Florida State University College of Medicine | Last Updated 5/19/23
BCC 7113
Internal Medicine Sub-Internship
2023-2024
Education Director
Jonathan Appelbaum, MD
Florida State University College of Medicine
Department of Clinical Sciences
1115 West Call Street, Suite 3140-F
Tallahassee, FL 32306-4300
Phone: 850-645-1227
Email: jonathan.appelbaum@med.fsu.edu
Campus
Clerkship Director
Daytona
Sheila Gupta, MD
Fort Pierce
William Hood, MD
Orlando
Ben Kaplan, MD
Pensacola
Robert Anderson, MD
Sarasota
Kathleen Kennedy, MD
Tallahassee
Gregory Todd, MD
AY2023-2024 Internal Medicine Sub-Internship Page 2 of 11
Contents
Overview ....................................................................................................................................................... 3
Course Description ................................................................................................................................... 3
Orientation and Syllabus Review .............................................................................................................. 3
Scheduled Hours/On-Call ......................................................................................................................... 3
Required Assignments .................................................................................................................................. 3
Required Assignment 1: Clerkship Educational Goal and Reflection ....................................................... 3
Required Assignment 2: Interprofessional Activities ............................................................................... 4
Required Assignment 3: Transition of Care Handoff ................................................................................ 4
Required Assignment 4: Faculty Observed History and Physical Examination ........................................ 4
Required Assignment 5: Discharge Summary .......................................................................................... 4
Required Assignment 6: Patient Safety and Ethics Case .......................................................................... 5
Patient Care................................................................................................................................................... 5
Inpatient Care ........................................................................................................................................... 5
Patient Log Requirements using the Encounter Tracking System (ETS) ................................................... 5
Written Documentation of Patient Encounters ....................................................................................... 6
Alternate Educational Experiences ........................................................................................................... 6
Online Curriculum ......................................................................................................................................... 6
Clerkship Director Meeting ........................................................................................................................... 6
Clerkship Examinations ................................................................................................................................. 6
Summative Examination ........................................................................................................................... 6
Optional Formative Self-Assessment ....................................................................................................... 6
Learning Resources ....................................................................................................................................... 7
Institutional Resources ............................................................................................................................. 7
Required Reading ..................................................................................................................................... 7
Canvas Resources ..................................................................................................................................... 7
Evaluation ..................................................................................................................................................... 7
Formative Evaluation ................................................................................................................................ 7
Summative Evaluation .............................................................................................................................. 7
Grading .......................................................................................................................................................... 7
Years 3 and 4 Grading Policy .................................................................................................................... 7
Clerkship-Specific Grading Criteria ........................................................................................................... 7
Course Objectives ......................................................................................................................................... 8
Policies .......................................................................................................................................................... 9
Absence and Attendance Policy ............................................................................................................... 9
Academic Honor Policy ............................................................................................................................. 9
Americans with Disabilities Act ................................................................................................................ 9
Clinical Experience and Education Policy (formerly Duty Hours or Work Hours) .................................. 10
Office of Student Counseling Services .................................................................................................... 10
Patient Log (ETS) Monitoring Policy ....................................................................................................... 10
Student Mistreatment Policy .................................................................................................................. 11
Syllabus Change Policy ............................................................................................................................ 11
AY2023-2024 Internal Medicine Sub-Internship Page 3 of 11
Overview
Course Description
The Internal Medicine Sub-Internship is an experiential, competency-based internal medicine acting internship, designed
to allow students the opportunity to actively participate in the management of patients with common clinical
presentations encountered in the practice of hospital-based internal medicine. Students will have the opportunity to
experience a broad range of patients with illness severity ranging from acute care upon presentation to the emergency
department to life-threatening processes in the intensive care unit. Many of these patients will not be previously worked
up. Students will be able to improve their basic clinical skills, learn new inpatient procedures and examination
techniques, assess the effectiveness of their clinical interventions, and work with an interdisciplinary team. Students will
have increasing responsibility for the care of their patients during this clerkship. Based on the Alliance for Academic
Internal Medicine’s AAIM Internal Medicine Sub-Internship Curriculum 2.0
and aligning with COM Educational Program
Objectives this sub-internship will focus on 5 broad areas:
1. Time management
2. Communication
3. Patient evaluation
4. Knowing when to ask for assistance
5. Wellness
Orientation and Syllabus Review
Students are required to read the syllabus located on the Office of Medical Education
site to become familiar with
expectations before beginning the clerkship. Students will also use the Canvas M.D. Clerkships AY2023-2024 site Internal
Medicine Sub-Internship page to access course material. A site-specific orientation will occur at the assigned clinical site
before the initiation of clinical activities. Students are responsible for communicating with Clerkship Faculty before the
start date of the clerkship to coordinate meetings.
Scheduled Hours/On-Call
The clerkship is four weeks in duration and will consist of inpatient shifts, in-house calls, lectures, conferences, and
reading assignments. It is expected that the student will work at least 10 hours per day for 6 days per week. Students
must have experience providing extended coverage and patient care after hours through night calls, "late" calls, or
night float. For this sub-internship, “short call” is defined as remaining with your team or attending on-call until about
5:00 PM, “long call” is defined as remaining with your team or attending until 10:00 PM, and “night float” is defined as
remaining in the hospital overnight. The student is expected to remain on-call with their team including weekend days.
The call schedule will be determined by the faculty member, while the mix of call types will be determined by the
Clerkship Director. Work hours must be documented in the Encounter Tracking System (ETS
) daily.
Required Assignments
Required Assignment 1: Clerkship Educational Goal and Reflection
At the start of the clerkship students will identify at least three specific educational goals within internal medicine that
they hope to learn during this sub-internship, along with a specific plan to achieve these objectives, such as extra
readings or following extra patients. The goals must be SMART (Specific, Measurable, Achievable, Relevant, and Timely).
Students must list the EBM sources they will use to achieve these goals and can also work with their Clerkship Director
and faculty to gain knowledge about these topics. These goals should be above and beyond the clerkship-specific goals
outlined in this syllabus.
Submission
• Upload clerkship educational goal plan to the “Project Documents” tab for the course in Student Academics by
5:00 PM on Friday of the first week of the clerkship. The Education Director will review and return with
feedback. If Student Academics is unavailable students will email their documents to the Education Director.
Evaluation
The Education Director will review and return with feedback.
At the end of the sub-internship students will briefly report on the extent to which their clerkship educational goals
created in week 1 were achieved and by what means.
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Submission
• Upload clerkship educational goal reflection to the “Project Documents” tab for the course in Student
Academics by 5:00 PM on Friday of the last week of the clerkship. If Student Academics is unavailable students
will email their documents to the Education Director.
Evaluation
The Education Director will review and return with feedback.
Completion of this assignment in a satisfactory fashion and timely submission is a clerkship requirement.
Required Assignment 2: Interprofessional Activities
Interprofessional relationships and working as an integral member of a team are important physician activities. Students
should function collaboratively on teams that include health professionals from other disciplines as they provide
coordinated services to patients. When acting or requesting a consultation, students will utilize and enhance their
expertise by understanding and engaging the unique and diverse knowledge, skills, and abilities of other professionals to
enhance team performance and maximize the quality of patient care. Students will find that working with other health
professionals enhances patient safety and improve the quality and value of care.
Submission
• Document completion of at least four (4) interdisciplinary conferences as an Educational Activity in ETS by
selecting “[IMSI] Participation in Interdisciplinary or Case Management Conference” in the drop-down box.
Evaluation
The assessment of this requirement will be completed by the Clerkship Director.
Required Assignment 3: Transition of Care Handoff
To prepare the student for PGY1 responsibilities, the student is expected to learn and be evaluated on both giving and
receiving patient handoffs by residents and/or their Clerkship Faculty.
Submission
• Document completion of at least four (4) handoffs as an Educational Activity in ETS by selecting “[IMSI]
Participation in Patient Care Handoff” in the drop-down menu.
Required Assignment 4: Faculty Observed History and Physical Examination
Clerkship Faculty will observe at least one partial history and physical examination by the student. It is the student’s
responsibility to make sure this observation occurs. Students will use the iPASS template located on the Canvas M.D.
Clerkships AY2023-2024 site Internal Medicine Sub-Internship page.
Submission
Document completion of at least one (1) faculty observation of a partial history and physical as an Educational Activity
in ETS by selecting “[IMSI] Completion of Faculty Observed Partial H & P” in the drop-down menu.
Required Assignment 5: Discharge Summary
The discharge summary shows the importance of proper management of a patient's transition at the time of their
hospital discharge or transfer to another healthcare facility, including an interprofessional collaboration that must occur
for a successful discharge. PGY1 residents are required to complete discharge summaries for every patient they
discharge or transfer from the hospital, therefore sub-interns must have experience in completing these summaries.
Students are required to complete at least one (1) discharge summary using the following guidelines and have it
reviewed for feedback from either their resident or Clerkship Faculty.
Submission
• Document completion of at least one (1) discharge summary as an Educational Activity in ETS by selecting
“[IMSI] Completion of Discharge Summary” in the drop-down menu.
Evaluation
The Clerkship Faculty or resident will review using the provided guideline and give feedback.
Discharge Summary guideline
Above expectations
Meets expectations
Below expectations
Feedback
Dates of admission and discharge
Admission diagnoses
Discharge diagnoses
Pertinent history and exam on
admission
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Pertinent diagnostic data (lab,
imaging, etc.)
Pertinent summary of hospital
course
Brief physical exam at discharge
Pertinent discharge labs including
those pending
Consultants
Medication reconciliation
Follow-up plan including
appointments
Patient education
Overall assessment
Required Assignment 6: Patient Safety and Ethics Case
Students will give a case presentation of a selected case at the weekly Clerkship Director meeting. Students will discuss
issues of biomedical ethics and futility that arise during their care of patients using the information posted on the
Internal Medicine Sub-Internship Resources page on Canvas M.D. Clerkships AY2023-2024
. The use of these readings is
expected to be incorporated into student presentations.
Submission
• During the final week of the clerkship, students will present a case where the principles of patient safety and
ethics are outlined and addressed in a patient-centered manner.
Evaluation
The assessment of this requirement will be completed by the Clerkship Director.
Patient Care
Inpatient Care
The Internal Medicine Sub-Internship is primarily an apprenticeship-style experience with an Internal Medicine
Clerkship Faculty member. The Clerkship Faculty will have primary responsibility for assessing the achievement of the
clerkship competencies; residents that the student may work with will also have input into the final student assessment.
Students will be preferentially placed within a residency program. Students will also learn about many of the ancillary
services that occur inside and outside the hospital setting through interactions with other professionals. Students will
learn and evaluate the basics of patient safety and the hazards of hospitalization as well as review ethical issues that
arise with their patients.
Patient Log Requirements using the Encounter Tracking System (ETS)
Students should enter patient encounter data into the Encounter Tracking System (ETS
) daily. A minimum of 60 patients
is required, with at least 90% of the patient encounters at the perform level of participation. Students will see 6-10
follow-up/established patients each week, and work up a minimum of three (3) new or undifferentiated patients each
week in the inpatient setting. By the end of their 4-week experience, students will see and document all of the required
problems/conditions listed below, and use Chapter 3 of the
AAIM Internal Medicine Sub-Internship Curriculum 2.0 as an
outline for the learning objectives for these conditions.
• Students who have difficulty seeing a patient within a problem or procedure category should notify their
Clerkship Director with sufficient time to enable remedial action.
• The problems and/or procedures marked with an asterisk* must be completed in the clinical setting and require
direct patient contact. The remaining conditions should be seen in the clinical setting but may be fulfilled by
alternate educational activities as determined by the Education Director.
Min.
Req.
Problem/Condition
Location of Service
Min. Level of Participation
Observe
Assist
Perform
1
Acute Pain
Inpatient Hospital
x
1
Altered mental state
Inpatient Hospital
x
Blood Pressure
1
Hypertension, Hypertensive
emergency, or urgency
Inpatient Hospital
x
1
Hypotension
Inpatient Hospital
x
1
Arrhythmia or dysrhythmia
Inpatient Hospital
x
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1
Chest Pain
Inpatient Hospital
x
Electrolyte
1
Hyperkalemia*
Inpatient Hospital
x
1
Hypokalemia*
Inpatient Hospital
x
1
Hyponatremia*
Inpatient Hospital
x
1
Fever
Inpatient Hospital
x
1
Hyperglycemia
Inpatient Hospital
x
1
Acute kidney injury*
Inpatient Hospital
x
1
Acute respiratory distress,
Shortness of breath* or Dyspnea*
Inpatient Hospital x
1
Hypoxemia*
Inpatient Hospital
x
Written Documentation of Patient Encounters
Students will document patient encounters in the appropriate format (e.g. admission note, SOAP note, discharge
summary) either in the electronic health record or in a Word document submitted to their clerkship faculty for review.
Evaluation of students’ charting of admissions and daily progress notes will be done by the clerkship faculty member
during patient care activities. Students are expected to participate in and be evaluated on their interprofessional
communication, including requesting consultations.
• Please review Chapter 4 of the AAIM Internal Medicine Sub-Internship Curriculum 2.0
for more details.
Alternate Educational Experiences
For students unable to complete and record a required clinical encounter or other clerkship requirements due to
circumstances beyond their control, the Education Director will determine an appropriate alternative educational
experience. Additional clinical encounters are the preferred method to complete the requirements of this clerkship.
Students may be exposed to the conditions or diseases secondarily through reading assignments, completion of Aquifer
cases, or discussions with the Clerkship Director, and will record as instructed in the ETS, and only under the direction of
the Education Director. The utilization of alternative educational activities is monitored by the curriculum committee
regularly.
Online Curriculum
The Alliance for Academic Internal Medicine (AAIM) sub-internship curriculum is a practical evidence-based curricular
toolkit to improve intern readiness. Developed by the Alliance in 2018, the curriculum integrates internal medicine
program director perspectives to prioritize core skills and EPAs most relevant to internal medicine residency. Each
chapter provides literature reviews, learning objectives, and tools for sub-internship directors. Students will use the
AAIM Internal Medicine Sub-Internship Curriculum 2.0
as a resource for the sub-internship.
Clerkship Director Meeting
Students will participate in morning rounds, noon conferences, and other educational meetings when available.
Students may be asked to present to residents at one of the educational meetings, and specific topics may be assigned.
Students are required to meet weekly with the Clerkship Director throughout the clerkship; this may be via in-person
meetings, zoom, telephone, or email. This meeting will include a discussion on clinical experiences, progress on
documentation of patient encounters in ETS, and any challenges or concerns. A mid-clerkship evaluation will be
completed by the Clerkship Director and will include feedback from the Clerkship Faculty and a review of the student
work hours log.
Clerkship Examinations
Summative Examination
At the end of the clerkship students will take the 100-question NBME Clinical Subject Examination for Advanced Internal
Medicine.
Optional Formative Self-Assessment
The NBME’s Self-Assessment Services (NSAS)
Clinical Science Mastery Series offers a $20 clerkship-specific exam
preparation that includes in-depth answer explanations. Students may purchase an NSAS examination for any clerkship.
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Learning Resources
Institutional Resources
The Maguire Medical Library offers 24/7 remote access to online resources such as Mobile Resources, Point of Care
, and
Subject Guides to support the core clerkships.
Required Reading
Required textbooks for this clerkship are located in the Internal Medicine Subject Guide
.
1. Cecil Essentials of Medicine, 10
th
edition 2021 (Andreoli, Benjamin, et al) Saunders Elsevier, Inc.
2. The Washington Manual of Medical Therapeutics, 36
th
edition 2020 (Crees, Fritz, Heudebert, Noe, Rengarajan,
Wand, editors) (Also available as a mobile resource through the UCentral app)
3. Harrison’s Principles of Internal Medicine 21
st
edition 2023 (Jameson, Fauci, Braunwald, Kasper, Hauser, Longo,
Loscalzo) McGraw-Hill, Inc.
Canvas Resources
The following resources are available on the Internal Medicine Sub-Internship homepage on the
Canvas M.D. Clerkships
AY2023-2024 IMSI homepage.
1. Ethics curriculum regarding futility
2. Additional readings on patient safety and the hazards of acute hospitalization
3. Internal medicine journal articles of interest
Evaluation
Formative Evaluation
A mid-clerkship evaluation is completed by the Clerkship Director to provide feedback on student progress toward the
achievement of clerkship objectives, competencies, assignments, and required encounters. A student workflow guide is
available on the Canvas M.D. Clerkships AY2023-2024
homepage.
Summative Evaluation
An evaluation of student clinical performance will be completed by the assigned clerkship faculty at the end of the
clerkship, as well as by the resident the student worked with during the clerkship. A final summative report will be
completed by the Clerkship Director at the end of the clerkship. The Education Director will review all components of the
clerkship and include an assessment of each in the final grade summary.
Grading
Years 3 and 4 Grading Policy
The standardized Years 3 and 4 Grading Policy for clerkships and courses is located on the
Office of Medical Education
site. The final grade is assigned by the Education Director and is based on all aspects of the clerkship, including clinical
performance, attitude, performance during weekly Clerkship Director meetings, and the results of the NBME Clinical
Subject Exam. There are no grade quotas, and any student can earn a grade of honors.
Clerkship-Specific Grading Criteria
1. Any breach in professionalism renders a student ineligible for honors
2. Any assignment submitted late or which requires remediation renders the student ineligible for honors and will
result in the assignment of an initial grade of IR (Incomplete Remediation) until remediation has been completed
3. Failure to document timely and accurate work hours renders a student ineligible for honors
4. Clinical performance and content knowledge must be exemplary to be considered for honors or high pass
5. End of clerkship NBME examination must be at the
a. 75
th
percentile or higher to be eligible for Honors consideration
b. 60
th
percentile or higher to be eligible for High Pass consideration
c. 10
th
percentile or higher to Pass
5. Active participation in weekly Clerkship Director meetings (pass/fail)
6. Satisfactory Clerkship Faculty and Clerkship Director evaluations documenting competency in all required
domains
7. Satisfactory documentation of at least 60 inpatient hospital (location of service) encounters in ETS with at least
90% at the perform level of participation (pass/fail)
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8. Satisfactory documentation all required problems at the perform level of participation in ETS (pass/fail)
9. Satisfactory completion and timely submission of clerkship educational goal and goal reflection in Student
Academics (pass/fail)
10. Satisfactory completion and documentation of at least four (4) interprofessional activities and record as an
Educational Activity in ETS (pass/fail)
11. Satisfactory completion and documentation of at least four (4) transitions of care handoffs and record as an
Educational Activity in ETS (pass/fail)
12. Satisfactory completion and documentation of at least one (1) faculty observed partial H&P and record as an
Educational Activity in ETS (pass/fail)
13. Satisfactory completion and documentation of at least one (1) discharge summary and record as an Educational
Activity in ETS (pass/fail)
14. Satisfactory presentation of the patient safety/ethics case to the Clerkship Director (pass/fail)
Course Objectives
The following tables outline the clerkship objectives and assessment method for each, intended to be used as a guide for
student learning. Each clerkship objective is mapped to the FSU COM Educational Program Objectives (EPOs)
and
ACGME Core Entrustable Professional Activities (EPAs).
INTERNAL MEDICINE SUB-INTERNSHIP COURSE OBJECTIVES
EPO
IMSI-1
Demonstrate the ability to gather essential and accurate information from hospitalized adult patients through
history-taking, physical examination, and the use of laboratory data, imaging, and other tests.
1.2
IMSI-2
Demonstrate the ability to develop focused and accurate differential diagnoses on hospitalized adults based on
patient information and preferences, current scientific evidence, and clinical judgment.
1.5,
2.6
IMSI-3 Recognize acutely ill adult patients that need immediate intervention. 1.4
IMSI-4
Demonstrate increasing responsibility under direct supervision to manage the care of hospitalized adults.
1.3
IMSI-5
Develop patient management plans for hospitalized adults with appropriate supervision with commonly
occurring inpatient internal medicine presentations, including acute pain, altered mental state, blood pressure
derangement, cardiovascular issue, electrolyte derangement, fever, hyperglycemia, renal issues, and
respiratory disorder.
1.6
IMSI-6
Communicate effectively with hospitalized adult patients and their families across a broad range of
socioeconomic and cultural backgrounds.
4.1
IMSI-7
Demonstrate interprofessional collaborative skills in working as a team member with other members of the
internal medicine team, care coordinators, nurses, and consultants.
1.6,
4.2
IMSI-8
Identify system errors and formulate potential systems solutions affecting hospitalized adult patients
6.4
Component
Learning Objective
Assessment
Inpatient
Medicine
1. Recognize ill adults in the hospital setting and the need for rapid
assessment and stabilization
2. Perform complete history and exams on adults newly admitted to the
inpatient service
3. Develop comprehensive and prioritized differential diagnoses on
hospitalized adults
4. Interpret diagnostic tests performed on hospitalized adults
5. Communicate effectively through oral and written documentation
6. Complete at least one discharge summary
• Performance
rating/checklist
• Faculty assessment of
communication skills
• Faculty assessment of
discharge summary and
feedback provided to
the student using a
rubric
Required
Patient
Encounters
1. Document at least 60 adult inpatient encounters with at least 90% at the
perform level of participation
2. Document the following problem categories at the specified minimum
number and level of participation: acute pain, altered mental state,
hypotension, hypertensive emergency or urgency, arrhythmia, chest pain,
hypokalemia, hyperkalemia, hyponatremia, fever, hyperglycemia, acute
kidney injury, acute respiratory distress, hypoxemia
• Weekly review of
patient logs in ETS
Required
Documentation
1. Document at least 4 transitions of care handoffs
2. Document at least 4 patient case management meetings
• Weekly review of
patient logs in ETS
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3. Document at least one inpatient history and physical examination
witnessed by a faculty member
Educational
Goals
1. At the beginning of the clerkship define 3 SMART educational goals
including EBM resources to be used
2. After the clerkship, self-assess progress on achievement of educational
goals
• Review and feedback
provided by Education
Director
Discharge
Summary
Project
1. Document a discharge summary
• Review and feedback
provided by Clerkship
Faculty or resident
Ethics and
Patient Safety
1. Understand and apply the concept of futility as it pertains to hospitalized
adults
2. Identify systems errors and propose and evaluate potential solutions
• Clerkship Director
assessment of the
appropriate topic,
adequate research,
organized, clear, and
properly cited
presentation
Weekly
Clerkship
Director
Meetings
1. Demonstrate oral presentation skills
2. Demonstrated clinical reasoning skills
3. Demonstrate time management skills through work hours
• Mid-rotation feedback
summary
• Clerkship Director
evaluation
• Review of work hours
NBME
Advanced
Clinical
Medicine
Examination
1. Demonstrate knowledge and clinical reasoning to analyze clinical scenarios
and answer basic, clinical, behavioral, and social science questions about
hospitalized adult patients
•
Minimum score of 10
th
percentile
Policies
Absence and Attendance Policy
The College of Medicine has detailed attendance policies as they relate to each cohort and events that conflict with
course schedules. See the FSU COM Student Handbook
for details of the attendance policy, a notice of absences, and
remediation. Students must use the student absence request form located on Student Academics. Extended absences
from the clerkships are not permitted. Any absence from the clerkships must be pre-approved by the Regional Campus
Dean before the beginning of the clerkship, using the
student absence request form. The clerkship faculty, Clerkship
Director, and Education Director must be notified of any absence in advance by the student, once approved by the
campus dean. Under no circumstances should a student arrange with the clerkship faculty or elective faculty to be away
from the rotation without first obtaining the approval of the campus dean. Any approved absence from a required
clerkship may result in the student receiving a grade of “incomplete” and the student is expected to make up missed
time and/or complete alternative/additional assignments before a final grade will be assigned. Unapproved absences
during the clerkship are considered unprofessional behavior, will result in a grade of “incomplete” until remediated,
and may result in a grade of “fail” for the clerkship. In the case of illness or other unavoidable absence, follow the same
procedure outlined above, and notify everyone as soon as possible.
Academic Honor Policy
The Florida State University Academic Honor Policy outlines the University's expectations for the integrity of student's
academic work, the procedures for resolving alleged violations of those expectations, and the rights and responsibilities
of students and faculty members throughout the process. Students are responsible for reading the Academic Honor
Policy and for living up to their pledge to "...be honest and truthful and...[to] strive for personal and institutional
integrity at Florida State University." (Florida State University Academic Honor Policy, found at
http://fda.fsu.edu/academic-resources/academic-integrity-and-grievances/academic-honor-policy
.)
Americans with Disabilities Act
Florida State University (FSU) values diversity and inclusion; we are committed to a climate of mutual respect and full
participation. Our goal is to create learning environments that are usable, equitable, inclusive, and welcoming. FSU is
committed to providing reasonable accommodations for all persons with disabilities in a manner that is consistent with
AY2023-2024 Internal Medicine Sub-Internship Page 10 of 11
the academic standards of the course while empowering the student to meet the integral requirements of the course.
To receive academic accommodations, a student: (1) must register with and provide documentation to the Office of
Accessibility Services (OAS); (2) must provide a letter from OAS to the instructor indicating the need for accommodation
and what type; and, (3) should communicate with the instructor, as needed, to discuss recommended accommodations.
A request for a meeting may be initiated by the student or the instructor. Please note that instructors are not allowed to
provide classroom accommodations to a student until appropriate verification from the Office of Accessibility Services
has been provided. This syllabus and other class materials are available in an alternative format upon request. For more
information about services available to FSU students with disabilities, contact the Office of Accessibility Services, 874
Traditions Way, 108 Student Services Building, Florida State University, Tallahassee, FL 32306-4167; (850) 644-9566
(voice); (850) 644-8504 (TDD), [email protected], https://dsst.fsu.edu/oas/
.
Clinical Experience and Education Policy (formerly Duty Hours or Work Hours)
The FSU COM uses the ACGME requirements regarding clinical experience and education as a guideline for our policy.
Our goal is to provide a structure that supports patient safety and student education and facilitates personal-
professional balance and well-being.
• Clinical experience and scheduled educational activities must be limited to no more than 80 hours per week
when averaged over 4 weeks.
• Students must have at least one day out of every 7 completely free from clinical duties and required educational
activities when averaged over 4 weeks.
• Clinical experience must not exceed 24 hours of continuously scheduled assignments, with the exception that up
to 4 hours of additional time may be used for effective transitions of care or student education. No additional
patient care responsibilities may be undertaken during these 4 hours. After 24 hours continuously on call,
students must have at least 14 hours free of clinical work and scheduled educational activities.
• Students should have 8 hours off between scheduled clinical experience and education periods.
Documentation of time spent on clinical experience and education:
Students will use ETS to document by self-report their daily work hours on required clerkships and courses. Students
must enter daily hours to include both clinical experience and required educational activities. Failure to report work
hours is considered a breach of professionalism.
Students will report the following:
• Clinical experience, including documentation in the medical record
• Required educational meetings (i.e. Doctoring 3, clerkship meetings, meetings with clerkship faculty, educational
meetings at residency programs)
• Hours that should not be included in self-reported "work” hours include reading about patient conditions and
procedures, self-directed study for clerkships/courses, work completed for assignments, learning modules, and
assigned reading.
Office of Student Counseling Services
Candidates for the M.D. degree must be able to fully and promptly perform the essential functions in each of the
following categories: Observation, Communication, Motor, Intellectual, and Behavioral/Social. However, it is recognized
that degrees of ability vary widely between individuals. Individuals are encouraged to discuss their disabilities with the
College of Medicine’s Director of the Office of Student Counseling Services and the FSU Office of Accessibility Services
(OAS) to determine whether they might be eligible to receive the accommodations needed to train and function
effectively as a physician. The Florida State University College of Medicine is committed to enabling its students by any
reasonable means or accommodations to complete the course of study leading to a medical degree.
Patient Log (ETS) Monitoring Policy
Encounter data are monitored by the Clerkship Directors to assure that students are meeting clerkship requirements. If
it becomes apparent that students are not encountering the required patient conditions, efforts will be made to
specifically select the patients with the required conditions. The level of participation in the care of patients is
determined by the student's involvement during the history, physical exam, assessment, and treatment plan. The
complexity of these components will vary, but to choose a level of participation, three categories have been created, all
of which include supervision of the medical student. The student will select the level of participation that most closely
describes their involvement in the patient encounter and will receive credit for documented participation at the
required level or higher.
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• Observe should be selected when the student observes a clinician conducting a patient encounter.
• Assist should be selected when the student assists a clinician in conducting the patient encounter.
• Perform should be selected when the student leads or conducts the patient encounter.
Student Mistreatment Policy
“Mistreatment” arises when behavior shows disrespect for the dignity of others and unreasonably interferes with the
learning process. It can take the form of physical punishment, sexual harassment, psychological cruelty, and
discrimination based on race, religion, ethnicity, sex, age, or sexual orientation. If a student feels they are being
mistreated, the student should report this concern to the Division of Student Affairs (Student Support Coordinator,
Assistant or Associate Dean for Student Affairs, or the Regional Campus Dean). We treat all such reports as confidential
and do not tolerate reprisals or retaliations of any kind. Please refer to the Student Mistreatment Policy in the
FSU COM
Student Handbook and report incidents of mistreatment as soon as possible.
Syllabus Change Policy
Except for changes that substantially affect the implementation of the evaluation (grading) statement, this syllabus is a
guide for the course and is subject to change with advance notice.