Medical Student Education

Medical Student Education
The Courtyard at Given
N-100, 89 Beaumont Avenue
Burlington, Vermont 05405-0068
T (802) 656-0722 • F (802) 656-9377
MEMORANDUM
Via Electronic Mail
To:
From:
Date:
Re:
University of Vermont College of Medicine Class of 2016 Students
Christa Zehle, M.D., Associate Dean for Students
November 13, 2014
Planning for Advanced Integration (Meeting)
Congratulations on reaching the final stages of your Clerkship Year! By this time, I am sure
many of you are beginning to think about the next phase of your medical education and
wondering what this will look like. This memo is intended to address many of your questions
about the Advanced Integration level of your medical education.
Meetings
There will be a class meeting on Thursday, November 20, 12:30-2:30 p.m. for all of those not
scheduled on a clinical rotation or to take an exam, to discuss and answer any questions about the
Advanced Integration year and the scheduling process. Lunch will be provided.
This meeting will be offered again on Monday, November 24, 5:00-7:00 p.m. to students who
are unable to attend the meeting on the 20th due to clerkship obligations. Dinner will be provided.
While not mandated, attendance is strongly encouraged. Please email dietary restrictions to
Barb Brisson. There will also be an opportunity to ask members of the Class of 2015 questions
about the Advanced Integration Year.
If after the meeting, you have additional questions about the Advanced Integration year, you may
schedule a meeting with your advisor, or contact Kiersten Hallquist to arrange a meeting with
me. Things you should review include:
1)
2)
3)
4)
5)
6)
Your progress in the Clerkship Year to date.
Any concerns you have about your experiences and/or evaluations.
Your current thoughts about specialty choices.
Your selection of a faculty specialty advisor.
Your plans and goals for Advanced Integration.
Any problems or concerns you wish to bring to my attention.
Exams
End of Clerkship Level CSE [Per the UVM COM Student Handbook]
To be eligible to take the CSE, which is required at the end of the Clerkship Level, all required clerkship
coursework must be successfully completed. Please read all policies related to Satisfactory Academic
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Progress (Policy 560.00 – 560.76) as well as the Review of Academic Performance Policy (Policy
565.30) thoroughly; these policies and other UVM COM Policies are all part of the Online UVM COM
Student Handbook.
You will receive more information about the End of Clerkship Level CSE from Cate Nicholas, in
early December, with dates and information about registering for this exam. This is a required
component of the VIC, and you must pass it in order to complete the Clerkship Year. The CSE is
excellent preparation for the Clinical Skills portion of USMLE Step 2. Please note that you are
not eligible to take this CSE until you have successfully completed each of the seven clerkships.
United States Medical Licensing Examination (USMLE)
You are required to take and pass USMLE Step 2 Clinical Knowledge before January 1, 2016.
It is strongly recommended that you take Step 2 CK before the middle of August, 2015, so that
your results are reported before the residency application due date, in September, 2015. This also
allows time for a repeat of the exam, should you need it, so that your graduation will not be
delayed or called into question.
You must receive a passing score for USMLE Step 2 Clinical Skills before the end of April,
2016. I strongly recommend that you take the USMLE CS exam before December 31, 2015, so
that the results are reported before programs rank applicants in February, 2016. The exam is
given in five cities: Atlanta, Chicago, Houston, Los Angeles, and Philadelphia. It is a one-day
exam and is given Monday through Saturday. You may not take it during a month when you are
doing an Acting Internship (AI). Slots fill early, so be sure to register for this exam as early as
possible. You may be excused from elective rotations for a maximum of 2 days to take the
USMLE Step 2 CS. EVERYTHING you need to know about USMLE can be found at the
NBME website (www.nbme.org).
Advanced Integration Requirements
Your Advanced Integration phase of the Vermont Integrated Curriculum begins 3/16/2015 and
ends 4/29/2016. Please see the attached Advanced Integration requirements grid for details.
You will need to choose either the general major or the surgery major.
1) A common question for many 3rd year students is how to choose between the surgery
major, or the general (non-surgery) major. The choice is based on one’s best estimate
regarding career direction. However, you are not expected to have finalized that decision
at this point and, even if you have, all opportunities within the curriculum leading to the
M.D. degree are available to all students in the College of Medicine.
Please note that this decision is reversible - you can switch out of the surgery major
before September 2015 and you can switch into it at any point, as long as sufficient time
remains to complete the requirements. Your assessment will determine which major will
better serve your educational needs.
To help make this decision, you can use this general guideline:
- Students who plan to apply in general surgery choose the surgery major
- Many students who plan to apply in urology choose the surgery major
- Some students who plan to apply in neurosurgery, orthopedic surgery, plastic surgery,
or ENT choose the surgery major
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-
Occasionally, students planning to apply in ophthalmology, ob/gyn, or emergency
medicine choose the surgery major
Very rarely does a student within other specialties choose the surgery major
2) Students in either major are required to do two AIs at Fletcher Allen Health Care
(FAHC),Danbury Hospital (DH), or Norwalk Hospital (NH)
3) One of the AIs for all students in either major must be in Internal Medicine AI at
FAHC, DH, NH. Dr. Mark Levine is the course director for the required Medicine AI
component of the curriculum. There is a formal curriculum for this AI, including didactic
and discussion sessions focused on skill development. Evaluation will include assessment
of clinical performance on patient care teams, assessment of quality of written
documentation, assessment of skills by faculty in a formal assessment context,
assessment via a 4-station CSE, and a knowledge-based examination to assess
understanding of common clinical situations. The AI in the medical intensive care unit
will not fulfill this requirement, nor will AIs in other specialties.
4) All students may take up to 6 weeks of vacation during the Advanced Integration
curriculum. One vacation month is generally used for completing residency interviews,
and it is most commonly taken in December or January.
5) All students may take one 4-week reading month to prepare for the USMLE exams.
The reading month does not count as a month of vacation and you receive 4 weeks of
credit for this month.
6) Students are not expected to schedule residency interviews or USMLE examinations
during AIs or teaching months. Once scheduled for an AI, a student may not drop it
unless s/he arranges for a student to take his/her place, or unless the department
concerned excuses the student.
7) Students in the general major are required to take a surgical specialty/subspecialty
month (SSM) composed of two weeks within two different surgical specialties or
subspecialties, or 4 weeks of a single specialty or subspecialty. That requirement is
usually fulfilled at FAHC, but students may consult Dr. Ted James, in the Department of
Surgery, for permission to fulfill it elsewhere.
8) Students in the general major are required to complete a teaching practicum or a
scholarly research project (see attached). Students in the surgery major meet this
requirement as part of the surgery major, which requires a scholarly research project.
9) In addition to the two required AIs, the surgery specialty/subspecialty requirement, and
the teaching requirement (if such a month is taken – see attached), students in the general
major must complete clinical or research elective rotations, with the optional reading
month being considered one of the electives, to total 48 weeks of rotations in the
Advanced Integration level.
10) Students electing the surgery major may switch out of it prior to September 1, 2015.
After September 1st students in the surgery major will be expected to complete all surgery
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major requirements. Dr. Ted James is the director of the surgery major. Requirements for
the surgery major include:
a) One Acting Internship in surgery at FAHC
b) Either the SSM described in #7 above, or a second AI in surgery at FAHC or at a
preapproved (by Dr. James) alternate location
c) One Acting Internship in internal medicine at FAHC or DH (as required for all
students)
d) 4 weeks of emergency medicine
e) Gross anatomy, the requirement for which may be fulfilled by taking a February
dissection rotation; by working as a teaching assistant in the first-year Human
Structure & Function course in October, November or December; or, by taking
elective rotations in autopsy pathology, surgical pathology, or diagnostic
radiology
f) A scholarly research project completed under the direction of faculty of the
Department of Surgery and presented in a formal symposium in April or May,
prior to graduation. Students may choose to spend 4 weeks of elective time
working on their projects. Dr. Ted James is the director of the scholarly project
component of the surgery major.
g) The Surgery Residency Readiness Course, given in March of the graduation year.
h) Additional clinical or research electives, with the optional reading month included
i) A total 48 weeks of rotations in the Advanced Integration level.
Choosing a Specialty Advisor
All students will need to select a specialty advisor prior to the Oasis scheduling process in
December 2014. Please contact the Specialty Director in your field of interest, and they will
assist you with selecting an advisor in their department. If you are undecided about a specialty,
you may list your current advisor (your PCR mentor) as your advisor until you have selected a
specialty or you can select an advisor in the specialty in which you are most interested. You can
always change advisors if you change specialties. As you prepare for applying to residency, it is
important to have an advisor in your specialty of choice who is familiar with the application
process, matching in that specialty, and career pathways within that specialty.
Please indicate your advisor choice in OASIS by December 4, 2014. You will not be able to
participate in the scheduling lottery if you have not identified an advisor.
Extramural Rotations
Many students wish to do rotations at other sites during Advanced Integration, while other
students prefer to do all their rotations at our affiliated clinical sites. This may be a matter of
personal choice, or may be important for your chosen specialty. The Careers in Medicine website
lists which specialties recommend extramural rotations under the Training and Residency
Tracks tab. Students may also want to travel to other institutions to be close to family and
friends, work in an environment with a different mix of patients, or experience medicine in a
different culture.
Students often wait until after they have received their UVM Advanced Integration schedules in
February before applying for extramural rotations. The other institutions frequently are not ready
to act on your applications until after they have scheduled their own students. The process of
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planning and applying for extramural rotations extends through much of Advanced Integration.
Do not expect to have everything finalized by March.
Many institutions impose a limit on the number of rotations for visiting medical students. Eight
weeks is a common limit. Some institutions require that students have passed USMLE Step 1
before their applications will be processed. Most institutions charge a registration fee, and some
charge substantial tuitions.
You can learn about opportunities at other institutions via the web, where you will be able to
download an application. Emma Faustner in the Office of Medical Student Education can assist
you with the application process. You will need to provide evidence of current HIPAA and
infection control training, up-to-date immunizations and TB skin tests, verification of your
student status at UVM, and liability insurance coverage. A significant number of institutions
require a recent physical examination, and some require an updated criminal background check,
so you may wish to plan accordingly.
Many schools have become participants in the AAMC’s on-line Visiting Student Application
Service (VSAS). Contact Emma for authorization to use that service.
Rotations in the Indian Health Service and the Alaskan Native Health Service fill early. If you
are interested in doing one of those rotations, or an international elective, it is advisable to
apply/plan early.
Students should be advised that all extramural rotations will require advance approval from
the Office of Medical Education before the rotation will be allowed onto the student’s schedule
for credit. Any extramural done without approval will not earn credit toward graduation.
Extramurals may not be added retroactively, after they have already been done. It is expected
that most established rotations at LCME accredited medical schools will be readily approved.
Letters of Recommendation for Residency Applications
Some of you have asked about requesting letters of recommendation from faculty you have
worked with during the Clerkship Level. Generally, it is advisable to wait and seek letters from
faculty who can evaluate your work at a more advanced level during Advanced Integration.
If you wish to request letters of reference now, you should obtain a cover sheet to request the
letter. You can download a copy of the COM generic letter request form on Comet > Lounge >
Student Affairs > green Residency Application button (this link will take you to the page if you
are already signed into COMET), scroll down to “Letters of Recommendation”. Letters should
be addressed “Dear Program Director” and sent to Emma Faustner in the Office of Medical
Education, where they will be kept on file until next fall. Your reference letters will not be due
until mid-September 2015, so you have plenty of time to arrange for them.
Careers in Medicine
The Careers in Medicine website has some helpful information about Choosing a Specialty and
Getting into Residency. Please familiarize yourselves with these sections of the CiM program
and let our office know if you have any questions. You may also find the book Iserson’s Getting
Into A residency A guide for Medical Students a useful resource. There are copies of this book in
the Office of Medical Student Education and the library.
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This is an exciting time in you medical education, however it may seem confusing or
overwhelming at times. We are here to help so please do not hesitate to contact our office with
any questions or for assistance during this final phase of the VIC. You may also email the
[email protected] account and we will direct your questions to the
appropriate person.
Thank you and good luck!
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