Dr. George Blackall (gblackall@psu.edu) of the Office for a Respectful Learning Environment. They are available as a free, confidential resource for students.

    Students who are being treated inappropriately by a resident or attending on a clerkship or have a conflict that they would like to discuss should contact the ombudspersons. Those meetings are also strictly confidential.

    Roadmap to Residency

    Pre-Residency Overview Expand answer
    • Students should try to decide early in M3 what specialty they want to pursue. After that decision, students should plan ahead for the application process.
    • Each student should find a mentor in their chosen field to help them evaluate their application’s competitiveness for various programs.
    • Students should do important rotations/acting internships before September of M4 so they can get those recommendations.
    • Students should get as much of their application done in ERAS as early as possible, even if a few recommendations are missing or they haven’t taken Step 2. Many residency programs will start sending invitation interviews before applications are complete.
    • It is important for students to start saving money for interviews. Traveling gets expensive.
    • When evaluating programs on interviews, students should be sure to talk to the residents.
    The Match System Expand answer

    National Resident Matching Program (NRMP, known as the “Regular Match”)

    Most residencies and fellowships use the Regular Match through the National Resident Matching Program. In this system, ERAS applications open Sept. 1; interviews occur in November, December and January; rank lists are finalized in February; and Match Day is in March.

    San Francisco Match (the “Early Match”)

    A few residencies use the early Match (ophthalmology, urology and pediatric neurology). The early Match has an accelerated timeline, so applying to the early Match involves deciding on a specialty early in M3 and then being very proactive about getting the application materials together. Interviews will typically start in October and peak in November and December for the early Match.

    Couples Matching

    The couples Match is a system under which two individuals applying for residency in the same year can match to the same general city/area. Students can enter the couples Match with anyone they want – spouse, significant other or best friend. Going through this match can be difficult; if the student and their partner are applying to different residencies, the same institution may not have competitive residencies in both specialties. On the flip side, for those who are applying to the same residency, it can still be difficult to match to the same institution, especially small programs, because both would be taking vacation at the same time (thus reducing their workforce by two in the same week). Thus, generally the couples Match attempts to match a couple in the same geographic area, not necessarily the same city or institution.

    Application Process Expand answer

    The most important first step in the residency application process is to find a mentor in the chosen field. This will most likely be the residency program director for that specialty at Hershey (not the clerkship director), but students may find other mentors as well. A good mentor will tell the student what certain programs are looking for and how competitive their application is. They should also proofread the personal statement and give feedback. For students who are especially good candidates, they may also make some phone calls to programs on the student’s behalf. Students should seek out a mentor as soon as they decide on a specialty.

    Electronic Residency Application Service (ERAS)

    ERAS is like AMCAS for residency. Students can submit their ERAS application starting Sept. 15. Sometime in the summer after M3, the dean’s office will give each student a token number for their ERAS application. The student will be able to register with the MyERAS website starting July 1. After registering with MyERAS, students can fill out the application sections (education, work experience, community service, research experience, etc). As they fill this out, ERAS will create an electronic CV for each student that will be sent to residency programs. The student will then upload their personal statement(s) to the website.

    All recommendations get sent to the Student Affairs office. Students should be sure to provide their recommenders with their ERAS application number so that they can include it in their recommendation. The Student Affairs office will upload all recommendations to ERAS.

    The student will then add the programs to which they would like to apply. At this time, the student can customize which personal statement and recommendations they would like to send to each program. Students should try to have everything uploaded and all programs selected before Sept. 1 so that all they have to do is hit “Submit.”

    ERAS costs are according to the number of programs to which a student applies. This is a per-specialty cost, so those who apply to multiple specialties or need to have a preliminary year will be spending more. See ERAS fee details here.

    There are additional fees for USMLE transcript ($80, assessed once per season) and COMLEX-USA transcript ($80, assessed once per season).

    Selecting programs

    Each residency specialty has guidelines for the optimal number of programs to apply to. The more competitive residencies will require that students apply to more programs in order to be sure they match. For details about specific residency guidelines, see the section on residency profiles.

    Personal Statement

    A student’s personal statement is an important part of the application because it is the one area over which the student has complete control. It is where each student’s passion for medicine and research should show. Students will need to start writing it as soon as they decide on a residency specialty, and revise, revise, revise. It is essential that students give this to their residency mentor, department chair and the MD/PhD co-directors for feedback and proofing.

    In terms of the content of the personal statement, subtle differences may exist for what each specialty looks for. However, most residency directors will tell students to include the following information: What got them interested in the field they have chosen? What are they looking for in a residency program? What are their expected goals in the field they have chosen?

    As for writing style: Students are advised to be themselves, be specific and be brief (one page maximum).

    Each statement should tell the reader what the student’s interests are for specialty, and why those interests are what they are. To do this, students should pick a few specific examples of experiences they’ve had that will help to illustrate their ideas. Students don’t need to list all extracurricular activities (they are already in the application), but should just elaborate on one or two that really affected their career path or research interests.

    While the personal statement is the place to show uniqueness, it is not the place to be unique for the sake of the “wow factor.” For residency applications, professionalism and sincerity are the best routes to take. Students should be careful not to ramble. Readers will have to sort through hundreds, if not thousands, of personal statements, so each one should be kept to one page.

    Note that a student can have more than one personal statement, and will be able to choose which version each residency program receives. This is especially useful if applying to a very competitive specialty, such as dermatology, as well as a backup specialty; the student can then have two separate personal statements, one for dermatology programs and one for backup programs.

    Recommendations

    Different residency types and programs have different requirements for recommendations. Most programs ask for three recommendations, but will allow applicants to submit one or two additional recommendations.

    Students who connect with an attending on any given rotation should ask for a recommendation. Chances to create close relationships with attendings will be few during some rotations because the students rotate through so many clinics, and the assigned attending may change from day to day. Students never know what future rotations will be like, so if there is a chance to get a good recommendation, they should jump on it immediately. If an attending ever offers to write a student a recommendation before being asked, the student should by all means accept.

    Also, students should remember that they can upload as many recommendations to ERAS as they want. The student will choose which recommendations to send to each program they are applying to. It doesn’t hurt to have several to choose from, so when in doubt, students should ask for a recommendation. After the dean’s interview in the fall of M4, the dean will often hint to students as to which recommendations in their file sound the best.

    If a recommender knows how to write a good recommendation, they will ask the student for a copy of their CV, a draft of the personal statement, their ERAS token number and any other relevant materials. If they don’t ask for these materials, students should give them copies anyway. It’s sometimes helpful to include a small photo of the student, in case they procrastinate and then forget who they are writing about. They may ask the student if the recommendation should be focused or un-focused, meaning whether it should be written as though the student already know what specialty they want to pursue, so they can say “Sarah will be an excellent pediatrician,” or if it should be more general, like “Sarah will excel in any field she chooses; she will be an excellent physician.” Both styles have pros and cons; students should consult their residency mentor for guidance.

    Finally, students should always waive their right to read the recommendation. If a student is nervous about the contents, then they shouldn’t be asking that person for a recommendation. It is a red flag to residency programs if the applicant does not waive their right to read their recommendations.

    Who to ask for recommendations

    • The first recommendation should be the thesis research adviser. It will look odd not to have this.
    • There should be at least one recommendation from a physician in the field in which the student is are applying. However, for those applying to pediatrics, a recommendation from someone in medicine might suffice, and vice versa.
    • Some residencies (such as surgery and medicine) require a recommendation from the department chair at the student’s medical school. If applying to such a residency, students should get to know their Hershey department chair as soon as possible. Students should schedule a meeting with that person and let them know which faculty and residents at Penn State they’ve worked with during clerkships so that they can get to know the student from the feedback from these individuals.
    • The best recommendations come from people who really know the student – who they are, how they interact with patients/staff, how they handle pressure or long hours, etc. It is always better to choose the recommender who knows the student the best over the recommender who is just a big name in the field, but doesn’t know the student at all. The worst kind of recommendation is a generic letter.
    • When asking someone for a recommendation, students should also be sure to ask if the person feels that they can write an excellent recommendation. If they hesitate, or say no, students should take the hint and not press them for a recommendation, because it will likely be a bad one.

    When to ask for recommendations

    • The earlier, the better. Even students who are not sure which field they are going into should for a letter or recommendation early on. They can always choose not to submit it during the application should they decide to go into a different specialty. While each student only needs three to five letters for the application, the more options that are available, the better.
    • Students should ask for recommendations at the end of the rotation, while the attending still remembers who they are. Those who wait several months after their clerkship to ask for a recommendation may find the attending may not remember them.
    • For those who know they want to pursue a particular specialty, it never hurts to be up front about it while doing that particular clerkship. Students can mention that they are interested in Specialty X and would like to get a recommendation out of the clerkship.
    • Students do not necessarily have to have all recommendations uploaded to ERAS before September. As mentioned before, many residency programs will send out interview invitations before the application is complete.

    Interviews

    Once the application is submitted, students will be hearing from programs inviting them for interviews. This will typically start in November and peak in December/January for the regular Match. For the competitive specialties like ophthalmology and dermatology, most programs will only interview applicants on two or three dates, with some interviewing on one date only. It is imperative that students take a vacation month or a very light rotation during that time to make their schedules very flexible.

    Interview costs

    In addition to being time-consuming, the interview process will be expensive, so students should start saving as early as possible. Because many MD/PhD students apply to competitive residencies, they apply to a high number of programs and go on a high number of interviews. Many students have reported spending $5,000 to $12,000 on traveling/lodging for interviews. Nonetheless, students should plan on going to as many interviews as possible (as invited) to maximize their chance of matching. Students will need to buy an interview suit if they do not still have one that fits from their medical school interviews eight years ago.

    The Financial Aid office has information on banks that are willing to give personal relocation loans that can be used for interviewing costs, but the interest on those is often high.

    Interview preparation

    The interview experience takes some preparation, but it is not stressful as some students think. Regardless of how much preparation a student has done, the first one or two interviews will be difficult. Scheduling a mock interview before the first interview is a good idea, and can be done with the in-specialty or out-of-specialty adviser. There are lists of the common questions on the internet (“Tell me about yourself” or “Tell me about your research” or “Why do you want to be an ophthalmologist?”) Students should practice answering these ahead of time. They should also anticipate the unexpected questions. (“Tell me your two favorite kinds of beer and compare and contrast the two” was actually asked in an interview by a residency director who is a beer connoisseur.) Finally, students should always have a question ready for the interviewer; often the most difficult question on the residency interview trail is “Do you have any questions for me?” Students should ask a question, any question, even if they already found out the answer somewhere else, just to look interested in the program.

    Keep in mind that however much a residency program is “research-oriented,” the interview is still for a clinical position. Some interviewers will be straight clinicians who don’t care about an applicant’s PhD. By all means, students should ask about residency research opportunities on interviews, but the program’s residents may have more truthful answers than the interviewers.

    The Rank List Expand answer

    After going on interviews, students will rank their programs using the NMRP rank list. Registration with NRMP has a cost that gives the student:

    • Access to the NRMP site.
    • Processing of up to 20 different program ranks on the primary rank order list at no additional cost (for each additional program over 20, there is an additional fee per program).
    • Processing of up to 20 different program ranks on supplemental rank order lists at no additional charge, regardless of the number of supplemental rank order lists having combinations of those programs (for each additional program over 20, there is an additional fee per program).
    • Each partner of a couple may rank up to 30 different programs on the primary rank order list and up to 30 programs on all supplemental lists combined at no additional charge. Each partner of a couple also must pay a nominal additional registration fee.

    The final rank list is due in February of the student’s last year. Each student will rank programs in order of preference and enter them into the NRMP wesbite. Just like the rest of the application process, the order of programs is a very personal decision that may be based on geography, personal factors, professional factors, etc.

    The Match Algorithm Expand answer

    Generally, the more programs that a student ranks, the better chance they have of matching. The top reason that applicants do not match is that they did not rank enough programs. Students can only rank programs they have interviewed with; therefore, maximizing the number of interviews will help maximize the chances of matching.

    While the student is creating their rank list, residency programs also create theirs, ranking the candidates that they interviewed in order of preference. Then, a computer algorithm matches applicants and programs. The NRMP website offers details on this process.

    The match process matches each applicant with one program. This program that the student matches to is the program at which they will do their residency. The match system is legally binding, and if a student decides that they do not want to attend the program that they matched to, there may be legal ramifications that will affect their medical career. Therefore, students who do not want to attend a particular residency program should not include it on their rank list.

    Match Day Expand answer

    Match Day is the day when every medical student in the United States participating in the regular Match finds out at the same time where they have matched for residency. Match Day is always the third Friday in March.

    All M4s are together in one lecture hall; envelopes are passed out to each student; and everyone opens their envelope at noon EST. Many schools, including Penn State, have big parties on Match Day to celebrate. Penn State’s Match results are posted outside of the Student Affairs office on Match Day and shared online so that everyone can see them.

    For Those Who Don't Match Expand answer

    As of March 2012, for individuals who were not matched to a residency position, the NRMP (National Resident Matching Program) debuted the Supplemental Offer and Acceptance Program (SOAP), a process developed in partnership with the Association of American Medical Colleges and in consultation with student affairs deans, residency program directors, resident physicians and medical students.

    Designed to help streamline, equalize and automate the process for students who are not matched initially, SOAP replaces the “scramble,” the unofficial name for the period of time during Match Week when unmatched applicants contact programs with unfilled positions.

    Under SOAP, the NRMP makes available the locations of unfilled positions so that unmatched students can submit applications for these positions through ERAS. After receiving applications through ERAS, residency program directors create a list of candidates in order of preference, and the NRMP offers positions in that order in a series of up to eight rounds. Applicants are able to receive multiple offers in a single round; if an offer is accepted, it is binding.

    Transition to Residency Expand answer

    At the end of M4, students must check the graduation requirements for Penn State to make sure that they have covered everything. Aside from completing their last rotations and going through one last Island week before graduation, there is not usually anything outstanding to take care of. Then, of course, students will be thinking about moving to their residency location – finding a place to live, moving, changing their driver’s license and other tasks.

    It is a good idea to check the USMLE rules of the state of the residency, since some states have different rules. Most states require that a student take Step 3 within seven years of taking Step 1. This means that a student must take Step 3 before their second year of residency. This is not usually a problem, since most residents take it at the end of PGY-1 or the beginning of PGY-2; it’s just important to keep the time frame in mind.

    Additional Information

    Clinical Research Conference Guidelines Expand answer

    Mission Statement

    The goals of clinical research conference are to:

    • expose students to a variety of clinical and research specialties across the University;
    • provide continued clinical exposure to those students in their graduate training;
    • develop specific examples of how to integrate and translate basic science into clinical practice; and
    • provide a forum to bring students from all years of the program together to engender peer mentoring, camaraderie and program unity.

    Scheduling

    Clinical research conferences are held every other month on the same day as the monthly MD/PhD lunch seminar, which typically falls on the second Thursday of the month. Clinical research conference occurs over the dinner hour. Food is provided starting at 5 p.m., with presentations starting promptly by 5:15 p.m. and concluding by 7 p.m. Scheduling of presentations is overseen by a student chair at the end of every academic year. All students in their graduate years are required to participate each year. The student chairperson maintains the right to re-assign people to different slots to follow the conference format. Graduate-year students will have one week to sign up for presentation slot, after which time they will be assigned. Once assigned to a time slot, students are responsible for resolving any scheduling conflicts among their peers and reporting changes to the student representative.

    Selecting a Faculty Clinical Research Conference Mentor

    In preparation for clinical research conference, the student team should identify and contact a faculty member who can facilitate a hands-on clinical experience and direct further investigation into scientific literature. The name of the mentor and department should be updated on the schedule once the mentor has agreed to participate.

    Typically, students meet with their mentor three times. In the first meeting, the mentor will provide students with an introduction to the clinical topic, schedule a clinical experience based on their patient schedule, and suggest relevant review articles and basic science literature. The second meeting is the clinical experience itself, in which students learn the details of the particular clinical case, while having the opportunity to observe and participate in patient care, at the mentors’ discretion. MD/PhD students are encouraged to inquire about opportunities to practice history and physical examination skills during this clinic day, so that it may satisfy a Clinical Exposure Program requirement. The third meeting is strongly encouraged, but can often be coordinated over email. Students should send their presentation materials to their faculty mentor at least two weeks before their presentation for review and input.

    Finally, the faculty mentor is expected to attend the actual conference, where they can answer questions about the case, their specialty, area of research and training path. Students who are having difficulty identifying a suitable mentor should reach out to the CRC operational committee.

    Conference Format

    MD/PhD students in the graduate school years work in a team of three students to present a clinical case under the mentorship of a student-selected faculty mentor. Each conference session is approximately 90 minutes in length. Each student presents a 20-minute segment of the conference, which is then rounded out with a faculty mentor presentation of 10 to 20 minutes that shares information about specialty, training path and how to integrate research into clinical practice. The end of the presentation period is reserved for questions from students and faculty in attendance.

    Presenter 1: 20-minute clinical case presentation (G3 or higher)

    • Presentation should include history of present illness (HPI), past medical history for the patient, pertinent lab results, radiology and other imaging studies, as well as any other necessary information.
    • If the patient does not have pathology or radiology images available, the student should work to find substitute images to incorporate in the presentation from literature. Consult Robbins Pathology.
    • The student presenter of the clinical case should make every attempt to engage audience participation in clinical reasoning and problem-solving, including developing a differential diagnosis.

    Presenter 2: 20-minute pathophysiology presentation (G1 to G3)

    • Presentation should include background and pathophysiology for the patient discussed by Presenter 1.
    • Make sure to include relevant treatments in the presentation, including a discussion of mechanisms of action of these drugs or other interventions such as surgical procedures, radiation, etc.

    Presenter 3: 20-minute primary research article/literature discussion (G1 to G3)

    • The article may involve basic or translational research. The student should not present a paper describing only a clinical study. If the clinical research conference faculty mentor suggests presenting a purely clinical paper or from a journal of lesser impact, the student should reach out to Dr. Aron Lukacher for assistance in identifying a suitable solution.
    • The caliber of the paper is more important than whether it is directly related to the differential diagnosis. In most cases, the article will come from a high-impact, peer-reviewed journal and will be reviewed by the clinical research conference faculty mentor.

    Presenter 4: 10- to 20-minute career trajectory (faculty mentor)

    • The student team should communicate with their selected faculty mentor that their attendance is required at clinical research conference. Additionally, students should ask their mentor to prepare a succinct presentation about their clinical and research careers. Suitable topics for discussion include a general overview of their training or career trajectory, daily life as a physician-scientist, overcoming career hurdles, or any other interesting information about their training, education, funding options and career options.
    Clinical Exposure Program Guidelines Expand answer

    The Clinical Exposure Program is a medical education and mentorship program that provides MD/PhD graduate students the opportunity to maintain their clinical skills and explore different specialties under the mentorship of a physician scientist.

    Mission Statement

    The goals of the Clinical Exposure Program are to facilitate the continued development of clinical skills, expose students to specialties that integrate medicine and biomedical research, and provide a platform for students to practice Grand Rounds-style case presentations.

    Program Requirements

    Attendance

    • Attendance and participation in Clinical Exposure Program is mandatory for all graduate-year MD/PhD students.
    • Students are expected to attend nine half-day clinic sessions with their Clinical Exposure Program mentor over the course of the year, and one clinic session with their Clinical Research Conference mentor.
    • Students can choose to attend one Clinical Exposure Program session every month or two sessions (one full day in clinic) every other month.
    • Students are expected to actively participate in patient interviews and physical exams.
    • Students should record their attendance on the Clinical Exposure Program log, available through Canvas.
    • Students should communicate their Clinical Exposure Program schedule to their doctoral thesis research mentor, so that mentors can anticipate absence from lab and support student participation in Clinical Exposure Program.
    • Failure to comply with attendance requirements will result in disqualification from consideration for MD/PhD and graduate school awards, including travel awards.

    G1 students

    • First-year graduate students are expected to attend a minimum of five half-day clinic sessions.
    • The program recognizes that graduate school class schedules often overlap with clinic schedules, so G1 students have the option to count participation in LionCare toward their Clinical Exposure Program requirement.

    Selecting physician mentors

    • It is the student’s responsibility to identify a physician mentor. An approved list of training faculty mentors and an email template to contact faculty is provided in Canvas, but students are free to identify physicians not on the list.
    • Students should identify their mentor for the year during the spring semester, and selected mentors should be reported to Dr. Sheldon Holder by June 1.
    • Those who are not successful in finding a mentor by this date should contact Dr. Sheldon Holder for assistance.
    • Students are encouraged to select physician mentors in different specialties each year.

    University Park students

      First-year graduate students are allowed to count participation in free clinics in State College toward their Clinical Exposure Program requirement.
    • Students are encouraged to select physician mentors from Penn State Health in Hershey, but mentors are also available in University Park.
    • Off-campus students are encouraged to schedule their Clinical Exposure Program clinic days to coincide with MD/PhD lunch seminar and Clinical Research Conference dates.

    Off-campus students

    • Students who elect to complete PhD thesis work at a different campus are encouraged to ask their thesis mentors and the MD/PhD co-directors for help identifying suitable physician mentors.

    Annual clinical compliance requirements for student health care providers

    • Influenza vaccine
      • Flu shot clinics are held yearly every September and October for students on campus. Vaccines are free of charge for all MD/PhD students in both medical and graduate training.
      • Students who miss scheduled flu shot clinics should contact Student Health at 717-531-5998 for an appointment to receive the vaccine at 845 Fishburn Road in Hershey.
    • PPD skin test
      • PPD clinics are held for medical students on a class-by-class basis. Graduate-year MD/PhD students are responsible for contacting Patty Hamner, Student Health nurse, at 717-531-5598 to schedule an appointment for PPD placement and reading.
    • Online annual infection prevention training
      • Annual infection prevention training should be completed annually through Compass.
      • Annual infection prevention training may not necessarily be assigned to the student’s queue or transcript in Canvas. If this is the case, students should click on “search training” and type “annual infection prevention.” The most recent training module will be available.

    Contact Information

    Questions and comments regarding Clinical Exposure Program should be directed to:

    Sheldon Holder, MD, PhD
    Faculty representative
    sholder@pennstatehealth.psu.edu

    Alison Smolinski
    MD/PhD program administrator
    als529@psu.edu

    Patty Hamner, Senior LPN
    Student Health nurse, Fishburn Family Practice
    phamner@pennstatehealth.psu.edu

    Physician Scientist Student Association Expand answer

    The Physician Scientist Student Association is the governing body for all dual-degree MD/PhD students enrolled at Penn State College of Medicine. The purpose of this organization is to acknowledge, represent and address the unique needs of dual-degree MD/PhD students in the Medical Scientist Training Program at Penn State College of Medicine. This student organization organizes both professional and social events to facilitate vertical integration among all years of the training program, as well as service to the program through student recruitment.

    Elections will be held each year, during the Spring MD/PhD Program Retreat in University Park. Election operations and ballot-counting are ideally to be overseen by an officer who is not seeking re-election. MS4 students graduating from the program who have previously served in leadership positions in the association would be suitable ballot counters and/or unbiased election facilitators. Students are able to run for a maximum of three leadership positions.

    All officers are expected to attend all scheduled officers’ meetings as well as general meetings. There shall be a minimum of one general assembly meeting per semester. There should be a minimum of one officer meeting per semester with additional meetings held as necessary and on the basis of subcommittee needs (e.g., recruitment team meeting, retreat planning meeting).

    All officers’ meetings will be scheduled at least two weeks in advance, and officers will be notified via email. The president will set the agenda for executive board meetings, although any officer may add an agenda item by emailing the president within one week of the scheduled meeting. Student officers unable to attend an executive board meeting or a general assembly meeting should contact the president about their absence and copy the secretary. Repeated lapses in attendance may result in dismissal from your leadership position.

    The Physician Scientist Student Association executive board will consist of a minimum of 19 officer positions that will work together to enhance the atmosphere, morale and programming initiatives that benefit student trainees in Penn State’s Medical Scientist Training Program. In the case of executive board initiatives or decisions that require a vote, student officers will be given one vote, regardless of how many positions they hold. These leadership positions and their responsibilities include, but are not limited to, the following:

    President

    • Collaborate with Medical Scientist Training Program co-directors, assistant directors, steering committee, training faculty and program administrator to provide student insights to develop and improve the program.
    • Be a positive and encouraging role model for other MD/PhD students.
    • Work with program administrator Alison Smolinski to schedule meeting and event spaces.
    • Call and preside over general assembly meetings of all student Physician Scientist Student Association members.
    • Call and preside over executive board meetings of all Physician Scientist Student Association officers.
    • Email agendas for general assembly and executive board meetings one week prior to the scheduled event.
    • Provide assistance to all Executive Board officers, sub-committees and chairs to support student recruitment activities, compliance and maintenance of the Clinical Exposure Program, scheduling of seminar/clinical research conference and MD/PhD retreats.
    • This position is recommended for a student in a graduate year of the program who has previously served in a Physician Scientist Student Association leadership position.

    Vice President

    • Collaborate with the Medical Scientist Training Program co-directors, assistant directors, steering committee, training faculty and program administrator to provide student insights to develop and improve the program.
    • Be a positive and encouraging role model for other MD/PhD students.
    • Work closely with the Physician Scientist Student Association president to support the mission and activities of the association.
    • Provide assistance to all Executive Board officers, sub-committees and chairs to support student recruitment activities, compliance and maintenance of the Clinical Exposure Program, scheduling of seminar/clinical research conference and MD/PhD retreats.
    • This position is recommended for a student in a graduate year of the program who has previously served in a Physician Scientist Student Association leadership position.

    Secretary

    • Work with program administrator Alison Smolinski to maintain an accurate and up-to-date list of student contact information.
    • Create a Physician Scientist Student Association student email group with contact information. Information should be kept current.
    • Help maintain the College of Medicine MD/PhD Facebook group, posting Physician Scientist Student Association content and adding new students to the group.
    • Email meeting minutes from general assembly Physician Scientist Student Association meetings to students.
    • Email meeting minutes from executive board meetings to officers.
    • This position is recommended for a student in a graduate year of the program. No previous leadership experience is required.

    Treasurer

    • Collect and maintain organized records of monies associated with Physician Scientist Student Association events. Examples would include fundraisers such as apparel sales.
    • Maintain an Excel spreadsheet of all transactions, including expenses.
    • Work with Graduate Education financial manager, Physician Scientist Student Association president and social chair to craft budgets for social events, including holiday parties, etc.
    • This position is recommended for a student in any year of the program. No previous leadership experience is required.

    Historian

    • Attend and photograph MD/PhD student events, including, but not limited to, retreats, seminars, clinical research conferences and social events.
    • Collaborate with the newsletter committee to provide content for the Medical Scientist Training Program newsletter.
    • Upload and share images of MD/PhD events in the Facebook group.
    • Suggest changes to website via program administrator.
    • This position is recommended for students in any year of the program. No previous leadership experience is required. Camera ownership and/or photography skills are a plus.

    MSTP Retreat Chair

    • Solicit student feedback on retreat programming and speakers.
    • Meet with program co-directors and program administrator to share ideas for venue, date and speaker preferences for the upcoming year.
    • Outline retreat tasks, timeline and responsibilities with oversight from program administrator and Graduate Education director. (Program administrator oversees day-of-retreat operations and event execution.)
    • Work with program administrator Alison Smolinski to coordinate speaker travel arrangements and lodging.
    • Schedule retreat planning committee meetings.
    • Train successors and maintain materials from retreat planning in Google Drive for records and future use.
    • This position is recommended for a student in a graduate year of the program. Prior experience on the Retreat Planning Committee is recommended. Prior leadership in the Physician Scientist Student Association would also be helpful.

    MSTP Retreat Planning Committee (three members)

    • Work with program leadership to create a retreat agenda and unique programming that will engage and benefit student trainees.
    • Reach out to potential alumni, keynote and Penn State speakers with oversight from program administrator and Graduate Education director.
    • Design a retreat program booklet containing biosketches for speakers and information about events.
    • Solicit case presentations, student poster presentations and MS4 participation in Match/residency panel.
    • This position is recommended for rising M2 and graduate-year students.

    Student Recruitment Chair

    • Serve as the main point of contact for the program administrator (Alison Smolinski) in coordinating MD/PhD interview days for program applicants.
    • Reach out to current students to find hosts for applicants, to ensure student escorts for interviews during the day on Monday of interview weeks, and to identify students in the current MS1 class who are able to attend the Monday interview lunch.
    • Attend Sunday recruitment activities with prospective applicants (e.g., on-campus tour, visit to Chocolate World, dinner at Houlihan’s.
    • Coordinate second-look day weekend events, recruiting current student involvement with program administrator.
    • This position is recommended for rising G1 and G2 students who have previously served on the student recruitment committee. It is required that the student must be at the Hershey campus to facilitate day-to-day planning of interview days with Alison Smolinski and also oversee interview weekends in Hershey.

    Student Recruitment Committee (three members)

    • Assist the recruitment chair in finding hosts for applicants.
    • Attend Sunday interview activities (e.g., on-campus tour, Chocolate World, Dinner at Houlihan’s)
    • Help escort students to their interviews on Monday during the day.
    • Attend the Monday lunch to mingle and answer questions.
    • Participate in planning and also attend second-look day events.
    • This position is highly recommended for MS2s. Students in this position should make every attempt to attend all interview weekends.

    Seminar and Clinical Research Conference Chair

    • Meet with program co-directors and program administrator Alison Smolinski to determine an annual schedule for seminar and clinical research conference presentations.
    • Assign lunch seminar presentations and clinical exposure program Grand Rounds presentations.
    • Administer student signups for clinical research conference presentation groups.
    • Communicate expectations for aspects of presentation (e.g., time, components, etc.) and award opportunities (e.g., Notterman Award for Clinical Research Conference and Case Presentation Award for Clinical Exposure Program Grand Rounds presentations).
    • This position is recommended for students in a graduate year of the program. No prior leadership experience in the Physician Scientist Student Association is required.

    Student Representative to the Medical Scientist Training Program Steering Committee (two members)

    • Attend steering committee meetings when and where appropriate.
    • Voice student feedback and concerns to faculty and program administrators.
    • Review and verify steering committee summaries posted on Box.
    • Attend interview day lunches with the applicants (no hosting or attendance at Sunday’s events).
    • This position is recommended for students in their G2 or G3 years. Ideally, these representatives should represent both on-campus (Hershey) and off-campus students.
    • Terms for the steering committee are two years in duration.

    Social Chair (one or two people)

    • Plan social events to promote vertical integration, including welcome activities for new students, holiday parties, happy hours, “tea times” in the program office, etc.
    • Generate ideas for fundraising initiatives or community service initiatives.
    • Work with the treasurer to determine the budget available for events and receive reimbursement for social gathering supplies from program funds. Alison Smolinski will assist.
    • This individual should be outgoing.
    • This is an ideal position for any year in the program.

    Clinical Exposure Chair

    • Meet with Dr. Sheldon Holder and program co-directors to review annual program guidelines and compile a list of approved physician mentors.
    • Work with program administrator Alison Smolinski to design a program log that is available on Canvas and monitor program participation.
    • Communicate program guidelines and expectations.
    • Encourage participation among peers.
    • This position is recommended for students in their graduate years of the program.

    Newsletter Committee (one or more)

    • Work with program administrator to send relevant content to marketing team.
    • Meet with program administrator to finalize content sent to marketing for layout and web design.
    • Work with program administrator to gather alumni email addresses for distribution list.
    • Review, edit and distribute an MD/PhD newsletter twice a year. This includes overall organization and timing of the newsletter.
    • Solicit information from program administrators, directors, alumni and students.
    • This is an ideal position for a student in any year in the program.

    American Physician Scientist Association Institutional Representative (two)

    • The American Physician Scientist Association (APSA) is a national, student-run organization with more than 1,300 members that strives to be the student’s leading voice for improving educational opportunities, advancing patient-oriented research, and advocating for future translational medicine. The institutional representative is a critical member of APSA as a whole because they serve as a means for communication for APSA’s larger initiatives and goals.
    • Work with program administrator Alison Smolinski and program co-directors to determine student membership in the College’s institutional chapter. Penn State’s Medical Scientist Training Program purchases a yearly institutional membership to APSA that has 10 student member slots.
    • Advocate during the selection process for student members who plan to use APSA benefits, such as discounted registration to the national APSA meeting in Chicago. Students approved for slots in APSA must be in good standing in the Medical Scientist Training Program, which includes, but is not limited to, active participation in Clinical Exposure Program for G-year students and no outstanding academic issues in medical or graduate school. APSA student members should have a strong desire to attend the national meeting to present their research.
    Travel/Vacation Policy Expand answer

    Students in graduate school must clear travel/vacation requests with their lab mentor and abide by University policies for Graduate Assistants.

    Students in medical school must clear travel/vacation requests with co-directors prior to travel by utilizing the program travel request form (same form used for professional development requests) found in Box.

    Students in M4 must receive permission from their residency adviser prior to travel.

    Travel forms are not required for holidays and campus closures. If travel impacts a student’s ability to attend a mandatory program event such as clinical research conference or seminar, the student should use the travel form and request permission to miss a mandatory event.

    For students at off-site locations (UP, etc.), the program is reviewing University policies regarding travel for required events and will provide updates when available.

    Attendance Policy Expand answer

    All students in the MD/PhD program are required to attend a minimum of 90 percent of all MD/PhD-specific events during the academic year. This includes MD/PhD seminars, clinical research conference and responsible conduct of research activities. Program retreats are mandatory and are not included in the 90 percent attendance minimum.

    Students who need to miss a program event must inform the program directors at least two weeks in advance so they may consider the request. Exceptions to the two-week notice include illness or weather-related reasons. Missing 10 percent of events without approval is not permitted.

    Failure to comply with this policy will make students ineligible to receive any academic awards or travel funds. Those out of compliance will also be required to appear before the MD/PhD steering committee and explain in person the failure to comply with this policy. Continued absences from program events could ultimately result in dismissal from the MD/PhD program for unprofessional behavior.