The clerkship phase includes the clerkship intersession course, six required core clerkships, and a selective block.
This phase of the curriculum begins with the clerkship intersession course, which offers content designed to prepare students for the clerkship experience. Subsequent intersession weeks are regularly interspersed throughout the clerkship phase, occurring at the conclusion of each clerkship block. These weeks focus on case-based learning based on the six threads and UCD 43, objective structured clinical examinations (OSCEs), and professional identity formation work with coaches. The core clerkships are in Family and Community Medicine, Internal Medicine, Obstetrics/Gynecology, Pediatrics, Psychiatry, and Surgery. The clerkships consist of a mixture of inpatient and ambulatory rotations on various services that provide in-depth, supervised patient care experiences. During the six-week selective block, students choose a combination of 2-, 4-, or 6-week courses from a menu of clinical selectives, clinical didactics, advanced clinical clerkships, and/or research as a means of customizing their educational experience.
Successful completion of this curricular phase entails passage of the six core clerkships and the clerkship intersession course. Some or all of the six-week selective block can be postponed until the post-clerkship phase, but completion and passage of all six weeks of selective time must be accomplished before graduation
In this clerkship, students learn the fundamentals of diagnosis and management of the most common health issues and medical problems, and how health care in the community is related to social, cultural, educational, economic, and environmental factors. Curative and preventive medicine and health promotion and rehabilitation are also covered, with a person-, family- and community-centered approach to patient care. Students will learn how primary care is provided, with exploration of the relationship between primary care physicians and other specialties.
In this clerkship, students learn to take care of adult patients with a variety of medical conditions. Under supervision, students assume the role of physician and take histories, perform physical exams, formulate differential diagnoses, write orders, and perform routine procedures. Students are encouraged to think critically and develop differential diagnoses, diagnostic outlines, and management plans for the patients they follow. Instruction in routine diagnostic and therapeutic procedures is provided. Indications, contraindications, and risks of these procedures are emphasized. This experience includes frequent written and oral presentations of patients and stresses the importance of working as a member of the health care team. Students attend department conferences and lectures and follow their assigned team's schedule.
In this clerkship, students recognize, understand, and address sex- and gender-related differences as they relate to the health of individuals and populations. Students develop an understanding of obstetrics and gynecology as a fast-paced surgical specialty that also provides longitudinal patient care in diverse settings. The clinical experience consists of inpatient and outpatient obstetrics (labor and delivery, high risk obstetrics clinics) and inpatient and outpatient gynecology (gynecologic surgery, ambulatory gynecologic specialty clinics).
In this clerkship, students acquire the knowledge, skills and attitudes necessary to provide quality healthcare to children regardless of ultimate specialty choice, explore how the medical care of children is different from that of adults, and experience some of the breadth of pediatrics, from primary care pediatrics to pediatric subspecialties, so students can decide if they are interested in a career in pediatrics.
In this clerkship, students are provided with experiences and knowledge that underlie psychiatric diagnosis and therapeutics. The goals are to develop clinical skills in psychiatric diagnosis, treatment, and referral. The emphasis is on routine patient management, psychiatric differential diagnosis, interviewing skills, the mental status exam, basic pharmacologic approaches, and crisis assessment and intervention. In addition to observation opportunities (e.g., watching individual and group psychotherapy), each student performs a comprehensive outpatient evaluation. Regular participation in didactics is required. Students will use learned psychiatric skills regularly in any medical practice that involves direct patient care.
In this clerkship, students learn surgical principles and topics, evaluate core surgical disease states in a clinical setting, and develop core clinical skills through observation or performance of basic procedures.
The major goals of the seven, 1-week, intersessions include:
- Supplementing and supporting the clerkships in their efforts to facilitate students’ acquisition of the knowledge, skills, attitudes, and behaviors necessary to meet the UC Davis graduation competencies.
- Facilitating the integration of the three pillars of I-EXPLORE, specifically ensuring biomedical science and health systems science are taught and learned in the context of the clinical science-focused clerkship phase.
- Supporting students’ professional identity formation and wellness by leveraging their relationships with their academic coaches and coaching cohorts and providing time for enrichment activities and scholarly work.
Specific components of the intersession course include:
- Active learning sessions (e.g., team-based learning, peer teaching) that integrate the three pillars and the six threads and are focused on the UC Davis 43.
- Formative multi-station OSCE sessions.
- Individual and group meetings with academic coaches including student case presentations highlighting common challenges not addressed elsewhere in curriculum, with emphasis on professional identity formation and wellness.
- Other sessions covering topics such as: Interprofessional education and collaborative practice, Diversity/Equity/Inclusion, and USMLE Step 2 Prep Sessions
Over the course of the clerkship phase, students have a 6-week selective rotation. Selectives offer significant flexibility in the clerkship period. A wide variety of two‐, four‐, and six-week selectives are offered, allowing students to potentially experience up to 3 different disciplines before beginning the post‐clerkship phase. Alternatively, selective time can be used for areas of scholarly concentration (ASC), preparation for deferred Step 1, remediation, medical leave, or vacation, with the recognition that selective time not used for a patient care experience or ASC will need to be completed in the post‐clerkship phase as an advanced clinical clerkship or clinical didactic instead.
Feedback and Assessment
Clerkships use a competency-based framework for clinical evaluations that assess the Clerkship Phase Milestones of the Graduation Competencies. All clerkships use NBME shelf exams to assess knowledge and problem-solving. A variety of other methods (observed clinical encounters, OSCE’s, Practice-based Learning and Improvement exercises) are designed to provide formative and summative feedback.