MedLaunch - College of Medicine and Life Sciences

Clinical

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M3

University of Toledo College of Medicine Policies

See all Medical Student Policies

Objective Structured Clinical Examinations (OSCE)

• OSCEs are standardized exams designed to evaluate your history taking skills, physical exam technique, differential diagnosis and medical work up relative to the pathology frequently encountered within the respective clerkship.
  • These will be conducted in the Hillebrand Skills Center. The structure is identical to the Step 2 Clinical Skills examination.
  • Information about the structure of Step 2 CS can be found in a useful video here
• Each clerkship (with the exception of Neurology and electives) will require an OSCE as a component of your final grade.
• Preparation for OSCEs
• Review the common pathologies relative to each clerkship including presentation, differential diagnosis and necessary laboratory or imaging exams.
• First Aid Step 2 CS also has example cases that may be helpful in preparing for OSCEs.

Area Health Education Centers (AHEC)

• Through a network of 250 doctors UToledo College of Medicine students are provided office practice, ambulatory and hospital clinical experience throughout Northwest Ohio in predominantly rural areas.
• All students are required to complete a minimum of 8 weeks at a designated AHEC center
• For more information about the AHEC program and locations visit the AHEC website

Clerkship Grading Policies

• All clerkships function on the same grading template. Each clerkship, however, has different thresholds for earning Honors and High Pass marks.
• Grade Composition
• Clinical evaluations are responsible for 50% of your final grade
  • Failure to achieve 25 points of the possible 50 will result in a grade of defer being submitted to the Registrar.
• The NBME is responsible for 30% of your final grade
  • The NBME minimum score is different for each clerkship
• The Departmental Educational Program is 20% of your final grade
• Failure to achieve 10 points of the possible 20 will result in a grade of defer being submitted to the Registrar
• The official UTCOMLS Policy on clerkship grading is located here.

Resource Overview

General information: realize that clinical questions are built on foundations from preclinical education. Key differences include:

• Less focus on histopath 

• Less focus on pathophys mechanisms 

• More focus on what is the diagnosis and what to do next for it

• Pathophys mechanisms tested in treatment choices

• Questions tend to describe a disease, you will have to recognize it, then select the proper treatment or diagnostic study to identify the disease process 

• Rarely will the questions stop at solely identify the disease

Online MedEd (OME)

• Does not truly have enough information to be your sole resource for a shelf, but gives a great background.

• Starter resource for every rotation

• Try to finish OME within a week or two in the rotation and then review your notes on it towards the end

Step Up to Medicine (SU2M)

• Useful for the full year as well as almost every topic has an IM tie in

• Review relevant sections as the year progresses

• For example, during family medicine review the ambulatory section and relevant medicine topics such as CHF, COPD and exacerbations, pneumonia, skin disorders, etc.

• Things not to read during family medicine would be topics similar to cardiomyopathy or pneumoconiosis as those would be more internal medicine speciality services 

UWorld

• Use as an interactive textbook throughout clerkships, not as an assessment tool.

• When it comes to 10 week rotations (IM, surgery), it is imperative that you study consistently throughout the rotation.  Generally, you should start doing practice questions within the first 2 weeks of the rotation.    The large number of questions in the UWorld bank allows for a nice mix of repetition and retrieval of information..

• As with step 1, proper review of the questions and identification of your knowledge gaps should always be the main goal of doing UWorld. 

AMBOSS

• Similar to UWorld, different format and presentation

• Outlines have been pre made that are extremely easy to search. Interface is user friendly.

• AMBOSS seems to have more niche, difficult questions than the UWorld bank.  This can have its advantages for gaining a few extra points on shelf exams.  With that being said, the core knowledge needed to obtain good shelf scores is found in both banks. 

• A growing number of students are preferring AMBOSS to UWorld.  Pick which is best for your learning style and commit to it.

NBME Self Assessments

• Use as an assessment tool and learning after, would recommend at least 2 exams for every clerkship

• Towards the end of third year, it is normal for students to have a good grasp of where they are performing on practice questions, and may not purchase as many NBME exams.

Family Medicine

• Course Coordinator: Lindsey Brillhart (lindsey.brillhart@utoledo.edu | 419.383.5557)
• Clerkship Structure
  • 4 weeks. Orientation will be the first two days of the rotation.
    • An optional Knee Exam Workshop is held after orientation. This is not required, but should be required. It is highly beneficial for your education and success.
  • Didactic lectures will be held the 3rd Thursday of the rotation
  • A debriefing will be held prior to the NBME where your OSCE and project grades will be reviewed.
• Department Educational Program
  • OSCE: Will be held the 3rd Thursday of the rotation after the morning didactics
  • Nutrition Project, Exercise Project and Geriatric Assessment. All of these are due the 3rd Thursday of the rotation
  Family Medicine Cases online modules will be required
  • Blackboard Quiz: There is a required Blackboard quiz the Monday of the final week. This quiz will be based on the material contained in the Family Medicine Cases.
• Resources
  • OME (OME has a schedule online (PDF) that has suggested videos to watch during your FM clerkship i.e. GERD, pneumonia, COPD, and general topics as such), SU2M relevant parts especially ambulatory and topics identified by the OME guide that are useful for FM, NBME
  • Resources specific to FM
    • Case Files Fam Med - would read through and have a differential + next steps for every primary complaint within this book ~50 including review questions
    • AMBOSS FM section
    • UVA FM quiz - 125 questions with UWorld style explanations
    • AAFP questions bank; see details at orientation to sign up for access

Internal Medicine

• Course Coordinator: Dawn Jagodzinski (dawn.jagodzinski@utoledo.edu | 419.383.5022)
• Clerkship Structure
  • 9 weeks. Three total 3-week rotations. Two of the rotations will be at an area hospital in services including but not limited to: Cardiology, Hospitalist, Nephrology and Pulmonology. You will be able to rank your preferences. The third rotation will be a local ambulatory service or Area Health Education Center (AHEC) rotation.
• Department Educational Program
  • OSCE: 15 points of the 20 Department Educational Program points
  • 5 points for attendance at required conferences, online SIMPLE case completion, participation and case logging
• Resources
  • OME, UWorld or AMBOSS, SU2M, Kaplan Step 2CK Review Book, NBME
  • Resources specific to IM:
    • Most of the longitudinal step 2 CK books are geared mainly toward IM so if you find one that you like then stick with it as a study resource!
    • Examples: SU2M, Master the Boards, FA for Step 2 CK

Neurology

• Course Coordinator: Brandi Hendrickson (brandi.hendrickson@utoledo.edu /419-291-6590)
• Clerkship Structure
  • 4 weeks. Orientation will be the first day of the rotation. Combination of inpatient (Neurology Primary, Neurology Consults, Stroke) and outpatient services.
  • Every day begins with an education conference on both inpatient and outpatient services
• Department Educational Program
  • Team Based Learning Session: After completing preparatory materials, students participate in a Team Based Learning Session by taking Individual and Team Readiness Assurance Tests for 5 points each and 10% of the total grade.
  • Neurology Vignettes: After the NBME exam there will be two Neurology Vignettes. You will be given 30 minutes to read the cases and answer the clinically relevant questions. Each Vignette composes 5 points of your Department Educational Program grade.
• Resources
  • UWorld or AMBOSS, NBME
  • Resources Specific to Neuro:
    • Case Files Neurology
    • AAN 100 question self assessment (required task for department points)

Obstetrics and Gynecology

• Course Coordinator: Tammy Brittian (tammy.brittian@utoledo.edu | 419.291.3122)
• Clerkship Structure
  • 4 weeks. Inpatient and outpatient services.
• Department Educational Program
  • OSCE
• Resources
  • OME, UWorld or AMBOSS, SU2M relevant parts, NBME, clerkship textbook
  • Resources specific to OBGYN
    • UWise from APGO
      • Has some questions that might be resident level or obscure but you will be able to tell which questions are more our level
      • Will help with obscure, challenging questions on the shelf.  Foundational information can be found in the other listed resources

Pediatrics

• Course Coordinator: Joseph Osinski (joseph.osinski@utoledo.edu | 419.291.0377)
• Clerkship Structure
  • 4 weeks. Combination of both inpatient and outpatient services. 
• Department Educational Program
  • OSCE.
  • Team Based Learning exercises.
• Resources
  • OME, UWorld or AMBOSS, SU2M relevant parts, NBME
  • Resources specific to PEDS
    • Board Review Series Pediatrics
      • Great especially if you have peds before a primary care service like IM or FM
      • Read relevant chapters- do not get too bogged down in details

Psychiatry

• Course Coordinator: Jenelle Thurn (jenelle.thurn@utoledo.edu | 419.383.5694)
• Clerkship Structure
  • 4 weeks. Combination of inpatient and outpatient services.
  • Orientation will be held the first two days of the rotation. The OSCE will be administered on Tuesday of the 3rd week.
• Department Educational Program
  • Two quizzes will constitute 10 points (5 each).
  • The OSCE will constitute the remaining 10 points. The diagnostic criteria in the DSM-V for commonly encountered psychiatric conditions are critically important for success on the OSCE.
• Resources
  • OME, UWorld or AMBOSS, NBME
  • Resources specific to psychiatry
    • First Aid (FA) for Psychiatry has most everything that will be tested on the shelf and is a great adjunct to OME. Like most of FA products it is in bullet point setup so easy to read but need to be able to take that info and apply it to a question.

Surgery

• Course Coordinator: Claudia Davis (claudia.davis@utoledo.edu | 419.383.3580)
• Clerkship Structure
  • 9 weeks. Three 3-week rotations between different surgical services including but not limited to: Cardiothoracic Surgery, General Surgery, Neurosurgery, Orthopedic Surgery, Plastic Surgery, Surgical Oncology, Trauma Surgery, Vascular Surgery and Urology. You will be able to rank your preferences.
• Department Educational Program
  • Case Logs and Diagnostic Category Requirements
  • Attendance at required conferences such as Ethics and Professor Conferences.
  • Ethics Paper: You will be required to write a 1-2 page paper describing an ethical dilemma you encountered while on service. A template for the paper will be provided during orientation.
  • Green Skills Card: You will be required to perform patient care procedures and H&P under the direct supervision of a nurse, resident or attending. Take pictures of the card as you complete each task in case you lose it. Be proactive in completing these procedures. Be honest with the medical staff about your skill level.
  • Surgery Oral Exam: On the same day you complete the OSCE an Oral Exam will be administered covering a predefined set of topics. It is at the discretion of the attending administering the exam whether to go discuss all topics superficially or certain topics in depth.
• Resources
  • OME, UWorld or AMBOSS, SU2M (would especially read GI medicine), NBME
  • Resources specific to surgery
    • Pestana's is better as a white coat stuffer to glance at in downtime between cases.
    • DeVirgilio Surgery is excellent (this is the primary resource during surgery), similar to case files with questions and high yield cases with key points/findings. It is a dense resource, which is why not everyone uses it.

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M4

curriculum requirements

• The 4th year curriculum is 40 weeks in duration. You are granted 8 weeks of Flex Time to use at your discretion in 2 week blocks. Of the remaining 32 weeks, 24 must be clinical electives as opposed to basic science or research. Within the 24 weeks at least 1 Acting Internship of 4 weeks duration must be completed at UTMC or Toledo Hospital. At least 12 of the 24 weeks must be completed at UTMC or affiliate hospitals. No more than 12 weeks may be completed within a single ACGME core discipline.  
• An incredibly valuable resource for determining 4th year requirements and Graduation eligibility is the Degree Audit
• MyUT → My Records → Run Degree Audit
• The University of Toledo College of Medicine Policy regarding 4th year requirements: Link coming soon

Electives

• The ability to individually design your 4th year curriculum is a great strength of UTCOM. Information regarding 4th year electives is located here. You need to be aware that the 3rd year clerkship directors may or may not be responsible for scheduling 4th year electives. There also may, or may not, be prerequisite requirements such as email permission in order to register for 4th year electives.

honor societies

Gold humanism honor society (GHHS)

• Induction into the Gold Humanism Honor Society is a multi-faceted process that begins with peer nominations. Students who are nominated are invited to complete a series of essays which will be read by active Gold Humanism Honor Society members, primarily students. A panel of physicians and administrators then utilize these reviews and other criteria to evaluate each students candidacy for induction

alpha omega alpha (AOA)

• Candidacy for induction into Alpha Omega Alpha is initially determined by each students' Grade Point Average. Students who achieve a certain threshold are invited to complete a series of essays regarding the core values of Alpha Omega Alpha. These essays in combination with the GPA are used as criteria to determine candidacy for induction into AOA. More detailed information about induction into AOA can be found here. 

USMLE Step 2

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