Council on Curriculum

Clerkship Policies


Subject Examination Policy

Rotation Score to Pass Number of Attempts Time Allowed to Pass Exam
Docent Rotation 60 or higher 2 Exam must be passed within a four-month period subsequent to the date of the failed exam.
Pediatrics 55 or higher 2
Ob/Gyn 65 or higher 2
Surgery 60 or higher 2
Psychiatry 60 or higher 2
Behavioral Science 34 or higher 2

***passing scores updated as of 2017-2018 academic year

****The chart above: under Time Allowed to Pass Exam – Exam must be passed within a four-block period subsequent to the date of the failed exam.

Number of Attempts & Time Allowance to Pass Subject Exam

When a student fails a required subject examination in a clerkship, he/she must post a passing score within a four block period subsequent to the date of the failed examination.  A student will be allowed to repeat the subject examination just once during that period.  Failure to pass the subject examination within four blocks will mean failure of and re-enrollment in the clerkship.  The subject examination schedule set by the Office of Assessment and Quality Improvement must be followed; no change in the schedule will be allowed except for documented illness or a family emergency.

No-Show/Unexcused Absence

A “no-show/unexcused absence” on the subject examination date scheduled at the end of the rotation results in a forfeiture of one of the two attempts.  A second “no-show/unexcused absence” on an examination date scheduled by the student results in a failure of the rotation.

Multiple Subject Examination Failures

Effective for all first-time takers of subject exams:

  1. Any student with two outstanding subject exams in different clerkships will not be permitted to enroll in any required clerkships until he/she has no more than one outstanding subject exam to complete. The student will receive remediation to address his/her difficulties and appropriate advising along with revision of his/her curriculum schedule.
  2. If the student then has a third outstanding subject exam, he/she will not be permitted to enroll in any further required clerkships until all outstanding subject exams have been successfully completed.
Failure on First Attempt of Subject Examination

Students who fail on their first attempt at a Subject Examination or internally written required examination are NOT eligible to receive Honors or High Pass in that Clerkship.

Subject Exam Reporting on Medical Student Performance Evaluation (MSPE)

Beginning with clinical clerkships in June 2005, the number of attempts a student needs to achieve a passing score on an NBME subject examination in a clinical discipline will be reported in his/her MSPE (dean’s letter). The passing score will also be reported.

Residency Interviewing & Excused Absences from Required Clinical Clerkships

The school recognizes there may be a need for Year V or Year VI students to take time away from clinical responsibilities, i.e., emergencies, death in family, hospitalization, and in Year VI, Residency interviewing. For Residency interviewing, the school recommends that students be allowed to interview for a period of no more than five working days per block. Excused absences are subject to the approval of the Clerkship Director and will be accommodated only to the extent that such absences do not interfere unreasonably with the goals and objectives established for the clerkship.

Per Council on Evaluation policy, “A student will receive a ‘Fail/No Credit’ grade if s/he is absent for any reason, either excused or unexcused . . . more than 5 working days from a one-block required rotation, or more than 10 working days from a two-block required rotation.”

Students requesting an excused absence from a clinical clerkship for any reason must make arrangements with the Clerkship Director; failure to do so two weeks prior to the clerkship start date may result in an unexcused absence. Students must complete the “Request for Clinical Clerkship Excused Absence” form and follow the procedures as listed below and on the form:

    1. Obtain a Request for Clinical Clerkship Excused Absence form from the website or from the student’s ETC.
    2. Take the completed form to the Clerkship Coordinator FIRST and the Director (or docent, in the case of Docent Rotation or Clinic) for their signatures. Do not just leave the form to be signed. Student must speak directly to the Rotation Coordinator and Director to obtain their signature.
    3. The Coordinator will retain the signed copy of the form for their tracking purposes.

Split 2-Block Rotations

All required rotations in Years 3 through 6 that are more than one block in length must be taken consecutively. These rotations include:

    • Docent Rotation
    • Pathology
    • Pharmacology (9408)
    • Obstetrics/Gynecology
    • Pediatrics
    • Surgery

Exceptions to this policy will be made only in the case of emergency circumstances such as academic failure (including failure of Step 1 or subject exams) or non-academic emergencies (illness, death in family, etc.).

The process for completing a split rotation is as follows:

    1. If a student cannot complete the second block of a two block rotation, due to the above stated circumstances, the student will receive an INCOMPLETE for the first block and will have no more than one year to complete the second block for credit.
    2. After completion of second block of two-block rotation, the student has four blocks to take and pass the Subject exam.

Required Clerkships with Family Members

Students will not be allowed to do scheduled required clerkships with family members. In a situation where no alternative faculty exists, the situation will be examined on a case-by-case basis by the Council on Curriculum.

Patient Tracking Policy

The UMKC SOM learning objectives are articulated with the Competency-Based Curriculum and all required clinical clerkships must provide students with sufficient and consistent opportunities to satisfy these objectives. It is the responsibility of the individual clerkship faculty to confirm that their clerkship objectives support the goals of the Competency-Based Curriculum. They accomplish this partially by identifying which disease states/conditions/skills/procedures are essential, and partly by stating what level or responsibility should be achieved by each student, and by defining the appropriate clinical setting. Patient Tracking Software (PTS) exists to assist clerkship directors and clerkship faculty in assessing what students are experiencing during their clerkship and how closely they have met previously identified clerkship objectives. PTS also provides assistance to clerkships and the school in meeting the LCME ED-2 standard.

The following principles serve to guide clerkships in meeting this responsibility:

  1. Clerkships are responsible for developing a list of clinical encounter and patient-type content (major disease states or conditions or clinical skills/procedures) that each student can reasonably expect to encounter during their clerkship. Most likely clerkships will identify general categories and provide specific disease states/conditions/skills/procedures which correspond to each of the identified categories.
  2. The length of the content list(s) should be sufficient to satisfy the core clerkship objectives. At this time, there are no specific requirements on numbers of encounters. The clerkship must provide a mechanism for students to encounter this experience regardless of the time of year the clerkship is scheduled for a student.
  3. The numbers of patients necessary to satisfy clerkship objectives is left to the individual clerkships to decide: however, these clerkship-defined numbers must be clearly identified for students. Requirements on numbers of experiences should be set consistent with the following:
    1. The necessary time to experience the required numbers of patients should not exceed reasonable work hours for students.
    2. A single patient may satisfy multiple content items (disease states/conditions/skills/procedures), but the requirements for a meaningful encounter (defined by the clerkship) must be satisfied for each.
    3. The level of student responsibility for each encounter must be defined (participation, observation, etc.), as well as the clinical setting in which the encounter takes place.
    4. As a component of the required mid-rotation assessment, a mid-rotation review of reported PTS activities should be documented by the clerkship director for all students to determine what each student has already encountered and what he/she is likely to encounter over the remainder of the clerkship. A timely review should allow the clerkship director sufficient opportunity to provide the student with a personalized experience to help them meet all outstanding clerkship encounters which may include use of alternative methodology such as MedU CLIPP Case(s), fmCASE(s), assigned readings, simulation experience or oral presentation.
  4. All students should enter patient data in the PTS on a weekly basis to provide adequate information for the mid-rotation assessment. Students who do not comply with this requirement will be penalized as defined by the clerkship director. Students must enter all required patient data into the PTS by midnight of the last day of the clerkship to show their clerkship requirements have been met. Students who fail to meet this PTS requirement will have their final grade in the clerkship reduced by one level (e.g., honors to high pass).
  5. Students are responsible to register with the correct course and section numbers in the UMKC Pathway system in order to maintain correct rosters in the Patient Tracking System. Any discrepancies should be reported to the Clerkship Coordinator and the student’s ETC immediately. Failure to register correctly does not excuse a student from this Patient Tracking Policy.


Policy on Student Duty Hours for Clerkships & Clinical Rotations

  • Clerkships and clinical rotations must be committed to promoting student well-being and to provide a supportive educational environment.
  • The learning objectives for the clerkship/clinical rotations should not be compromised by reliance on students to see and manage patients.
  • Didactic and clinical education must have priority in the allocation of students’ time.
  • Duty hour assignments must recognize that faculty and residents collectively have responsibility for the safety and welfare of patients.

Duty hours are defined as all clinical and academic activities related to the program: patient care, administrative duties related to patient care, time spent on-call and scheduled activities, such as a conference.

  1. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call.
  2. Students must be provided with one day in seven free from all required educational activities and clinical responsibility averaged over a four week period, inclusive of call.
  3. Adequate time for rest and personal activities must be promoted. Students should have 10 hours, and must have eight hours, free of duty between scheduled duty periods and after in-house call.

Call definitions/restrictions:

  1. Call is defined by individual clerkships, and their policies apply.
  2. No continuous, on-site call duty should exceed 24 consecutive hours.
    1. Students may remain on duty for up to six additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care.
    2. No new patients may be accepted after 24 hours of continuous duty.
    3. Strategies to encourage rest and alertness for learning should be employed by the individual clerkship.
    4. Students must communicate any deviation to the above “Call Policy” to their Clerkship Director, Clerkship Coordinator, and/or to their Attending.
  3. Home call (pager) is not included in these hours of in-house call but students need to report the hours when called in to count toward the 80 hour limit.
  4. Students taking at-home call must be provided with one day in seven off from all educational and clinical responsibilities, averaged over a four-week period.

Students’ evaluations of the clerkship will be used to monitor compliance with this policy. Clerkship directors agree to review student evaluations and are prepared to discuss compliance at the clerkship director subcommittee meetings. Council on Curriculum will also review compliance with this policy through the biennial review process. Students may report directly to the Clerkship Director, education coordinator for the clerkship, or the Council on Curriculum if required clinical duties or educational activities exceed the duty hours set forth by this policy.

Call Room Accommodations for Continuous Duty
For any clerkship that requires students to take in-house call for more than 16 hours of continuous duty, students must be provided a call room that allows for student privacy and the opportunity to study or sleep.

Course Evaluation Compliancy Policy

The School of Medicine continually and systematically collects, utilizes and responds to students’ feedback regarding medical school courses, rotations and clerkships. Students’ perceptions are a critical component of the curriculum evaluation process. Student ratings and comments are carefully reviewed by faculty, department chairs, and the Council on Curriculum in order to promote positive curricular change.

Therefore, students are required to complete evaluations of all courses, rotations, and clerkships that the School of Medicine requires by using OASIS. The OASIS evaluation form will be available for student use for a total of 14 days, seven prior to the close of the course, rotation, or clerkship and seven after the course, rotation, or clerkship is over.

Students who do not complete evaluations by the deadline (by the end of the seventh day after the course, rotation, or clerkship is over) are subject to the following actions.

    1. The Council on Evaluation will record in its monthly minutes a student’s failure to submit a required course/rotation/clerkship evaluation and will send him/her an e-mail noting the first and, if necessary, the second instance of non-compliance.
    2. When a student has failed to submit three evaluations, he/she will receive a letter of unprofessional behavior from the Council. The letter will be placed in the student’s official record and will remain there.
    3. The three instances of non-compliance triggering a letter of unprofessional behavior will include failure to submit course/rotation/clerkship evaluations, as well as sets of peer assessments required in docent rotation and in the obstetrics-gynecology rotation. For example, two instances of failure to submit course evaluations plus one instance of failure to complete a set of peer assessments will trigger a letter of unprofessional behavior.
    4. Persistent non-compliance with the policy will result in review by the Council on Evaluation to determine if the student’s Medical Student Performance Evaluation, used in the process of application to residency programs, will refer to the student’s non-compliance.

Faculty must communicate the course/rotation/clerkship evaluation policy to students at the beginning of the curricular experience. A summary of the policy and the consequence for noncompliance must be included in the syllabus along with the relevant information for accessing evaluations.

Peer Assessment Policy

The purpose of peer assessment is to help students help their peers develop their clinical and professionalism competencies. Participation in peer assessment in medical school is also intended to prepare students for professional practice. Peer assessment in residency programs is commonplace, and it is a professional obligation that physicians in practice are expected to fulfill.