Student Site and Community Faculty Assignments

In the spring, second-year medical students’ preference their third-year clerkship schedule. The medical education division of the Department of Family Medicine receives from the registrar a rotation roster. Students are then placed with one of the 400+ community-based, family medicine physicians in Indiana.

Travel and Housing Accommodations

IU School of Medicine offers clinical learning opportunities that allow medical students to complete their training in centers of medical education around the state. If you are required to travel for your learning opportunities while on required rotations, including in-person orientations and/or rotations away from your home campus, you will be provided with housing and/or reimbursed for required travel in accordance with the IU School of Medicine’s student travel guidelines. Please consult the Medical Student Travel Guidelines (md.mednet.iu.edu/policies-guidelines/student-travel-expenses) for more information about how to request housing and/or transportation reimbursement.

Travel expectations: Students should expect to travel up to 45 minutes from the assigned site to the community faculty office. As well, students traveling to distant cities should plan to report the day before the first day of clerkship.

Travel reimbursement: Travel costs are not reimbursed for the Family Medicine Clerkship.

Housing accommodations: Housing accommodations are provided for Indianapolis-based students assigned outside Indianapolis and surrounding counties. Campus-based students will be provided housing if assigned to a site outside their regional campus area. Housing information will be provided by the program site before the rotation begins. Housing amenities vary by site. Students should inquire at least two weeks prior to rotation start regarding site-provided amenities.

Housing requests: Housing must be requested by students at the beginning of the academic year. In the event of a change in personal circumstances requiring a need for housing, the housing request must be made 60 days prior to the rotation start date. Requests made less than 60 days prior to the rotation start date will not be considered; students will be responsible for obtaining their own housing and all expenses incurred. Students will not be reassigned to another program site based on housing issues.

Housing reimbursement: Housing reimbursement is not available to individual students, their families/friends or other individuals/entities where personal arrangements have been made.

Problems with housing accommodations: Non-emergency issues with accommodations must be reported to the program site director. Emergency issues should be reported to the housing authority contact listed in housing information provided by the program site director.

Hospital/Office Credentialing

Students may be required to provide immunization records, background checks, and other credentialing information, including any training (e.g., CPR), to assigned sites PRIOR to the start of the clerkship. Students are expected to respond to these requests promptly. Due to HIPAA regulations, students are required to obtain their own immunization records from their personal physician and/or campus health services. Direct and timely communications with the assigned site are required. Failure to comply with credentialing needs can result in inability to participate in the clerkship, and possible rescheduling in the next academic year and/or professionalism competency concerns noted on transcript.

In some cases, this might require you to complete a 2 step TB test. Please know this requires four visits over the course of two weeks or more so please start this process early.

First Day of Clerkship

Every rotation will begin with a required live 2-hour (9a-11a ET) orientation via Zoom. In your “welcome” email prior to the start of the clerkship, you received the date, time and Zoom link (the link is also included in your “Rotation Specific Checklist”). You are required to attend this session. Attendance will be taken. Not attending the orientation can affect your professionalism for the family medicine clerkship.

Each training site will provide information to the student regarding when and where to report on the first day. Those students going to sites outside the Indianapolis area should plan to travel the night before the first clerkship day. Depending on the start day of the rotation, some sites may have a brief orientation before sending students to the community faculties’ offices.

CPR Training and Certification

It is expected your CPR certification is current throughout the Family Medicine Clerkship. If your CPR certification will not be current, please contact the IU Health Emergency Cardiac Care Programs at ecc@iuhealth.org. IU Health offers free CPR training to IU School of Medicine students. It is recommended students schedule this training at least two months in advance to assure certification is complete prior to clerkship. Students at Fort Wayne, Muncie, South Bend, Gary, Bloomington, Evansville, and Terre Haute may wish to contact their campus coordinator for local CPR training options.

Adaptive Educational Services

Any student at any IUSM campus requesting accommodations for a disability must apply to the IU School of Medicine Disabilities Accommodations Committee and must register with the adaptive educational services office at the host campus. Guidelines for applying along with a list of the adaptive services offices on each campus are available in the Student Handbook under the heading "Diversity and Disabilities Services".

Clerkship Goals

The overall goal of the Family Medicine Clerkship is to provide an outstanding learning experience for all medical students. At the completion of the clerkship, students will be able to effectively and competently evaluate a patient and produce a competent history and physical that facilitates differential diagnosis and the development of a treatment plan (Society of Teachers of Family Medicine National Family Medicine Clerkship Curriculum - stfm.org/teachingresources/curriculum/nationalclerkshipcurriculum/overview).

Clerkship Objectives

At the end of this rotation, students will be able to: 

Consult the IUSM Competencies (medicine.iu.edu/md/curriculum/competencies) section for a description of each competency and the corresponding institutional learning objectives.

Overview of Clerkship Requirements

Much of your time (4 days each week) in the Family Medicine Clerkship will be spent with the assigned community faculty in their office and possibly in the hospital and engaging in other patient care activities. This participation provides students the opportunity for one-on-one involvement with a community-based family physician. Through interaction with the community faculty, as well as the nurses and other health team members, it is anticipated students will also acquire practical knowledge about personnel and other managerial aspects relevant to a group or solo practice. 

The other day of the week is considered dedicated study time for you to focus on the clerkship assignments and prepare for the final exam. It is your responsibility to communicate this to your faculty and work with their schedule.

Participation

You can expect to participate in the care of the patients you see in the office with your assigned preceptor. Each preceptor and office are unique so in-office experiences will vary. You will be part of the healthcare team taking care of patients in the surrounding community.

Focused History & Physical

Within the first seven (7) business days of the clerkship (see "Rotation Specific Clerkship Assignments" for rotation due date), all students are required to have completed an observed, focused history and physical (this is not a complete history) submitted via the Canvas assignment. This is to be observed by the preceptor and includes only pertinent portions of each. The form is downloaded from the Canvas assignment and requires both the patient diagnosis/reason for visit and your preceptor signature. 

Required Clinical Encounters/Skills

Patient Encounter Minimums

The Family Medicine Clerkship provides students opportunities to encounter the many aspects of primary care. To ensure all students are exposed to an adequate breadth of family medicine and progress in their participation in patient care, students are required to record a minimum number of Core Diagnoses as outlined in the table below.

Please note: Alternative Clinical Experiences are only made available in the event a Required Clinical Experience cannot be completed.

When logging required clinical experiences, a student should ensure their level of responsibility is performed at the appropriate level, using the following definitions:

• Performed – The student acted as an independent clinician with appropriate supervision…
  • Carried out a procedure/task that required physical skill and cognitive attention.
  • Put a plan into effect (i.e., executed or implemented).
  • Successfully completed the procedure/task/plan.
• Assisted – The student acted as a secondary clinician who…
  • Provided hands-on support to a primary clinician to carry out a procedure/task (i.e., physically aided).
  • Received assistance from a primary clinician to carry out a procedure/task.
  • Shared in the communal execution/implementation of a plan (i.e., helped).
  • Contributed to the completion of the procedure/task/plan as a team member.
• Observed – The student acted as a bystander who…
  • Was present at an event without participating (i.e., a spectator).
  • Watched and/or listened attentively.
  • Witnessed the completion of the procedure/task/plan without contribution.

Patient Encounter Tracking

All students must record the minimum required diagnoses during the Family Medicine Clerkship. Patient encounter tracking is a school-wide requirement in MedHub. The Clerkship Director uses this data to help determine if students’ patient clinical experiences are appropriate for achievement of the clerkship objectives. It is expected your preceptor will observe a focused history or focused physical and it will be submitted via Canvas assignments within the first 7 days of the clerkship.

Students should expect to interact with patients directly during the family medicine clerkship. If you experience the majority of your patient encounters are observation only, please contact the site director and email fmclerk@iupui.edu with this information. The site director and/or the clerkship director will attempt to resolve this issue or make other arrangements to provide an increased learning experience.

Each clerkship has been assigned specific core clinical skills that require validation. During the Family Medicine Clerkship, students are required to demonstrate skill proficiency in each of the following musculoskeletal (MSK) examinations:

Video and PDF resources are available on the Family Medicine Clerkship Canvas site in the “Musculoskeletal Physical Exams” module. This MSK module is provided as an optional resource and is not required.

Additional Requirements

Students will spend non-clinical time in self-directed, online learning. This time is to be used to complete all non-clinical assignments as outlined below, in addition to reviewing select Aquifer Family Medicine Cases. Additionally, the day before your final exam is a designated study day. 

Orientation Day

Orientation to the Family Medicine Clerkship is required for all students. The orientation is from 9:00a-11:00a (EDT) on the first day of the Clerkship via Zoom (see your Rotation Specific Checklist a and Announcement for Zoom details). After orientation, you are to spend the rest of your morning reviewing the Canvas site. You are to report to your clinical assignment for the afternoon session on the first day of your clerkship.

Special Note on Zoom/Video Conferencing Sessions. Our Zoom didactic sessions are interactive and rely on student engagement and participation. Our expectation for these sessions is that students actively participate with their cameras on. Any students that are not actively engaged and participating, or that are trying to participate in an environment that is not conducive to active engagement (i.e., while traveling/driving in a car, etc.), will be removed from the session and will not receive credit for attending. Any attempts to deceive by using background filters will be considered professionalism issues. Please plan accordingly to ensure you are able to participate and fully engage during these sessions. Students have permission to be late to clinic on the days where there are scheduled Zoom sessions (just let your preceptor know in advance).

Interprofessional Education (IPE) Exercise 

Recognizing that high-quality patient care is delivered in the setting of inter-professional teams, inter-professional education (IPE) in the health sciences is viewed as extremely important in the United States and internationally. IUSM has adopted a competency-based objective to reflect our commitment to IPE: demonstrate effective teamwork through collaboration with diverse patients, their supporters, and the multi-disciplinary healthcare team (SBP1). For this IPE exercise, you will speak with a colleague from another health profession who is involved in the care of a mutual patient. Students are required to complete this IPE exercise at least once during each clerkship and will document completion via submission of this canvas quiz. Students are required to speak with a different type of healthcare professional during each clerkship. IPE Curriculum Objective:

• Demonstrate effective teamwork through collaboration with diverse patients, their supporters, and the multi-disciplinary healthcare team (SBP1)

Point of Care Ultrasound in Outpatient Settings: Abdominal Aortic Aneurysm

The benefits of point of care ultrasound (POCUS) in primary care are making a more rapid diagnosis, the potential to save health care costs, and the potential to improve patient outcomes. This is module which focuses on aortic aneurysm. The most common reason we would perform an abdominal aorta ultrasound examination in the primary care office would be to screen for abdominal aortic aneurysms (AAA) in at-risk patients. There is also a required POCUS OSCE via Zoom for you to attend during the first week of your clerkship. See your Rotation Specific Checklist  for details. There is an additional resource available to you in the Ruth Lilly Library, Point of Care Ultrasound in Primary Care. 4th year elective available. Point of Care Ultrasound in Outpatient Settings Curriculum Objectives:

• Differentiate the steps of the exam protocol
• Identify pathologies associated with the abdominal aorta

Preventive Medicine

Preventive Medicine is the practice of promoting preventive health care to improve patient well-being. The goal is to ultimately prevent disease, disability, and death. Physicians trained in Preventive Medicine evaluate and administer preventive treatment that is derived from possessing expertise in a broad range of health care skills, including: preventive medicine practice in clinical settings, biostatistics, epidemiology, planning and evaluation of health services, management of health care organizations, and research. This module serves as an introduction into preventive medicine with taking a patient history, patient screening, and special emphasis on USPDSTF and CDC guidelines. Preventive Medicine objectives:

• Explain the principles and importance of preventive medicine in promoting patient well-being and reducing disease, disability, and mortality.
• Demonstrate the ability to take a comprehensive patient history and conduct patient screenings in accordance with preventive medicine best practices.
• Apply the U.S. Preventive Services Task Force (USPSTF) and Centers for Disease Control and Prevention (CDC) guidelines to assess and recommend appropriate preventive interventions for patients.

Practice-Based Learning and Improvement for Clinical Clerkships

The PBLI for Clinical Clerkships assignment is to assess your ability to take a clinical case, identify a knowledge gap you have in the management of this patient's problem, and fill that knowledge gap with evidence from the medical literature. All students are required to complete and submit a PBLI via the Canvas assignment during their Family Medicine Clerkship rotation. For this assignment, students are to identify a patient during their rotation and develop a "clinical inquiry" based upon something that is unfamiliar. Clinical inquiries can be on therapy, diagnosis or screening, prognosis, etiology, harm, and cost. The PBLI assignment is rather straightforward. Please note as Phase 2 students, the expectations are higher for this assignment and will be graded as such. (See "Rotation Specific Assignment Checklist" for your specific due dates). PBLI for Clinical Clerkships Curriculum Objectives:

• Identify a knowledge gap based on patient clinical presentation
• Complete a systematic review of the literature
• Identify if applicable to patient and/or patient population

Dermatology in the Family Medicine Clinical Setting

This module focuses on common skin conditions found in the primary care outpatient setting. Dermatology Objectives:

• Differentiate common skin disorders and cutaneous diseases
• Diagnose and manage common skin conditions

Non-Medical Drivers of Health

Trigger Warning. The Non-Medical Drivers of Health module explores non-medical drivers of health in the context of maternal mortality and COVID deaths, focusing on two real-life case examples from Indianapolis. With this module is the Social Needs Project, which allows you to focus on the health and social needs of a case patient. You will learn about the practice of public health and ways that family doctors and other primary care providers can play an important role in influencing not only your patients’ health, but population health as well. Additionally, this module incorporates telehealth visits. Curriculum Objectives

• Recognize concepts around the non-medical drivers of health that play important roles in patient health and well-being.
• Develop strategies for alleviating health disparities for individuals, their families, and their communities.

Professional Development Module (select any two modules)

Conceptually, family medicine is built around a social unit (the family) as opposed to either a specific patient population, organ system, or nature of an intervention. Consequently, family physicians are trained with the intent to be able to deal with the entire spectrum of medical issues that might be encountered by the members of a family unit. However, what many students do not know is that the discipline of family medicine also has its own unique scope and sub-specialties not limited to geriatric health, OB-GYN, and women’s health. These introductory professional development modules represent a small portion of those sub-specialties. Due to time constraints and the availability of 4^th year electives in many of these areas, treatment plans are not a part of these modules. Professional Development Curriculum Objectives

• Apply the principles of evidence-based medicine in the family medicine outpatient setting to frequently encountered areas of healthcare and preventive health
• Using differential diagnosis, construct a diagnosis in the family medicine outpatient setting
• Differentiate diagnostic tools used in the family medicine outpatient setting

As a requirement of the Family Medicine Clerkship, you are to select any two modules that appeal to you. However, if you are interested in more than the required module, and you feel you have the time, you can complete as many as you like (lowest scores will be dropped). Please note that not all modules are equal: the Sports Medicine module has been broken into four parts (see below).

Chronic Pain - Psychiatry Spotlight - An Evidence-Based Approach to Treating Chronic Pain (counts as 1 module).

The management of chronic pain is an important topic for training competent family physicians. The majority of chronic pain patients are treated by primary care physicians, and family physicians are well-suited to address multiple dimensions of a pain patient’s care. Current guidelines strongly emphasize an interdisciplinary, multimodal approach to treatment. However, most primary care physicians feel poorly prepared to take on this problem. This module, developed in conjunction with IUSM psychiatry faculty, serves as an introduction on understanding chronic pain, the clinical presentation, diagnosis, and treatment.

HIV/PrEP (counts as 1 module)

PrEP reduces the risk of contracting HIV by 44–88% in at-risk populations, with risk reductions of 92–100% among individuals most adherent to PrEP. However, dissemination and uptake of this HIV-reduction opportunity requires clinicians to be trained in its use and willing to prescribe PrEP. Primary care providers should be equally, if not more, knowledgeable of the utility of PrEP and practiced in its delivery within primary care settings, as many HIV specialists may not care for many patients who are HIV negative. The HIV/PrEP module is an overview of PrEP in the primary care setting.

Comprehensive Care: Optimizing Patient Outcomes Across Communities (counts as 1 module).

This module provides an overview of LGBTQIA+ healthcare. Lesbian, gay, bisexual, transgender and questioning or queer (LGBTQIA+) patients should always be treated with dignity when seeking and receiving health care. But often, they experience significant disparities in care and barriers to health care access that can lead to potential health complications. 

Lifestyle Medicine (counts as 1 module)

Many consider lifestyle medicine to be a relatively new subspecialty, although it has been practiced for thousands of years. Unlike conventional medicine, the focus of lifestyle medicine is not on the treatment of chronic diseases but rather on their prevention. Chronic diseases are presently the leading cause of morbidity and mortality and are responsible for most of our health care expenditure. Most of these chronic conditions are preventable and are the result of an unhealthy lifestyle. The Lifestyle Medicine module is an introduction to the practice of lifestyle medicine and its powerful effect on these modern instigators of premature disability and death. 4^th year elective available

Maternal Health (counts as 1 module)

Family medicine is the most widely distributed specialty in the United States encompassing metropolitan to rural areas. Therefore, family physicians are in the best demographic position to provide obstetric care. Family medicine physicians are an important part of obstetrical care and perform about 800,000 deliveries per year or 20% of all deliveries in the United States. There is a tremendous need for family physicians to provide obstetric care, especially in rural and underserved areas. Indiana is no exception as it ranks as the third highest state with maternal mortality. Obstetrics is a part of several 4^th year family medicine electives.

Palliative Care (counts as 1 module)

Palliative care is specialized medical care focused on improving quality of life for people living with serious illness and their families, with a focus on symptom management, emotional well-being, communication, and caregiver need. Palliative care is appropriate at any age and any stage of a serious illness and can be provided concomitantly with curative treatments. It is based on patient need, not prognosis, although palliative care needs often increase over time with advancing illness. Palliative care can be delivered in any setting (including hospitals, outpatient clinics, nursing facilities, and in patients’ homes).

Point of Care Ultrasound: MSK (counts as 1 module).

This module focuses on one of the of the most commonly seen complaints in the primary care setting, musculoskeletal issues. Point of care ultrasound (POCUS) is instrumental in the diagnosis and treatment of many Sports Medicine pathologies. This module provides an in-depth look at using POCUS in outpatient settings when your patient presents with knee effusion and wrist/carpal tunnel syndrome. There is an additional resource available to you in the Ruth Lilly Library, Point of Care Ultrasound in Primary Care. 4th year elective available.

Sports Medicine (counts as 4 modules)

Primary care sports medicine is the medical sub-specialty that focuses exclusively on the diagnosis, management and treatment of musculoskeletal injuries and disorders. Sports medicine physicians are highly trained and capable of treating a wide variety of orthopedic conditions, whether they stem from an acute injury, chronic overuse, or normal wear and tear on the muscles and joints of the body. A primary care sports medicine physician is typically board-certified in Family Medicine, Emergency Medicine, Internal Medicine, Pediatrics or Physical Medicine and Rehabilitation; fellowship-trained in Sports Medicine, which requires an additional one to two years of training following residency; and holds a Certificate of Added Qualification in Sports Medicine (CAQSM). The Sports Medicine module introduces you to a few common pathologies and diagnosis seen in the primary care/emergency setting. 4^th year elective available. Module Breakdown:

• Knee = 1 module
• Shoulder = 1 module
• Hip, Ankle, and Hand = 1 module
• Lower Back Pain = 1 module

Learning Materials and Resources

Aquifer^® Family Medicine Case-Based Curriculum

There is no required textbook to purchase for the Family Medicine Clerkship. Instead, the clerkship utilizes the case-based, on-line curriculum Aquifer^® Family Medicine. The Aquifer^® Family Medicine case-based curriculum has interactive virtual patient cases which build clinical competency, fill educational gaps, and help instill the core values and attitudes of family medicine (see "What You Will Learn" for complete listing of suggested cases). This online “textbook” is used by most family medicine clerkships nationally that utilize the NBME Shelf Exam. Students must register with Aquifer^® Family Medicine (see instructions below) in order to access the materials. Instructions to register for Aquifer^® Family Medicine:

1. Click on the Aquifer^® Family Medicine link (aquifer.org/courses/aquifer-family-medicine)
2. Click “Sign In” at the top of the page
3. Click "Register" at the bottom of the page. Enter your IU email address (username@iu.edu is the only address that will work)
4. You will be sent an email with a link to complete registration. Upon receipt of the registration email, click on the link "Click Here." You will then be brought to the profile setup page.
5. You will be asked to fill in your profile information and set up a password (8 character minimum). Once you have completed your user profile and created a password, you will receive a welcome email with links to useful information and guides. You would also be logged into the Aqueduct learning management system.
6. Once your profile is completed successfully, you will be brought to Indiana University's course page.
7. Now that you have completed your user profile and created a password, your sign in will be quick and easy. Go to Aquifer.org and click "Sign In" at the top right corner. This will work with all Aquifer^® products.

NBME Self-Assessment

You are required to take the NBME Self-Assessment. The Family Medicine Clerkship has set the exam to open and close at the midway point during your clerkship (see “Rotation Specific Checklist” for exact dates). Once you have completed the practice test, you are to upload the report into the Canvas assignment. Details on how to access the practice exam will be emailed to you. NBME Student Voucher tips:

• All students should take the voucher exams standard-paced unless they have approved accommodations for NBME exams.
• Students must complete the exam by selecting the "Finish" button and not by exiting out of the exam screen, otherwise they will not receive a grade.
• Students will receive their results immediately. These results should be uploaded in the clerkship Canvas assignments as specified by the clerkships.

NBME Study Sessions

Students are required to join the NBME Study Session to work out common medical conditions encountered in Family Medicine and Primary Care. The NBME Study Session will be held virtually on Zoom, where high yield topics on the NBME final exam will be discussed. 

If you miss the study session due to clinical responsibilities, it is up to you to reach out to the clerkship team at fmclerk@iu.edu. You will be allotted two (2) days past the missed session date to make up the points. NBME Study Session Curriculum Objectives: 

• Demonstrate preventative health measures utilized in family medicine primary care practice.
• Organize necessary management for chronic health conditions commonly encountered in primary care practice.

Optional Learning

In addition to the required textbook, there are required modules within Canvas. See the above section “Non-Clinical Learning Experiences/Requirements” for details. Below are optional resources.

MSK Module

The MSK Physical Exams module is a supplemental reference module that is not required. However, it is highly recommended that you review these physical exams as they are a part of the required physical exams.

TrueLearn

This platform is available to all medical students for free thanks to IU School of Medicine’s three-year contract. TrueLearn is a valuable resource for students in clerkships, offering a comprehensive platform to prepare for clerkship exams and Step 2. This resource includes a Question Bank of over 3,000 Step 1 and 4,000 Step 2 questions. Through this platform you will receive detailed explanations for correct and incorrect answers. Additionally, Picmonic Videos offer visual mnemonics, similar to Sketchy, and Anki Sync allows for a streamlined study process. You can also set up SmartText reminders to keep key points fresh by texting practice questions. For assistance, access the Learner Guide, contact TrueLearn support, or reach out to AskMSE. Within the Family Medicine Clerkship, we have embedded the practice quiz within this Canvas site.

NBME Practice Quizzes

In addition to NBME Self-Assessment from IUSM, the Family Medicine Clerkship also provides a NBME practice quizzes on various topics found on the final exam. The quizzes pull random questions from a question bank, and you can take these quizzes as many times as you like.

Extra Credit Points

Each year the FMC offers students an opportunity to earn up to two (2) extra credit points toward their final grade (overall points). This year we are offering two mini modules for extra credit

Lifestyle Medicine Podcast (1 point)

For this extra credit activity, we would like you to listen to a podcast version of the Lifestyle Medicine module and provide feedback. This podcast was created with generative AI directly from the module content. Your feedback is very important in deciding if more podcasts like this should be developed for other modules. After you have listened to the podcast, please complete the short survey to receive your extra credit point. You can listen to the podcast in Spotify or within Canvas.

PBLI Extra Credit: AI (1 point)

For this extra credit activity, we would like you to review the mini-module on Generative AI. After you have completed this, in order to receive your extra credit point, you are to do the following:

• Using generative AI, re-answer question 7 on your PBLI
• Complete the short survey 

Please note, de-identified data will be collected for research purposes, however you can opt out of allowing your data to be used and still receive the extra credit point.

Clerkship Grading

Please refer to the Grade Policy for Courses, Clerkships, and Electives in Phase 2 and 3 (md.mednet.iu.edu/policies-guidelines/handbook/grade-policy-courses-clerkships-electives). Students who fail 2 NBME exams and need to remediate their examinations, will be considered to have used their retake opportunities.

Final grades are determined by several indicators of student performance on the Family Medicine Clerkship including appropriate and full completion of all assignments/requirements. The grade distribution and grading scale are outlined in the below tables. NOTE: The community faculty preceptor does not assign the student’s final grade.

Total Point Distribution

NBME Exam Cutoffs (2024-25)

NBME Self-Assessment Scale

Grading Scale

Late Work

Students are expected to complete all assignments on time and with concerted effort. Students exhibiting late or unsatisfactory completion of assignments/requirements may receive an ID-P. Additionally, students are expected to respond promptly to communication from Family Medicine Clerkship staff and affiliates. Consistent failure to do so may result in documented competency concerns. Late submissions of assignments or failure to complete tasks on time without approval from the statewide clerkship office (fmclerk@iupui.edu) will result in a deduction of up to 5% of the total course points. One point per day, per late assignment will be subtracted from your final grade, even if the assignment has no points. See Grade Policy for Courses, Clerkships, and Electives in Phases 2 and 3 (policies.medicine.iu.edu/policies/edu-cur-0016)

Timeliness of Assignments

Timeliness of Assignments: It is expected that all required assignments and tasks will be submitted on time. Late submissions of assignments or failure to complete tasks on time without approval from the statewide clerkship director will result in a deduction of up to 5% of the total course points.

• If a student submits two or more graded assignments or non-graded clerkship tasks late OR other types of professionalism concerns arise, an AOC or ID-P may be submitted as deemed appropriate by the clerkship director.
• If a student fails to achieve a passing score on the NBME, they will be given an ID-MK and will be referred to the Student Promotion Committee for eligibility to remediate the isolated deficiency.
• An ID will serve as a designation while the remediation process is carried out and will not appear on the permanent transcript. Successful remediation of the ID will result in a passing grade (P or S) for the course.

Students have the opportunity to voluntarily retake one NBME subject examination to attempt to improve their score at the end of the Phase 2 academic year. The higher of the two scores will be incorporated into the student’s final course grade. Students who are required to remediate an examination(s) are ineligible for the voluntary retake.

How Will I Know How I’m Doing in This Course?

Clerkship Assessments

Mid Clerkship Evaluation. During the second week of the clerkship, students will need to download the 5-page Mid-Clerkship Feedback form (Word or PDF) and take to their preceptor to complete. Once completed, upload to the Canvas assignment. The Mid-Clerkship Feedback provides an opportunity for the student and the community faculty to: 1) review the student’s progress; and 2) set goals for the balance of the clerkship. Students should identify areas where assistance is still needed (i.e., what encounters do you still need to cover to meet your minimum requirements), as well as review history taking, physical exam, and problem assessment skills. This is also a good time to review a copy of the community faculty’s evaluation of the student to understand how he or she will be evaluating the student at the end of the clerkship. Completion of this form is required and must be signed by evaluator and student. Students may consult with site directors through telephone conversations and verify receipt of feedback via email. Documentation will be provided to the main clerkship office for compliance purposes.

This must be submitted within three (3) business days of the due date:

• Warning: If a student is a late in submitting the completed mid-clerkship formative evaluation form, the student will receive an email reminder to get this completed and submitted ASAP.  
• AOC:  If a student is more than three (3) business days late submitting the completed mid-clerkship formative evaluation form without any prior provisions, an AOC in professionalism will be issued.

Formative Feedback. During the second week of the clerkship, the site director will meet with student to discuss the requirements for successful completion of  the clerkship. Students should discuss with the site director anticipated difficulty regarding successful completion of requirements. For example, if the community faculty rarely sees female disorders, the student should talk with the site director to identify other resources to meet the required minimum. Additionally, the site director will identify any concerns with student performance not addressed through the community faculty. Any modifications to the student’s clerkship assignments or areas for improvement will be noted on the formative feedback form. Completion of this form is required and must be signed by evaluator and student. Students may consult with site directors through telephone conversations and verify receipt of feedback via email. Documentation will be provided to the main clerkship office for compliance purposes.

Final Preceptor Evaluation (200 points). Your preceptor will complete an objective, competency-based evaluation (click here for example) designed to measure specific knowledge, skills and attitudes. The evaluation is automatically sent to your preceptor via MedHub. Once the preceptor submits your final evaluation, the points will be added to your Canvas gradebook and your final grade will then be available. Note: This is typically done 30 days after your clerkship ends. 

If a student is evaluated poorly on any area of the community faculty evaluation, the student’s overall clerkship performance will be reviewed by the clerkship director to determine the appropriate course of action. This may include remediation in specific content, repetition of all or part of the clerkship, or assignment of a grade of “Fail”. Please note that written comments offered by the community faculty may be paraphrased on the final IUSM Clinical Performance Evaluation form. 

Fail – Repeat Family Medicine Clerkship

A grade of Fail will be reported for students who score less than Pass on the Preceptor Evaluation, score less than Pass on the final exam twice, or whose final clerkship score is less than 240 points. The first time a student fails the final exam, the student will receive an ID-MK and be required to retake the final exam. The highest final grade for the Family Medicine Clerkship after one failure of the final exam is an ID-MK/Pass. The Department of Family Medicine reserves the right to assign a failing grade for the entire clerkship if a student has performed in an unsatisfactory, unprofessional, or unethical manner in terms of behavior with the community faculty, one of their health care team members and/or patients, the site director, or the statewide office staff.

Course Absence

General Time Away

Students should submit time away request using the online request form (teaching.mednet.iu.edu/time-away-schedule-conflicts-request-form) Requests should be made through the “Time Away/Schedule Conflict” option on the form and should be made at least 30 days before the beginning of the impacted rotation. For unforeseeable circumstances, such as illness, students should contact their clinical teams immediately and submit the request as soon as it is feasible to do so. Students should request time away from their required clinical rotations only for professional development opportunities that require their active participation, with reasonable considerations for travel time. Accommodations are at the discretion of the clerkship director, with expectations that students will complete all missed educational time, activities, or duties. See the Schedule Conflicts, Absences, and Vacations Policy (md.mednet.iu.edu/policies-guidelines/handbook/schedule-conflicts-absences-and-vacations-policy) and the Adverse Weather Procedure (policies.medicine.iu.edu/policies/as-sp-0001) for more details or reach out to your statewide clerkship/sub-internship director or Dr. Dan Corson-Knowles (dcorsonk@iu.edu), Director of Clinical Distinction for Phase 3, with any questions.

Phase 3 Time Away for Interviews

Students should contact the statewide and site course directors, course coordinator, and lead advisor immediately upon becoming aware of a conflict between the required rotation schedule and a residency interview to plan appropriately. Accommodations for time away for interviews is at the course director’s discretion and is based on the circumstances and availability of accommodations, with expectations to make up time missed from the required curriculum. For additional clarification regarding time away for interviews, please review the information on the Time Away for Phase 3 page (md.mednet.iu.edu/education-programs/phase-3-year-4/time-away-for-phase-3). We recognize that a successful transition to residency is required for all physicians. It is our intent to provide as much flexibility as possible for residency interviews. We also recognize the importance of attaining a sound medical education.

Community Faculty-Student Incompatibility

It is possible that a good community faculty and a good student simply do not work well together. If you sense this is the case, bring the situation to the attention of your site director immediately. They will recommend a strategy for handling the situation or intervene directly. If you are concerned about your preceptor's behavior in any capacity, it is imperative you contact Dr. Renshaw immediately via fmclerk@iupui.edu. Do not wait until the end of the rotation.

Attendance

Clerkship attendance is required unless approved by the clerkship director.

Consult the Schedule Conflicts, Absences, and Vacations policy and the Adverse Weather procedure prior to completing a request form.

Students will have an opportunity to evaluate the Family Medicine Clerkship after taking the final exam.

It is expected that students will be responsible and always conduct themselves in a professional manner. This includes among other items such as reliability; honesty; integrity; self-discipline; professional standards regarding manner, dress and grooming; maturity; treating patients and staff with respect; respecting patient rights and privacy. Cheating is not an acceptable behavior and will not be tolerated. A demonstrable lack of interest in the clerkship and a disinterest in improving performance following feedback may lead to an Isolated Deficiency in Professionalism.

Consult the IUSM Mission and Vision (medicine.iu.edu/about/mission-vision-values) and Professional Conduct Policy (policies.medicine.iu.edu/policies/edu-cur-0009) that provide the foundation for the culture of professionalism expected at IUSM.

Please know that the course/clerkship leadership is always available to help with understanding content and what resources to use. If you find you need additional support, your Lead Advisor can help connect you with the resources you need and is your main point of contact for academic support services such as tutoring and learning specialists. IU School of Medicine tutors work with students on a one-on-one or small group basis to help students with course content, academic coaching, or board exam preparation. Tutoring is free to students. (For more information, please visit: https://medicine.iu.edu/mse/support/tutoring) Additionally, your Lead Advisor may recommend that you meet with the Learning Strategist, Perry Monnin to discuss study strategies in more depth, or with the Senior Director of Student Academic Success, Dr. Althea Kaminske, to discuss more personalized learning recommendations.

Indiana University School of Medicine has policies and procedures in compliance with applicable law including the ADA and others. For students who have properly documented and diagnosed disabilities recognized by ADA, IUSM will permit reasonable accommodations provided that the accommodations meet certain guidelines, including technical standards, fundamental competencies, and learning objectives. If you feel you are a qualified individual with a disability requiring accommodation, click here to apply for accommodation. For more information, refer to the Disabilities Accommodations Policy or contact the Disabilities Accommodations & Accessibility Resources Team at dartreq@iu.edu. 

IU School of Medicine offers clinical learning opportunities that allow medical students to complete their training in centers of medical education around the state. If you are required to travel for your learning opportunities while on required rotations, including in-person orientations and/or rotations away from your home campus, you will be provided with housing and/or reimbursed for required travel in accordance with the IU School of Medicine’s student travel guidelines. Please consult the Medical Student Travel Guidelines (md.mednet.iu.edu/policies-guidelines/student-travel-expenses) for more information about how to request housing and/or transportation reimbursement.

Canvas Technical Support

Students who need help accessing Canvas, resetting a password, using email, or with any technical problems, can contact their campus IT Helpdesk using this link: University Information Technology Services (UITS) (kb.iu.edu/d/abxl). Students can also find answers to frequently asked technology questions in the IU Knowledge Base (kb.iu.edu).

Canvas Technical Support

If you have questions or problems with Canvas, contact the University Information Technology Services (UITS) (kb.iu.edu/d/abxl) or call (317) 274-HELP.

MedHub Technical Support

Students who need help with MedHub can submit a Help Ticket. (iusom.sitehost.iu.edu/support/open.php).

Any faculty member/attending physician who has a current or prior relationship with a student that could reasonably be perceived as a conflict of interest may not evaluate that student. This includes familial relations, currently or previously providing medical or mental healthcare to the student or if either party feels that there is a conflict of interest. Faculty or students who believe there may be a conflict of interest in assessment should contact the Clerkship Director immediately upon discovering the issue. Any resulting issues will be handled with confidentiality and respect for all parties. For additional information please see the Non-Involvement of HC Providers in Student Assessment Policy (policies.medicine.iu.edu/policies/edu-cur-0002).

The IUSM has a clear mistreatment policy and reporting process to ensure a systematic approach to intervening in incidents of mistreatment to maintain a positive learning environment consistent with the school’s core values. For more information about the IU School of Medicine Learning Environment, please refer to this MedNet resource (md.mednet.iu.edu/policies-guidelines/learning-environment) Per the AAMC, examples of mistreatment include “sexual harassment, discrimination or harassment based on race, religion, ethnicity, gender, or sexual orientation; humiliation; psychological or physical punishment; and the use of grading and other forms of assessment in a punitive manner”. If you are concerned that you have experienced or witnessed possible mistreatment, you are strongly encouraged to report it through the IU School of Medicine Mistreatment Incident Report Form (iu.co1.qualtrics.com/jfe/form/SV_9SmcPmlr4fX82HP). For more information about the Mistreatment Reporting Process please refer to this MedNet resource (md.mednet.iu.edu/policies-guidelines/learning-environment/mistreatment-reporting-process).

IUSM is piloting a new system that allows students to report non-mistreatment-related concerns and incidents in the learning environment (i.e., microaggressions/bias in curricular content, inadequate clinical supervision, etc.). Students can scan the QR code below to fill out the form. Students can also find the Student Concerns Reporting Form on all course Canvas sites by clicking the "IUSM Resources" button on the left-hand navigation menu and following the link listed under "Learning Environment." Concerns can be reported anonymously; per IU policy, retaliation against anyone submitting a report is strictly prohibited. To report mistreatment, follow the IUSM Mistreatment Reporting procedure linked above.

For all policies, please go to the IU School of Medicine Student Handbook (md.mednet.iu.edu/policies-guidelines/handbook).

• Adverse Weather Conditions (medicine.iu.edu/policies/as-sp-0001)
• Area of Concern Policy (medicine.iu.edu/policies/edu-cur-0010)
• Grade Policy for Phase 2 and 3 (policies.medicine.iu.edu/policies/edu-cur-0016)
• Infectious Disease and Environmental Hazards Exposure Policy (policies.medicine.iu.edu/policies/edu-saf-0015) 
• Time Away Policy (policies.medicine.iu.edu/policies/edu-emr-0002)
• Supervision and Scope of Practice Policy (policies.medicine.iu.edu/policies/edu-cur-0004)

Please note that students have access to these and many other resources from the left navigation of the canvas site.

• IUSM Academic Calendar (medicine.iu.edu/md/curriculum/academic-calendar) 
• IUSM Student Handbook (medicine.iu.edu/mse/policies/handbook)
• Academic Advising (medicine.iu.edu/mse/support/advising)
• Career Development (medicine.iu.edu/mse/support/career-development) 
• MSE Resources for 4th Year Students (medicine.iu.edu/mse/education/phase-3)
• Ruth Lilly Medical Library (library.mednet.iu.edu)
• Hospital Resource Guides and Student Space Improvements (medicine.iu.edu/mse/student-voice/action-on-feedback/hospital-resources)
• Needlestick, Injury and Environmental Exposure (medicine.iu.edu/about/policies-guidelines/emergency-response/universal-precautions) 

The Statewide Clerkship Director reserves the right to revise or adjust the syllabus to best accommodate the pace and needs of the students. The Statewide Clerkship Director also reserves the right to revise or adjust the course syllabus to remain compliant with all local, state, and federal regulations.