3rd Year Core Program & Department Information

Jan M. Willcox, D.O.
Associate Dean for Clinical Academic Affairs

The Clinical Affairs Division provides oversight of 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 Clinical Program

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 is responsible for supervising and directing the clinical education of VCOM students. To fulfill this role, the Associate Dean for Clinical Academic Affairs may delegate appropriate authority to the DSME and Clinical Department Chairs within the College.

The Associate Dean for Clinical Academic Affairs is responsible for decisions directly affecting the educational experience of the students within the clinical site. The Associate Dean for Clinical Academic Affairs has the authority to evaluate, establish, and arrange for clinical rotations at hospitals and/or clinics that he/she believes are of high quality, and to make decisions relative to preceptors, services, academic issues, and behavioral issues that occur. Decisions will be made to maximize the educational experience of the student. Other factors that may be considered in such decisions include personality conflicts, availability of staff, hospital census, or any other factor that impacts medical education.

The Associate Dean for Clinical Academic Affairs may require student attendance at scheduled conferences and presentations, writing of papers, case presentation and other appropriate activities. In short, the Associate Dean for Clinical Academic Affairs has the authority and responsibility to enforce the academic policy of the College at the clinical sites. In the event that a student does not abide by the decisions of the Associate Dean for Clinical Academic Affairs, further procedures may be initiated as defined in the in the Student Handbook.

The Associate Dean for Clinical Academic Affairs is responsible for providing a progress report for VCOM students to the Promotion Board with recommendations for pass or failure, following the completion of all third year requirements. The Associate Dean for Clinical Academic Affairs is also responsible for providing a progress report for VCOM students to the faculty at the completion of fourth year to recommend for graduation.

As part of the Medical Student Performance Evaluation (Dean’s letter), the Associate Dean for Clinical Academic Affairs will provide an assessment of the student’s strengths and weaknesses in their clinical training. Both cognitive skills and non-cognitive issues will be addressed. This assessment is based on discussions during site visits, preceptors or site leadership. student interviews, as needed, evaluation forms and log sheets. Those students who are experiencing clinical academic difficulties will be required to meet with the Associate Dean for Clinical Academic Affairs. All students are encouraged to meet with the Associate Dean for Clinical Academic Affairs, especially those who are unsure of the direction of their fourth year.

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; a written record of these interviews will be kept. 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. The Associate Dean for Clinical Academic Affairs may enlist the appropriate clinical chair to assess the student difficulties and the terms of the remediation.

The Associate Dean for Clinical Academic Affairs has the authority to initiate interim temporary suspension or an immediate medical leave for VCOM students. If the Associate Dean for Clinical Academic Affairs determines that a student may constitute a threat to their own welfare or that of fellow students, staff, or patients, the student may be suspended or placed on medical leave effective immediately. Once placed on leave or suspended, the student is no longer covered by College policy (liability coverage, etc.). This notification must be in writing, and the Dean must be notified within three working days of such action. Possible situations where such action
may be necessary include, but are not limited to the following:

1. Substance abuse (alcohol & other drugs);
2. Medical or psychological illnesses;
3. Suspected illegal behavior; or
4. Suspected physical, sexual, or emotional abuse.

The power of the Associate Dean for Clinical Academic to initiate interim suspension is not limited to the above list. Immediately following a temporary suspension, a Behavioral Board or Promotion Board will be called. The initial step in the process is to notify the Dean as to the need for such a hearing.

Early Clinical Experience

Medical students in years one and two have approximately 20 one-day clinical experiences. These experiences are in both ambulatory and hospital sites. The experiences are varied and include such experiences as pharmacology rounds, geriatric assessment, Appalachian medical missions, and internal medicine rounds.

Clinical Core Rotations

Medical students in years three and four are assigned to regional hospital sites. Here the clinical experiences occur primarily within hospital sites for inpatient experiences, in ambulatory family practice sites, in geriatric acute care facilities, and in rural small and critical access hospitals for the underserved care experience. The didactic and online curriculum for the educational program
in each institution is provided by the College. In addition, the clinical rotations are assigned and the program assessment is managed through the campus office for Clinical Affairs, therefore the College is the main point of contact for each site regarding the educational programs for students.

Osteopathic Medical Student—Year Three

VCOM’s third year medical students are required to complete nine clinical rotations. Each rotation is estimated at 180 hours, with 160 hours in the regular program and 20 hours or greater on call per month. The required rotations for third year are listed below; all rotations must be taken and completed at VCOM core rotation sites. These rotations must be successfully completed to progress to the fourth year.

Core rotations are:

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


Clinical Modules

Students are provided with required curriculum during the third year. Independent learning objectives are provided for the core discipline rotations. Campus clinical conferences occur and are broadcast to each clinical site. Students are required to attend the monthly clinical
conferences.

Students are also provided with web-based teaching including clinical case modules and interactive web based instructional programs. These programs provide additional hours of curriculum instruction. The modules contain clinical material, basic science review/integration, and osteopathic principles and practices.

Clinical cases include:

Family Medicine 20 hrs
Underserved Care 20 hrs
Internal Medicine 20 hrs
Surgery 20 hrs
Obstetrics/Gynecology 20 hrs
Pediatrics 20 hrs
Emergency Medicine 20 hrs
Psychiatry 20 hrs
Geriatrics 20 hrs

Some departments require additional curriculum such as Emergency Medicine Sim-cases. Specific requirements are listed on the clinical chair’s webpage.

Examinations

A post-rotation exam follows each third year rotation and a comprehensive exam is given at the end of the third year. 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 pass the comprehensive exam at the end of the year in order to progress to fourth year.

A Clinical Performance Examination also is given to assess clinical skills at the end of the third year. Students must take and pass the OSCE and Standardized Patient Exams in order to progress to the fourth year.

Exams cover the educational objectives in the Learning Objectives for Ambulatory Care Rotation guide, the Learning Objectives from the Core Disciplines guide, and the material found in the web-based instruction. Students must successfully pass the Comprehensive MS III examinations prior to taking required fourth-year rotations.

In addition, to become eligible for the fourth year each third-year student must take and pass COMLEX Level 1.

For more information about Clinical Rotations, VCOM students and faculty may log on to
the Intranet (VCOM Portal)