USMLE Step 1 Practice Assessments: In order to support students’ preparation for Step 1, the number of practice assessments offered for USMLE Step 1 was increased. Students now have the opportunity to take three Comprehensive Basic Science Exams (CBSE) in October, January and March of their second year. In addition, students are offered two Comprehensive Basic Science Self-Assessments (CBSSAs) to assess progress and readiness for Step 1 during the dedicated study period.

USMLE Step 1 Deferral: Students wanted to be able to begin their dedicated Step 1 study period and complete additional self-assessments before making a decision to defer their first clerkship in order to study. In order to accommodate this, the deadline for requesting to defer the first clerkship was moved from mid-February to early April to allow students to complete four weeks of dedicated study and three practice assessments offered by UC Davis School of Medicine before making a decision about clerkship deferral. 

Longitudinal Clinical Experience (LCE): Students requested greater consistency in site experiences, placement, schedule flexibility and training. Students are now provided a preference form prior to the start of the LCE cycle to note specific consideration for travel and accommodation needs. Students can also volunteer for morning clinic schedules on Tuesday and Thursdays (pending preceptor availability). The greater LCE schedule was also revised to allow for clearer preceptor responsibilities and teaching approaches, supported by a schedule that now begins in October with dedicated clinical reasoning sessions, EMR trainings, and discussions in patient care and cultural humility before clinic visits that begin January of the following year and end in December, which helps to minimize scheduling and cognitive load in the transition to Step 1 study.

Attendance: Students have requested greater flexibility in the personal time use and a less onerous reporting procedure. Under the efforts of pre-clerkship leadership, a revised policy will be implemented with the 2023-2024 academic year that will provide clearer time away expectations and greater allowances based on the length of required coursework, and more a transparent time away request and approval process.

Course Communication: Students requested that they receive greater contextualization of course content to be covered in subsequent weeks as well as more guidance on course preparation. Courses will now provide consistent weekly communication to review the week and better prepare students for the week ahead. 

Grading Equity: Following students’ concern over the equity of grading across clinical clerkships, and a subsequent review by the Dean’s Racial Equity Advisory Committee a task force was formed to address the Committee’s report and recommendations. Subsequent actions include a bylaws change that will facilitate a pass/fail grading system starting in the 2023-24 academic year.

Procedure Logging: To streamline and consolidate clerkship procedure and duty hours reporting, clerkships will deploy a new direct observation toolkit or “DOT” that captures preceptor signatures electronically in real time, as well as required procedure logging, duty hours reporting and feedback in a single web app.

Graduation Requirements: Reducing student confusion over courses that meet graduation requirements, “core clerkship” acting intern rotations and required ICU rotations have been consolidated. Students now received preference surveys to help guide rotation placement in required ICU courses to minimize scheduling challenges and departmental communications.