Family Medicine (4 weeks)
This four-week rotation covers the basic principles of Family Medicine: Caring for individuals in a community setting and understanding the epidemiology of the most common health issues affecting one’s clerkship community. Students learn 19 common complaints through comprehensive self-assessment exercises and complete an OSCE at the end of the month on one of the self-assessment cases. Students are issued a Personal Digital Assistant (PDA) to use as resource to record clinical activities. Family Medicine also loans a laptop computer so that students may complete CD-ROM interactive cases and participate in electronic discussions. In addition, students create a self-directed project for the office and preceptor.
Internal Medicine (12 weeks)
The IM rotation at Inova campus consists of a 12 week rotation. Students spend four weeks working in ambulatory clinics. They are assigned to a primary preceptor who is typically a general internist. They focus on preventive issues and on long term management of chronic medical problems in ambulatory patients. In addition, the students also spend half-days every week rotating through subspecialty clinics which include Infectious Diseases, Gastoenterology, Nephrology and Cardiology. They also spend two afternoons with the nutritionists in the hospital.
The eight-week inpatient rotation is divided into two four-week blocks. The inpatient rotation is based on Inova-Fairfax Hospital. Students are part of a call team which typically includes a senior resident, one or two interns and an acting intern. They take overnight call including weekends on a every fourth day cycle. They admit and follow the patients until discharge. The students have the opportunity to participate in their own third year student morning report, Monday-Friday, where they present cases. Along with their teams, they also participate in daily noon conferences, chief of service rounds once a week and auscultation rounds once a week. The students have their core topic lectures at 2pm every Monday and Friday.
Neurology (4 weeks)
The Neurology clerkship seeks to educate medical students in the diagnosis, treatment and care of patients with a wide variety of neurologic conditions. This is accomplished through direct patient contact, didactic lectures, interactive teaching sessions, assigned text and other reading and electronic media. During the one-month rotation, students work with the teaching faculty at the Alexandria Fairfax Neurology practice, where they spend time in an outpatient clinic as well as the neurology service at Inova-Fairfax Hospital. Students are also exposed to the indication for and basic understanding of tests and procedures frequently used in the evaluation of patients with neurological conditions including lumbar punctures, neuroimaging studies, electroencephalography and duplex carotid studies. Students are evaluated based on clinical performance and the NBME neurology shelf exam.
Obstetrics and Gynecology (6 weeks)
The Obstetrics and Gynecology rotation is a six-week rotation designed to give an overview of primary and tertiary care of women. The Inova Fairfax Hospital Clerkship is divided into antepartum, day float and night float, labor and delivery, emergency room experience, benign gynecological surgery, gynecology and ambulatory services. The students care for pregnant patients in the hospital and clinic, participate in vaginal and cesarean deliveries and follow patients after delivery. In addition to the labor and delivery experiences, day float and night float exposes students to gynecologic admissions and consults within the hospital. Gynecology incorporates office practice, ambulatory surgery, benign surgery and inpatients women’s care. Students participate in the assessment and management of women in the office, hospital and operating room.
Gynecologic Oncology rotation introduces students to tertiary care of cancers of the cervix, uterus, ovaries, vulva and vagina. Students see some of the case presentations of these diseases as well as their surgical and medical treatments. In addition to the informal teaching on these services, students are expected to attend didactic sessions and grand rounds. Students are evaluated by clinical performance and the National Board of Medical Examiners shelf exam.
Pediatrics (8 weeks)
The Pediatrics clerkship is an eight-week rotation of which four weeks is inpatient and four weeks are outpatient. During the inpatient month, the goals are to learn about the management of acute and chronic conditions that are treated in the hospital setting, to sharpen history taking and physical exam skills as they apply to children of different ages and to learn to write comprehensive admission notes including assessments and plans. For the outpatient month, two weeks are spent in the office of a community physician where students see well child visits and common outpatient complaints under the supervision of their preceptor and learn how a pediatric office functions. The remaining two weeks are divided between the newborn nursery, the pediatric emergency room and the subspecialty clinics. There is also a series of approximately 17 lectures which cover core topics in pediatrics in an interactive format.
The evaluation of students is based on their ward performance (40 percent), their outpatient work (20 percent), an oral exam based on three or four of 30 case scenarios which the students are given ahead of time (10 percent) and the written exam provided by the National Board of Medical Examinations (NBME) (30 percent).
Psychiatry (6 weeks)
The goal of the Psychiatry rotation is for students to become competent in the fundamentals of psychiatric diagnosis and treatment necessary for practice within a primary care setting, as well as preparation for those who plan to apply for a psychiatry residency. The clerkship represents a continuum of the development of the Behavioral Sciences curriculum. Students learn to recognize, diagnose and treat patients with various forms of psychopathology.
Students at the Inova Campus spend one month on the inpatient psychiatry service, two weeks on the psychiatry consultation-liaison services and one afternoon a week in the outpatient community mental health clinic adjacent to the hospital. Students will participate both in team learning modules as well as problem-solving case presentations linked to specific lectures. Students also participate in on-call experiences and electroconvulsive therapy. Student grades are based on their clinical evaluations, one final psychiatric admission write-up and OSCE, and a written shelf examination.
Surgery (8 weeks)
The goal of the Surgery Clerkship is to provide an experience in the principles and practices of surgery in eight weeks. Students spend four weeks on a general surgery rotation and four weeks on a surgical subspecialty or community surgery month. Students are expected to assume responsibility for patient care and participate in the evaluation of patients and the decision making process, further developing interviewing and physical diagnosis skills. Students are expected to read the required textbook, ask questions and participate actively in the learning process.
While on the general surgery rotation, students make a weekly case presentation to the chairman. There is a core curriculum lecture series available on the Surgery website, and a faculty present clinical, case-based discussion on these lectures on Mondays and Thursdays. Students are required to view on-line lectures as well as attend scheduled conferences, including weekly Grand Rounds and M&M (Kaizen) conferences. In addition, each service has conferences specific to their specialty.