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3rd Year Clinical Program

VCOM has developed a model medical curriculum that provides an academic environment within the community based hospital.  In the third year students have a variety of primary care experiences in including family medicine, internal medicine, pediatrics, obstetrics, and geriatrics.  In addition each student experiences at least one month of care in a rural or medically underserved setting,  Balanced with the primary care, students participate in hospital based medicine, surgery and psychiatry rotations.

VCOM appoints and employs a dedicated clinical faculty from each of the affiliated community based hospitals to assure a structured academic program. Educational resources are provided including a monthly lecture series, electronic libraries and web based videoconferencing.  Each core regional site is overseen by a Director of Student Medical Education and Student Coordinators are employed to assist students with the academic program. 

Most regions include rural training for one to three months in hospitals that range in size from 25 to 100 beds balanced with medical center training in urban or suburban areas in hospital from 100 to 500 beds. The blend of rural hospital training with the training in larger community hospital experience provides the students with the hands-on experience in a one-on-one academic service and the traditional formal hospital service based education. VCOM has recruited many talented academic physicians to the area.  Through this recruitment and enrichment of current faculty, VCOM is improving the quality of care throughout Southwest Virginia, North Carolina, and South Carolina.

Clinical Division

The Clinical Affairs Division provides oversight of the Clinical Curriculum and the Early Clinical Experiences for students in their first and second years of medical school; the third year Core Clinical Curriculum and hospital training sites; and the fourth year selective and elective clinical rotations.

The responsibility for decisions directly affecting the educational experience of students in their clinical setting resides with the Associate Dean for Clinical Academic Affairs.

The Associate Dean for Clinical Academic Affairs oversees the clinical education division.  The Clinical Department Chairs and the Directors of Student Medical Education in the clinical sites assure the education of the student.

The Associate Dean for Clinical Academic Affairs and Clinical Chairs evaluate, establish, and arrange for clinical rotations in affiliated hospitals and ambulatory sites clinics with appointed clinical faculty. Decisions are made to maximize the educational experience of the student.

Student Evaluation and Promotion

The Associate Dean for Clinical Academic Affairs is the officer with the authority and responsibility to enforce the clinical academic policies of the College. In the event that a student does not abide by VCOM policies in the clinical region, further procedures may be initiated as defined in the in the College Catalog and Student Handbook. Students must pass all nine clinical rotations, the Foundations of Clinical Medicine on line curriculum, and the one-month Foundations of Clinical Decision Making Curriculum, and pass all end of third year testing to be eligible for promotion to fourth year.  Additional requirements exist that include preparation for and taking of the COMSAE and COMLEX exams prior to promotion to fourth year, see this section for further information. The Associate Dean for Clinical Academic Affairs is responsible for providing the Registrar with the list of students eligible for Promotion.

If a student fails a clinical rotation, the Associate Dean for Clinical Academic Affairs will interview the student and either the appropriate clinical chair or the Associate Dean for Clinical Academic Affairs will interview the preceptor. The Associate Dean for Clinical Academic Affairs also will make a recommendation to the Promotion Board concerning the student's failure based on overall performance and overall knowledge content that was gained or missed. This recommendation is non-binding. The Promotion Board makes the final decision.

 
Core Curriculum OMSIII

VCOM’s third year osteopathic medical students are required to complete a four week on-line review prior to beginning clinical rotations Foundations of Clinical Medicine I.  Students then complete nine core clinical rotations.  During the year students have one month to complete Foundations of Clinical Medicine II which is comprised of on-line interactive curriculum covering the most urgent and emergent conditions seen in the clinical setting.  Beginning in fall of 2012, students also return to complete ACLS testing and Diagnostic Medicine training  in the Center for Simulation and Technology (Foundations of Diagnostic Medicine and Foundations of Clinical Medicine). Each clinical rotation is estimated to require a minimum of 180 hours to complete, including 40 to 60 hours each week in the regular program and after hours on call duty. The required core rotation list for third year is below. All rotations must be taken and completed at VCOM core hospitals or ambulatory rotation sites. All rotations and assigned curriculum must be successfully completed to progress to the fourth year. Four credit hours are awarded for each rotation.

Core Clinical Rotations are:

Family Medicine
Geriatrics
Internal Medicine 1
Internal Medicine 2
Pediatrics		 Psychiatry
Obstetrics/Gynecology
Surgery
Underserved Care

Students should visit the Discipline website each month to access the rotation syllabi, information and expectations. Please refer to the clinical rotation course descriptions and credit hours section of the College Catalog and Student Handbook for more information.

Required Clinical Curriculum and VCOM TV

With each core rotation, students are provided a required accompanying on-line curriculum that includes reading assignments, VCOMTV delivered didactic presentations, and interactive web based instructional programs. In addition students are required to attend a clinical education day and OMM laboratory. The clinical material also integrates basic science reviews and osteopathic principles. 

Evaluation and Grades in the OMS III YEAR    

Students are evaluated using a Competency Based Clinical Evaluation and an End of Rotation Exam.

A competency based evaluation form exists for each rotation and is based on core osteopathic competencies as well as the clinical competencies specific to the rotation. The evaluation form includes the core osteopathic clinical competencies including interpersonal and communication skills, problem solving skills, clinical skills in patient care, osteopathic philosophy and manipulation, medical knowledge, professionalism and ethics.

Students are awarded a grade of Honors, High Pass, Pass, or Fail according to the comprehensive review of these areas of competency.

The medical knowledge is also evaluated through an end of rotation exam.  The exam is primarily based on the curriculum assigned by the Chairs through assigned learning objectives, website materials, assigned readings, VCOM TV delivered materials, and  other web-based instruction.  The end of rotation exam is awarded 1 credit hour and students receive a letter grade for this exam under the title of the specific Discipline and termed Clinical Modules. The educational objectives for each rotation may be found on the Clinical Chair’s Discipline Webpage (or by choosing one of the links below). Students who do not pass the post-rotation exam are given one chance to remediate. If the exam is failed twice, the student will be given an F and the case will be sent to the Promotion Board.

Students must also pass an End of Third Year Exam. The COMSAE exam is used as the End of Third Year Exam.  Information on this exam is provided through Laura Robinson annually and can also be seen on the COMLEX information section.  A Clinical Performance Examination also is given to assess clinical skills at the end of the third year. Students must take and pass an Objective Structured Clinical Exams (OSCEs) and Standardized Patient Exams (SP exams) in order to progress to the fourth year. 

End-of-year Testing

In addition to completion of an exam at the end of each 3rd year rotation, students are required to successfully complete an end-of–year comprehensive, or summative, exam prior to promotion to the OMS-4 year.  End-of-year testing involves both didactic and clinical skills performance components.  The COMSAE Phase 2 exam serves as the comprehensive didactic portion of end-of-year testing and serves to evaluate the student’s overall knowledge as well as their preparedness for the COMLEX Level 2 CE exam.  Clinical skills performance is evaluated through standardized patient (SP) encounters and Osteopathic Structured Clinical Performance Examinations (OSCE’s).  These exams evaluate the student’s ability to perform fundamental clinical skills such as taking a medical history, performing an appropriate physical exam, interpreting the results of common diagnostic and physical exam tests, evaluating signs and symptoms to form appropriate differential diagnoses, and formulating an appropriate treatment plan and documentation and communication skills.  Successful completion of all components of end-of-year testing is required for promotion to the OMS-4 year. 

For additional information on grading and requirements for academic progress and COMSAE and COMLEX policies, please refer to the Academic Policies and Procedures section of the College Catalog and Student Handbook.