Clerkship Guidelines and Information

When & Where to Report

Prior to the start of each clerkship, log onto your student schedule (https://regweb.med.tufts.edu/Registrar/Student/login.asp) to confirm when and where you are to report for the first day of the rotation. This site has the most up-to-date information.

TUSK

Each clerkship has a section on TUSK that has general clerkship information and reference information (e.g. Learning Objectives, Grading Policy, Clerkship handbook, required and recommended text books, Student Treatment Policy, mid-clerkship feedback form, parking instructions etc.). Please be sure to review the clerkship pages on TUSK.

Clerkship Attendance Policy

Attendance is mandatory for all hospital and outpatient clinic rotations in the third and fourth year.  There is plenty of scheduled vacation time during third year (at Winter Break, up to 4 weeks during elective periods and another 2 weeks at the end of April (following core clerkships and prior to advanced clerkships in May). Outside of that time, there are no “personal days” during the core clerkship year however, we do want you to be able to take care of yourself. This includes being able to schedule doctor’s appointments for routine healthcare. Please aim to schedule those appointments at times when it might cause the least disruption in patient care and always let your site director know that you will be leaving for an appointment so that you are not considered “missing.”  Should your health circumstances necessitate more frequent doctor’s visits, please contact one of the deans in the OSA as special accommodations may be necessary. Time off for weddings (other than your own!), to attend meetings, run marathons, etc. will not be granted. However, we recognize that students do become ill or have other emergencies that require them to occasionally miss time. In the event of a brief illness (one or two days), the student and clerkship director may work together to arrange for time to be made up (at the discretion of the CD).  Illness of any length requires written documentation from your physician.  If illness or personal emergency require you to miss more than two days of a rotation, the clerkship director and the Dean for Students or the Associate Dean for Students must be notified (617-636-6534). Students in the Maine Track or Maine for the Year, should contact Dr. Jo Linder (207 662-8766). Students who do not report for a rotation or are absent without appropriate notification to the course director, clerkship director and the Dean or Associate Dean of Students will receive a grade of “Fail” for the rotation.

Please note that time off for hospital holidays is at the discretion of the Clerkship Director and is not to be presumed. Medical School and University holidays are not observed during third and fourth year.

Thanksgiving: students should expect to work 2 of the 4 days (Thursday, Friday, Saturday, Sunday) of the Thanksgiving holiday. The schedule will vary from site to site, clerkship to clerkship).

Religious holidays

Time off may be provided (at the discretion of the clerkship director and only  if coverage can be arranged) to observe the religious holiday but not to travel (e.g. leaving early from the site in time to be at temple on Thursday is okay but it is not ok to request the entire day off to travel home).  It is expected that time missed will be made up.

TUSK Patient Logs

Completing the Patient Logs is mandatory.

For each clerkship, there is a list (in table form) of the required clinical encounters and the expected level of student responsibility for each encounter. Students are required to log ALL patients seen who fall into one of the required encounters. You will see patients who do not fit into the required clinical encounters. These patients will not appear on your patient log.

The Patient Log enables you to report what you have seen, track your patients and link to articles on diagnoses. All Patient Logs are not alike - the logs match the goals and objectives of each clerkship. You should log patients on a daily basis – do not wait until the end of the clerkship. During the course of the clerkship, the clerkship directors periodically review your patient log to determine if the goals and objectives are being met via patient encounters.

The Patient Log for a particular clerkship is only open while you are on the rotation. When the rotation ends, the log closes and you can no longer do any patient information entries.

Completion of the Patient Log for each clerkship is required. Third year students will be given a failing grade and will be brought to the TUSM Student Ethics and Promotions Committee if they do not complete their Patient Log.

Personal Appearance and Dress Code

The following standards of dress and safety are in effect at all times and in settings where patients or standardized patients may be present. The expectation is for all students to adhere to the following grooming and clothing standards. Some hospitals may have additional requirements.

Any student whose appearance, image or hygiene is inconsistent with this policy will be counseled and may be sent home to change clothes/remediate the situation.  Continued disregard of the policy will result in disciplinary action.

  • Professional attire is clean, neat, moderate in style and appropriate for the type of work being performed.  Clothing that is revealing or tight fitting is not professional and therefore inappropriate. Clothing should be clean, not wrinkled, torn, faded or frayed. Fabric such as denim, sweat-jersey, and lycra are not appropriate. Hooded attire is not appropriate.
  • No team/political/graphic logos or buttons on attire. Students will avoid wearing accessories on their clothing or person that could present a safety and/or infection hazard, or are embarrassing or offensive to patients.
  • Sandals and flip flops are unacceptable.
  • No exposed midriffs.
  • Students are responsible for maintaining appropriate levels of personal hygiene.
  • Fragrance use is discouraged in consideration of patients. Makeup or perfume/aftershave/cologne should not overdone.
  • Extreme or eccentric hairstyles and colors are inappropriate.
  • Visible body piercing should be minimal. Multiple earlobe piercings should be removed. Eyebrow and tongue piercings should be removed. Nose rings are not acceptable. Exposed tattoos are discouraged. Tattoos should be covered when possible. 
  • The hospital issued ID badge and TUSM school ID is considered part of the required uniform and is to be worn above the waist at all times while on the premises, visible, front facing so that name, title and photo are visible. The badge cannot be altered, changed or obscured in any way.

Core Clerkship Representatives

Each class will have students appointed to be Core Clerkship Representatives for the various clerkship disciplines. Their role is to ensure that you have another venue to report things such as mistreatment or major concerns about your clerkship experience. We sincerely hope that you will feel comfortable discussing these issues first and foremost with your clerkship directors or with one of the deans in the OSA but if not, please let your representative know. Deans Kuhlik, Kerle, Duffey and Epstein will be meeting quarterly with the reps. The list of representatives will be emailed to the class in May.

Hospital Requirements

If you receive notice (usually via email from a clerkship administrator) of requirements that must be met before the clerkship, take care of it immediately. 

Failure to complete and submit any required paperwork or online Orientation modules by the deadline the clerkship sets will prevent you from being able to take the clerkship and will result in a review of your record by the Student Ethics and Promotions Committee for unprofessional conduct.

CORI - Criminal Offense Record Information

While we have conducted a Massachusetts state criminal background check on every student, some of the TUSM affiliated sites (e.g. Baystate) are required by law to do a national criminal background check on anyone who will be caring for patients.  Should you be informed that this is a requirement (usually you will receive an email regarding this matter from the hospital prior to the start of their scheduled block), you are required to complete and return the required paperwork to the hospital by the deadline established by the individual hospital.  Failure to complete the paperwork will prevent you from taking the rotation. It is required that you complete and return the hospital's required paperwork by the deadline they set.

Failure to complete and submit any required paperwork by the deadline the clerkship gives you will prevent you from being able to take the clerkship and will result in a review of your record by the Student Ethics and Promotions Committee for unprofessional conduct.

Respirator Fit Testing (Mask Fit)

Many of our clinical sites and many away rotations require a respirator mask fit. Ryan Flaherty and his staff at Tufts Medical Center will perform mask fit tests for our students on Tuesdays from 7:00-7:30 AM and Thursdays from 3:00-3:30 PM on Atrium 4 in the Hallway. You will need a verification form signed after you have completed the test. You will be responsible for keeping this form as “proof” that you completed the test. You can bring a copy of that document to the Registrar’s Office, we would be happy to keep a copy of it for your file.

Prior to the start of the academic year, you will be required to complete and submit to the OSA, the OSHA Respirator Fit testing clearance form. That document will be reviewed by a physician.  Before going to TMC, you will stop by the OSA to pick up the OSHA questionnaire you completed signed by either Dr. Kuhlik or Dr. Epstein. You cannot have the test done without this document. The completed forms will be kept in the OSA and can be picked up from 8:30 AM – 5:00 PM.;

During third year Orientation, Maine track students will have their mask fit done at Maine Medical Center and Baystate students will have theirs done at Baystate.

End of Clerkship Examinations - NBME Miniboard Examinations, CLIPP exam, Family Medicine (Note: The NBME Miniboard is also known as the Shelf Exam or Miniboards)

On the morning of last day of each rotation block, students are required to take a National Board of Medical Examiners Subject examination (miniboard exam), CLIPP exam (Pediatrics) or Family Medicine exam.  These exam scores are a portion of your final clerkship grade. The results are received by the Registrar’s Office about one week after the examination is given and then forwarded to the overall clerkship directors.  Examinations take place on the Boston campus, Baystate Medical Center and Maine Medical Center.  Students participating in clerkships at Baystate Medical Center will take the examination at Baystate Medical Center. Students participating in clerkships at Maine Medical Center will take the examination at Maine Medical Center. Students in the Maine track participating in the Longitudinal Integrated Clerkship (LIC) have a separate set of exam dates and will take their exams at MMC.

The exams administered in Boston start at 9:30 am. Exams at Baystate start at 9:00 am and exams at Maine Medical Center start at various times (between 8:00 - 9:00 am).

The exams are 2 hours and 45 minutes long. The miniboards and CLIPP exams have 100 questions. There is information on the NBME Subject Examinations content and sample questions on the NBME web site.

Any questions about these examinations should be directed to the Registrar’s Office. All students are required to take the exam on the last day of the rotation at the scheduled time. Students will not be allowed to take the exam early or on another date. Please make your travel plans accordingly. Under extenuating circumstances, if a student is not able to take the exam, he/she must contact the Dean for Students.

Exam Release Policies

Course

End of Clerkship Exam Release Policy

Family Medicine

Released when Thursday office hours are over for their preceptor.

Medicine

All day Thursday off.

Obstetrics/Gynecology

Released between 1:00 – 3:00 pm Thursday.

Pediatrics

Released between 3:00 – 5:00 pm on Thursday.

Psychiatry

Released at noon Thursday.

Surgery

Students are required to work on clinical duties until noon on Wednesday.
After that they are released from all clinical duties
(including M+M and grand round conferences).

Clerkship Evaluations Completed by Students

Student evaluation of the curriculum provides Course Directors, Department Chairs, Deans, the Curriculum Committee and others with valuable feedback vital to the planning of the educational program.  Evaluation questionnaires are administered to students throughout the four years in both preclinical courses and clerkships. Students have the opportunity to be a part of the ongoing evaluation and feedback process to assure the highest quality curriculum to meet TUSM’s overall mission.

Online questionnaires are administered to students via TUSK during the last week of third-year and fourth-year clerkships. Completion of an evaluation form for clerkships is required. Third year students will be given a failing grade if they do not complete the clerkship evaluation. Evaluations for third year clerkships are posted a week before the end of the clerkship and will stay available for 3 weeks after the end of the clerkship.

The following explains the purpose of the online evaluations, how the process works, and the level of privacy that students can expect when providing feedback.

The online evaluation forms are intended to make the feedback process more efficient. Students have the convenience of accessing the forms on TUSK, anywhere at any time. Data entry and processing is simplified, allowing course directors, faculty, chairs and deans to see the results quickly, and respond to student suggestions more effectively.

When completing an evaluation, usernames are requested to record who has submitted an evaluation.  Once the evaluation is completed and submitted, the usernames are separated from the responses electronically; usernames and the responses are sent to separate data tables. Responses are sorted and stored safely on TUSK. The evaluator, faculty, chairs and deans do not have access to the data except through the evaluation reports generated as described above. The evaluator can only see responses in a confidential evaluation report. The report is sent to the course director, department chair, and appropriate deans. Student names will never be associated with the responses or comments.

Evaluation forms are designed and processed through the OEA.  Feedback is extremely important to course directors and deans for course improvement.  Evaluation feedback is anonymous for all courses and clerkships except for the PBL Program.  Students are encouraged to be as candid as possible in their evaluations while maintaining a standard of professional and constructive comments.

Clerkship evaluation results are available for review on reserve in the library and on TUSK.

Objective Structured Clinical Examination (OSCE)

The OSCE (Objective Structured Clinical Examination) is an end-of-third-year assessment of clinical skills. Students must pass the exam in order to graduate.

For all Boston and Springfield- based students, the nine station OSCE, conducted at the Clinical Skills Simulation Center (CSSC) (3rd floor, 35 Kneeland Street), consists of seven encounters with standardized patients (SPs) and two skills stations. SPs score student performance while faculty monitor the student-standardized patient encounters from a control room.

For all Maine-Track students and those in Maine for third year, the OSCE will be conducted in the Hannaford Center for Safety, Simulation and Innovation.

The exam runs from approximately 9:30am-3:00pm.  The dates for the OSCE take place between mid March and the end of June. The date that you are assigned to take the OSCE will be sent to you about three months prior to the exam. 

Two documents that will help you prepare for the exam; they are posted on TUSK:
http://tusk.tufts.edu/view/course/Medical/380

1) UMASS Standardized Patient (SP) Program Physical Exam Scoring Guidelines for OSCEs, and
2) TUSM Checklist for Complete Physical Exam.

Also, the OSCE FAQ on TUSK contains detailed information about the OSCE:  http://tusk.tufts.edu/view/url/M2044C/775325.

If you have any questions or concerns about the exam after review the FAQ, please contact Ann Maderer, ann.maderer@tufts.edu.

Annual Clerkship Grading Policy

Annual grading policies for clerkships are distributed at 3rd-Year Orientation and posted on TUSK.