|
Fourth Year Course Catalog
2008-2009
Information for Developing Your Fourth-Year Program
Graduation Requirements
Prerequisites
Off-Sites
Area Health Education Centers (AHEC)
Extramurals
Residency Interview Period
United States Medical Licensing Examination (USMLE)
Acting Internships
Medical Records/Orders
Acting Intern Orders
Vacation Month
Professionalism
COM Policy on Duty Hours
Official Time Away from Clinical Rotations
Graduation Requirements
All students must complete a minimum of eight fourth-year, four-week clerkship periods and the Dean's Colloquium for a total of 33 weeks. Split rotations will not be allowed.
Your eight fourth-year rotations must include rotations that fill the following four requirements:
1. Acting Internship from a Medical Specialty to be chosen from the following offerings:
2. Acting Internship Selected from a Surgical Specialty to be chosen from the following offerings:
* Your acting internships in Medicine and Surgery must be from different departments.
3. An off-site rotation to be chosen from the following offerings:
NOTE: If you completed only one AHEC rotation during your third year, your fourth-year off-site must be at an AHEC location. If you completed two AHEC rotations during your third year, your fourth-year off-site may be done with any voluntary faculty preceptor. You may also fulfill the requirement for a second AHEC rotation by taking FP 854 Acting Internship in Family Practice, which counts as both an AHEC and an acting internship in a medical specialty, but not as an off-site.
4. MD-842 Clinical Pharmacology and Anesthesiology (offered in Period 07)
In addition to the four rotation requirements, each student has four periods (16 weeks) available for elective rotations of their choice with the following restriction: No off-site rotation may be taken under the supervision of a relative. Each student may also take one period off as vacation.
The Dean's Colloquium will be held May 11 and 12, 2009, and is required for graduation.
Prerequisites
The latitude given a student in choosing fourth-year clerkships is dependent on performance during previous years. The description of the clerkships includes a listing of prerequisites for each offering.
Please be aware of the following stipulations:
- Any student who receives an "Unsatisfactory" grade (U or E) in a third-year clerkship, or for any reason has not completed third-year clerkships, shall not be promoted to the fourth year until the deficiency has been rectified to the satisfaction of the Student Progress and Promotion Committee and the department involved. Repetition of one or more third-year clerkships at the normal beginning of the fourth year does not alter the required number of credits which must be acquired as a fourth-year student.
- When a student has achieved only minimal performance on a third-year clerkship, a department may recommend to the SPPC that the student include a particular clerkship in fourth-year work.
Off-sites
An off-site course is a University of Kentucky course which a student takes away from the tertiary care center, usually in a private practitioner's office. The site must be within the state of Kentucky and the student must be supervised by a preceptor who is a member of the College of Medicine volunteer faculty.
Beginning in early May, students are given an opportunity to select from available preceptors. This process is administered by the departments with the assistance of the Registrar. They will be informed via e-mail of the particulars of this process.
Students must submit a Preceptor Assignment Form to the department at least two months prior to the start of scheduled off-site rotation. Some departments may require earlier submission of request form. The list of preceptors and the form will be provided via e-mail in early May.
Area Health Education Centers
The Area Health Education Center program combines the resources of carefully selected community hospitals and physicians engaged in the private practice of medicine to provide rotations for senior medical students. These rotations enable the student to receive a portion of their education in a setting other than that of the University of Kentucky Medical Center in Lexington . All physicians are volunteer faculty members in appropriate College of Medicine departments. Students select a practice in the specialty and location of their choice for a period of four weeks. During this time the student resides in the community and is instructed and supervised by a physician preceptor. (Travel, housing and meal stipends are typically provided. Some restrictions apply.) This rotation allows the student to experience life in a smaller Kentucky community, participate with a great deal of flexibility and autonomy in delivering medical care in a private practice setting, and benefit from a one-to-one teaching relationship with a qualified and interested voluntary clinical faculty member. Rotations are available in numerous specialties and sites are statewide. Each student must complete two rotations at AHEC sites prior to graduation. To receive AHEC funds to help cover expenses of your off-site rotation, you must submit the appropriate forms to the AHEC office at UK at least one month prior to the start of the rotation.
Extramurals
An extramural is a clinical rotation done outside of Kentucky and administered by a medical school other than UKCOM. (Rotations in Louisville done through the University of Louisville and in Northern Kentucky done through the University of Cincinnati are also considered extramurals.) Extramural clerkships are primarily for students who have shown a strong past academic performance. Approval will be limited to three clerkship periods or four periods for students who chose to use their available vacation time. Each extramural must be four weeks long. You may apply for up to four extramurals per period in which you register to do an extramural.
Planning an extramural requires an early start and diligence with regards to paperwork and follow-through:
1. Identify institutions that offers extramurals that you would like to apply for. The Extramural Electives Compendium on the AAMC site (http://www.aamc.org/students/medstudents/electives/start.htm) provides a good starting place. Many residency programs also offer extramurals. A complete listing of residency programs can be found in the Graduate Medical Education Directory , available in Student Affairs.
2. Contact the institution where you would like to conduct an extramural. Most institutions now have information for prospective visiting students on their Web sites. Obtain an application and a complete course/clerkship description. Review the application to familiarize yourself with the documentation that will be required.
3. Go to the Registrar's office to obtain an Extramural Clerkship Approval Form (see page 115 of the Fourth-Year Course Catalog) and to review the application with the Registrar (who will be providing some of the required documentation).
4. An extramural clerkship must be approved by the designated departmental representative from UK prior to the start of any extramural rotation in order for UK credit to be awarded. Your Extramural Clerkship Approval Form with attached clerkship description must be signed by the appropriate faculty member listed below before the Registrar can provide the documentation required for your application. The departmental representatives are:
- Anatomy, Jennifer Brueckner, Ph.D., MN-224, UKMC
- Anesthesiology, Arundathi Reddy, M.B.B.S., N-204, UKMC
- Behavioral Science, H. Jean Wiese, Ph.D., 107 COM Office Bldg.
- Biochemistry, Louis Hersh, Ph.D., MS-607B, UKMC
- Diagnostic Radiology, Arthur Lieber, M.D., A-125 Kentucky Clinic
- Emergency Medicine, Bill Young , M.D., M-53, UKMC
- Family Practice, Jennifer Joyce, M.D., K-302, Kentucky Clinic
- Micro and Immunology, Alan Kaplan, Ph.D., MS-411, UKMC
- Internal Medicine, Steven Haist, M.D., M.S., F.A.C.P., K-512, Kentucky Clinic
- Neurology, William C. Robertson Jr., M.D., L-408, Kentucky Clinic
- OB/GYN, Wendy Hansen, M.D., C-367, UKMC
- Ophthalmology, Julia Stevens, M.D., E-302, Kentucky Clinic
- Pathology, Michael Cibull, M.D., MS-125, UKMC
- Pediatrics, Jenna Ross , M.D., J-443, Kentucky Clinic
- Pharmacology, Nada Porter, PhD, MS-315, UKMC
- Physiology, Brian Jackson, Ph.D., MS-581, UKMC
- Preventive Medicine, Scott Prince, M.D., 2400 Greatstone Pt.
- Psychiatry, Jim Norton, Ph.D., A-301, Kentucky Clinic
- Radiation Medicine, Mahesh R. Kudrimoti, M.D., N-013, UKMC
- Rehabilitation Medicine, Chadwick Walters, D.O., B-127B, Kentucky Clinic
- Surgery, Raleigh Jones, M.D., C-236, UKMC
- Orthopaedics, William Shaffer, M.D., K-401 Kentucky Clinic
- Neurosurgery, Karen Swartz, MS-108, UKMC
5. An affiliation agreement must be in place between the College of Medicine and any extramural site which is not part of an LCME-accredited medical school. If you are planning such an extramural, contact the Registrar in ample time to allow for arrangements that will include multiple levels of institutional approval.
6. Notify the Registrar as soon as you have been accepted for an extramural that you plan to do. The Registrar will update your registration to reflect the specific rotation and institution. If you decide to decline an extramural for which you have been accepted, notify the institution immediately and no later than one month prior to the beginning of the rotation.
7. The Registrar will provide you with an evaluation/grade form and instructions before you leave for your extramural. It is your responsibility to be sure that a completed evaluation with a final letter grade is returned so that academic credit can be awarded.
Residency Interview Period
In an effort to provide flexibility to students for residency interviews, the fifth period of the fourth-year curriculum covers eight weeks. Student may register for a clerkship which will be offered for four weeks between November 24, 2008 and January 16, 2009. Departments will specify which four of the eight weeks they will offer the course. The remaining four weeks are to be used for winter break and residency interviews.
Any additional interview leave must be approved by the course coordinator and is subject to his or her discretion.
Students should recognize that the majority of their residency interviews will take place in Periods 5 and 6. With that in mind, students should carefully plan their schedules to include as much flexibility as possible during these periods. Students should avoid scheduling Acting Internships during these periods.
United States Medical Licensing Examination
Passing USMLE Step 2-CK and Step 2-CS is a prerequisite for graduation. Students are expected to register for both exams by Sept. 1 and to take both examinations by Dec. 31 to insure adequate time for scores to be recorded prior to graduation. Students may take USMLE Step 2-CK and Step 2-CS in whatever sequence they like as long as both examinations have been completed by Dec. 31.
Students will not be required to be on call the night prior to the exam and are relieved of rotation responsibilities on the day of the examination. The Student Affairs Office and clerkship coordinator must be notified of the your scheduled date at least three weeks prior to the test.
Acting Internships
Several clinical departments offer an acting internship (AI) experience during the fourth year. Some require special permission from the course director as noted in the descriptions. Also note that since acting interns take the place of an intern, special duties and responsibilities are assigned and may involve extended rotation dates. (Acting Internships may end on the final Sunday of a rotation period as opposed to Friday.) Try to schedule AI rotations in the months where you will not have interruptions for interviews, USMLE exams, etc., as your attendance is imperative. Additionally, once an AI is scheduled, the clerkship coordinator may not be able to allow students to change rotation dates, unless coverage for service can be arranged.
Medical Records/Orders
Much information in patient charts is written by medical students. Make sure that you identify yourself as an M4 in the chart. If you are participating as an acting intern, you should sign the chart as such. Orders can only be written by licensed physicians, thus any M4 order must be co-signed by the intern, resident or attending before its implementation.
Acting Intern Orders
Selected senior students may be approved to be acting interns by certain departments. All students so selected will wear readily visible identification badges during performance of their responsibilities.
Acting interns may write orders for patients in general patient care areas. Acting interns are not authorized to give verbal or telephone orders, or to write orders in critical care units. All orders written by acting interns must be reviewed and co-signed by the supervising resident or attending physician before those orders are implemented.
The Chief of Staff's Office will monitor acting intern orders. Violations may result in but are not limited to the following sanctions: revocation of the acting intern's order writing privileges, effect the acting intern's grade, and/or other sanctions.
At the VA Medical Center, acting intern orders must be countersigned before they are picked up and acted upon.
Vacation Month
With few exceptions, each senior will have one month of vacation. Students should carefully consider how to best use this month in scheduling their fourth year. Examples include the following:
- Period 1: Allows time to take USMLE Step 2 exams, begin to work on residency applications or to have a break after third year.
- Period 5: Allows additional time for residency interviews without clinical responsibilities.
- Period 9: Allows time after the Match for those students moving away for residency to begin to look for a home and prepare to move.
- The vacation month may be sacrificed for those students wishing to do an additional extramural rotation in their fourth year.
The vacation month may be used between Periods 1–5 to prepare for and/or take either or both USMLE Step 2 examinations as long as the strict Dec. 31 deadline is still met.
Professionalism
At all times in the fourth year, students will be expected to act in a professional manner in their interactions with patients, faculty, residents, staff and other students. As such, students must abide by all applicable policies and regulations governing professional behavior including but not limited to the following:
Policy on Duty Hours
The College of Medicine follows the ACGME guidelines on duty hours, namely that:
- medical students are to have on average one day out of every seven days free from clinical duties;
- medical students are never to work more than 80 hours per week; and
- duty periods for medical students cannot last for more than 24 hours although a student may need to stay a few hours longer than the allowed 24 hours in order to maintain continuity of patient care. Every effort should be made by the student's resident to get the medical student out of the hospital post-call.
If a student finds that the rotation that they are doing is not in compliance with these guidelines, the student should alert the Assistant Dean for Student Affairs right away who will follow up on this issue.
Official Time Away from Clinical Rotations
Students on outpatient clinic rotations typically have weekends free. On these rotations, students are allowed up to a maximum of two days off per 4-week rotation for official use. Students may use these two days for interviewing or taking Step 2-CK or CS.
Students on acting internships have increased patient responsibilities and are expected to be at the hospital more than those students on outpatient rotations. Acting internship rotations must still comply with the COM policy on duty hours as listed above. Students on acting internships are therefore allowed four days off per 4-week rotation. Students may use these four days for interviewing and/or taking Step 2-CK or CS. Students are not, however, encouraged to schedule interviews while on acting internships due to the increased patient care responsibilities.
Course Listing
Key Dates
Mechanics of Program Scheduling
Information for Developing Your Fourth-Year Program
|
