1. science
2. medicine

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