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Getting the Most Out of Your Basic Medicine Clerkship

If you will be starting your clinical rotations soon, it may not be long until you are in the third year internal medicine clerkship. This rotation is sometimes referred to as the "basic" or "core" internal medicine or medicine clerkship since it is one of the primary educational courses of your early clinical training. The third year medicine clerkship is also sometimes called a "foundational" rotation for students, primarily because it is so important to your subsequent clinical training experiences, and because the things you will hopefully learn will start to build a foundation of knowledge you will use for your entire career.

The third year clerkship is usually one of the longest of the year or occupies the most time in a longitudinal rotation. Many medicine clerkships include experience rotating on one or more inpatient services, either in general internal medicine, an internal medicine subspecialty, or possibly both. Some medicine clerkships also have an ambulatory/outpatient component, although at some institutions this may be a separate rotation or may be combined into a primary care experience. Although there are many variations on the theme, the core medicine clerkship will be designed to help you learn what is involved in caring for patients with often complex disease, and in the process will introduce you to different aspects of internal medicine.

Many students view the medicine clerkship with some ambivalence—usually with great excitement at what they will be experiencing and learning, but also with some trepidation because of the amount of information involved and the complexity of the patients. Add to this the fact that you will likely be stepping into what may seem like a foreign place since you may not have had a lot of clinical experience beforehand, the level of anxiety can be quite high!

But rest assured that virtually all students survive the experience, and actually come out on the other side a lot smarter and more experienced than when they went in! Here are some things you can do to prepare for the medicine clerkship:

  • Find out the practical details of what your medicine clerkship is like. Because the clerkship is large, students may rotate at different sites or have options to choose different places or experiences that may be part of their rotation. Knowing the types of experiences you will likely have and where they will occur may decrease your level of anticipatory anxiety.
  • Talk to students who have already rotated through the clerkship. Later third year students or your fourth year colleagues can help you know what to expect during the clerkship. As is always the case, each student will have their own perspective of what is good and what is bad, so it is often good to talk to several people; doing so may give you a more realistic perspective of what the clerkship is like.
  • Take a look at the CDIM Primer for the Medicine Clerkship before you start your rotation. CDIM is the Clerkship Directors in Internal Medicine, the national group of internal medicine student educators across the US, and the Primer was created specifically to help you understand how to approach the rotation and what is considered important. This is extremely helpful information to have before you begin the clerkship.
  • Be aware that ACP, in conjunction with CDIM, produces an educational resource specifically for use in the medicine clerkship: IM Essentials. IM Essentials consists of an abbreviated textbook of core internal medicine (IM Essentials Text) and a book of over 500 self-assessment questions that are linked to the textbook content (IM Essentials Questions). These are available as print books or combined on a digital platform (IM Essentials Online) that also has additional educational features, such as electronic flashcards and a custom quiz function using the self-assessment questions. ACP student members receive a discount on these materials.
    • Your clerkship director may recommend their use during your clerkship, and glancing at these materials can provide a glimpse of the type of information you will be expected to learn during your clerkship rotation.
  • Try to relax! Although the medicine clerkship may seem intimidating, your faculty and teachers understand where you are in your clinical training and will help you learn as much as you can during your clerkship. And even though the rotation may be busy and at times intense, try to take advantage of the many learning opportunities you will encounter and enjoy getting to know and care for a wide range of patients.

The third year medicine clerkship will likely be an experience you will remember for the rest of your career, regardless of your ultimate professional path—try to make the most of this important rotation!