Introduction to Clinical Medicine is a year-long course for second-year medical students that serves as a bridge between the preclinic and clinical years. It is one of the first opportunities for patient contact as well as an introduction to acquiring the communication and physical exam skills necessary to becoming a good physician. ICM seeks to incorporate as many interactive learning opportunities as possible to foster a “hands-on” approach to learning. We also encourage self-directed learning in the curriculum through the following mediums:
The lectures are given by physicians in their specific area of expertise, a unique opportunity for students to hear from clinical experts in the field. The speakers focus on clinical history and physical examination findings, utilizing real patients, case presentations, and audience feedback and participation when possible.
Time spent with ICM preceptors is consistently rated the most beneficial, educational and enjoyable portion of the course. It is a unique opportunity for second-year students to spend individual time dedicated to their medical education with a clinical faculty member. ICM preceptors are highly motivated teaching faculty who have volunteered their time and efforts for the benefit of clinical training. ICM preceptor time begins in October and lasts until late March. Students are expected to meet with their preceptor for at least 2 hours approximately twice a month.
The students will perform a total of five formal history and physical examinations during preceptor time. Preceptors will identify the patients, but the student will perform these exercises on their own. Second-year students will be expected to “write up” the patient in standard format as well as eventually give brief oral presentations on the patient. H&Ps are critiqued by preceptors and returned to them with useful feedback. Final H&Ps will be witnessed and evaluated by the preceptor.
Small group sessions are scheduled throughout the course so that second-year students may obtain some hands-on experience. It is an opportunity to learn and demonstrate under direct supervision physical examination skills that are often illustrated during lectures. Group sessions are organized by organ systems and typically occur in the afternoons due to lecture schedule in combination with clinical faculty commitments. Students will be required to demonstrate competence in the various components of the physical exam as well as interviewing skills.
Small discussion groups consisting of approximately 10 students per group will meet to work through various patient case presentations with the assistance of a faculty discussion leader. Unknown patient cases will be given to the students ahead of time. Students will be expected to read ahead, form a reasonable differential diagnosis, and decide upon a proper strategy of diagnostic evaluation. They will then meet as a group with their faculty leader to discuss findings and plans for management. This is an excellent opportunity to practice self-directed learning as well as obtain knowledge from classmates and the wisdom of an experienced clinician.
Internal Medicine residents have agreed to meet with small groups on a regular basis on Fridays, generally from noon-2 p.m. All students will be assigned to a specific resident who will take them "to the bedside" of patients with interesting physical examination findings. This will be a good time where students can ask questions without the fear of "affecting your grade" (as with your preceptor), whether it be about writing progress notes as M-3s, finding radiology reports, how to put on gloves or looking up labs in the computer.
Classroom-led interviews of patients (CLIPs) will be an opportunity for the students to interview a patient (or someone trained to act as a patient) in the classroom, then discuss the differential diagnosis as a group.