Clinical Clerkships MS3 and MS4

From the UKCOM Office of Medical Education

Third Year - Third year provides the clinical exposure students need to apply their earlier learning into the care of patients and experience the "Art of Doctoring."

Individual rotations balance the need for adequate exposure to and involvement with patient carte with the time necessary for the assimilation of information.  Student learning occurs in hospital facilities and ambulatory settings.  Students are required to complete a rotation at a rural site through UK's Area Health Education Center (AHEC) program during either third or fourth year.

 Third-Year Clerkships
The third-year curriculum provides the student with broad exposure to the major medical disciplines. The required third-year clerkships are as follows:

 Clinical Neurology:  This four-week rotation provides a foundation in neurologic disease with experiences in adult neurology, child neurology and the stroke service. 

 Clinical Psychiatry: This four-week rotation provides experience in psychiatric disease with experiences in adult psychiatry and child psychiatry at UKHealthcare and Eastern State Hospital. 

 Internal Medicine and Emergency Care: This 16-week integrated clerkship combines 12 weeks of inpatient and outpatient Internal Medicine and four weeks of Emergency Medicine. Students are an integral part of UK and Veterans Affairs inpatient teams, and work with a single preceptor one afternoon per week in an academic or community-based ambulatory practice for the duration of the clerkship. Students also gain experience in both the intensive care unit and emergency room settings, and receive training and certification in Advanced Cardiac Life Support. Additional clinical experiences occur in subspecialty clinic settings and diagnostic laboratories (endoscopy, cardiac catheterization).  Last, students explore a number of topics relevant to the practice of medicine such as professionalism, service learning and ethics in weekly small-group learning experiences.

Third- and Fourth-Year Distinguishing Features

  • Integrated Internal Medicine and Emergency Medicine clerkship with a continuity clinic experience.
  • Exposure to rural health issues.
  • Formal assessment plan to track progress in attaining competency in clinical skills.
  • Flexible final year scheduling incorporating electives or research to meet individual student interests.
  • An intern preparation course focusing on discipline-specific skill development.

Family and Community Medicine: The specialty of Family and Community Medicine has a long history of caring for people of all ages in their communities. During this four-week clerkship, students work with practicing family physicians in a variety of outpatient settings, including UKHealthcare and community-based practices. 

 Obstetrics and Gynecology: This four-week rotation allows students to participate in the care of women; assist in prenatal care, birth and follow-up with mothers; and focus on the family unit. This clerkship offers the opportunity to care for women in both clinic and hospital settings.  Students also observe in a gynecology operating room setting.

 Pediatrics: This eight-week rotation gives students four weeks of ambulatory pediatrics and four weeks of inpatient pediatrics. Students participate in well-child visits and see patients with a wide variety of illnesses, including rare pediatric diseases. Students learn through direct patient care, small groups, lectures, and one-on-one mentoring.  The ambulatory rotation may be completed at a Kentucky AHEC location, where students spend the entire month with a community-based physician.

 Surgery:  This eight-week clerkship presents surgical approaches to disease. Students learn through direct involvement in patient care, as well as weekly conferences and clinical skills workshops. Students rotate on a general surgery service for four weeks and on two two-week surgery specialty services.  During the General Surgery clerkship, students participate in Trauma Call and function as part of the Trauma Surgery Team. This rotation is designed to give all students an exposure to a wide variety of general surgery patients and problems.

M3 Capstone:  The final course of the third-year of medical school ensures that students have the appropriate preparation for the fourth year of medical school.  It includes the Clinical Performance Exam (CPX), which uses standardized patients portraying symptoms commonly seen in ambulatory settings to assess students’ basic clinical skills.  The CPX prepares students to take the USMLE Step 2 CS, which must be scheduled prior to September 30 of that calendar year.  Interactive sessions during the course introduce the advanced clinical skills that are the focus of the fourth year of medical school and necessary for success in residency.  

Fourth Year - The fourth year of study is designed to allow students to further develop and demonstrate their clinical skills and prepare for residency in their chosen specialty.

The emphasis across the curriculum is toward mastering the skills that students will be performing at the start of their intern year.  Recognizing that students will have very different needs depending upon their residency selection, the fourth year curriculum allows students the flexibility to select those rotations integral to their future skill sets.  The three required courses for fourth year are:

Acting Internships: Students must complete two four-week acting internships during which they will assume the role of an intern for patients on inpatient clinical services.  This is a practical application of the skills used by first-year residents on clinical rotations.  Students can select the specialty area for these experiences from a diverse list of choices to meet each student's future career needs.

 Transition to Residency:  This four-week course provides students with practical knowledge and specific skill practice necessary to become a successful intern.   This course uses simulation, standardized patient interactions, interactive small groups, student presentations to create an interactive experience.  Students are divided into groups depending upon their chosen specialty to focus on the most pertinent skill set for their career.

Clerkship Elective:  In addition to the required courses, students select five clerkship electives.  Students are required to complete a rotation at a rural site through UK's Area Health Education Center (AHEC) program during either third or fourth year.  If not completed during third year, one clerkship elective will be scheduled at a rural site.

Vacation:  The fourth-year curriculum maintains flexibility for students to study for their USMLE exams, attend residency interviews and vacation.  Students have eleven total blocks, but can choose three to use toward these other activities.