Clerkships

Clerkship rotations provide third and fourth year students in Penn State College of Medicine the opportunities for clinical experiences after spending the first two years of medical school primarily in a classroom. During this training, students are required to rotate through different medical and surgical specialties and interact with patients under close physician supervision. Students review patient histories, complete physical examinations, write progress notes, and sometimes assist in surgeries and medical procedures. Hours are that of a full-time job, similar to residents. Students may also be required to work on weekends and be on-call.

For the last few years, Penn State College of Medicine faculty at University Park, as well as physicians from Mount Nittany Physician Group and the community, have teamed together to create eight clerkships for Penn State medical students.

Curriculum

Clerkship site directors at University Park have worked with clerkship directors at the Medical Center in Hershey to develop an equivalent curriculum on both campuses. The learning experience at University Park has been somewhat adapted based on the unique resources of a regional campus.

Simulation Laboratory

In collaboration with Penn State School of Nursing, regional campus medical students have access to a state-of-the-art simulation laboratory at University Park. Learn more about the SimLab at the Penn State College of Nursing’s website.

Overview

Goals

  • Integrate basic science and clinical knowledge, applied to patient care
  • Learn skills important in Family Medicine
  • Experience, first hand, the practice of family physicians – focused on both preventive and chronic care, as well as acute care for family members of all ages with diverse types of medical problems

Enrichment Program

  • Surgical procedure training
  • Use of dermoscopy
  • Disaster medicine
  • Hospice care
  • Opportunity to develop a publication in conjunction with regional campus faculty
  • Each student is assigned to a specific family physician mentor to ensure an excellent learning experience

Overview

 

Goals

  • Immersion in acute inpatient medicine
  • Become part of a highly functioning inpatient hospitalist team with direct, one-on-one interaction with attending physicians
  • Understand the multidisciplinary approach to inpatient medical care
  • Understand inpatient experience from the patient perspective by accompanying assigned patients to various testing and treatment modalities
  • Exposure to procedures performed by primary team and various sub-specialties at Mount Nittany Medical Center and Penn State Milton S. Hershey Medical Center
  • Practice and master the art of bedside presentation
  • Participate in a series of teaching conferences via distance learning and live at Mount Nittany Medical Center

 

Overview

  • Required 4th year core rotation
  • 4 weeks in length
  • Direct inpatient and outpatient neurological evaluation and care
  • Students are not required to take call, but optional call can be arranged

Goals

  • Learn to independently form neurologic assessments of new patients
    • Neurologic history and examination
    • Diagnostic impression and treatment plan
  • Exposure to a variety of neurologic conditions with video lectures and expanded case studies
    • Stroke
    • Seizure
    • Parkinson’s Disease
    • Multiple Sclerosis
    • Peripheral neuropathy
    • Dementia
    • Migraine
    • Chronic pain
  • One-on-one learning with neurologists

Typical Schedule

Overview

Knowledge Goals

  • Approach to and critical components of OB/GYN history taking
  • Physiologic changes of pregnancy, and its relationships with other medical disorders
  • Principles of antepartum care
  • Principles of intrapartum management
  • Physiologic ovulatory cycle, and how it is evaluated and therapeutically manipulated
  • Common gynecologic disorders
  • Pelvic anatomy as illustrated in the operating room
Technical Goals
  • Perform an OB/GYN history and physical
  • Perform a complete pelvic exam observed by faculty
  • Observe and participate in pelvic surgery
  • Perform phlebotomies, IV insertions, catheter insertions, pelvic exams, wet preps

Overview

  • Required core rotation
  • 6 weeks in length (3 week rotations in inpatient and outpatient settings)

Inpatient Rotation (On-call 1-2 nights/week)

Outpatient General Pediatrics

  • Acute cases
  • Well-child and sports physicals
  • Hearing and vision screenings
  • Triaging

Outpatient Adolescent Medicine

Goals

  • Standards of normal growth and development of infants, children and adolescents
  • Principles of preventive pediatrics
  • Recognition, evaluation, and management of common presenting complaints, common chronic disorders, significant physical findings and diagnostic test results in infants, children and adolescents
  • Gain and practice pediatric history and physical exam skills
  • Recognize and appreciate the importance of the roles of the family and the community in shaping a child’s future and the role of the pediatrician in the comprehensive care of children and adolescents

Objectives

  • Obtain comprehensive newborn, pediatric and adolescent medical histories
  • Perform complete and accurate physical examinations in newborns, infants, children, and adolescents
  • Differentiate normal from abnormal physical and social development in infants, children, and adolescents
  • List methods of disease and injury prevention in the pediatric age group
  • Describe symptoms, physical signs, evaluation and management of the common acute and chronic diseases of childhood (as defined in the COMSEP curriculum)
  • Create an assessment, problem list, differential diagnosis, and initial evaluation and management plan for common presenting complaints in pediatric patients
  • List common disorders of the newborn infant
  • Recognize common congenital anomalies
  • Attend newborn deliveries and c-sections to learn initial assessments, newborn care and resuscitation

Overview

  • Required core rotation
  • 4 weeks in length
  • Inpatient rotation on behavioral health unit and consult service at Mount Nittany Medical Center
  • Outpatient rotation in several areas based on student interest:
    • Adolescent partial hospitalization program – home nursing with academic
      learning for children too ill for school
    • Autism program – spectrum of disorders
    • Child and adolescent outpatient health at SunPointe Health
    • Inpatient drug and alcohol program

Goals and Objectives

  • Become clinically adept at performing psychiatric evaluations, formulating a differential diagnosis and developing a treatment plan using a biopsychosocial approach to patient care
    • Elicit and clearly record at least two complete psychiatric histories including all relevant sections, as well as mental status exam, differential diagnosis and treatment plan
    • Perform at least one mental status exam in the presence of an attending physician, successfully covering all primary components
    • Accurately use all five axes of the DSM-IV in recording a diagnosis
    • Identify general signs and symptoms (diagnostic criteria) for common mental illnesses in each of the major categories of the DSM-IV
    • Demonstrate the ability to form a positive therapeutic alliance with the patient during psychiatric interview
  • Develop a solid knowledge base in the specialty of psychiatry, prepared to address the biopsychosocial issues in any field of medicine
    • Document clinical interaction with at least one patient for each of the categories of mental illness listed in New Innovations and explain how the patient meets the criteria for each illness
    • Obtain a passing score (equal to or greater than the 10th percentile) on the psychiatry SHELF exam given at end of rotation
    • Demonstrate familiarity with use of psychotropic agents, ECT and basic psychotherapy techniques during clinical experience
  • Appreciate psychiatry as a branch of medicine and how mental health issues play an important role in overall patient care
    • Explain the role of “medical workup” in the evaluation of patient presenting with psychiatric problems and how psychiatric signs and symptoms can be the result of a medical illness
    • Discuss how mental health factors can affect the course of hospitalization for patients on general medical/social services

Overview

  • Required core rotation
  • 8 weeks in length
  • Four week rotation on general surgery and four weeks on specialty surgeries based on student interest
  • No formal on-call requirement

Goals

  • Develop adequate knowledge, basic technical skills, and attitudes about surgical disease
  • Display professional behavior and function effectively as a member of surgical team, often serving as first assistant with hands-on exposure in operating room at Mount Nittany Medical Center
  • Recognize surgery as a specialized area of knowledge, practice, and research dealing with evaluation, medical management, and invasive treatment of patients with injuries and surgically treated diseases
  • Evaluate, provide initial care, and consult surgical specialists appropriately for patients with injuries and surgically treated diseases (describe natural history, pathology, and pathophysiology)
  • Exposure to da Vinci robot technology
  • Outline the relevant anatomy and expected outcomes for commonly performed surgical procedures, as well as the indications and risks
  • Discuss principles of preoperative, intraoperative, and postoperative evaluation and care
  • Develop independent learning skills

Overview

  • Required core rotation
  • 4 weeks in length
  • Core concepts of comprehensive and longitudinal care in rural setting

Goals

  • Learn the principles of primary health care by participating in the care of at-risk populations to improve clinical skills and patient care in ambulatory settings, especially limited health care environments.
  • Explore the complexity and diversity of health care needs in these community settings to understand the integration of health and public health issues.
  • Develop an appreciation for the complexity of systems-based care to understand efficient clinic operations.
  • Develop and refine the following clinical skills related to the primary care setting: patient interviewing, physical examinations, patient management, patient education, and health promotion to provide quality health care services.
  • Develop and refine communications skills in challenging patient encounters to improve compliance with clinical interventions and maintain professional integrity in physician-patient relationships.
  • Emphasize the core concept of practice-based learning and improvement through self-directed learning to advance lifelong learning skills.

Additional Resources