Clerkship Manual Kansas City University of Medicine and Biosciences
Transcription
Clerkship Manual Kansas City University of Medicine and Biosciences
Clerkship Manual Kansas City University of Medicine and Biosciences COLLEGE OF OSTEOPATHIC MEDICINE CLASS OF 2015 KCUMB-COM/OCCE 08.20.13 1 TABLE OF CONTENTS INTRODUCTION 4 KCUMB-COM MISSION KCUMB-COM VISION KCUMB-COM OFFICE OF COMMUNITY CLINICAL EDUCATION - MISSION COMMUNITY CLINICAL EDUCATION 4 4 4 4 GENERAL INFORMATION 5 A. B. C. D. E. F. NON-DISCRIMINATION/HARASSMENT POLICY CODE OF PROFESSIONAL CONDUCT WRITTEN COMPLAINTS AGAINST A STUDENT ON CLERKSHIPS CLINICAL CLERKSHIP COORDINATORS COMMUNICATION COUNSELING AND SUPPORT SERVICES 5 5 5 5 5 6 CONTACT INFORMATION 7 OFFICE OF COMMUNITY CLINICAL EDUCATION ASSISTANT REGIONAL DEANS 7 8 KCUMB-COM CLINICAL CLERKSHIP OVERVIEW 9 A. THIRD-YEAR CURRICULUM B. FOURTH-YEAR CURRICULUM OPTION I OPTION II ASSESSMENT A. REGISTRATION B. SUBJECT EXAMINATIONS FAILURE OF SUBJECT EXAMINATIONS FAILURE TO SUCCESSFULLY PASS FOUR SUBJECT EXAMINATIONS SUBJECT EXAMINATION SCHEDULES C. D. E. F. G. H. I. J. NBOME COMPREHENSIVE OSTEOPATHIC MEDICAL STUDENT ASSESSMENT STUDENT EVALUATION OF THE CLERKSHIP: THE MEDIQ ELECTRONIC PORTFOLIO (E-PORTFOLIO) CLERKSHIP ASSESSMENT OF STUDENT PERFORMANCE BY PRECEPTOR DEFICIENCIES CLERKSHIP GRADES-HONORS (H) AND HIGH SATISFACTORY (HS) GRADE DETERMINATION FOR CORE CLERKSHIPS REQUIRED ELEMENTS GRADE DETERMINATION FOR ELECTIVE CLERKSHIPS REQUIRED ELEMENTS COMLEX LEVEL 1 AND LEVEL 2 CE AND COMLEX PE EXAMINATIONS FAILURE OF COMLEX LEVEL 1 FAILURE OF COMLEX LEVEL 2-CE FAILURE OF COMLEX 2-PE SCHEDULING COMLEX LEVEL 2 EXAMINATIONS 9 9 9 9 10 10 10 11 12 12 13 13 13 14 15 15 15 16 16 17 18 18 18 19 19 KCUMB-COM/OCCE 08.20.13 2 K. LETTERS OF RECOMMENDATION L. CLERKSHIP GRADUATION REQUIREMENTS POLICIES AND PROCEDURES I. A. B. C. D. E. F. G. H. I. J. K. L. M. N. O. P. Q. R. S. T. U. V. W. X. Y. II. A. B. C. D. III. A. B. C. D. E. F. G. 20 GENERAL POLICIES DEFINITION OF A BLOCK ABSENCE FROM CLERKSHIPS VACCINATIONS/IMMUNIZATIONS BACKGROUND CHECKS AND DRUG SCREENS HEALTH INSURANCE STUDENT SUPPLEMENTAL MEDICAL INSURANCE POLICY HIPAA REGULATIONS AND PATIENT ENCOUNTERS MEDICAL PROFESSIONAL LIABILITY INSURANCE STUDENT IDENTIFICATION DRESS CODE AND PROFESSIONAL APPEARANCE HOSPITAL RULES AND REGULATIONS SPECIAL ACCOMMODATIONS EXPOSURE TO BLOOD-BORNE PATHOGENS AND INFECTIOUS DISEASES DIDACTIC CONFERENCES AND READING ASSIGNMENTS WORK/CALL SCHEDULE MEDICAL ETHICS PHYSICAL EXAMINATIONS REPORTING CLERKSHIP PROBLEMS LEAVES OF ABSENCE WORKER’S COMPENSATION INSURANCE TRANSPORTATION FOR CLERKSHIPS REQUEST TO APPEAL ELIGIBLE PRECEPTORS DOCARE AND INTERNATIONAL CLERKSHIPS (INMED) MILITARY CLERKSHIPS INDEPENDENT STUDY AND RESEARCH ELECTIVES 20 20 20 20 21 21 21 22 22 23 23 23 23 23 24 24 24 24 25 25 26 26 26 27 27 28 28 SCHEDULING 28 CLERKSHIPS OUTSIDE KANSAS CITY REGION CLERKSHIPS IN THE KANSAS CITY REGION APPLICATION AND OTHER FEES CANCELING/CHANGING A FOURTH-YEAR CLERKSHIP 28 29 30 30 THIRD YEAR 30 A. ELECTIVE B. NON-CREDITED TIME-OFF IV. 19 19 31 31 FOURTH YEAR 31 EMERGENCY MEDICINE AND CARDIOLOGY RURAL/UNDERSERVED PRIMARY CARE CLINIC SUB-INTERNSHIPS ELECTIVES TWO-WEEK ELECTIVES NON-CREDITED TIME-OFF 31 32 32 33 33 33 INTERNSHIP/RESIDENCY INTERVIEWS 33 KCUMB-COM/OCCE 08.20.13 3 INTRODUCTION KCUMB-COM Mission The College of Osteopathic Medicine prepares students to become highly competent, caring and compassionate osteopathic physicians who demonstrate the highest level of professionalism, ethics and sensitivity to the diverse personal and cultural contexts in which care is delivered. We are committed to the service of humanity and the advancement of knowledge through a collaborative environment that provides distinctive osteopathic clinical training and fosters excellence in education, research and scholarly activity, and lifelong learning. KCUMB-COM Vision The College of Osteopathic Medicine is recognized as a leader in osteopathic medical education and health care by exceeding standards of academic and clinical achievement. KCUMB-COM Office of Community Clinical Education – MISSION Kansas City University of Medicine and Biosciences-College of Osteopathic Medicine’s (KCUMB-COM) Office of Community Clinical Education (OCCE) is a center for excellence in all aspects of osteopathic clinical education. OCCE passionately supports KCUMB students with a focus on service and quality education through developing and maintaining professional partnerships in an ever-changing environment. Community Clinical Education Throughout the University’s history, strong and valued partnerships have been established with highly regarded physicians, clinics and hospital systems across the nation. Annually, the OCCE conducts a “match” process whereby each student is assigned to an affiliated core-training site. KCUMB’s third- and fourth-year curriculum requires students to successfully complete a minimum of twenty clerkships. Required core clerkships are completed in the following disciplines: • • • • • • • • • Family Medicine (2 blocks) Internal Medicine (2 blocks) Surgery (2 blocks) Obstetrics/Gynecology Pediatrics Psychiatry Cardiology Emergency Medicine Rural/Underserved Primary Care All clerkships are supported by a patient-based curriculum, which represents an integrated, seamless continuation of the osteopathic curriculum offered during the first two years of training at KCUMB-COM. KCUMB-COM/OCCE 08.20.13 4 GENERAL INFORMATION A. Non-Discrimination/Harassment Policy Please refer to the KCUMB Student Handbook for additional details. B. Code of Professional Conduct The University expects all students to be responsible individuals who possess the highest standards of integrity, honesty and personal conduct. These traits are prerequisites to independent learning, professional development, the successful performance of academic and clinical assignments, and the conduct of one’s personal life. Accordingly, students are expected to adhere to a standard of behavior consistent with the University’s high standards at all times off and on campus. Compliance with institutional rules and regulations, in addition to city, state and federal laws, is expected of all students. For further information on the University’s conduct policies, please refer to the KCUMB Student Handbook. C. Written Complaints Against a Student on Clerkships If an attending physician, director of medical education, clinical staff member, patient or other relevant party files a written complaint against a student with the University, the Executive Vice President for Academic and Medical Affairs, and Dean of the College of Osteopathic Medicine may immediately suspend the student from school pending investigation. D. Clinical Clerkship Coordinators KCUMB Clinical Clerkship Coordinators are the initial point of contact for matters pertaining to clinical education. Coordinators are available to students via the official University e-mail system or by telephone during regular University business hours. Contact information for Clinical Clerkship Coordinators is provided below on Page 7. For emergency circumstances contact University Security at 816-654-7911. E. Communication Students are responsible for becoming aware of all information disseminated by the University and must be in compliance with all stated policies as modified from time to time by the University. It is highly recommended that students check their e-mail a minimum of two times per day. To comply with privacy policies (FERPA or otherwise), all information provided must be directly communicated between the student and the OCCE (e.g. no spouses, parents, etc). When a student is unable to access the Internet during clinical training, he or she should notify their assigned Clinical Clerkship Coordinator and request alternative means for receiving communications. Students who experience problems with e-mail should directly contact the Information Technology (IT) Helpdesk at 1.800.234.4847 ext. 7700. At all times, students are obligated to ensure that the University is in possession of current contact information, including current/permanent mailing address and telephone numbers. Any KCUMB-COM/OCCE 08.20.13 5 change in this information should be immediately updated via the PowerCampus Self Service Portal. F. Counseling and Support Services Counseling Services The University understands the intense environment and extra stress which graduate and medical students experience. Because we know how important it is for students to be emotionally healthy, KCUMB encourages students to utilize the New Directions program, a free and confidential counseling service available to all students and their families 24 hours a day, seven days a week. All counseling referrals and sessions are confidential and are not recorded in the student’s file. Students wishing to take advantage of this University-paid service may contact the Office of Student Affairs for information or New Directions directly at http://www.ndbh.com or (913) 982-8398. Social Activities Student social activities are scheduled to provide KCUMB students and their families opportunities to socialize off campus. The Office of Student Affairs will coordinate the events and obtain group rates when possible. Students are encouraged to suggest additional activities and events to the Office of Student Affairs. KCUMB-COM/OCCE 08.20.13 6 CONTACT INFORMATION OFFICE OF COMMUNITY CLINICAL EDUCATION (OCCE) 1750 Independence Avenue Kansas City, MO 64106-1453 1.877.425.0248 Fax: 816.654.7331 Associate Dean of Clinical Education Jeffrey A. Suzewits, D.O., MPH, FAAFP, FAODME 816.654.7341 - [email protected] Directs the oversight of clinical clerkship experiences throughout the continuum of the College of Osteopathic educational curriculum Administrative Director Valorie L. Millican 816.654.7332 - [email protected] Responsible for overseeing the daily office functions, office personnel, point of contact for the Assistant Regional Deans, affiliation agreements, directing programs and activities Preceptor Coordinator Michelle L. Houser 816.654.7335 - [email protected] Assists in updating the credentialing of community clinical faculty and preceptors, Continuing Medical Education credit, coordinating preceptor awards and receptions Clinical Clerkship Coordinator – Kansas City Region Kelly Handschin 816.654.7337 - [email protected] Responsible for scheduling and coordinating clerkships in the Kansas City region, working closely with the Assistant Regional Dean for Kansas City Clinical Clerkship Coordinator - Outside Kansas City Region Angela Imes 816.654.7334 – [email protected] Responsible for scheduling and coordinating clerkships outside the Kansas City region, working closely with the Assistant Regional Deans in Colorado, Florida, Michigan, Missouri, Ohio and Oklahoma Clinical Clerkship Assistant Whitney Campbell 816.654.7336 – [email protected] Assists students as needed and provides support to Clinical Clerkship Coordinator KCUMB-COM/OCCE 08.20.13 7 CONTACT INFORMATION KCUMB ASSISTANT REGIONAL DEANS COLORADO REGION Gregory D. Smith, D.O., FACOFP Office Phone: 720.859.6139 [email protected] FLORIDA REGION (GULF COAST) Eugene Usberghi, Jr., D.O. Office Phone: 239.694.5632 [email protected] SOUTHWEST MISSOURI REGION Larry D. McIntire, D.O. Office Phone: 417.347.6767 [email protected] KANSAS CITY REGION Gary M. Johnston, D.O., MACOI Office Phone: 816.654.7338 [email protected] DETROIT/TOLEDO REGION Steven J. Karageanes, D.O., FAOASM Office Phone: 734.254.0453 [email protected] KCUMB-COM/OCCE 08.20.13 8 KCUMB-COM CLINICAL CLERKSHIP OVERVIEW A. Third-year Curriculum • • • • • • • General Family Medicine (2 blocks) General Internal Medicine (2 blocks) General Surgery (2 blocks) Obstetrics and Gynecology (1 block) Pediatrics (1 block) Psychiatry (1 block) Elective (1 block) B. Fourth-year Curriculum Option I • • • • • Emergency Medicine (1 block) Cardiology (1 block) Rural/Underserved Primary Care Clinic (1 block) Sub-internship (2 blocks) Electives (5 blocks) For Option I, both sub-internships and three electives may be completed in the same area of specialty. Option II • Emergency Medicine (1 block) • Cardiology (1 block) • Rural/Underserved Primary Care Clinic (3 blocks) • Electives (5 blocks) For Option II, three electives may be completed in the same area of specialty. KCUMB-COM/OCCE 08.20.13 9 ASSESSMENT The purpose of the clerkship assessment is to provide feedback to guide both clinical and professional development. Students are required to complete both clinical and online components for clerkships. Failure to submit these required components within the allotted time will result in a minor deficiency for the clerkship. See Clerkship Grades/Credit, Letter I for additional details. A. Registration Students must complete/verify registration within five business days following the designated start date of the clerkship. Registration information is utilized to ensure enrollment for continued financial aid benefits, to retrieve evaluations in a timely manner and to ensure that proper clerkship credits are being issued. Students may access this system through the KCUMB Web Portal located at www.kcumb.edu. Failure to complete/verify registration in the prescribed time frame precludes eligibility for Honors or High Satisfactory. Be sure to register information for the attending physician completing the assessment. IT IS IMPERATIVE TO VERIFY AND SUBMIT ACCURATE AND COMPLETE OFFICE OR PREFERRED CONTACT INFORMATION (e.g. address, phone, fax, e-mail, etc.). Once submitted, changes may only be made by the OCCE and should be e-mailed to the assigned Clinical Clerkship Coordinator. Occasionally, students will work with more than one physician on a clerkship. In these cases, the KCUMB Web Portal will not allow registration of a second physician. The student should email their assigned Clinical Clerkship Coordinator with all necessary information. B. Subject Examinations Students are required to pass a subject examination, in each of the third-year core clerkships (total of six examinations), prior to graduation. A minimum of four subject examinations must be passed prior to taking the COMSAE and COMLEX Level 2CE. These are prepared by the National Board of Osteopathic Medical Examiners (NBOME COMAT) and the National Board of Medical Examiners (NBME). Either the COMAT or NBME examination or combination of NBOME and NBME examinations are acceptable. Passing is determined by a national standard of all students who have taken the examination. Students must declare which examination(s) they wish to take four weeks prior to the date of the examination. Failure to register on time will result in a minor deficiency. Late requests will be considered within the limitations of ordering the examinations. Examinations will be given at either the core site or through certain Prometric Testing Sites. Only NBME examinations are available at the Prometric Testing Sites. Core sites may offer COMAT and/or NBME. To register for examinations contact Curricular Affairs. For examinations taken at the Prometric Testing Sites a voucher will be issued and students will be responsible for scheduling a testing time within a seven-day window. Examinations must be taken once scheduled. Unexcused absences or late cancelations will result in a minor deficiency and can be referred to the Associate Dean for Student Affairs for unprofessional conduct. Examinations are available for the following disciplines: • • Family Medicine Internal Medicine KCUMB-COM/OCCE 08.20.13 10 • • • • • • • • Obstetrics and Gynecology Pediatrics Psychiatry Surgery Clinical Neurology Emergency Medicine Ambulatory Medicine (FMED 401 only) Osteopathic Principles and Practice (COMAT only) Only one examination may be taken on a test date. Students may take examinations in Family Medicine, Internal Medicine, and Surgery only after completion of both blocks. Students may take an examination at a non-core site, but should discuss this with the Associate Dean for Curricular Affairs in advance to make arrangements with the site. Travel to a nearby site to take the examinations and any expenses incurred for travel will be the sole responsibility of the student. Failure to comply will affect advancement to the fourth year. Scores and score reports will be sent to the student electronically. Failure of Subject Examination Students who fail an examination must schedule and retake the examination within one month of notification of a failing grade. Students who fail a second attempt must schedule an additional elective clerkship in the discipline and the examination will be retaken at the end of the clerkship. These additional disciplines will count as an elective. Elective clerkships must be selected from the following: • Family Medicine FMED 402 – Rural/Underserved Primary Clinic II FMED 406 – General Family Medicine FMED 409 – Primary Care • Internal Medicine IMED 405 – General Internal Medicine IMED 420 – Critical Care Medicine • Obstetrics and Gynecology OBGY 402 – Maternal Fetal Care OBGY 406 – General Obstetrics/Gynecology • Pediatrics PEDS 401 - Neonatology PEDS 411 – General Pediatrics • Psychiatry PSYC 401 – General Psychiatry PSYC 402 – Pediatric Psychiatry • Surgery SURG 401 – General Surgery In the event the examination is failed three times, the student must retake and pass the examination prior to graduation. A minimum of two weeks is generally required for scheduling. KCUMB-COM/OCCE 08.20.13 11 Failure To Successfully Pass Four Subject Examinations If failure keeps you from advancing with your peers, the following process will be implemented: • • • • • • • • Clinical Clerkship Subject Examination failures or failure to accomplish the required number of exams, are reviewed by the Academic Review Committee and additional information or clarification is obtained as deemed appropriate Conference call or on-campus meeting is scheduled with the student Serious issues or concerns related to professionalism are referred to the Associate Dean for Student Affairs Student may return to Kansas City for formal review or additional assessment by KCUMB Specific plan is formulated to address relevant discipline deficiencies, issues or concerns Student is required to repeat the failed subject examinations Student may be referred to the Dean of the College of Osteopathic Medicine for further action Student is released back to clinical clerkships once requirements and outlined conditions of the remediated/repeated examinations are met Subject Examination Schedules - Each core site is within proximity of one of the testing sites listed below. Tests will generally require a student laptop unless taken at a Prometrics Testing site. All testing arrangements are made through the Curriculum Office. Testing Site Kansas City MO Examination NBME COMAT St. Louis MO COMAT Joplin MO NBME Jefferson City MO NBME Springfield MO NBME Toledo OH NBME Dayton OH NBME Popular Bluff MO Denver CO NBME NBME Grand Junction CO INTEGRIS Southwest (Oklahoma City, OK) Wichita KS COMAT, NBME NBME Dates (tentative) 8/31, 9/28, 10/26, 11/23, 12/21, 2/1, 3/1, 3/29, 4/26, 5/31, 6/28 9/6, 10/4, 12/6, 1/10, 2/7, 3/7, 4/4, 5/2, 6/6, 6/30 8/30, 9/27, 10/25, 11/22, 12/20, 1/31, 2/28, 4/25, 5/30, 6/27 8/30, 9/27, 10/25, 11/22, 12/20, 1/31, 2/28, 3/28, 4/25, 5/30, 6/27 8/2, 8/30, 9/27, 10/25, 11/22, 12/20, 1/31, 2/28, 3/28 8/30, 9/27, 10/25, 11/22, 12/20, 1/31, 2/28, 3/28, 4/25, 5/30, 6/27 8/3, 10/4, 10/25, 11/22, 12/20, 1/31, 2/28, 3/28, 4/25, 5/23 8/30, 9/27, 10/25, 11/22, 12/20, 1/31, 2/28, 3/28, 4/25, 5/30, 6/27 8/30, 9/27, 10/25, 11/22, 12/20, 1/31, 2/28, 3/28, 4/25, 5/30, 6/27 8/30, 9/27, 10/25, 11/22, 12/20, 1/31, 2/28, 3/28, 4/25, 5/30, 6/27 NBME KCUMB-COM/OCCE 08.20.13 12 Prometrics Testing Sites • Ft Myers FL • Orlando FL • West Palm Beach FL NBME • Detroit MI • Evansville IN • Mobile, AL End of each month: student arranges testing date and time after receiving voucher from Curriculum Note: Core sites with Prometric Testing, may develop additional testing capabilities. Once this occurs, Prometric Testing sites will not be utilized for testing. C. NBOME Comprehensive Osteopathic Medical Student Assessment Examination II Students must take and pass the NBOME Comprehensive Osteopathic Medical Student Assessment Examination II (COMSAE II) prior to taking COMLEX Level 2 examinations. After June 1 and following the successful completion of four subject examinations, examinations will be arranged by the Curriculum Office and students will be provided online examination instructions. A passing score of 450 is required. Students may be provided additional examinations if warranted. D. Student Evaluation of the Clerkship: The MedIQ The University relies upon students to provide constructive feedback about clerkships. As such, students are required to complete a MedIQ (online evaluation of the preceptor) for each clerkship within five business days following the designated end date of the clerkship. Failure to complete the evaluation in the prescribed time frame precludes eligibility for Honors or High Satisfactory. Clerkship credit will not be granted until the MedIQ has been completed. Access to the MedIQ is provided via the KCUMB Web Portal. The University generates periodic, confidential, anonymous summary reports for review and appropriate content is shared with preceptors and/or core sites. E. Electronic Portfolio (E-Portfolio) Students must electronically transmit an E-Portfolio for all core clerkships. The purpose of this exercise is to provide KCUMB with important information about clerkships and to assist students in documenting their training experiences. E-Portfolio will be completed through T-Res – a mini-iPad and web-enabled application that allows students to quickly and accurately document their activities in order to enhance the effectiveness of medical education. It is strongly recommended the student sync and transfer the information to the T-Res server daily. Information entered into the E-Portfolio includes patient encounters, procedures and other clinical experiences, role in procedures, completion of learning objectives, and mastery level for procedures. For patient encounters, students are encouraged to log not only patients assigned to them but also patients they observed through rounds with other students and the preceptor because these are learning experiences. There is an expectation that students accurately log all experiences in order to achieve a satisfactory grade for the clerkship. Failure to meet the minimum expectation for a site will be a minor deficiency. KCUMB-COM/OCCE 08.20.13 13 * Misrepresentation or falsification of patient encounters can result in immediate dismissal from the university. All information must be transferred within five business days following the designated end of clerkship. Failure to complete the E-Portfolio in the prescribed timeframe precludes eligibility for Honors or High Satisfactory. Installation instructions for all web-enabled devices are available at www.T-Res.net. Contact information for questions regarding T-Res may be directed to the Curriculum Office or the T-Res Helpline at 1.866.694.2323. F. Clerkship Assessment of Student Performance by Preceptor Preceptors complete a Clerkship Assessment at the end of the clerkship (sample form available through the KCUMB Web Portal under “Useful Links”). This evaluation asks the preceptor to rate student performance compared to other students at the same educational level. Assessments submitted by interns or residents must be co-signed by an attending physician or Director of Medical Education (DME). Only comments are entered from intern or resident evaluations. The University recommends that students ask preceptors for a mid-clerkship assessment. Sample assessment tools are available for students to use when requesting a mid-clerkship assessment. These include a Peer Assessment, Mini-Case-Based Examination and Case Discussion. Mid-clerkship assessments allow the student to determine whether there is consistency between the preceptor’s and student’s perceptions. In addition, should a student be experiencing difficulty on a clerkship, a mid-clerkship assessment allows time to improve before the end of the experience. This may help avoid surprises at the end of a clerkship and provides the opportunity for the student to proactively address any problems. Preceptor approaches vary widely in providing students with feedback on performance. The University recommends that all students request time during the final week to receive an appraisal of their performance from the preceptor. Occasionally, students will work with more than one attending physician on a clerkship. In these cases, multiple assessments will be accepted for the experience. When there is more than one assessment submitted for a student for the same clerkship, the assessments will be averaged together to determine a final grade. Additional assessments received more than 60 days after the receipt of the original assessment will be added to the students assessment file, but may not be averaged into the final grade. All assessments are returned by the preceptor directly to the OCCE. Students found handling completed assessment forms may be referred to the Associate Dean for Student Affairs for unprofessional conduct. OCCE works directly with each site to coordinate dispersal and retrieval procedures for assessments. KCUMB reviews all clerkship assessments and determines the final grade for the clerkship. If significant performance issues arise, an appropriate University official will notify the student. Students should attempt to schedule an end-of-clerkship meeting with the preceptor to discuss their performance and review the assessment for self-improvement. However, at no time is it appropriate for a student to request a preceptor to change an assessment rating, revise comments on an assessment or challenge a preceptor regarding an assessment. If the preceptor is not available to review the assessment with the student and the student has questions KCUMB-COM/OCCE 08.20.13 14 or concerns, the student should contact their OCCE Clinical Clerkship Coordinator to discuss the most constructive way to obtain the desired feedback. Students failing to maintain the utmost level of professionalism in dealing with any part of the assessment process may be referred to the Associate Dean for Clinical Education. G. Deficiencies All minor or major deficiencies will result in review by the Associate Dean for Clinical Education and can be reviewed with the evaluating preceptor. Pending this review, the following can result in failure of the clerkship requiring remediation and repeating the clerkship: • • • One major deficiency Several minor deficiencies Any major unprofessional behavior The student will be notified of a poor assessment and/or failure relating to academic issues by the OCCE and reviewed by the Associate Dean for Clinical Education. Issues relating to professionalism may be referred to the Associate Dean of Student Affairs. The final disposition of the assessment in question is pending upon completion of this process. Additional assessments submitted following official review will be accepted, but may not impact the outcome. For deficiencies relating to professionalism, the student can be referred to the Promotion and Graduation Committee when deemed appropriate by the Dean. For complete policies regarding clerkship failure, review the KCUMB Student Handbook Subsequent to the review process, any student identified as having failed a clerkship may be required to return to Kansas City and remediate with KCUMB faculty. The failed clerkship must then be repeated. Any remediation requires accomplishment of satisfactory performance on all assessments. AT ANY TIME AND FOR ANY REASON, KCUMB RESERVES THE RIGHT TO REQUIRE ADDITIONAL METHODS OF ASSESSING THE STUDENT. STUDENTS MAY BE REQUIRED TO RETURN TO THE KCUMB CAMPUS FOR A FORMAL REVIEW. H. Clerkship Grades Honors (H) and High Satisfactory (HS) Honors and High Satisfactory grades are determined by the Academic Review Committee of KCUMB. Students in the same class will be compared to other students enrolled on the same service, at the same point in their training. (i.e. Class of 2014, IM 301, Block 1) 1. Third- and fourth- year core clerkships are eligible for H or HS grades. 2. Some elective and sub-Internship clerkships are eligible for H or HS grades. Those eligible require a minimum number of students enrolled in the clerkship the previous year (see Table 2) or a large number of students enrolled in the current year. 3. Remediated clerkships are not eligible for H or HS grades Grade Determination for Core Clerkships 1. Eligibility for H or HS is determined utilizing the preceptor evaluation(s) and the other elements of the clerkship. KCUMB-COM/OCCE 08.20.13 15 2. Satisfactory completion of all required elements for a clerkship will initially be given a “Satisfactory (S)” pending receipt of all clerkship evaluations for that block and subsequent review of those evaluations by the Academic Review Committee. 3. Once evaluations for each core service and block have been received, the Committee will award Honors or High Satisfactory to approximately the top 20% of students. Failure to accomplish required elements will exclude a student from H or HS considerations. Required elements include: 1. Clerkship registration within 5 business days following the start of the clerkship 2. Completion of the following within 5 business days of the clerkship end date: a. E-Portfolio (T-Res) – with all encounters and procedures accurately logged b. MedIQ c. Syllabus assignments (MedU® cases and Nutrition in Medicine® assignments, if assigned) 3. No major or minor deficiencies are reported on the preceptor evaluation 4. A scaled score is achieved as shown in the Table 1. a. Subject Examination scores apply to both months if applicable (IMED 301 and IMED 302). b. Students must complete both blocks of Internal Medicine, Family Medicine, or Surgery prior to taking the Subject Examination in one of these disciplines. c. Students may retake a failed exam if desired. d. Passing four (4) Subject Examinations is a requirement to take COMSAE II. Table 1 Honors and High Satisfactory are based on recommendations by clerkship directors nationally. COMAT* Examination Scores Family Medicine Internal Medicine Ob/Gyn Pediatrics Psychiatry Surgery NBME Examination Scores H HS F H HS F 85 81 58 82 78 58 81 77 53 82 78 64 87 83 59 79 75 59 80 75 55 79 75 59 85 80 60 84 80 63 85 81 57 80 76 58 *Comprehensive Osteopathic Medical Aptitude Examination H=Honors, HS=High Satisfactory, F=Failure Grade Determination for Elective Clerkships 1. Students may earn Honors or High Satisfactory for elective clerkships which had at least 10% enrollment in the prior year. Honors or High Satisfactory may be earned for Sub-I clerkships which had at least 5% enrollment in the prior year. (Table 2) 2. Honors or High Satisfactory grades may be earned by exemplary clinical performance documented in the preceptor evaluation or by performance on a national subject examination if available. 3. Honors or High Satisfactory grades will be awarded predominantly, but not exclusively, for exceptional performance through the fall semester of year IV. KCUMB-COM/OCCE 08.20.13 16 4. Grades will be determined for elective clerkships with the same criteria as for core clerkships. Failure to accomplish required elements will exclude a student from H or HS considerations. Required elements include on time accomplishment of: 1. Within 5 business days following the start of the clerkship a. Clerkship registration 2. Within 5 business days following the clerkship end date a. MedIQ Table 2 Course ID Clerkship ANES 402 EMED 402 EMED 402s FMED 311 FMED 405 FMED 406 FMED 406s IMED 403 IMED 404 IMED 405 IMED 405s IMED 410 IMED 412 IMED 415 IMED 416 IMED 420 IMED 420s OBGY 406 OBGY 406s PEDS 411 PEDS 411s PSYC 401 PSYC 401s RADI 401 RADI 401s SURG 401 SURG 401s SURG 403 SURG 404 SURG 406 SURG 410 SURG 410s Anesthesiology Emergency Medicine Emergency Medicine (Sub-I) DoCare: International Medicine Sports Medicine General Family Medicine General Family Medicine (Sub-I) Gastroenterology Infectious Disease General Internal Medicine General Internal Medicine (Sub-I) Neurology Hematology/Oncology Dermatology Nephrology Critical Care Medicine Critical Care Medicine (Sub-I) General Ob/Gyn General Ob/Gyn (Sub-I) General Pediatrics General Pediatrics (Sub-I) General Psychiatry General Psychiatry (Sub-I) General Radiology General Radiology (Sub-I) General Surgery General Surgery (Sub-I) ENT Ophthalmology Urology Orthopedic Surgery Orthopedic Surgery (Sub-I) Projected Honors 10 12 5 3 3 11 6 3 4 7 4 5 3 4 3 6 2 4 2 4 2 3 2 14 2 7 3 3 3 3 6 3 Projected High Satisfactory 10 12 5 2 2 11 6 3 4 6 4 5 2 4 2 5 2 3 2 3 2 3 2 14 2 7 3 3 3 2 6 2 KCUMB-COM/OCCE 08.20.13 17 I. COMLEX Level 1 and Level 2 CE and COMLEX PE Examinations Successful completion of the National Board of Osteopathic Medical Examiners examination is required for osteopathic medical graduates to become licensed. The NBOME examinations are composed of four sequential segments – COMLEX 1, COMLEX 2-CE, COMLEX 2-PE and COMLEX III. All students must pass COMLEX 1, COMLEX 2-CE and COMLEX 2-PE to qualify for graduation from the University. A preponderance of students successfully pass each segment of the NBOME examination on their first attempt. The NBOME examination sequence follows exacting timelines and has restrictions on numbers of retakes in cases of initial failures. COMLEX 1 and COMLEX 2-CE can be taken three times each and is restricted by the University to a total of six combined attempts at passing COMLEX 1 and COMLEX 2-CE. A student will have two separate attempts to pass COMLEX 2-PE. Students must successfully complete the requirement of passing COMLEX 1 and COMLEX 2CE within six attempts and within five years from the date of matriculation. A student failing to meet these precise timeline requirements will be dismissed from the University. Refer to the KCUMB Student Handbook for additional details. Failure of COMLEX Level 1: • Failure of first attempt: Student is placed in a modified curriculum that includes up to a two-month delay in clinical clerkship participation and mandatory enrollment in IDIS 001 – NBOME Preparation. For additional details, please refer to the COM National Boards Examinations portion of the KCUMB Student Handbook. Student passes COMLEX Level 1 on second attempt: Promotion to third year. (Note: once student retakes the COMLEX Level 1 examination, he/she is allowed to continue with clinical clerkships in anticipation of a passing grade.) • Failure of second attempt: Student is placed in a modified curriculum that includes additional delays in clinical clerkship participation and mandatory enrollment in IDIS 001 – NBOME Preparation for a second or subsequent time. For additional conditions and details, please refer to the Student Handbook. • Failure of third attempt: DISMISSAL Failure of COMLEX 2-CE: • • • • Failure of first attempt: Student is placed in a modified curriculum that includes up to a two-month delay in clinical clerkship participation and mandatory enrollment in IDIS 002 – NBOME Preparation. For additional details, please refer to the COM National Boards Examinations portion of the KCUMB Student Handbook. Student retakes COMLEX Level 2-CE examination: Student is allowed to return to clinical clerkships in anticipation of a passing grade. Failure of second attempt: Student is placed in a modified curriculum that includes additional delays in clinical clerkship participation and mandatory enrollment in IDIS 002 – NBOME Preparation II, for a second time. For additional details, please refer to the COM National Boards Examinations portion of the KCUMB Student Handbook. Failure of third attempt: DISMISSAL KCUMB-COM/OCCE 08.20.13 18 Failure of COMLEX 2-PE: • • • Failure of first attempt: Student is removed from clinical clerkships and required to return to Kansas City to receive one-to-one instruction from clinical faculty as assigned by the Provost and Dean of the College of Osteopathic Medicine. The Student is placed in a modified curriculum that includes up to a one-month delay in clinical clerkship participation and mandatory enrollment in IDIS 002 – NBOME Preparation II. For additional details, please refer to the COM National Boards Examinations portion of the KCUMB Student Handbook. Student retakes COMLEX Level 2-PE: The student is allowed to continue with clinical clerkships in anticipation of a passing grade. Failure of second attempt: DISMISSAL NOTE: Taking the USMLE is not a University requirement for graduation, however if a student elects to take the examination, they MUST report this on ERAS. COMLEX examination applications are available online at www.nbome.org or from the Registrar’s office. J. Scheduling COMLEX Level 2 Examinations Students must schedule and sit for the COMLEX Level 2 CE and COMLEX 2 PE before November 30, 2014. Extensions must be approved by the Associate Dean for Curricular Affairs. Students are eligible to sit for both examinations AFTER all third-year requirements have been successfully completed; in most cases, this will be after June 1, 2014. Students must take and pass the NBOME Comprehensive Osteopathic Medical Student Assessment Examination (COMSAE II), prior to taking COMLEX Level 2 examinations. K. Letters of Recommendation As students request letters of recommendation from preceptors, the following information is provided to assist in the process. The physician writing the letter should be informed by the student to address the salutation of the letter “Dear Program Director” and send it to the Office of the Registrar, 1750 Independence Avenue, Kansas City, Missouri 64106. It is recommended for the letter to be submitted on letterhead from the hospital or clinic and signed by the attending. Students who want to find out what letters of recommendation have been received should directly contact the Registrar’s Office. ERAS Letter of Recommendation Request form link: http://www.kcumb.edu/academics/academic-resources/records-forms/ L. Clerkship Graduation Requirements Each student must successfully complete and receive credit for all clerkships to qualify for graduation. This is in addition to meeting other graduation requirements as set forth in the KCUMB Student Handbook and/or KCUMB University Catalog. Students graduating on the posted graduation date must complete all clinical requirements by May 1, 2015. This will ensure proper time to process the student file for graduation. KCUMB-COM/OCCE 08.20.13 19 POLICIES and PROCEDURES Medical students are required to adhere to the following policies and procedures at all times while on clerkships. I. General Policies A. Definition of a Block Clinical clerkships, sometimes referred to as rotations, clinical experiences or externships, are blocks of time the student will spend with a teaching physician, who is referred to as a preceptor. A clerkship block is defined as four consecutive weeks (28 days) or one month of clinical duties. Federal guidelines require a minimum of 37.5 clock hours per semester credit awarded. This equates to approximately 48 hours per week (187.5 clock hours per block) for the expected educational experience. Students are expected to adhere to each site’s scheduling protocols and procedures. B. Absence from Clerkships All absences must be communicated to the core site and preceptor by their preferred means of contact prior to the start of an assigned shift. In addition, the Clinical Clerkship Coordinator must be notified by email within 24-hours of the absence. Failure to report an absence is considered abandonment of duties and unprofessional conduct, which may result in referral for disciplinary action. KCUMB reserves the right to request documentation after the first day of an absence for emergent, unforeseen circumstances. A student absent for three or more days due to illness must submit a physician’s release to the Clinical Clerkship Coordinator prior to returning to clinical duties. Chronic absenteeism is defined as missing five days per any six-month time period and can be cause for disciplinary action. If KCUMB should close for inclement weather, that does NOT excuse a student from their clerkship. In addition, the KCUMB calendar regarding scheduled time off and breaks (e.g. Memorial Day, Labor Day, Winter Break, Spring Break, etc.) does not apply to third- and fourthyear students. Absences that result in a student accomplishing less than 187.5 hours on task per clerkship must be made up prior to the end of the clerkship or as approved by the Associate Dean for Clinical Education. C. Vaccinations/Immunizations A student who cannot provide an official up-to-date immunization record, in accordance with University requirements, will not be allowed to begin or continue with clinical training. Medical students entering first-year classes who are not current on their immunizations and/or do not provide an official KCUMB immunization record form, completed and signed by an authorized health official, will not be allowed to matriculate. KCUMB students are responsible to maintain a current and thoroughly documented official record of immunizations at all times. KCUMB-COM/OCCE 08.20.13 20 Students, who cannot provide official, up-to-date immunization records in accordance with University guidelines, will not be allowed to continue their education. Medical students enrolling at the University are required to complete an immunization form and a pre-matriculation physical and history form. Areas to be completed include, but are not limited to, physical examination (performed by a licensed physician), proof of immunization for poliomyelitis, rubella, rubeola, mumps, varicella and diphtheria/tetanus. Before matriculating, a student must also provide the results of a TB test demonstrating a negative PPD-TB test, a negative chest X-ray within the last year, or proof of completion of INH therapy. Students are encouraged to be immunized annually for influenza. D. Background Checks and Drug Screens All KCUMB-COM students must undergo a Criminal Background Check and 14-panel drug screen to proceed with clinical training. These are conducted through Validity Screening Solutions at the student's expense. SPECIAL NOTE: Some clerkship sites (core or otherwise) may require additional checks and/or drug screens. These are beyond the scope required by KCUMB and the student is responsible to initiate those requested and remunerate any related fees. E. Health Insurance All students are required to maintain personal health insurance. COM students must submit proof of personal health insurance to the Office of Admissions before matriculating and to the Office of Community Clinical Education before beginning clinical experiences. All students must immediately report any break in coverage or change in health insurance to the OCCE. Student Supplemental Medical Insurance Policy KCUMB has partnered with Hartford Life Insurance Company to provide Student Supplemental Medical Insurance coverage for all students. The Student Supplemental Medical Insurance policy attempts to help students cover medical expenses that are incurred during KCUMB-related activities, which are not covered by the student's personal medical insurance. The Student Supplemental Medical Insurance policy does not replace a student's personal medical insurance policy and students are still required to carry their own personal medical insurance. In accordance with every insurance policy, exclusions apply. If a medical injury, including a needle stick occurs as a first- or second-year student, please contact the Office of Student Affairs for information as to whether your injury qualifies for this coverage and directions for filling out a medical claim form. If a medical injury, including a needle stick, occurs as a third- or fourth-year student, please contact your Clinical Clerkship Coordinator for information as to whether your injury qualifies for this coverage and directions for filling out a medical claim form. Forms for filing a medical claim through this policy can be found on the OCCE Web Portal as well as the KCUMB intranet, under the Student Affairs section. SPECIAL NOTE: A student who cannot provide documentation of current personal health insurance coverage, in accordance with University requirements, will not be allowed to begin or continue with clinical training. KCUMB-COM/OCCE 08.20.13 21 F. HIPAA Regulations and Patient Encounters All students are required to become familiar with and adhere to all aspects of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Public Law 104-191 including The Privacy Rule published by the US Department of Health and Human Services (HHS). The Privacy Rule establishes, for the first time, a foundation of Federal protections for the privacy of Protected Health Information. This rule sets national standards for the protection of health information, as applied to the three types of covered entities: health plans, health care clearinghouses, and health care providers who conduct certain health care transactions electronically. By the compliance date of April 14, 2003 (April 14, 2004, for small health plans), covered entities must implement standards to protect and guard against the misuse of individually identifiable health information. More specific information may be obtained at www.hhs.gov/ocr/hipaa/. As a medical student, these standards pertain to all individually identifiable health information (Protected Health Information or PHI) encountered during medical training with the University including, but not limited to, medical records and any patient information obtained and recorded for use in KCUMB E-Portfolio. HIPAA regulations prohibit the use or disclosure of PHI unless permitted or required by law therefore, each student must utilize reasonable safeguards to protect any information he or she receives. Each student is responsible for ensuring the safety and security of any written or electronic information he or she receives, creates or maintains. The misplacement, abandonment or loss of any information in the student’s possession will result in disciplinary action. At no time should a medical student alter, remove or otherwise tamper with medical records. Specific rules and regulations with respect to student entries in medical records must be clarified during orientation or on the first day of the clerkship. Furthermore, each student is responsible for ensuring that PHI is used or disclosed only to those persons or entities that are authorized to have such information. Students are expected to maintain strict confidentiality in their patient encounters; to protect the physician-patient privilege; and to ensure that there are no unauthorized uses or disclosures of PHI. Any unauthorized use or disclosure of PHI, to include but not limited to digital images, video recordings, or any other patient related materials, committed by a student, or any observation of the same by a student or employee, should immediately be reported to OCCE. Any questions related to compliance with the HIPAA Privacy Regulations or about this or other privacy policies should be directed to the KCUMB Compliance Officer. G. Medical Professional Liability Insurance KCUMB provides medical professional liability insurance commensurate with industry standards. Malpractice coverage extends only to clinical activities specifically determined by the university as requirements for successful clerkship completion. Changes made to clerkship dates, type, and/or location without prior OCCE approval will jeopardize malpractice coverage. Understandably, students may wish to participate in volunteer activities such as health fairs during the course of their medical training. Student malpractice coverage does NOT extend to volunteer or non-KCUMB approved activities. It is the student’s responsibility to personally KCUMB-COM/OCCE 08.20.13 22 determine that any activity in which he or she participates outside of clerkship assignments is covered by alternative malpractice coverage. The student is personally responsible should an issue of malpractice arise during activities not covered by KCUMB malpractice insurance. H. Student Identification While performing duties related to patient care, all students must clearly identify themselves as a medical student both verbally and by wearing their KCUMB picture identification badge in addition to any hospital issued identification. Misrepresentation of oneself as a licensed physician is both illegal and unethical. Should the KCUMB identification badge become lost or broken, the student should contact KCUMB Security immediately to order a replacement and a charge may apply. I. Dress Code and Professional Appearance COM students are expected to maintain the highest standards of professional appearance at all times and reflect the dignity and standards of the medical profession. Students must abide by the Dress Code as articulated in the KCUMB Student Handbook. Appropriate dress for third- and fourth-year clerkships will be addressed during clerkship orientation. J. Hospital Rules and Regulations Each hospital/health care system has individual rules and regulations. Medical students must familiarize themselves with and adhere to these protocols during training. Students must respect and follow all policies regarding the use of hospital facilities, housing, and equipment. Students are financially responsible for any damage to or loss of hospital-related property, including but not limited to library materials, pagers and keys. K. Special Accommodations KCUMB is committed to students’ equal access to programs, services and activities in accordance with Section 504 of the Rehabilitation Act of 1973. It is the University’s policy to provide individuals with disabilities full and equal enjoyment of the services, facilities, and privileges of the University. The University does not discriminate on the basis of disability in its admission, recruitment, academics, housing, research, financial aid, counseling, employment assistance, and/or any other service, facility, or privilege available to students or potential students. Further, the University does not screen out, exclude, expel, limit, or otherwise discriminate against an individual seeking admission as a student, or an individual enrolled as a student, based on disability. The University promotes an environment of respect and support for individuals with disabilities, and will make reasonable accommodations for such individuals pursuant to applicable law. Students or potential students with disabilities as defined by applicable law have the right to request reasonable accommodations from the University. For additional information on this policy or on requesting accommodations, please refer to the KCUMB Student Handbook. L. Exposure to Blood-borne Pathogens and Infectious Diseases Students exposed to blood, body fluids and/or at risk environments for infectious disease exposure should follow, at a minimum, the employee policy of the facility where the incident occurred. KCUMB-COM/OCCE 08.20.13 23 Any expense incurred due to exposure is the student’s responsibility and should be billed to his or her personal health insurance. For additional details see Student Supplemental Medical Insurance policy. M. Didactic Conferences and Reading Assignments Didactic conferences and reading assignments are critical components of the medical education process. While the focus of years three and four is hands-on experience, didactic conferences and reading assignments are often provided as an adjunct to this learning process. Completion of reading assignments and attendance at didactic conferences scheduled by KCUMB, the Assistant Regional Deans, the core site hospital, clerkship service or preceptor is required without exception. N. Work/Call Schedule The work and call schedule during clerkships is at the discretion of the core site hospital, service and/or preceptor. Students generally follow the same schedule as their preceptor, however, if the preceptor is on vacation, or scheduled away from the office or hospital, additional arrangements must be made for completion of the clerkship. If this occurs, contact your Clinical Clerkship Coordinator immediately. Additional call time may be required on evenings, weekends or holidays. Students should clarify work and call schedules during orientation. Work/call scheduling imposed by KCUMB, the core site hospital, the service or preceptor must be followed without exception. Failure to comply can affect the student’s enrollment status and consequently their financial aid eligibility. FEDERAL LAWS RESTRICTING INTERN/RESIDENT WORK HOURS DO NOT APPLY TO MEDICAL STUDENTS. O. Medical Ethics All medical students are expected to conduct themselves in a professional manner demonstrating an awareness and compliance with the ethical, moral and legal values of the osteopathic medical profession. In observing the principles and practices of medical ethics, students will: • • • • Place primary concern on the patient’s best interests Be available to patients at all reasonable times as expected by the preceptor/core site Perform medical activities only within the limitations of a medical student’s capabilities and within the guidelines determined by the site and/or preceptor Strictly maintain patient and institutional confidentiality. P. Physical Examinations During third- and fourth-year clerkships, students are routinely expected to see and examine patients. It is necessary that all examinations of patients be appropriately structured, supervised, and consented in the interests of all parties, including the patient, student and attending physician. Students must wear their KCUMB picture identification badge and introduce themselves to patients as a medical student. Patient consents for a student to perform an intimate examination must always be voluntary. Consent for an intimate examination must be either verbal and/or KCUMB-COM/OCCE 08.20.13 24 written. Irrespective of the gender of the examining student and the patient being examined, a chaperone, defined as another medical professional, preferably the preceptor is required during all intimate examinations. A chaperone is not an accompanying person i.e. friend or relative of the patient. A chaperone, similarly, is not another medical student. Students are highly encouraged to record the date, time and the results of the examination as well as the name of the chaperone in the medical record. Q. Reporting Clerkship Problems During the clerkship, students are encouraged to discuss issues and concerns with the utmost degree of professionalism. Concerns should be addressed directly with the preceptor and/or core site if at all possible. If an effective resolution cannot be reached, or if the student is not comfortable addressing the issue themselves, the student should contact their Clinical Clerkship Coordinator. This does not include evaluation comments after the completion of the clerkship. R. Leaves of Absence A leave of absence may be granted from the University for several reasons, including: • Medical emergency or illness • Financial emergency • Personal emergency • Military service • Pursuit of an academic endeavor other than the regular classroom work, either on campus or at another recognized educational institution The Provost and Dean of the College of Osteopathic Medicine may grant a leave of absence for a designated period of time with or without conditions. Conditions are commonly prescribed in cases of academic deficiency or medical related issues. Students granted a medical leave of absence must have a licensed physician, selected by the Provost and Dean of the College of Osteopathic Medicine, certify in writing that their physical and/or mental health is sufficient to continue in a rigorous educational program before they may return to the University. Students granted a leave of absence with conditions may be required to meet with the Associate Dean for Student Affairs before reinstatement. Students granted a financial leave of absence must, prior to returning to the University; demonstrate to the finance department of the University that they have the financial capability to advance in their education. Students seeking an academic leave of absence must verify that all terms and conditions of the leave are stated before the leave will be granted, thereby ensuring that the student does not miss important core information. All leaves of absence should be requested in writing to the Provost and Dean of the College of Osteopathic Medicine, who is responsible for approving or denying requests for leaves of absence. KCUMB-COM/OCCE 08.20.13 25 Students granted a leave of absence must follow the checkout process detailed in the University Catalog under Leaves of Absence. Note: Students approved for a leave of absence will retain their KCUMB email account and have access to PowerCampus Self-Service, but all other access to electronic services will be suspended until such a time that the student is officially reinstated to active status. SPECIAL NOTE: All changes to a student’s schedule MUST be communicated to their Clinical Clerkship Coordinator. For additional information, please see the KCUMB Student Handbook. S. Worker’s Compensation Insurance Some clinical training sites may require students to provide proof of Worker’s Compensation Insurance. Medical students are not employees of the University; therefore KCUMB does not provide worker’s compensation insurance. The purchase of required coverage may be offered at the facility. Any expense incurred is the student’s responsibility. T. Transportation for Clerkships Travel arrangements are the sole responsibility of the student. Students are not considered an agent or an employee of the University and are not insured for any accidents or mishaps that may occur during any traveling that is done as a part of the student’s academic program. Standard means of transportation are classified as personal vehicles or accepted public transit systems. Any other form of transport, as it relates to clerkships, must be approved and authorized by the Associate Dean for Clinical Education (contact your Clerkship Coordinator for a “Request to Appeal” form). (Refer to the Student Supplemental Medical Insurance Policy on page 21) U. Request to Appeal The following are guidelines and procedures for submitting an appeal: 1. Students must first discuss issues and concerns with their Clinical Clerkship Coordinator. 2. When a situation warrants special consideration, an Appeals Form will be forwarded to the student by e-mail, where all pertinent information regarding the appeal must be submitted. 3. All information must be submitted directly to the Clinical Clerkship Coordinator. Decisions rendered through the appeals process are final. The Clinical Clerkship Coordinator will notify the student via e-mail when a decision has been reached. KCUMB-COM/OCCE 08.20.13 26 V. Eligible Preceptors All preceptors must be a licensed D.O. or M.D. and approved by KCUMB. If a student would like to work with a physician who is not currently affiliated with KCUMB, the following must be received: 1. A Clerkship Request through the KCUMB Web Portal 60 days prior to the clerkship start date or 90 days prior to the clerkship start date for Kansas City area requests. 2. A copy of the physician’s current medical license. Once documentation is received it will be reviewed as part of the clerkship approval process. Students are NOT permitted to complete any clerkship with a family member. This includes immediate family members who are related by blood or marriage. This policy is in place to ensure impartiality of student assessments. Failure to comply will result in loss of academic credit for the experience. Students interested in a non-clinical clerkship may select a D.O., M.D., Ph.D. or Pharm.D. preceptor. Any research preceptor, not licensed as a D.O. or M.D., must submit their current CV. W. DOCARE and International Clerkships (INMED) Approval of DOCARE as a four-week ELECTIVE opportunity for credit through KCUMB is reviewed on an annual basis. When approved, selected students may participate in the provision of health care for medically underserved communities. This will be done in accordance with supervision by KCUMB Clinical Faculty. Approval of Institute of International Medicine (INMED) as a four-week ELECTIVE opportunity for credit through KCUMB with additional approval from INMED. This elective clerkship is designed to introduce fourth-year medical students to health care provided in foreign countries. All first and second year course/section requirements (no remediations) and a minimum GPA of 2.5 1. COMLEX I 2. All third-year core clerkships (no clerkship failures are allowed) 3. Scheduling of COMLEX II and PE confirmed 4. Approval of the Associate Dean for Clinical Education Students requesting to participate in any international rotations are expected to maintain professional and academic standards. Students receiving a COMLEX failure, a failing grade in any section or clerkship, maintaining a G.P.A. below 2.5 or exhibiting any unprofessional behavior as defined by the Office of Student Affairs, will be required to resign from their leadership position. KCUMB-COM/OCCE 08.20.13 27 X. Military Clerkships Students must discuss the details of his or her military requirements with the core site and Clinical Clerkship Coordinator before plans are finalized. Y. Independent Study and Research Electives One block during the third or fourth year may be completed as an independent study or research elective. To complete this elective, the student must submit an Independent Study and Research Form, which is available on the KCUMB Web Portal under “Useful Links”. Be sure to include the required documentation as outlined in Part IV of the request at least 90 days prior to the elective start date. All research projects involving human subjects or PHI must be approved by the Institutional Review Board, either through a preceptor-approved research protocol or through a student-submitted and approved protocol. Similarly, the Institutional Animal Care and Use Committee must approve research involving animals. Students completing an independent study or research clerkship should submit a summary report of progress and data to date during the last week of the clerkship to the Associate Dean for Clinical Education. The faculty sponsor or preceptor will complete an assessment for the student. II. Scheduling To maximize internship and residency opportunities, the student determines the third-year elective and fourth-year schedule in cooperation with his or her Clinical Clerkship Coordinator or core site. Students are eligible to begin the scheduling process at the start of third-year clerkships. It is strongly recommended to begin planning fourth-year clerkships by December of the third year. NOTE: However, larger institutional programs might not accept visiting student applications before May or June. In order to receive credit for a clerkship and coverage under KCUMB’s medical professional liability insurance, all clerkships must be approved by the OCCE prior to the start date and meet the following criteria: 1. Institutional paperwork (e.g. site application, hospital forms, immunization/health forms, etc.) completed, signed and submitted to the Clinical Clerkship Coordinator a minimum of 60 days prior to the requested clerkship start date (90 days for KC Region). 2. Electronic Clerkship Request submitted for review via the KCUMB Web Portal. 3. Clerkship arranged at an OCCE-approved site with a licensed D.O. or M.D. SPECIAL NOTE: To comply with privacy policies (FERPA or otherwise), all information provided must be directly communicated between the student and OCCE (i.e. no spouses, parents, etc). A. Clerkships Outside Kansas City Region The process for scheduling clerkships is as follows: KCUMB-COM/OCCE 08.20.13 28 1. The student contacts potential clerkship sites. Most application processes are available on the Internet by searching the facility’s homepage. In the event information is not available online, the student should obtain a phone number from the osteopathic or allopathic web site and contact the facility. Students may also go to the KCUMB Web Portal and search by specialty, site or preceptor. * Affiliation Agreements must be in place prior to clerkship start date. Be aware this process can take up to six-months and KCUMB cannot guarantee consensus can be reached with every facility. a. A listing of KCUMB Core Sites is located at www.kcumb.edu or on the KCUMB Web Portal. b. A general listing of osteopathic institutions is located at www.aacom.org. c. A listing of allopathic institutions is located at www.aamc.org/meded/medschls. d. KCUMB also participates in the Visiting Student Application Service (VSAS). VSAS is an AAMC application system designed to make it easier for medical students to apply for senior electives at U.S. medical schools and teaching hospitals. A list of host institutions, elective opportunities and specific eligibility requirements is available at https://www.aamc.org/students/medstudents/vsas/. 2. Students should e-mail or speak with the person in charge of clerkships, externships or rotations to inquire about the facility’s specific process (e.g. availability, fees, housing, etc). 3. The student completes institutional paperwork (e.g. site application, hospital forms, immunization/health forms, etc.) and forwards to OCCE Clinical Clerkship Coordinator for processing. Incomplete applications and those received without an electronic Clerkship Request will not be processed. THIS PROCESS MAY TAKE UP TO 30 DAYS TO COMPLETE. 4. The visiting site generally sends the student verification of acceptance for a clerkship. If verification is not received, it is the responsibility of the student to contact the site or preceptor to discuss the status of the clerkship. 5. Once a clerkship is scheduled, students may not cancel or change the dates or service type without OCCE approval. Submission of paperwork 60 days in advance allows adequate processing time for the site/preceptor to determine availability and for the OCCE to review KCUMB requirements. SPECIAL NOTE: Failure to comply with the 60 day submission requirement can result in referral to the Associate Dean for Student Affairs for unprofessional conduct. The student can also be placed on a vacation month, which may delay graduation. B. Clerkships in the Kansas City Region ALL CLERKSHIPS IN THE KANSAS CITY REGION MUST BE SCHEDULED 90 DAYS IN ADVANCE THROUGH THE OCCE. Students MUST submit a Clerkship Request through the KCUMB Web Portal 90 days in advance to be considered. Any requests received fewer than 90 days prior to the start date of the clerkship will not be considered and must be completed outside the Kansas City Region. The process for scheduling clerkships is as follows: 1. Students should NEVER contact a hospital, clinic or physician in the Kansas City Region to set up or confirm a clerkship without first contacting OCCE to obtain approval. This is KCUMB-COM/OCCE 08.20.13 29 2. 3. 4. 5. 6. vital to ensure the integrity and growth of our clinical program. If a student contacts one of the above on their own, it will be considered a breach of professionalism. Due to limited availability, only students completing their third-year core rotations in the Kansas City Region will be allowed to complete the Emergency Medicine or Cardiology core rotations in the Kansas City Region. All clerkships in the Kansas City Region are scheduled to start the first day of the month and end the last day of the month, with the exception of KU Medical Center. Two-week clerkships are generally not available in the Kansas City Region so students should plan to complete a full one-month experience. Clerkships scheduled in the Kansas City Region without going through OCCE are subject to cancellation, which might affect the student’s graduation date. Once a clerkship is scheduled and confirmed in the Kansas City Region, students should not anticipate being able to change or cancel. C. Application and Other Fees Students participating in the osteopathic medical curriculum are required to receive instruction in a clinical setting. As a result, it will be necessary for students to make arrangements for transportation to and lodging near clinical facilities. The University does not provide for the cost of transportation or lodging. Travel arrangements are the sole responsibility of the student. Students are not considered an agent or an employee of the University and are not insured for any accidents or mishaps that may occur during any traveling that is done as a part of the student’s academic program. Students are responsible for all out-of-pocket expenses associated with clinical education, such as transportation, housing, meals, professional attire, laboratory fees, etc. D. Canceling/Changing a Fourth-year Clerkship It may be necessary to cancel or change a clerkship. Cancellation/change requests must be received 45 days prior (60 days for Kansas City clerkships, however please refer to B.6 as a reminder that student’s should not anticipate being able to change or cancel clerkships) to the start date. A student might be required to attend the scheduled clerkship if requests to change or cancel are received after the deadline. For consideration, requests should include the following: 1. A cancellation/change request must be submitted in writing to the Clinical Clerkship Coordinator via e-mail or fax. 2. Acknowledgement and agreement of the cancellation/change request by the previously approved/scheduled site must be submitted in writing to the Clinical Clerkship Coordinator via e-mail or fax. 3. A Clerkship Request for the alternative clerkship must be submitted via the KCUMB Web Portal. Circumstances are considered on a case-by-case basis and approval is NOT guaranteed. III. Third Year Third-year students are required to complete nine (9) core clerkships and one (1) elective block. Although third-year core clerkships are established, confirmed and completed at the assigned KCUMB core site, exceptions are reviewed on an individual basis and cannot be guaranteed. KCUMB-COM/OCCE 08.20.13 30 A. Elective One (1) block during the third year may be taken as an elective. The core site determines the third-year schedule and as such, may set the time and/or location at which this elective may be completed. The elective can be split into two, two-week increments; however they must be completed consecutively. Two-week electives are generally not available in Kansas City. SPECIAL NOTE: Clerkships completed in the third-year may not fulfill any fourth-year clerkship requirements. B. Non-credited Time-off Students on a month-to-month schedule are allotted five days of non-credited time off from clerkships between September 1, 2013 and May 31, 2014. This time is not permitted on either the first or second day of any clerkship. Time off must NOT drop the total clerkship below 20 weekdays (187.5 clock hours on task per clerkship). For consideration of approval, a signed Time-off Request form must be submitted to OCCE no later than 30 days prior. The form is available on the KCUMB Web Portal. Students on four-week blocks are automatically scheduled for third-year time off during Winter Break. All students should verify policies regarding time off with the core clerkship site as soon as possible. Core sites have the prerogative to schedule any student for holiday duty as University breaks DO NOT apply during clinical training. The student should be scheduled by the site to work with an alternative eligible preceptor in the event that the regularly scheduled preceptor is taking time off. SPECIAL NOTE: Unused third-year vacation time will NOT carry over to the fourth year. IV. Fourth Year Students are permitted flexibility in designing the fourth-year schedule and may determine the location at which clerkships are completed provided all KCUMB scheduling and curricular requirements are met. Scheduling and curricular requirements are set by the University to ensure students receive structured, quality education. Students will not be permitted to begin fourth-year clerkships until all third-year requirements have been successfully completed, excluding receipt of the clinical assessment from the preceptor. Financial Aid is awarded at the beginning of each academic year and only to those students who have met eligibility requirements. A. Emergency Medicine and Cardiology Students are strongly encouraged to complete fourth-year core clerkships at the third-year core site. This allows core site personnel to prepare more informed letters of recommendation for internship/residency applications. KCUMB-COM/OCCE 08.20.13 31 Students must complete one block of emergency medicine and one block of cardiology during the fourth year. Completion of a third-year elective in either of these disciplines will not fulfill this requirement. These clerkships must be scheduled at a KCUMB core site and completed in a general adult medicine setting. A listing of sites for these clerkships is available at www.kcumb.edu or through the KCUMB Web Portal. An electronic Clerkship Request must be submitted via the KCUMB Web Portal before approval of these clerkships may be granted by the OCCE. Students should complete both the core emergency medicine and cardiology clerkships prior to April 1, 2015. Emergency medicine shifts must span four, full weeks or one month. Attempting to complete these shifts in a shorter period of time will result in the student needing to complete additional shifts to meet the block requirement. SPECIAL NOTE: Due to limited availability, only students assigned to third-year core rotations in Denver or Kansas City are allowed to complete the Emergency Medicine or Cardiology core clerkships in the student’s assigned region. B. Rural/Underserved Primary Care Clinic Students must complete one block of rural or underserved primary care clinic selecting from approved preceptors located through the KCUMB Web Portal. Students may choose from primary care opportunities in general family medicine, general internal medicine, or general pediatrics. If a suitable location is not found, students may request to have an alternative preceptor considered. This form should be obtained from the Clinical Clerkship Coordinator. Once arranged, students submit a Clerkship Request 60 days prior to the start date through the KCUMB Web Portal. Late requests may not be considered for approval. Students interested in rural/underserved primary care, are strongly encouraged to complete a continuous three-month experience with the same preceptor/clinic (see Clinical Clerkship Overview, Alternate Option II). The two additional blocks of rural/underserved primary care clinic fulfill the sub-internship requirements. Students should complete the rural/underserved primary care clinic clerkship prior to April 1, 2015. C. Sub-internships Students must complete two blocks of sub-internships. Each block must be a continuous fourweek or one month experience and cannot be split into two-week increments. Sub-internships are restricted to fourth-year students and are designed to provide the student with an increased level of patient care responsibilities. Training focuses on self-education and includes more advanced study of discipline. Sub-internships must be scheduled at a recognized training program or KCUMB Core Site. SPECIAL NOTE: If completing Alternate Option II, the two additional blocks of rural/underserved primary care clinic fulfill the sub-internship requirements. KCUMB-COM/OCCE 08.20.13 32 D. Electives Students must complete a total of five elective clerkships during the fourth year. Students may complete no more than three elective clerkships, for a total of twelve weeks within the same subspecialty. All elective clerkships must be completed at a recognized teaching institution or with an OCCE approved preceptor. Eligible Preceptor information must be submitted when applicable. E. Two-week Electives Up to two fourth-year elective blocks may be completed as two, two-week elective clerkships (minimum of ten business days per experience). All other electives and required clinical clerkships must be full block experiences. SPECIAL NOTE: Two-week clerkships are generally not available in the Kansas City Region. F. Non-credited Time Off Students are permitted the equivalent of one full block of non-credited time off. The University strongly recommends that this block be utilized to accommodate board study and/or internship/residency interviews. Time off may be split into two, two-week increments and combined with a two-week elective. This option is available for students located in regions with two-week elective opportunities, and generally does not include the Kansas City Region. Students who wish to schedule fourth-year time off must submit an electronic Time-off Request through the KCUMB Web Portal a minimum of 60 days prior (90 days prior for Kansas City) to the requested start date. SPECIAL NOTE: Students enrolled in the DO/MBA Program are not eligible for a fourthyear time-off through KCUMB. Refer to the Rockhurst University Program Schedule for details. G. Internship/Residency Interviews OCCE strongly recommends students utilize their fourth-year time off to accommodate internship/residency interviews. In an effort to maximize internship/residency interview opportunities, students are encouraged to arrange clerkships either in the discipline or at the program to which they plan to apply – if possible, during prime interview months (usually October - December). To request additional time off, students must complete a Time-off Request, located on the KCUMB Web Portal under “Useful Links”. This form should be completed by the student, signed by the preceptor and submitted to the Clinical Clerkship Coordinator a minimum of ten business days prior to the requested time off. The preceptor has final approval for requested time off. If the preceptor denies a requested absence, that decision will prevent the application from being considered by OCCE. Any time off, dropping the clerkship below twenty working days, will need to be made up by the student prior to receiving final credit. KCUMB-COM/OCCE 08.20.13 33