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Introduction to Clinical Years
This required course is designed to provide an introduction or bridge from the basic
science years to the clinical continuum. The course
will cover concepts, practices, expectations, and attitudes that will confront
students on their clinical rotations. The information is both practical
and hands-on. A basic cardiac life support course is required as part of
the course. Students will review clinical policies and be provided an understanding
of expectations from the courses, faculty, residents, and nurses. Small
group sessions will review issues of patient privacy and confidentiality,
writing orders, prescriptions, SOAP notes, histories and physicals, and
use of the computer. Practical sessions involving clinical skills such
as skin testing, drawing blood, CPR, and interpretation of x-rays and ECG's
are included. A variety of viewpoints are expressed in the different subject
areas from fourth year medical students, deans, attending residents,
nursing staff, pharmacists, primary care physicians, and information specialists.
Doctoring 3 consists of two components. Beginning early in September this required course takes place over a full day, on alternate weeks, throughout the academic year.
Clinical Component: Students participate in a longitudinal clinical experience in community health centers and clinics.
Didactic Component: Small groups of eight students with faculty will manage a panel of patients with different representative ambulatory problems--as new patients, and for follow-up visits. Students will consider patients with common medical problems, emphasizing the use of evidence-based medicine, including psychosocial, cultural, economic, and insurance issues. Students also will be given the opportunity to share and discuss experiences from their current rotations. The major themes of this component that will run throughout the clinical cases are:
(ME 025 through ME 052)
The required twelve-week clinical clerkship in Medicine is given on the Medical Service of seven of the UCLA teaching hospitals: UCLA Center for Health Sciences, Cedars-Sinai Medical Center, Harbor-UCLA Medical Center, Kaiser Medical Center-Sunset, Olive View-UCLA Medical Center, Sepulveda VA Medical Center, and West Los Angeles VA Medical Center. The twelve-week rotation is divided into three blocks, each of four-weeks duration. Students will rotate at two or three different hospitals. They will have eight weeks of inpatient medicine and four weeks of out-patient medicine. Although the teaching programs vary somewhat according to the character of the individual hospital, the general format is similar at all seven hospitals.
On the medical wards, patients are assigned to students for history taking and physical examinations. The student participates in diagnostic and therapeutic decisions as a member of the ward team. They are responsible for daily notes and orders. Teaching and supervision are provided by the attending physician and residents on the service. The student is encouraged to exercise as much responsibility as possible in patient care and is expected to be on-call with the housestaff team.
The four-week ambulatory care block will provide an opportunity for students to evaluate patients whose illnesses do not require hospitalization. Concepts of preventive medicine, health maintenance, and patient education, as well as evaluation and management of common diseases, will be emphasized in this experience.
In addition to the availability of on-going hospital conferences and subspecialty teaching rounds, a structured medical curriculum which includes formal student conferences provides a didactic basis for this clerkship. Suggested textbooks in Medicine include those edited by Stein, Kelley, Harrison, Cecil, and Fishman. The majority of the student's grade is based on evaluations of clinical performance by housestaff and faculty. In addition, a written examination is administered during the twelfth week of the clerkship.
The required Clerkship in Medicine must be completed within the first 64 weeks of the 94 week continuum and is a prerequisite for many, but not all, elective courses in Medicine.
This course is designed to provide the student with a balanced, multidisciplinary perspective of the surgical sciences. The objectives are to provide an understanding of the surgical management of disease, to illustrate special problems encountered with surgical patients, to fix clearly in the studentĒs mind the means available for establishing diagnoses of surgical problems, to expose the student to the expectations and limitations of appropriate surgical theory, and to give students familiarity in the pre- and post-operative care of patients. Major surgical problems are presented so that a correlation between clinical observations, surgical (operative) pathology, and the physiological alterations brought about by operation can be made. This background is intended to lead the student to appreciate both the philosophy and practice of surgery and their relationships to the medical practice in general.
Students are required to complete the 12 week surgery course, which consists of exposure to both inpatient and outpatient surgery, encompassing General Surgery, Orthopaedics, Otolaryngology, Neurosurgery, Urology, Cardiothoracic Surgery, Plastic Surgery, Pediatric Surgery, and Transplantation. Each student will be assigned to rotations at some or all of the following locations: UCLA Center for Health Sciences, West Los Angeles VA Medical Center, Olive View Medical Center, Harbor/UCLA Medical Center. Objectives of the course in Surgery are the same at all locations, but administrative details and the flavor of the course will differ somewhat in each hospital.
Students will be assigned to evaluate and follow both inpatients and outpatients, and are considered part of the treatment team of each service. Although they will not have primary responsibility for ward duties, they will be expected to become familiar with ward procedures and to participate in patient care activities. Teaching on the wards is provided by the association of students with all levels of the staff, including junior and senior housestaff and faculty. Students are expected to follow their patients to the Operating Room where they may be asked to "scrub," so that the entire treatment cycle of the surgical patient from diagnosis to operative management and through recovery can be observed. Attendance at Problem Based Learning (PBL) sessions, a student lecture series, and certain departmental conferences are required of all students on all rotations. The on-call schedule varies with the service to which the student is assigned. A number of rotations require occasional overnight attendance. Secure and comfortable accommodations are available.
All students will take a written and oral final examination. The final grade is based upon the ward grade (50%), the written examination (25%), and the oral examination (25%). Students are reminded that although they may not be assigned rotations on every surgical specialty service, they are expected to have a working knowledge of the major principles of each and may be examined on these. Readings and syllabi will be distributed at the initial orientation meeting. No scheduling preferences will be accepted. Electives in most General Surgery and Specialty Surgery areas are available. Check with the Student Affairs Office for enrollment forms.
Students may contact the Surgery Education Office at (310) 825-6643 if they have questions.
(OG 011, OG 012, OG 013, OG015)
The six-week clinical clerkships in Obstetrics and Gynecology are offered at four teaching hospitals: UCLA Center for the Health Sciences, Cedars-Sinai Medical Center, Harbor-UCLA Medical Center, and the Olive View-UCLA Medical Center.
The objective of the clerkship is to acquaint the student with the varied aspects of the medical care for women, with emphasis on acquiring the basic skills of gynecologic and obstetrical history taking and physical examination, participating and assuming responsibility in the evaluation and care of outpatients and inpatients, and acquiring practical experience in the operating and delivery room areas with close supervision by the staff.
Formal and informal daily teaching sessions and rounds with the faculty and resident staff are an integral part of the six-week experience. The Problem Based Learning System is used with daily sessions at the Center for Health Sciences and twice weekly sessions held at the other teaching hospitals. Those sessions are constructed so as to cover the Association of Professors of Obstetrics and Gynecology Care objectives under the guidance of faculty preceptors. Students are on call approximately every fourth night. The criteria used in determining the final grade are the ward evaluation (50%) and a written examination (50%).
(PE 011, PE 012, PE 013, PE 014)
A required six week clinical clerkship in Pediatrics is given in the Departments of Pediatrics at one of four UCLA teaching hospitals: The Center for the Health Sciences/Olive View-UCLA Medical Center, Cedars-Sinai Medical Center, King/Drew Medical Center, and Harbor-UCLA Medical Center. Students spend the entire time in one of the four programs. Although the teaching programs vary somewhat, essentially comparable material in pediatrics is presented at each of the institutions.
Students spend time in both inpatient and outpatient settings as defined below. For all patients followed, each student is required to take a thorough history and to perform a thorough physical exam and developmental assessment, to formulate a differential diagnosis by synthesis and analysis of the information obtained, to acquire the ability to use laboratory and diagnostic studies, and to perform simple procedures on his/her own patient. Teaching and supervision is primarily the responsibility of a faculty member assigned to each student group, and secondary teaching is provided by the housestaff. The student is encouraged to take as much responsibility as he/she is able in the care of his/her patients. An additional primary goal is to learn about approaches to patient management. During the clerkship, students learn about care and disease of newborn infants, normal healthy infants and toddlers, child development, and well baby care. Throughout the clerkship the students have frequent seminars in various subspecialty areas. Students are evaluated on their performance in the ambulatory setting, on the ward, in the nursery, and on the final written examination.
* Intermediate Critical
* Intermediate Critical
(PS 010, PS 011, PS 012, PS 013, PS 015)
A required six-week clinical clerkship in Psychiatry is provided for Junior and Senior medical students, utilizing the clinical services and facilities of six of the UCLA teaching hospitals: West Los Angeles VA Medical Center, Harbor-UCLA Medical Center, UCLA/Neuropsychiatric Institute (NPI), Cedars-Sinai Medical Center, and San Fernando Valley Combined Programs (Sepulveda VA Medical Center and Olive View-UCLA Medical Center). The clerkship is designed to provide the opportunity for students to assume primary responsibility under close supervision for the evaluation of patients seeking help for psychiatric disorders. The program includes experience in adult inpatient, adult and child outpatient, and consultation\liaison (psychosomatic) services.
Educational objectives include: 1) familiarization of students with the clinical psychopathological disorders of adults, adolescents and children; 2) knowlege of methods and modalities of evaluation, diagnosis, management, treatment and disposition of patients; 3) ability to communicate their findings and formulations clearly and efficiently both through verbal presentations and through written documentation in the patients' charts when appropriate. Patient contact and case-based learning are emphasized. Students are expected to read about and discuss the various syndromes and disorders they encounter. Since the stated objectives cannot be achieved merely through unsupervised independent study, active participation and attendance during the assigned hours are required.
Students are evaluated on the basis of their clinical work, their participation in seminars and classes, and their performance on the psychiatry subject examinations of the National Board of Medical Examiners. The overall course textbook is Modern Synopsis of the Comprehensive Textbook in Psychiatry (latest edition) by Kaplan and Sadock. Additional readings are suggested by the various teaching staff at the six hospitals and different services therein. Each student works in an Emergency Room one night a week during the six-week clerkship under the supervision of the resident on call. On-call schedules are handled by the course coordinator at each hospital.
(FP011, FP013, FP018, FP019, FP020, FP021, FP022, FP023, FP024, FP025, FP026, FP027, FP028, FP029)
A required four-week clinical clerkship in Family Medicine is offered at the twelve teaching sites listed below. Each of these sites has unique advantages and different patient demographics. A detailed description of each site is available in the Student Affairs Office and the Family Medicine Predoctoral Office (50-071 CHS).
The goal of this clerkship is for the student to learn family-centered primary health care that is humanistic, comprehensive, cost-effective, continuous, and sensitive to psychosocial, ethical, and financial issues. Because family physicians take care of families, the clerkship will include family dynamics, the family's influence on health, and the impact of illness on the family.
Our clerkship provides an opportunity for students to learn about the diagnosis and management of patients with common problems. Students will be expected to learn a comprehensive approach to the patient with these problems that entails consideration of etiology, incidence, pathophysiology, clinical presentation, course, prognosis, treatment, and appropriate aspects of patient education, disease prevention, and health promotion. Students should develop sensitivity to social, familial, ethical, legal, cultural, and economic issues encountered in an ambulatory setting.
The clerkship is a predominantly ambulatory-based experience. Students see patients within the ambulatory setting of the assigned site Monday through Thursday. All the students from the eight sites will return to UCLA every Friday for workshops and tutorial group learning experiences. During the 4 weeks, each student gives one case presentation that leads to a discussion on one aspect of 4 major themes: health promotion and disease prevention, family issues, biobehavioral medicine, and health education. The tutorial group experiences are designed to be interactive and to promote enjoyment in learning.
There may be one evening or night call per week. The evening or night call will vary by site and will allow students to experience other aspects of family medicine (e.g., delivering babies, admitting patients to the hospital, volunteering in a free clinic).
The final evaluation of the student is based on clinical performance at the assigned site, a final written exam, participation in the tutorial group, and the student's case presentation.
UCLA Family Health Center
Students will see patients with a variety of faculty and resident preceptors with a continuity on a weekly basis. Independent evaluation of patients will be emphasized. One evening per week will be spent in the busy Urgent Care Center within the Family Health Center seeing patients with acute problems. Students will see patients independently with supervision in this setting.
General Hospital, Ventura County
Students will participate in an orientation at the beginning of the rotation and attend several educational conferences offered at Ventura County Hospital. Students will be assigned to see patients at one of the four practices described below.
Buenaventura Medical Clinic, Ashwood Office
The office is open Monday through Friday from 8 a.m. to 5 p.m.. The doctors see 20-25 scheduled patients per day. There are also acute services available. Each student is assigned to four of the groupĒs physicians, and will work closely with them throughout the month.
Las Islas Family Medical Group
Students work with a faculty preceptor seeing patients in the continuity clinic. The faculty each see approximately 25 patients per day. The majority of the patients are Spanish speaking. There is an acute care clinic on site. All the physicians include obstetrics in their practice.
Buenaventura Medical Clinic-Oxnard Office and Camarillo
The students will be working closely with all Family Physicians, experiencing a wide variety of patients and their problems. The student will spend one day per weeek at the Camarillo site and three days per week at the Oxnard site. The patient population consists of people that are English speaking and Spanish speaking.
These Family Physicians do not do Obstetrics but otherwise practice full-spectrum Family Medicine and admit to St. Johns' Medical Center, Oxnard.
Moorpark Family Health Center
Glendale Adventist Medical Center
Approximately 24,000 patients with a variety of health care plans are seen in the outpatient center per year. Forty-eight percent of the patients are HMO members. Students will spend much of their time at the outpatient Family Medicine Center doing patient care. In addition, students will participate in daily specialty clinics, student-faculty conferences, and daily noon conferences. A day with a private community family physician is also an optional part of the curriculum.
Long Beach Memorial Medical Center
Students will participate in patient care alongside residents and faculty in their continuity clinics and will have their own schedule of patients.
Whittier Presbyterian Intercommunity Hospital (PIH)
Seeing patients in the medical clinic makes up the bulk of experience for students. They also take part in daily reports on the patients that have been admitted during the night, and those being followed on In-Service. Weekly, the student visits the neighboring Skilled Nursing Facility, and makes home visits to our geriatric population. Also, the students are taken on Home Care rounds with three HospitalĒs Home Care Nurses to see continuity of care issues as they are dealt with in the home setting. Hospice and terminal care are also experiences to which they are exposed. Finally, the students are encouraged to attend the weekly clinical conferences that Family Practice Residents are required to attend.
Northridge Foundation Hospital
Students will see patients with the faculty and residents, attend tutorials with the nutritionist, attend sessions on home health-care and geriatrics, and participate in computer education. One morning per week will be devoted to learning about in-patient family medicine issues.
Harbor-UCLA Medical Center
The area surrounding Harbor-UCLA is a health professional shortage area. The patient population of the clinic is 50% Spanish speaking and includes a large number of other ethnic minorities,including recent immigrants.
Students will be involved in seeing patients at the continuity clinic with the various faculty and residents. Morning report is held daily and students will be required to attend and present one case in the month. One evening in a month is spent in a homeless clinic at a local church.
Santa Monica-UCLA Medical Center
Students will be involved in continuity clinic and will attend medicine and pediatric rounds. A daily noon conference covering core family practice issues will be held. Responsibilities will include patient calls, outpatient care,and hospital admissions.
Students will be involved in continuity clinics with faculty and residents. They also participate in several evening clinics at the Venice Family Clinic and the Los Angeles Free Clinic.
Kaiser-Permanente Woodland Hills
Students work with the 12 full-time faculty and 10 residents as well as other practitioners while on their rotation. Approximately 20-25 patients are seen per day by each practitioner at the Family Health Center. An urgent care experience with the faculty is optional.
Twelve full-time teaching faculty, along with over fifty other faculty members and twenty eight residents provide care for the full spectrum of Family Medicine at this community-based medical center.
Medical students rotating through Kaiser-Permanente Fontana will work with residents and faculty seeing patients in continuity clinic and they will participate in daily family medicine noon conferences where lunch is provided.
Riverside General Hospital - University Medical Center
Residents and faculty see approximately 90 patients each day. Medical students have their own assigned patients and work closely with both faculty and residents in the clinic and hospital setting. While the emphasis of the experience in Riverside is ambulatory care, there are many other opportunities available. Arrangements can be made for students to see patients at the Public Health Clinics, which offer students the opportunity to satisfy their own individual needs and interests.
San Bernardino County Medical Center
(NE 011, NE 013, NE 017)
The required two-week clerkship in Neurology is given on the Neurology Services of three UCLA teaching hospitals: Center for Health Sciences, Harbor-UCLA Medical Center, and West Los Angeles VA Hospital. Students are assigned patients to interview, examine, write up, care for, and follow, participating in the Neurology Service team with supervision by the resident and attending faculty. They join in ward rounds, conferences, clinics and seminars. They may meet in small groups for case discussions and didactic sessions with a neurology faculty member. The required Neurology and Medicine clerkships are prerequisites for electives in Neurology. The grade is derived from ward performance, conference participation, and case presentation. A list of recommended readings will be provided on the first day. There is little to no on-call.
(RA 011, RA 013)
The Radiology Clerkship consists of a well constructed didactic lecture series and representative teaching cases. This controlled experience in the description, analysis, and diagnosis of radiological case material is supplemented by participation in planned conferences. The clerkship is offered at both CHS and Harbor. A practical examination is given as a learning experience on completion of the course at CHS. At Harbor, a case presentation is required in lieu of an examination, though a practical examination may be added later in the year. Recommended readings will be available the first day. Students evaluate the course and receive evaluations on their individual performance. There is no on-call schedule or weekend call. It is highly recommended that this course be taken in the 3rd-year because of its fundamental importance to other disciplines.
(OP 011, OP 013, OP 017)
The Ophthalmology Clerkship offered at Jules Stein Eye Institute, Harbor-UCLA Medical Center, Sepulveda VA Medical Center, and West Los Angeles VA Medical Center is a practically and clinically oriented rotation designed to introduce the student to basic ophthalmic skills and procedures required for all physicians. Exposure to clinical ophthalmology is accomplished by attendance at scheduled teaching rounds, participation in the consultation service, observation of ophthalmic surgical procedures, and attendance at the Wednesday afternoon conferences. Audiovisual teaching programs are available. By the end of the five-day rotation, the student should be familiar with the basic skills of history taking, be able to perform a preliminary ophthalmic examination, and identify common ophthalmic disorders. The clerkship is graded on a pass\fail basis. Selected chapters from several ophthalmology texts are assigned during the week; these books will be provided. There is no on-call schedule. A written or oral exam will be administered at the end of the course.
Note: Students should not schedule the one week Ophthalmology clerkship during National Board Exams, internship interviews, or Match Day, as the course must be taken for the total five day period.
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