Sub-Internship

Description of Course

The Plastic Surgery Sub-Internship is a 4-week immersive course in which students expand their fund of knowledge and clinical skills during a rigorous clinical experience in which patient care responsibilities, workload, and work hours closely parallel those of a resident intern in the specialty.

Full course syllabus

Course Objectives

As a result of successfully completing Core Sub-Internship in Plastic Surgery, students will have demonstrated the ability to perform each of the following for ambulatory and hospitalized patients presenting with new and follow-up core chief complaints/diagnoses relevant to the clerkship:

1. Perform an accurate complete or focused patient interview and physical exam in a prioritized, organized manner without supervision, with respect for the patient, and tailored to the clinical situation and specific patient encounter. Integrate the scientific foundations of medicine with clinical reasoning skills to guide information gathering (EPA 1a, 1b).
2. Dynamically Integrate patient data to formulate an assessment, develop a working diagnosis and prioritized list of alternate potential diagnoses. Avoid common cognitive errors of clinical reasoning (EPA 2).
3. Select and interpret common diagnostic and screening tests using evidence-based and cost-effective principles (EPA 3).
4. Enters accurate, focused, and context-specific documentation of a clinical encounter in either written or electronic formats (EPA 5).
5. Concisely and accurately present a summary of the clinical encounter and synthesis of clinical reasoning to the health care team (including patients and families) to achieve a shared understanding of the patient’s current condition (EPA 6).
6. Apply understanding of roles, responsibilities, and contributions of individual team members to communicate effectively with physician and non-physician members of the team to provide safe, timely, effective, efficient, and equitable patient care (EPA 9).

Successful students will have also:

7. Professionalism: Demonstrated professional responsibility and commitment to ongoing improvements in medical student education through accurate and timely completion of Case and Work Hours Logs as well as the Clinical Activities Form (PCRS P 5.6; UUSOM P 5.4).
8. Practice-Based Learning and Improvement: Employed the Mid-Point Formative Feedback process to reconcile similarities and differences between their self-identified strengths and deficiencies in clinical skills and those identified by their preceptor (PCRS PBLI 3.1; UUSOM PBLI 3.1).
9. Practice-Based Learning and Improvement: Employed the Mid-Point Formative Feedback process to work collaboratively with their preceptor to set learning and improvement goals (PCRS PBLI 3.2; UUSOM PBLI 3.2).

Course Format & Schedule

Timeline

The Core Sub-Internship in Plastic Surgery is 28 days in duration.

Educational and Instructional Modalities

Role of the Student in this Course

Sub-Internship students are expected to function at the level of an early resident intern with respect to core responsibilities, patient load, and work hours. For assigned patients, students should conduct and document the initial history and physical examination, retrieve clinical information from the electronic medical record and other sources, present the patient to the supervising resident and preceptor, finalize the admission plans with the supervising resident or preceptor and patient, and discuss admission orders/diagnostic testing/therapy with the resident/preceptor. Each day students should pre-round on their panels of patients (i.e. gather interval history and data, perform focused physical examinations, present the patients during rounds, enter new orders, and construct daily progress notes).

Required Textbook(s)/Readings

Preceptor Evaluations

All Phase 4 Courses employ a common preceptor evaluation form that instructs evaluators to select performance-based behaviors along multiple dimensions that best represent the student’s highest sustained performance during the preceptor’s period of observation. The preceptor evaluations are must pass elements of the course. The passing student must achieve an overall score of 2.0 for the preceptor evaluations. A student who does not achieve a passing score for the preceptor evaluation component will receive a grade of FAIL for the course.

Assessments

Grading System

Each score from the table above is converted to a score between 0-4, where 2.0 represents the minimum passing score and 4.0 is the maximum score. The final overall numerical course score is the weighted average of each score from the table above. Final overall course scores are rounded to one decimal point using standard rounding (e.g. 3.49 = 3.5).

Students will receive final letter grades of HONORS (H), HIGH PASS (HP), PASS (P), or FAIL (F).

HONORS: A student who earns a final numerical course score of 3.5 or greater, passes each of the Must Pass elements on the clerkship on the first attempt, and completes all of the Must Complete elements will earn a grade of HONORS for the course.

HIGH PASS: A student who earns a final numerical course score of 3.0, passes each of the Must Pass elements on the clerkship on the first attempt, and completes all of the Must Complete elements will be assigned a grade of HIGH PASS for the course.

PASS: A student who earns a final numerical course score of 2.0 or greater, passes each of the Must Pass elements, and completes all of the Must Complete elements will be assigned a grade of PASS for the course.

FAIL: A student who earns a final numerical course score of less than 2.0 and/or fails one or more Must Pass elements of the clerkship and/or fails to complete all of the Must Complete elements will be assigned a grade of FAIL for the course.