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-block 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

Emergency Medicine

63 or higher

56 or higher

2

1

Behavioral Science 340 or higher 2
***passing scores updated as of 2021-2022 academic year
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.

Policy on Absences from Required Clinical Clerkships

Scope: The policy applies to all required clerkships including Docent Rotation in Years 4, 5 and 6; Family Medicine Clerkship, General Surgery Clerkship, Obstetrics and Gynecology clerkship, Pediatrics Clerkship, Psychiatry Clerkship and Emergency Medicine Clerkship.

The School recognizes the need for students to take time away from clinical responsibilities and also recognizes that a student’s participation in clinical training and their prioritization of patient care is essential for the student to meet the program’s learning objectives and for the development of competency in professionalism, communication and professional development.

OBJECTIVE: To create an absence policy that applies to all clerkships and ensures consistent processes from Clerkship Coordinators. The policy must allow flexibility for students to attend personal appointments, while not detracting significantly from clerkship learning outcomes or creating an overwhelming administrative burden for clerkship administration. Students requesting a planned absence from a clinical clerkship must make arrangements with the Clerkship Coordinator and Director two blocks prior to the clerkship start date whenever possible. Failure to meet this deadline may result in an unexcused absence from the clerkship.

Clerkship Directors will develop and maintain expectations that provide meaningful clinical and didactic experiences for students. Particular attention should be given to scheduling, work intensity and work compression that impacts student well-being. Regular administrative time, testing schedules and orientation dates will be provided to students during Year 5 orientation. Clerkships will request planned absences from students in advance of the start of the clerkship and will make every attempt to accommodate the student’s request. It is the responsibility of the student to respond in a timely manner to these requests.

The Continuity Clinic Clerkship has a separate absence policy that is detailed in the clerkship syllabus.

Planned excused absences from a clerkship must be requested to the Clerkship Director and/or Clerkship Coordinator in writing two blocks prior to the start of the clerkship and will generally be allowed for the following reasons:

  1. Presenting at a professional conference or representing UMKC in an official capacity (it is recognized that this information may not be known in advance)
  2. Scheduled USMLE examination
  3. Significant event, such as a wedding or graduation
  4. Student Personal Holiday as approved by the Office of Student Affairs

Emergency excused absences from a clerkship must be requested to the Clerkship Director and/or Clerkship Coordinator prior to the scheduled start of the day of absence and will generally be allowed for the following reasons:

  1. Hospitalization or illness of self (mental and physical illness)
  2. Unexpected circumstances such as car problems or motor vehicle accident
  3. Critical illness, hospitalization, or death of immediate family member (as defined by the UMKC Bereavement Policy to include parent, child, partner, partner’s parent, siblings, grandparent)

Students will be given the opportunity to attend medical, mental health and dental care appointments, including those scheduled during work hours. Students will not be charged an absence for these occurrences. Students should schedule appointments that are least disruptive to patient care and didactic experiences.

Students are expected to attend and participate in every session of a clinical clerkship to facilitate their development of the competencies in each core specialty. Students are allowed to miss two days per two block clerkship and one day per one block clerkship for a planned or emergency absence, averaged over the entire clerkship. This is in addition to scheduled days off.

Documentation may be required for any planned absence or clinic appointment. This requirement will be outlined in the syllabus. Emergency absences will not require documentation unless the student misses more than the allowed number of days off for the rotation.

In general, students may not have a planned absence on the days of the clerkship exam, clinical performance assessments and orientation. If an emergency absence occurs during these times, the clerkship may require documentation to substantiate the absence. This requirement will be outlined in the clerkship syllabus.

The School recognizes that circumstances may require a prolonged absence from a clerkship. A prolonged absence is defined as more than four days total in a two-block clerkship and two days total in a one-block clerkship. The days off do not have to be consecutive to qualify as a prolonged absence. The clerkship may require documentation to substantiate a prolonged absence. This requirement will be outlined in the syllabus. In this circumstance, the student must meet with the Clerkship Director to determine a plan to meet the clerkship objectives. This could include making up missed clinical experiences. It may be necessary for a student to withdraw from a clerkship (without assessment) and re-enroll in the clerkship later.

Year 6 students are given additional absence time to facilitate residency interviews. They may miss 5 days total from Emergency Medicine and 5 days per block of Docent Rotation. The clerkship may require documentation of the interview to substantiate the additional time away.

Missing clinical duties without an excused absence will result in the following consequences:

  1. First unexcused absence: The student’s overall grade will be reduced by 10% (of the total allowable points for the clerkship) and the student will be notified by the Clerkship Director
  2. Second unexcused absence: The student’s overall grade will be reduced by 25% (of the total allowable points for the clerkship) and the student will be notified by the Clerkship Director
  3. Third unexcused absence will result in failure of the clerkship

Important Links:

Request for Clinical Clerkship Absence: https://med.umkc.edu/docs/curriculum/ClkshpExcsdAbsence.pdf

Student Personal Holiday Policy: https://med.umkc.edu/sa/student-personal-holiday-policy/#:~:text=Each%20student%20may%20also%20receive,Excused%20Absence%20and%20Interview%20Policy%E2%80%9D.

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.

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Policy on Student Workload and Clinical Duty Hours for Clerkships

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Policy on Student Workload Hours for Preclinical Coursework

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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.

Professionalism Competency Assessment for Clerkships

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