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Welcome to the Internal Medicine Clerkship. The clerkship consists of an intensive two-month experience on the medical team at VCU Medical Center and Hunter Holmes McGuire VA Medical Center. This clerkship is augmented by weekly conferences and scheduled departmental lectures and rounds.
We have made every effort to provide an environment in which your own skill-directed learning can be maximized.
The guiding principle is that, under appropriate supervision, you will be as responsible for the care of assigned patients as you are able to be, for your level of training and your schedule of teaching activities.
For a detailed breakdown of grading components, please see: Internal Medicine Clerkship Grading
Breakdown of Direct Observation request requirements per EPA
There is no arbitrary “required” patient number during inpatient rotations. However, a reasonable goal is 3 patients at any given time. However, the number of cases that you both admit and carry is up to your supervising medical team. You are expected to perform a complete history and physical examination and formal write-ups on each patient that you admit to your service. Your resident is in charge of assigning patients.
You are responsible for pre-rounding on each of your assigned inpatients. You are expected to arrive on the wards at an early enough time to have seen your patients and be ready to present your patients on rounds. At both MCV and the VAMC, rounds will begin at 8:00 or 8:30 AM. Rounds are expected to be finished by 10:30-10:45 AM so that residents may attend morning report at 11:00 AM. You are encouraged to accompany your team to morning report. You are expected to remain available until 5:00 PM or later (as patient responsibility dictates). You will admit patients with the team as directed by your supervising resident and attending. None of the inpatient ward teams take overnight call.
The Department of Internal Medicine is committed to providing discretionary time off to residents, interns, and students. During your inpatient rotations, you will be given one weekend day off each weekend. On the weekend between your two rotations (after the 4th week of the clerkship), you will have the entire weekend off. You may not take weekdays off. Any additional time off must be requested through the Clerkship administration—please complete an Exception Request Form and turn it in to the Clerkship Administrator for approval. For additional information about the Clerkship’s policy regarding excused absences, please see the Internal Medicine Clerkship Absence & Exception Request Policy (found on page 17 of this manual). PLEASE NOTE: Exception requests are approved at the discretion of the Clerkship Director and will be honored according to the guidelines set forth by the School of Medicine.
You are expected to help with patient care duties on your assigned patients. This can include obtaining outside medical records, transporting patients in urgent situations, sending hospital records to referring physicians, etc., and these duties are not considered “scut.” Note that attendance at formal didactic sessions is required and you are not to perform these patient care duties if they preclude you from attending mandatory clerkship activities.
Students should adhere to the School of Medicine policy on student attire in the inpatient setting. This policy recommends-- but does not require--a "bare below the elbows" approach for inpatient care. It is the preference of the IM Clerkship that students prioritize professional dress which complies with a "bare below the elbows" approach when possible. Students wishing to wear scrubs may do so, provided that the scrubs are freshly laundered. Further questions regarding appropriate dress on your rotations should be directed to your supervising attending. Your VCU ID badge must be visible at all times in all clinical areas.
An occupational exposure to blood and/or body fluid should be treated with medical urgency and evaluated by a specially trained health care practitioner. Medications prescribed for HIV exposure should ideally be started within one to two hours of exposure. Please report all exposures to MCV Student Health so that appropriate care and follow-up can be provided.
If a student experiences a blood or body fluid exposure, he or she should:
Contact or go to MCV Student Health:
1000 East Marshall Street, Room 305
Phone: (804) 828-9220
Contact the Post Exposure Prophylaxis (PEP) Team:
The PEP Team will provide immediate phone counseling and medications if indicated. The student should then report to MCV Student Health the next work day for labs and follow-up care.
The teaching of M3 IM Clerkship students is taken very seriously by the Department of Internal Medicine. We strive to provide an excellent educational experience for all students in Internal Medicine. The following is a set of expectations to better define the role of housestaff as teachers during this rotation.
The Internal Medicine Grading Committee reviews all of the individual components of a student’s grade before a final decision is made.
One or more of the following must be listed to receive a Fail or Incomplete:
All grades in Internal Medicine are determined by committee. A careful review is given to every student prior to finalization of his/her individual grade. Students may review the content of student file in the presence of the Clerkship Coordinator. These reviews must be scheduled one day in advance of the desired meeting time. The Clerkship Director or Associate Clerkship Director is available to meet with students should they have any additional questions regarding a grade calculation after they have reviewed the orientation materials.
If a student disagrees with his/her final grade in Internal Medicine, he/she is encouraged to file a formal appeal with the Department of Internal Medicine according to the policies outlined by the School of Medicine. Please note, the Department of Internal Medicine highly values the evaluations of its faculty and residents and is not in the habit of expunging evaluations and comments.
A student who would like to file a formal appeal of his/her final grade has 30 days from receipt of his/her final grade to do so. To submit an appeal, the student must draft a letter of appeal to the Internal Medicine Clerkship Appeals Committee. This letter should be submitted directly to the Clerkship Coordinator, by email or campus mail, along with any other additional documentation the student would like included supporting the appeal. Once the coordinator has received the letter of appeal, s/he will compile an appeal summary which includes: the student’s letter of appeal, a summary of the student’s final grade scores, and a copy of each evaluation the student has received. The student will be informed of the Internal Medicine Appeals Committee’s decision by email within 30 days of the initial appeal submission. Should the student disagree with the Appeals Committee, a second formal appeal may be submitted to the Department Chair. The student has 30 days from receipt of the Appeals Committee’s decision to file the second appeal, which is also sent to the Clerkship Coordinator, who will prepare a file for the Department Chair. The decision of the Department Chair is final.
*Note: Only completing the minimum 3 per week will not result in meeting the 42 requirement.
Failure to submit at least 42 requests will result in submission of a letter of concern for professionalism.
Phoebe Ashley, MD
Phone: (804) 828-9726
Fax: (804) 740-1100
Rabia Qaiser, MD
Hunter Holmes McGuire VA Medical Center
Medical Services (4C-103)
1201 East Broad Rock Road
Richmond, Virginia 23249
Phone: (804) 675-5000, ext. 6419
Pager: (804) 351-0100
Nathaniel Warner, MD
Office: VMI Building, room 205c
Phone: (804) 828-5724
Cell: (757) 404-5295
West Hospital, Sixth Floor, East Wing, Room 208
Phone: (804) 628-0247
Fax: (804) 828-4926
Gilda R. Harris-Howard
West Hospital, Sixth Floor, East Wing, Room 208
Phone: (804) 628-3260
Fax: (804) 828-4926
Clinical Coordinator, VAMC
Phone: (804) 828-5163