M.D. Program

Years 3 & 4

YEAR 3

TRANSITION TO CLERKSHIPS 

 

The transition from the pre-clerkship experience to patient care is facilitated by a structured program. The nine-week curriculum includes instruction in clinical radiology, active learning in high yield content areas in the core clerkships, coaching in note writing, clinical reasoning, effective use of the electronic medical record, cultural competency, and more. The tools learned during the transition curriculum enhance student success in clerkships.

 

CLERKSHIPS 

 

The Y3 curriculum is currently constructed to allow students to take United States Medical Licensing Examination (USMLE) Step 1 prior to, or immediately after, their clerkship experience. However, we will be shifting the USMLE series to after clerkships once the Step 1 changes to Pass/Fail scoring.

The core clerkships are internal medicine, general surgery, pediatrics, psychiatry and neurology, obstetrics and gynecology, and family medicine and primary care. During this important phase of medical education, the students become virtually full-time inhabitants of the various public and private health care affiliates of Einstein. The students learn to take responsibility for patient care under supervision and, during this learning process, interact with attending physicians, residents, nurses, social workers, and physician assistants. 

Learning experiences during clerkship training are diverse and include conferences, seminars, lectures, demonstrations, ward rounds and grand rounds. But the essence of this training is, above all, interaction with patients in both inpatient and ambulatory patient environments. It is primarily through direct encounters with patients that students learn a systematic approach to patient care based upon accurate and comprehensive histories, thorough physical examinations, proper analysis and interpretation of laboratory and imaging data, understanding of disease mechanisms, formulation of rational therapeutic goals, and careful evaluation of treatment effectiveness.  

While attending to the patient's medical problems, the students are also expected to be considerate and compassionate, appreciate the influence of sociocultural and economic factors on the patient and family, acquire understanding of ethical issues in clinical decision-making, and practice high standards of professional behavior.  

Each clerkship is 6 weeks in duration and there are 4 vacation periods that are the same for all students: a week in the fall, a two week vacation around New Year’s, a week in late winter/spring, and a week after the last clerkship. 

At the end of year three, all students participate in a six-hour Clinical Skills Assessment, where faculty review each student's encounter and provide formative feedback.  

YEAR 4

 

During Y4 all students are required to complete two 4-week acting internships. Functioning as an integral member of the patient-care team, the acting intern assumes many of the responsibilities of a first-year resident under supervision of the resident and attending physician staff. One of the acting internships must be in internal medicine or pediatrics and the second can be in internal medicine, obstetrics, pediatrics, or surgery. Students pursuing family medicine training can perform acting internships in in-patient family medicine. 

A major part of the senior year is the elective period. Students choose from a wide selection of electives offered by nearly every department. Through the elective program, a student may choose to obtain additional acting internship experiences, further training in ambulatory medicine and primary care, or participate in a research project. Electives in clinical specialties such as cardiology, infectious disease, endocrinology, dermatology, nephrology, gastroenterology, pulmonary medicine, and emergency medicine are very popular. Also available are programs in community medicine, drug abuse, alcoholism, and geriatrics. Students may arrange to take the elective in other medical schools in the United States or abroad. Funding may be available for students to travel abroad to participate in exchange programs with overseas medical schools or obtain clinical or research experience in less developed nations. Students also complete USMLE Step 2 Clinical Knowledge and Step 2 Clinical Skills.

  

Highlights of the clinical curriculum include: 

1.During clerkship rotations in the third year, students from different clerkships gather together in small groups to participate in case-based discussions of topics and issues in prevention, professionalism, and ethics in Patients, Doctors, and Communities course. 

2.Seminars and conferences on topics at the cutting edge of the scientific foundations of medicine are scheduled during third year clerkships. 

3.There is enhanced emphasis on learning the fundamental skills of the physician-patient interaction, ensuring that students are adequately observed during the clinical encounter and assessing students' competence in this encounter. 

4.     A Population Health and Practice of Medicine theme curriculum has integrated concepts of community medicine, health economics, health care systems, inter-professional team care, practice management, quality improvement, and safety sciences into clerkships. 

 

 

Scholarly Paper Requirement

Every Einstein student writes a Scholarly Paper (SP) as a requirement for graduation. This can be an opportunity to learn about a new field or to delve more deeply into an established area of interest. Students can write a research paper, a basic science review, a formal systematic review, a case report, or a paper based on a bioethical issue in medicine or research. These papers can be based on global health experiences, bench work, or library research resulting in a systematic review of existing medical literature. Montefiore’s Clinical Looking Glass is an existing data source that allows the student to explore clinical questions and can lead to an SP. Although SPs can take many forms, all students work with a mentor to develop their paper idea, write a paper proposal, and complete the SP.

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