YEAR THREE

POLICIES AND PROCEDURES

Class of 2013

SIU School of Medicine Curriculum Guidelines:

These Guidelines represent the School's blueprint of educational concepts that are to provide guidance in curriculum development.  There shall be a competency-based curriculum, which shall prevail throughout the medical school.

1. Students should be encouraged to become self-directed, lifelong learners.

Medical school should model the behavior expected of the trained physician.  The student should be encouraged to take responsibility for their continuing educational development.

2. Students should be exposed to a variety of clinical settings throughout their entire undergraduate education and should be expected to show progressive development of skills and professional behaviors.

Students will be assigned to a variety of clinical preceptors throughout their undergraduate career. In these settings they will develop their clinical skills, their socialization into the profession, their appreciation of the roles of a diversity of health care professionals, their understanding of the economics of health care delivery, and the nature of the physician-patient relationship.  Students will be expected to show developing levels of patient care and responsibility as they move toward their residency training. 

3. Learning of basic and clinical sciences shall be integrated.

The basic sciences shall extend beyond the "classic eight" (Anatomy, Biochemistry, Physiology, Behavioral Sciences, Pharmacology, Microbiology, Immunology, and Pathology) to include Ethics, Humanities, Epidemiology, Nutrition, and Biostatistics.  Wherever possible the basic sciences should be learned and evaluated in the context of solving patient problems.

4. Active learning in small group settings should be encouraged.

Wherever possible, learning should occur in small groups with active participation by all members. Not only is this deemed to be educationally effective, but it will also develop those interpersonal skills necessary to function as members of multidisciplinary teams in health care delivery.

5. The curriculum shall develop the flexibility necessary for students to function in the rapidly evolving health care delivery system, and in a variety of roles such as individual patient care, community health, and preventive medicine.

Students should develop the skills to respond to evolving societal needs, practice patterns and scientific developments.

6. All curricular events should be evaluated; such evaluations should be diverse in style and performance-based.

Given the variety of skills, knowledge and attributes expected of our graduates, we anticipate that they will be evaluated in a diversity of ways, including self-evaluation.  All such evaluations should be performance-based (defined as assessing the application of knowledge and skills in settings approximating actual clinical situations).

7. The following content areas should receive emphasis in the new curriculum: history and physical examination skills, medical practice management, health policies, evidence based medicine, resource acquisition and medical informatics, and opportunities to explore diverse career choices. 

8. Where appropriate, management of the curriculum should be by interdisciplinary teams, which cross geographical and calendar barriers.

PURPOSE

The third year consists of a series of multidisciplinary clinical rotations, with emphasis on both hospital-based and ambulatory practice.  These activities will take place at various locations throughout the State. Students will also have two Option Periods, each two weeks in length, for a total of four weeks.  This time can be used to schedule extra vacation, remediation, research, electives, or the 4-week Neurology Clerkship.  Basic sciences continue to be integrated throughout the third year as students are working with patients.  See the Year Three Curriculum website for more detailed information. 

1. Academic Year

The Year Three clerkships begin the first workday following the July 4^th holiday and run through the last week of June of the following year.  There are 43.5 weeks of regularly scheduled Clerkship rotations plus two weeks of Doctoring.  Students have a two-week Winter Break and an additional two days of vacation during the short-clerkship semester.  Each student also has two 2-week Option Periods which provide an opportunity to schedule extra vacation time, or use the time for academic endeavors such as remediation, electives, research, or the Neurology Clerkship rotation.

2. Assignment to Clerkships

Students are assigned randomly to clerkship schedules, however, students may request to have long or short clerkships in the first semester, and to the extent possible, such requests will be honored.   After such assignments are made, with mutual consent of the students involved and the respective clerkship directors, a student may be allowed to switch clerkship rotations with another student.  Requests for schedule changes must be submitted no later than three weeks prior to the beginning of the clerkship to the appropriate clerkship directors (see the Clerkship Contact List on the Year Three website).

3. Attendance

Students are expected to participate in all activities of the clerkship.  Special scheduling needs or absence requests of a non-emergency nature, including scheduled medical appointments, should be directed to the appropriate Clerkship Director for approval no later than three weeks prior to the start of the rotation.  For absences longer than one day, the Office of Student Affairs should also be notified.  Depending on the length of the absence, the Clerkship Director will determine if the student will be required to make up missed curricular time.

A Policy regarding work hours during Clerkships was adopted by the Year Three Curriculum Committee.  This Policy will prevail during clerkships in Year Three and Year Four.  A copy of this Policy is on the Year Three website.

4. Honor Code

Faculty and students of Southern Illinois University School of Medicine are expected to understand and accept the responsibilities of their profession as outlined in the Honor Code.

5. Guidelines for Clinical Activities

The vast majority of Year Three will be spent in the clinical setting.  Year Three students are advised to become familiar with the Guidelines For Clinical Activities, the standards to which they will be held accountable.  A copy of these Guidelines can be found on the Year Three Curriculum website.

6. Dress and Decorum

The "best interest of the patient ..." is the most fundamental consideration for the establishment of policies and procedures at SIU, and dress and decorum is no exception.  The appearance and attitude of the people at SIU have a tremendous impact on the perception of our patients and, consequently, their impression of SIU and their willingness to return.

The following guidelines have been established to provide appropriate direction to SIU students and staff. 

7. Student Abuse

To provide a fair and open learning and working environment, Southern Illinois University School of Medicine faculty and students shall observe the Standards of Conduct approved by the Executive Committee on June 19, 2000.  A copy of this document is available on the website. 

8. Clinical Experience Logbooks in Clerkships

Students' clinical experiences are logged within all Clerkships.  Data can be entered into each clerkship's log using a computer-based form.  Each clerkship has a specific procedure for using logbooks that is explained at the clerkship orientation.

9. Performance Evaluation

At the clerkship level, student performance is evaluated as honors, satisfactory, or unsatisfactory on a five-point scale in the categories of Clinical Performance, Knowledge and Clinical Reasoning, and Non‑Cognitive Behaviors.  Clerkship failures are reported to the Office of Education and Curriculum within six weeks after the end of the clerkship.

End-of-clerkship student performance data are placed on file in the Office of Student Affairs and are used by the Student Progress Committee in making promotion decisions and also provide the substance of the dean's letters to residency program directors. 

Clerkships will advise students when their individual performance evaluation has been submitted.  If a student disagrees with a performance evaluation submitted by the Clerkship Director, s/he should, as a first step, discuss the matter with the respective Director.   The faculty member may submit a revised evaluation form as a result of that discussion; however, if a consensus is not reached, the student may formally appeal the evaluation through the Clinical Clerkship Grade Review Process.  Students will be notified via email when an elective evaluation has been entered; this computer-generated reminder will provide a link to the Grade Review Process to be followed if s/he chooses that course of action.  Year Three students should be aware that although the Clinical Clerkship Grade Review Process is similar to the Elective Grade Review Process, there are significant differences in the procedure.  Students who are taking Electives during Option Periods should familiarize themselves with the Elective Grade Review Process, as well. 

In submitting student performance evaluation data, departments make recommendations to the Student Progress Committee regarding student promotion decisions.  The SPC may accept or ask for modifications in these recommendations.  Departmental recommendations are not official or considered requirements until the SPC makes a decision to accept such recommendations.

Each clerkship has set criteria for Honors, and if a student qualifies for Honors, it shows as "H" on the transcript. 

If a student receives Excellent (EXC) in one or two of the areas, s/he receives a grade of Satisfactory with excellent ratings in the one or two areas; the transcript will reflect a grade of "S" on their transcript.

If a student receives grades of Marginal (MAR), Meets Expectations (MEE) and/or Commendable (COM) in all three areas, his/her grade on the transcript is "S."

If a student receives an Unsatisfactory (UNS) in 1 or more areas, s/he must remediate the clerkship.  Remediation can be:

1. Without scheduled weeks (example: retake an exam).  In this case, the student will receive a "U" that will change to an "S*" when remediation is successfully completed. The official transcript grade for students who fail a clerkship because of a final examination failure and subsequently retake and pass the examination should be an S-asterisk (S*);

2. Scheduled weeks equaling less than one-half the length of the original clerkship.  In this case, the student will receive a "U" that will change to an "S*" when remediation is successfully completed;

3. Scheduled weeks equaling more than one-half the length of the original clerkship.  In this case, the student will receive a grade of "U" for the original clerkship and "S" for the remediation, if the remediation is successfully completed.

10. Remediation:

Remediation in Year Three is determined on a student-by-student basis and depends on the particular deficiency exhibited.  The clerkship director, in conjunction with other clerkship faculty, makes a recommendation to the Student Progress Committee regarding the activities, length, and content felt to be necessary for that particular student to complete clerkship requirements.  Common remediation experiences include, but are not limited to, multiple-choice examinations, practical examinations, oral examinations, tutorials, and additional weeks of clerkship time. 

EXCEPT UNDER EXTRAORDINARY CIRCUMSTANCES, NO CLERKSHIP WILL DENY A STUDENT THE OPPORTUNITY FOR AT LEAST ONE REMEDIATION, GIVEN APPROVAL BY THE STUDENT PROGRESS COMMITTEE. After careful consideration of the recommendation submitted by the clerkship director, a decision about the remediation to be required will be made by the SPC. The Student Progress Committee does not modify departmental remediation requirements without compelling reasons and prior consultation with the clerkship director and/or department faculty.

Clerkship time is considered inviolate:  that is, all work or remediation for a given clerkship should be completed during that clerkship, during Year Three Option Periods, vacation time or during the elective period, so as not to infringe on a subsequent clerkship's time.  However, limited exceptions to this rule may be negotiated, with the full agreement of the clerkship directors involved.  Students are encouraged to complete remediations during Year Three whenever possible.

On March 22, 2004, the Year Three Curriculum Committee approved Remediation Guidelines.

11. Student Transcripts:

There is an "in progress" transcript showing your academic progress through the curriculum and an official, permanent transcript available after you graduate or otherwise terminate enrollment. Both types of transcripts provide such information as your name, current address, date of birth, social security number, date of matriculation (with advanced standing or transfer noted, if applicable), and date of graduation (or exit, if applicable).  For further details, please refer to the Student Handbook section, "Student Transcripts."

12. Deferral of Clerkships

Except in special circumstances, students may not defer third-year clerkships, but must take them as scheduled in the regular rotation.  Approval of a request to defer a clerkship is granted by the Associate Dean for Student Affairs in consultation with the clerkship director(s) involved.  It is recommended that any such request be submitted to the Office of Student Affairs at least four weeks prior to the start of the clerkship.  Deferred clerkships will be scheduled during the first rotation of the next academic year when possible.

13. Completion Date

All clerkships, including Neurology, and the Years Three and Four Doctoring segments must be successfully completed two weeks prior to Graduation Day.

14. Additional Graduation Requirements

All students are required to record a score on the U.S. Medical Licensing Examination (USMLE) Step 1 before beginning clerkships and must pass the exam to graduate. Students are also required to record a score on the USMLE Step 2 (both Clinical Knowledge and Clinical Skills exams) prior to graduation. Course designations of honors, pass or fail are included on students' official transcripts. The School has a chapter of Alpha Omega Alpha, the medical honor society.

Students are required to participate in the Clinical Competency Examination (CCX) early in Year Four, which assesses their ability to apply knowledge and clinical skills.  Students are evaluated and receive feedback regarding competencies such as inquiry strategy, diagnosis development, test selection and interpretation, and patient management.

The School's Student Progress System (SPS) prescribes the standards of academic conduct that must be met by students in order to graduate.  The SPS also describes how students' academic performance and professional conduct are evaluated.  A Student Progress Committee, composed of students, faculty and administrators, monitors the student progress decision process.  For more detailed information about this area, please go to Student Progress System website.

15. Monitoring Student Lapses in Non-Cognitive Behaviors

To track student performance in the area of non-cognitive behaviors during Clerkships, a system for Monitoring Student Lapses in Non-Cognitive Behaviors has been adopted by the Year Three Curriculum Committee.  This system is fundamentally consistent with the process established in Years One and Two.  The complete Policy is available for review in this packet and on the Year Three website.  A similar procedure will be followed if concerns regarding non-cognitive behaviors are observed during Electives taken during Year 3 Option Periods; therefore, students are encouraged to become familiar with the processes as delineated in the comprehensive documents and supporting forms.  (See links on Year Three website.)