Clerkship Courses - Year 3

Detailed Learning Objectives, Content, and Materials are Available on Each Course's Website (UTORid Login Required): 
https://meded.utoronto.ca/medicine/courses

Contact Information for Each Clerkship Course: 
http://www.md.utoronto.ca/clerkship-course-directors-and-administrators

 

Transition to Clerkship [TTC310Y]

Transition to Clerkship [TTC310Y]

Course Director: Dr. Kien Dang
Course Duration: 1 week

The Transition to Clerkship (TTC310Y) course strives to assist students in developing the knowledge, skills and attitudes they require to successfully transition from their role as a student in the Foundations curriculum, to a member of the healthcare team as a clinical clerk. The course builds on the very substantial learning from the first two years of the MD program and provides students with the opportunity to immerse themselves in the skills required to begin their clerkship rotations. TTC is delivered using both virtual and in-person teaching. Learning events take place on campus as well as at academies and consist of large and small group interactive learning sessions, immersion and shadowing experiences, as well as registration tasks (e.g. mask-fit testing, computer systems training) and practical skills (order writing, managing violent patients).

Anesthesia [ANS310Y]

Anesthesia [ANS310Y]

Course Director: Dr. Anita Sarmah
Course Duration: 2 weeks

The two-week Anaesthesia course is based on a 'flipped classroom' model. Students are required to complete seven e-modules. The rotation includes two days of simulation training at Sunnybrook Health Sciences Centre. The first day includes a comprehensive training on IV skills, airway management and fluid responsiveness using ultrasound. Case scenarios are used to teach ACLS protocols and communication skills during critical events in a simulated operating room. During the exit simulation day, the students rotate through preoperative, intraoperative, and postoperative scenarios that reinforce the content in the e-modules. There is an interactive Jeopardy quiz to reinforce course learning objectives. For clinical shifts, you are assigned to a faculty staff member in the operating room, labour floor, pre-admission clinic, or pain service, where one-on-one teaching is provided. You assist in all aspects of anesthetic care. There is no overnight call.

Emergency Medicine [EMR310Y]

Emergency Medicine [EMR310Y]

Course Director: Dr. Michelle Klaiman
Associate Course Director: Dr. Adam Kaufman
Course Duration: 4 weeks

The four-week Emergency Medicine course commences with three days of hands-on workshops and seminars utilizing simulation, skills-based teaching, and case-based interactive sessions. These sessions provide opportunities to acquire essential knowledge and skills in preparation for clinical experience, and cover topics that include medical imaging, airway management, cardiac dysrhythmias, trauma, ultrasound, toxicology, chest pain, wound management, and splinting. Students are then placed at one of the ten Emergency Departments in the Greater Toronto Area to complete 13 shifts, including up to two weekends and up to two overnight shifts. During the clinical experience you function as members of an interprofessional team and are assigned one or two preceptors with whom at least half their shifts occur. Each clerk spends half a shift with members of the interprofessional team. You learn to manage many types of patient problems that present to the Emergency Department, including exposure to core emergency medicine cases. There are additional opportunities to perform basic procedures (intravenous insertion, venipuncture, foley catheter insertion, NG insertion, ECG) and observe the triage process. 

Family & Community Medicine [FCM310Y]

Family & Community Medicine [FCM310Y]

Course Director: Dr. Azadeh Moaveni
Associate Course Director: Dr. Sharonie Valin
Course Duration: 6 weeks

The six-week Family and Community Medicine course begins with centrally delivered core seminars for the first two days. Core seminars include: orientation, family violence, motivational interviewing, palliative care and geriatrics. Students will also participate in site-specific seminars and complete e-modules online. The course syllabus is online (https://meded.utoronto.ca/medicine/community/fcm310y_83_86_98_104_109_113:handbook_syllabus).

Students then go to their respective sites to start the clinical portion of the rotation. Clinical rotations are distributed across 20 sites including large academic teaching units to rural placements, coordinated through the Rural Ontario Medical Program (ROMP). The course exposes students to various comprehensive care models and strives to have students learn in an interprofessional environment. 

Internal Medicine [MED310Y]

Internal Medicine [MED310Y]

Course Director: Dr. Luke Devine
Course Duration: 8 weeks

The eight-week Internal Medicine course begins with an interactive, case-based seminar series and physical examination review session for one and a half days. Each clerk is assigned to a single Internal Medicine Team for the entire rotation. A sub-group of students may choose a dedicated ambulatory care experience for 1-2 weeks. Over the entire length of the course, there is a graduated experience with increasing responsibility. You have the opportunity to perform the admitting history and physical examinations on patients who present to the Emergency Room and require Internal Medicine (IM) Consultation.  You will be asked to provide a provisional diagnosis and differential diagnosis, and to construct an investigation and management plan. You also provide ongoing direct patient care for your assigned patients, under supervision. Later in the rotation, you carry up to six patients and have enhanced responsibilities for patients while on call. Support is provided by other members of the team, including the attending physician and supervising residents. You are also assigned approximately four half-days in ambulatory clinics and non-IM ward experiences to provide you with an opportunity to learn about how care is delivered to medical patients in this setting.

Obstetrics & Gynaecology [OBS310Y]

Obstetrics & Gynaecology [OBS310Y]

Course Director: Dr. Dini Hui
Associate Course Director: Dr. Cici Zhu
Course Duration: 6 weeks

The six-week Obstetrics and Gynaecology rotation offers a variety of clinical activities related to all aspects women’s health care, including rotations in labour and delivery, inpatient antenatal and postpartum units, antenatal clinics, gynaecologic ambulatory care, inpatient gynaecology units, the operating room and the emergency department. In addition to clinical activities, you attend daily small-group teaching seminars on a range of obstetrical and gynaecological topics. Further to the seminar series, each hospital site also conducts its own set of teaching and/or grand rounds which you are expected to attend. Students are assigned to one of eight teaching hospital sites. 

Ophthalmology [OPT310Y]

Ophthalmology [OPT310Y]

Course Director: Dr. Jennifer Calafati
Associate Course Director: Dr. Cindy Lam
Course Duration: 1 week

The one-week ophthalmology course begins with a clinical skills review and orientation session. Throughout the week, you see a variety of ambulatory ophthalmology patients in eye clinics or in the offices of attending ophthalmologists. In clinic, you examine patients, which may involve taking an ophthalmic history and performing relevant ocular examinations, as well as formulating a differential diagnosis and management plan. Students may attend the operating room for a half day. You are expected to research each assigned patient’s disease using appropriate texts and journals and review course topics including: cornea and anterior segment (the red eye), lens and optics, glaucoma, retina, uveitis and inflammatory diseases, neuroophthalmology, oculoplastics and orbital diseases, paediatric ophthalmology and strabismus, and ocular emergencies and trauma. In addition, all students attend seminars on paediatric ophthalmology at the Hospital for Sick Children.

Otolaryngology – Head & Neck Surgery [OTL310Y]

Otolaryngology – Head & Neck Surgery [OTL310Y]

Course Director: Dr. Ambrose Lee
Course Duration: 1 week

The one-week Otolaryngology course includes site-specific teaching sessions and clinical experience in outpatient clinics. The remainder of the time is spent on the wards, in the operating room, on seminars and self-directed learning. The rotation includes a series of online seminars, covering common and important topics in otolaryngology including hearing loss, vertigo, epistaxis, rhinosinusitis, emergencies, and neck mass. You are also given a paediatrics otolaryngology seminar,  and an audiology lecture at the Hospital for Sick Children. Attendance in the operating room is available to students and may be arranged at their Academy with the site director at the beginning of their rotation.

Paediatrics [PAE310Y]

Paediatrics [PAE310Y]

Course Director: Dr. Hosanna Au
Course Duration: 6 weeks

The Paediatrics course begins with a full day of orientation seminars and small group teaching sessions at SickKids. There is a second ‘day back’ for Neonatology Teaching and Exam Review near the end of the rotation. In their clinical placements, students are exposed to a combination of ambulatory and inpatient paediatrics. Students are either in a paediatric setting at a Community Hospital for 6 weeks, or at SickKids on paediatric wards or in the Emergency Department for 3 weeks and in an ambulatory Paediatric practice for 3 weeks. Learning resources include the Computer Assisted Learning in Pediatrics Cases (CLIPP) which offer comprehensive interactive cases that cover important core topics, the Paeds-on-the-Go Handbook, and web-based e-modules on core topics on Elentra.

Psychiatry [PSS310Y]

Psychiatry [PSS310Y]

Course Director: Dr. Carla Garcia
Associate Course Director: Dr. Kien Dang
Course Duration: 6 weeks

The six-week Psychiatry course clinical experience may take place in a variety of settings including inpatient units, outpatient clinics, consultation liaison teams, and emergency settings. An integral component of the course is interviewing patients with anxiety, mood, psychosis, cognitive, and substance disorders with focus on symptomatology, diagnosis, and basic treatment principles. All clerks will have exposure to psychiatric emergencies mostly by taking night and weekend on-call not exceeding one in five, until 11 p.m. Clinical experience with children and families take place during two half-days in a child psychiatry setting under the direct supervision of a child psychiatrist. Seminars are held weekly at each hospital site and include case based learning as well as interviewing skills and dealing with challenging personality styles.

Surgery [SRG310Y]

Surgery [SRG310Y]

Course Director: Dr. Jory Simpson
Course Duration: 8 weeks

This 8-week course commences with a 2-day centralized program, “Prelude to Surgery,” which provides an orientation and introduction to important surgical topics. Learners then rotate through two 3-week sub-rotations, one in General Surgery and the other in a surgery specialty. The last week is comprised of debriefing and exam preparation sessions, and other administrative tasks in addition to clinical duties. Students have input into their choice of sub-rotation specialties and are assigned to a surgeon preceptor for each of their sub-rotations. Students contribute to the admissions and daily patient care and attend the operating room and the clinic/office of their preceptor or team. The on-call schedule is one night in four with General Surgery being in house. This provides learners with the opportunity to see patients in the ER as well as taking call to the ward and OR, where appropriate.

Portfolio – Year 3 [PFL310Y]

Portfolio – Year 3 [PFL310Y]

Course Director: Dr. Nirit Bernhard
Associate Course Director: Dr. Lindsay Herzog
Course Duration: Year 3 – Longitudinal

In third year, the Portfolio course continues to facilitate professional and personal development through guided reflection.  Portfolio encourages students to develop their knowledge of the six non-Medical Expert CanMEDS roles of Collaborator, Communicator, Leader, Health Advocate, Scholar and Professional. Through self and critical reflection of their clinical experiences in third year, students will learn to navigate and integrate these core competencies into their professional identities.  The various CanMEDS roles are incorporated throughout the six themed sessions which take place over the academic year. Examples of the themed topics include Patient Safety, Resilience and Wellness, Power Dynamic and the Hidden Curriculum, Death & Dying, and Humility & Uncertainty. There are two summative assessment components to the evaluation of Portfolio: the Process Component and the Written Component. The Process component consists of mandatory attendance at six small-group meetings, where the themed reflections are shared in student groups of approximately eight, with one resident (Junior Academy Scholar) and one faculty member (Academy Scholar). During the meeting, Scholars provide support in developing reflections on clinical experiences and their meaning and impact on personal and professional development. There are also two mandatory one-on-one Progress Review meetings with the Academy Scholar throughout the academic year where students have the opportunity to develop personal learning plans and reflect on the assessment data in their MD Program Learner Chart. The Written Component of the evaluation includes two progress review reports and the six thematic session reflections.  Three of the assigned reflections are marked anonymously with a pass/fail grade and formative feedback based on the Portfolio Assessment Rubric. There is also at least one  MD Program Professionalism form completed per year.

Clerkship Objective Structured Clinical Examination (OSCE) [OSC310Y & OSC410Y]

Clerkship Objective Structured Clinical Examination (OSCE) [OSC310Y & OSC410Y]

Chief Examiner: Dr. Fok-Han Leung

The Clerkship Objective Structured Clinical Examination (OSCE) is a transcripted assessment situated with the clinical skills curriculum occuring after the first half of clerkship is complete. The exact timing of the Clerkship OSCE will vary slightly each academic year, and will be dependent on the Year 3 Clerkship schedule. 

Students will be assessed on clinical content areas that they were exposed to the in the first half of clerkship. The assessment blueprint will cover key areas as outlined in the Medical Council of Canada (MCC) blueprint including the dimensions of care provided by physicians (i.e. health promotion and illness prevention, acute, chronic, psychosocial) and key physician activities (assessment/diagnosis, management, communication and professional behaviours). The OSCE stations will focus on content from both the Clerkship Course Objectives and the MCC’s Clinical Presentations and Diagnoses.

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