The third year primarily consists of the required clinical clerkships. The required third year clerkships are in Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery.
Rehabilitation Medicine/Chronic Care, Emergency Medicine, Neurology and an additional four-weeks of Surgery Selectives are also required and may be taken in the third or fourth year.
Because of the regional nature of the University of Washington School of Medicine and the value of seeing health care delivered in different settings, it is expected that ALL students will take at least three clerkships outside the Seattle area. There is some time allocated for electives in the third year, however, most of the clinical electives are taken during the fourth year when students typically schedule clerkships that permit advanced coursework in areas of specialty interest and that provide a broad general medical education in preparation for assuming patient care responsibility during residency training.
Clinical Rotation Programs
Medical students at the University of Washington School Of Medicine may choose from one of three alternative approaches to their third year clinical rotations:
General Clinical Schedule: This is the mode in which approximately 75% of third year medical students will register for their required third year clerkships through a complex ranking process allowing them the opportunity to schedule all of their required clerkships across the entire WWAMI region. Students ranking their preferences in the general pool are expected to take at least three required rotations outside the Seattle area.
WWAMI State Track Program - The WWAMI State Track Program allows students to complete at least five of the six required third year clerkships and/or all of the fourth year required clerkships in that given State Track location. Currently, third year WWAMI State Track opportunities exist in Boise, Idaho; Spokane, Washington; Billings and Missoula, Montana; Anchorage, Alaska; and Wyoming. Fourth year WWAMI State Track opportunities are available in Boise, Idaho and Spokane, Washington; with Alaska, Montana and Wyoming working toward full fourth year offerings.
WRITE - The WRITE program (WWAMI Rural Integrated Training Experience) is a 20-week rural clinical medical training experience for a pre-selected group of third-year medical students. During the student’s third year and prior to embarking on the WRITE experience, they will complete portions of their required clerkships in Seattle (July-Dec). Following the required WRITE Orientation, which is held in Seattle (Jan), the students will report to their selected WRITE site where they complete their remaining 20 weeks of third-year required clerkship experiences (Feb-Jun).
Required Third Year Clinical Clerkships
This clerkship stresses ambulatory primary care with emphasis on common problems, biopsychosocial issues, preventive care, and introduction to the role of the primary care physician. Students function in the role of a clerk in a community or residency site and participate in the care of patients using office, hospital, home, or community resources.
This basic clerkship serves as a prerequisite for most other medicine courses and clerkships. Currently this clerkship is divided into 8 weeks of inpatient and 4 weeks of outpatient experience at the Seattle and Spokane sites, and 6 weeks of inpatient and 6 weeks of outpatient experience at other WWAMI sites. Students participate in the care of hospitalized patients to refine their skills of history-taking and physical examinations and to learn to care for the acutely ill. Daily rounds and conferences are held. A written and computer-based patient management examination for this course is given on the last day of the clerkship.
This clerkship experience provides an introduction to the comprehensive medical care and counseling services for adult and adolescent female patients. Students are actively involved in both inpatient and outpatient settings with management and delivery of obstetric patients as well as diagnosis and management of gynecologic conditions and diseases. Students participate in hospital rounds on both obstetric and gynecologic patients, in outpatient clinics, in seminars, tutorials, and are introduced to community health care agencies for women.
This clerkship provides a general introduction to inpatient and outpatient pediatrics. The aim is to expose students to settings where children receive medical and health care services. Approximately half of the six-week experience takes place in an inpatient hospital setting with the other half in an outpatient department, a clinic, or a series of offices.
This clerkship provides both outpatient and inpatient experiences. Students have primary responsibility under supervision of attending psychiatrists and residents for diagnosis and care of patients at UWMC, HMC, VAMC, or Boise VA. Emergency room, crisis intervention, consultation appropriate to patients with psychiatric dysfunction; familiarity with psychopharmacology, and short-term hospitalization are emphasized.
This clerkship introduces the student to the diagnosis and management of problems amenable to surgical therapy. A comprehensive program is offered which includes instruction in the physiological basis of surgical care, differential diagnosis and decision making, and the basic principles of surgical management. Active participation in the care of inpatients and outpatients, including participation in the operating rooms, provides practical experience in the application of these skills. Students will be assigned to the surgical service of one of the major affiliated hospitals. Approximately 40 hours per week is devoted to working with assigned patients on the ward or in outpatient clinics, in the operating room or in study. A series of lectures (required attendance) and/or discussions expand on major topics related to general, vascular, cardiothoracic, and plastic surgery.
Fourth Year Required Clerkships
The fourth year required clerkships can also be taken during 3rd
year with fulfilled prerequisites.
Students work at the level of sub-interns, with senior resident and attending supervision, encountering a wide range of patients, presenting complaints, and levels of acuity, spanning the scope of all specialties and both private and public hospital populations. Learning is primarily through direct patient care experience and bedside teaching, supplemented with lectures and directed readings. Development of the knowledge and skills necessary to evaluate and manage multiple patients simultaneously will be emphasized direct patient care experiences, bedside teaching, and readings.
Students in this clerkship gain a general understanding of basic clinical neurology and to develop neurology exam skills. A combination of inpatient and outpatient experience is the general rule. Available in the 3rd and 4th years; prerequisite for 3rd year students are: medicine, family medicine, surgery, or pediatrics.
Students in this clerkship are exposed to four content areas: Rehabilitation Medicine, Geriatric Medicine, Palliative & End of Life Care, and Acute and Chronic Pain Management. Students will choose to focus on one content area and will be assigned to a clinical site and preceptor to concentrate their clinical activities in that content area. This clerkship focuses on integrative learning experiences and involves didactic sessions designed around a series of content themes including management of individuals with chronic disease and resultant impairments, disabilities, and prognoses. Didactic sessions emphasize exposure to all four content areas and will include a variety of learning experiences including: lectures, small group discussions, standardized patients, and case presentations.
These additional four weeks of surgery are designed to allow students to learn more about general surgery or surgical subspecialties in a variety of inpatient and/or ambulatory care settings. Students may select a single 4- week rotation or two 2-week blocks available throughout the WWAMI region, from the approved list of Surgery Selectives.
Clinical Elective Clerkship General Policies
All clerkships are approved by each department, School of Medicine Clinical Curriculum Committees, the UWSOM Office of Curriculum, and the University of Washington Curriculum Office for a maximum number of allowable credits and with specific prerequisites.
EXAMPLE: MED 682 P-Clinical Cardiology and Electrocardiography (8) is approved as a 4- week, full-time elective for 8 credits. The maximum number of credits a student can earn for this clerkship is 8. Similarly, the clerkship cannot be taken for credit for less than four weeks.
Some clerkships have been approved for variable credit and may be repeated.
EXAMPLE: MED 699, P-WWAMI Medicine Special Electives (*, max 24) is approved to be taken for 2, 4, or 6 weeks full-time for up to 12 weeks or 24 credits. So a student could take MEDEDK 699 as a 4-week full-time elective in Cardiology and then MEDECK 699, as a 4 week, full-time elective in Respiratory. Electives may not be taken repeatedly for the same experience, in the same specialty, at the same location.
Students are allowed to take a maximum of three 4-week, full-time elective clerkships in a given specialty, and these credits will be counted toward the minimum number of clinical elective credit required for graduation. Electives may not be taken repeatedly for the same experience, in the same specialty, at the same location.
EXAMPLE: A student could take:
ORTHP 677 P-Musculoskeletal Trauma Clerkship (4 week =8 credits)
ORTHP 680 P-General Orthopaedic Clerkship (4 week =8 credits)
ORTHP 697 P-Orthopaedic Away Special Elective (4 week =8 credits)
Total Ortho Credits: 24