Saint Louis University

Internal Medicine (IM-301)

Internal Medicine (IM-301)
Welcome to the Internal Medicine Clerkship!

The Internal Medicine Clerkship provides you with an opportunity to refine and apply skills and knowledge acquired during the first two years of medical school and to learn the basics of medical decision-making, diagnostics, and therapeutics. You will find it to be an intense but challenging and rewarding experience.

The basic emphasis lies with improving skills in obtaining an accurate medical history and performing physical examinations under the supervision of faculty attendings and resident physicians. The student has opportunities to synthesize the data, create problem lists and logical diagnostic and therapeutic plans for patient care. The knowledge base in Internal Medicine is strengthened by development of a regular reading program.

The enthusiasm that medical students bring to patient care improves the learning environment for all involved. The Internal Medicine Clerkship provides a strong foundation for students interested in a future in Internal Medicine and for students who desire to excel in other specialties. This can be achieved only through a commitment to scholarship. The Internal Medicine faculty are available to facilitate progress toward these goals.

Sincerely,

H. Douglas Walden, M.D., M.P.H.
Co-Director
Int. Med. Clerkship
Nora L. Porter, M.D., M.P.H.
Co-Director
Int. Med. Clerkship

 

Course Co-DirectorsEducational Coordinator
H. Douglas Walden, M.D., M.P.H.
Nora L. Porter, M.D., M.P.H.
Department of Internal Medicine
Division of General Internal Medicine
Desloge Towers, 12th Floor
(314) 577-6139
Madeleine Rowe
Department of Internal Medicine
Division of General Internal Medicine
Desloge Towers, 12th Floor
(314) 577-6139
Hospital Course DirectorsAdministrative Assistants
H. Douglas Walden, M.D., M.P.H.
Nora L. Porter, M.D., M.P.H.
Saint Louis University Hospital


Morey Gardner, M.D.
St. Mary's Health Center
(314) 768-8778

Phillip Chisholm, M.D.
Ari Reddy, MD
John Cochran VA Hospital

Bill Logan, M.D.
Mercy Medical Center
(314) 251-6959



Madeleine Rowe
Saint Louis University Hospital
(314) 577-6139

Tamara Steffens
St. Mary's Health Center
(314) 768-8887

Leslie Weiss
John Cochran VA
(314) 289-7628

Michelle Kempf
Mercy Medical Center
(314) 251-6959


 

Clinical Sites Used for Third Year Clerkships
HospitalStudentsWeeks
Saint Louis University Hospital 18-21 4
John Cochran VA 8

4

St. Mary's Health Center 5 4
Mercy Medical Center
2 4

 

Clerkship Overview
The eight-week clerkship in Internal Medicine offers the Year 3 student an opportunity to function as an integral component of the medical team in the inpatient setting. Students are expected to participate in the care of their patients.

A major goal of the Year 3 clerkship in Internal Medicine is to develop the capacity to obtain a comprehensive medical history and to perform a detailed physical examination. The student will learn to identify patient problems based on findings in the history and physical examination. For each problem, the student will produce a differential diagnosis, identify a working diagnosis and develop a diagnostic and therapeutic plan. While on inpatient services the student will learn to give a concise, organized oral presentation of a patient's case. Knowledge in internal medicine is obtained through an organized reading plan.

Orientation
On the first day of the clerkship, students spend the morning in an orientation session. At this session, detailed information about the goals and objectives of the clerkship, evaluation processes,  evaluation instruments, hospital schedules and other information is discussed. Proper format for the history and physical exam and an introduction to medical decision-making are provided.

Team Assignments, Organization, and Makeup
Inpatient teams are comprised of an attending physician, an upper-level resident team leader, first-year residents, and Year 3 and Year 4 medical students.

 

Description of a Typical Day
Begin day by independently seeing patients before work rounds
Time Activity
8:00 a.m. - 11:00 a.m. Work and Teaching Rounds
12:00 p.m. - 1:00 p.m. Noon Conference
7:30 a.m. - 8:30 a.m. Grand Rounds on Friday
Afternoon Patient Care
4:00 p.m. - 5:00 p.m.

Resident Teaching Conference


Students are allowed one day free of clinical responsibilities. .

Lectures
Internal Medicine Grand Rounds are held each Friday at 7:30 a.m. in the Learning Resources Center Pitylk Auditorium. Each hospital site also provides a lecture series.

Once each week there are required didactic sessions. Sessions cover essential clinical skills, physical diagnosis, and clinical problem-solving and evidence based medicine.

Reading
Students are required to read each day about problems identified in their patients—a comprehensive text such as Harrison's Principles of Internal Medicine is recommended. Structured reading about common topics in Internal Medicine using Cecil's Essentials of Medicine or a similar text is also required.

Quizzes and Tests
On the last Friday of the clerkship, students take an online examination supplied by the National Board of Medical Examiners.  A written examination covering material from the didactic sessions is given during the 7th week of the clerkship.

Evaluation and Grading
Evaluation of the student comes from several sources: clinical performance evaluations from each hospital and ambulatory site, written examinations and successful completion of tall clerkship requirements. The clinical performance ratings account for the bulk of the clerkship grade.

At the end of each clerkship, the clerkship directors review the student performance and assign grades. A narrative summary of each student's performance on the clerkship is prepared for the individual student's final evaluation. 

A grade of HONORS will be awarded to those who have received above average to superior ratings in all clinical categories, and have successfully completed all of the requirements of the clerkship.

A grade of NEAR HONORS will be issued to those students who have received above average clinical evaluations and test scores and have sduccessfully completed all other course requirements in a timely fashion.

A grade of PASS will be awarded to those who have received satisfactory ratings in all clinical categories, passed the written examination, and successfully completed all other course requirements.

A grade of FAIL will be given to those who have not exhibited an acceptable performance, or who fail to complete required coursework.

A mark of IMCOMPLETE may be issued in the event the student has successfully completed only part of the clinical work or has failed the end-of-clerkship examination.

Students will have the opportunity to complete an evaluation of their experience in Internal Medicine. All replies remain confidential and are important to the department in efforts to evaluate and improve the clerkship.

Call Schedule and Weekend Activities:
There is no overnight call during the blocks on the general medicine inpatient service.

Additional Comments and Other Special Requirements:
On the first day of the rotation, students spend the day in an orientation session.

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