University of Medicine and Health Sciences

St. Kitts

Clinical Student Handbook:

Policies and Procedures for Clinical Rotations

Effective: July 1, 2011

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 University of Medicine and Health Sciences
St. Kitts

Clinical Student Handbook:

Policies and Procedures for Clinical Rotations

TABLE OF CONTENTS

Program Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Clinical Orientation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
USMLE Steps 1 & 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Professional Conduct . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Dress Code and Conduct Requirements . . . . . . . . . . . . 11
Clinical Attendance Policy . . . . . . . . . . . . . . . . . . . . . . 11
Absences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Daily Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Clinical Rotation Health Requirements . . . . . . . . . . . . . 12
Supervision of Students . . . . . . . . . . . . . . . . . . . . . . . . . 13
Evaluation of Faculty . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Patient Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Lectures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Leaves of Absence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Clinical Clerkships . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Clinical Curriculum . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Clinical Tuition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Financial Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Fourth Year Visiting Senior Electives . . . . . . . . . . . . . . 18

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Clinical Evaluations and Rotation Conclusion . . . . . . . 20
Core Clerkship Exams. . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Information Requests During Senior Year and Residency 21
State Board Regulation Restrictions . . . . . . . . . . . . . . . . 22
Graduation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Residency Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Student’s Statement of Understanding and Compliance 24
Signature copy to be returned to the Clinical Dean’s Office 24

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 University of Medicine and Health Sciences
St. Kitts

Clinical Student Handbook:

Policies and Procedures for Clinical Rotations

Date Effective: July 1, 2011

The following information is provided by UMHS for the purpose of assisting in the
completion of your clinical clerkships. Please read carefully all the information
outlined in this document. If you have any questions regarding the enclosed
information, please contact the Clinical Dean or Clinical Staff at the New York
office. For written correspondence, please mail to: University of Medicine and
Health Sciences, Attention: Clinical Staff, 460 West 34 th St., 12th Floor, New York,
New York 10001. You may also send email to Dr. Burton Herz, Clinical Dean at -
bherz@umhs-sk.net, or Maxine Paul mpaul@umhs-sk.net

Program Objectives

The educational objectives of the Clinical Program are:

 Provide supervised experience and training in basic clinical skills through
patient contact and instruction.
 Provide students with an overview of the practice of medicine emphasizing
the inter-relationships among various levels of specialization.
 Provide exposure to the variety of medical specializations from which the
students may choose a residency upon graduation.
 Prepare students to function effectively and ethically in all facets of clinical
medical education.

Contact Information

At the end of your fifth semester of basic sciences, you will be leaving the
Portland, Maine campus to start your clinical rotations. Once you leave campus, it
is important that we are able to contact you at any time. Therefore, we ask that
you immediately establish and report to us a permanent address, temporary
address, and phone number. Please submit this information as soon as possible
to the Clinical Coordinator (Rehana Izhar: rizhar@umhs-sk.net) in the NY office
via e-mail, phone or mail. We will send all clerkship materials to you and contact
you regarding upcoming rotations or changes using the information you provide. If
any of your contact information changes, it is required that you submit these
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changes immediately. A permanent UMHS e-mail address has been assigned to
you by the IT department. This e-mail address will allow us to be in contact with
you regardless of your physical location. Timely completion of all requests will
help reduce unnecessary delays in the process.

UMHS E-Mail Policy

The UMHS Information and Technology Services Department (ITS) assigns all
students an official e-mail address, which is provided (along with the password) at
student registration. All official electronic UMHS correspondence is sent via this e-
mail address; students are required to use this e-mail address while enrolled at
UMHS. In addition, faculty and staff may correspond with students regarding
course clerkship issues via UMHS e-mail. It is the student’s responsibility to
ensure your e-mail account is working and being accessed daily for important
messages from faculty or the University. If a student is having problems or
difficulty with e-mail services, please contact the IT Department: Wayne Williams –
(212) 868-4720 ext. 655 wwilliams@umhs-sk.net or Mohit Saxena – (212) 868-
4720 ext. 659 msaxena@umhs-sk.net . As a reminder, below is the official UMHS
Email Policy:
University use of email

Email is a mechanism for official communication within the University of Medicine & Health Sciences. The University has the
right to expect that such communications will be received and read in a timely fashion. Official email communications are
intended only to meet academic and administrative needs of the campus community.

Assignment of student email

Official University email accounts are available for all enrolled students. The addresses are all of the same naming convention
(First Initial Last Name) @umhs-sk.net. These accounts must be activated before the University can correspond with its
students using the official email accounts. Students will receive their email addresses by the campus IT department during
Student Registration. They will be instructed on how to access the student email website & log in with their credentials.

Expectations about student use of email

Students are expected to check their email on frequent and consistent basis in order to stay current with University–related
communications. Students have the responsibility to recognize that certain communications may be time–critical.
“I didn’t check my email”, error in forwarding mail, or email returned to the University with “Mailbox Full” or “User Unknown” are
not acceptable excuses for missing official University communications via email. Students are prohibited from opting out of
University email communications. Students are prohibited from forwarding their University email account to their
personal Email accounts. Students are only allowed to access their own individual email accounts given to them. They
are not allowed to access their fellow student, staff, administration & faculty email accounts. The student will face disciplinary
action if the latter is proven to be true. This is stated in the University Student Handbook under “Code of Conduct” – Section III
– categories of misconduct.

Authentication for confidential Information

It is a violation of University policies, including the Student Code of Conduct, for any user of official email addresses to
impersonate a University office, faculty/staff member, or student.

Privacy
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Users should exercise extreme caution in using email to communicate confidential or sensitive matters, and should not assume
that email is private and confidential. It is especially important that users are careful to send messages only to the intended
recipients(s). Particular care should be taken when using the “reply” command during email correspondence.

Educational uses of email

Faculty will determine how electronic forms of communication (e.g., email) will be used in their classes and will specify their
requirements in the course syllabus. This “Official Student Email Policy” will ensure that all students will be able to comply with
email- based course requirements specified by faculty. Faculty can therefore make the assumption that student’s official
@umhs-sk.net accounts are being accessed, and faculty can use email for their classes accordingly.

Clinical Orientation

During your fifth semester of basic sciences, you will participate in a Clinical
Orientation that provides information regarding available clerkships and their
specific requirements. In addition, you will receive a Clinical Welcome Packet that
will list all requirements for placement. Your clinical file will be considered
complete once you have submitted all required documents [see below: Clinical
File Checklist*] to the Clinical Coordinator and have passed Step 1. At that time,
you will receive your rotation schedule from the Clinical Department. Rotation
assignments are determined by specific hospital requirements (i.e., start dates,
minimum Step I scores, and availability). Every effort will be made to assign
students to hospitals of their preference, but ultimately it is the University’s right
and responsibility to make the most appropriate assignment.

*Clinical File Checklist – note: Clinical Dept. must be in receipt of all documents
listed in order to begin placement process

Bursar clearance

Registrar clearance – including original official transcripts from ALL schools

attended, whether or not transfer credit was awarded

□ Clinical Student Information Sheet

□ Clinical Handbook Receipt (last page of the Clinical Handbook)
□ USMLE Step 1 score and Performance Profile
□ MMR vaccination history or titer: 2 doses MMR - measles/mumps/rubella
(vaccine) or 1 dose rubella vaccine, 2 doses rubeola (measles vaccine) 1
dose mumps vaccine or immune titer results for rubella, rubeola (measles)
and mumps

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□ Hepatitis B vaccination history or declination form: 3 doses hepatitis B
vaccine, 1 dose mumps vaccine or immune titer for hepatitis B surface
antibody
□ PPD skin testing: within the last 12 months or if PPD positive, date and
result of last chest X-ray
□ Varicella history or titer: titer or proof of immunization series
□ Student curriculum vitae (CV)
□ 10-panel Drug Screen (must submit ORIGINAL to Clinical Department)
□ Police Background Check (must submit ORIGINAL to Clinical Department)
□ Copy of Driver’s License/State ID
□ Copy of inside (front) and outside (front and back) of Passport
□ Copy of US Citizens Documents or Visa (if applicable)
□ Proof of OSHA, ACLS and Infection Control Training certification

USMLE Step I Instructions (USMLE/ECFMG)

Listed below are detailed instructions on how to apply to take the USMLE Step 1
exam. Please read and follow directions carefully.

Applying for the United States Medical Licensing Exam (USMLE)

If you have not registered for the USMLE prior to joining UMHS you will need to
apply for a USMLE/ECFMG ID number. This process takes up to a week so you
will need to do this immediately. This number will be required on all
communications, applications, medical education credentials, request forms and
payments that you send to ECFMG. You will also need this number to access
ECFMG’s online services. Go to www.ecfmg.org and clink on IWA (apply for
examination). Carefully read the instructions.

If you have a USMLE/ECFMG ID number you must use this number. You cannot
apply for a new number.

Once you receive your USMLE/ECFMG ID number you will be able to register for
Step 1. Apply on-line using ECFMG’s Interactive Web Application (IWA). Detailed
instructions accompany the application. Follow the instructions carefully and
answer all questions completely. You should review the instructions before you
begin working on the application. Some of the necessary items require advance
planning. It is advisable that the Certification of Identification (Form 186)
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procedure take place prior to the completion of the fifth semester to prevent any
delay in certifying your Step 1 eligibility.

It is very important that the name you use when applying to take the exam exactly
matches the name on the form(s) of identification you intend to present at the test
center. If the name does not match, it may delay or prevent you from taking the
exam on your scheduled test day.

All students must schedule the exam immediately following the fifth semester.
Failure to do so will result in being administratively withdrawn. The eligibility
period you should select is September - November 2011. You will require
approval from Dr. Pringle should you choose to apply for an eligibility period
beyond the September - November 2011 eligibility period. For those of you
that are anxious to take the test you may apply for the August 2011 – October
2011 eligibility period, however there is no guarantee that you would be able to
take the exam in August. The earliest that your application can be certified is when
we receive your grade at the completion of fifth semester.

At the end of the online application process, print the Certification of

Identification (Form 186). Include 2 passport photos with the application. Paste
one picture in the box on the Certification Form 186 and paper clip the other photo
to the application. Don’t forget to sign the back of each picture and put your
ECFMG number! If there are any additional documents required to complete your
application, these documents must be accompanied by a completed IWA
Document Submission Form (Form 187). If you would like UMHS to submit
copies of your previous medical school transcript to validate transfer credit you
must ALSO include ECFMG Medical Education Credentials Submission Form
(Form 344). Do not include Form 187 if you do not have any additional documents
to submit to ECFMG or if you are submitting Form 186 only. All forms and
documents required to complete your application must be sent to ECFMG in one
envelope.

All forms should be submitted to Cheryl Bailey in the Maine Campus Office as
soon as possible. Your form will be certified online only when the Registrar’s
Office has received: PASSING GRADES for all required basic science course
work; PASSING GRADES for 5th semester coursework; and complete and official
transcripts for ALL college/university coursework, whether or not transfer credit
was awarded. Failure to provide these documents or pass all of these
required courses will result in your certification being placed on HOLD.

Once we receive your forms they will be certified and sent to ECFMG to be
processed. ECFMG will then notify UMHS to certify the application online. When
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you successfully complete 5th semester you will be certified online. You may track
the status of your application through OASIS on the ECFMG website. Shortly
following the certification you will receive a Scheduling Permit specifying your
three month eligibility period via email from ECFMG. This may take up to two (2)
weeks after the certification is received by ECFMG. During this three month
eligibility period you must schedule to take the USMLE Step 1. Verify the
information on your Scheduling Permit before scheduling your appointment with a
Prometric Test Center.

Keep the Scheduling Permit in a secure place since you will be required to bring
the scheduling permit to the test center on the day of the exam.

You must notify the Office of the Registrar of your scheduled test date by
forwarding the email you receive from Prometric to cbailey@umhs-sk.net or
by faxing a copy of the email to (207) 253-5699 within 30 days of being
certified for your first attempt. If you are taking Step 1 for the 2 nd or 3rd
attempt, you should forward the e-mail you received from Prometric to
leveret@umhs-sk.net or by faxing a copy of the e-mail to (212) 868-4719
within 30 days of being certified. Failure to do so may result in being
Administratively Withdrawn from UMHS.

Approximately four (4) weeks after taking the exam, you will receive a USMLE
score report by email. Whether you pass or fail, you must forward your score
and performance profile to cbailey@umhs-sk.net or fax a copy to (207) 253-
5699. We must receive both pages which includes the score report and the
performance profile. ECFMG does not forward the score and performance
profile to UMHS. You are responsible for doing so. Unless we receive the
score report you will not be able to begin clinical rotations. Should you fail to email
or fax your score report within 45 days of your test date, you will be
administratively withdrawn.

If you receive a failing score it will be forwarded to the Clinical Dean for
evaluation. The Clinical Dean’s office will determine any conditions
necessary for recertification. For example, the student’s prior failing score
may be significantly low. In such case the Clinical Dean may require that in
order to be recertified, he or she must retake a formal external Step 1 review
program and to present such evidence including post-test scores. In some
cases the student may have only missed a passing score by a few points
and at the discretion of the Clinical Dean be permitted to be recertified to sit
for Step 1 without a formal review program. The determination for
recertification is the responsibility of the Clinical Dean. If a student exceeds
180 days from the first failing of Step 1 and has not achieved recertification,
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he/she is subject to being dismissed from the University.

Students have three attempts within one year from date of eligibility (end of 5th
semester) to take and pass the USMLE Step 1. Should you fail for the 3rd time
you will be Academically Dismissed.

Please read the USMLE 2011 Information booklet for additional information.

If you cannot meet the above time requirement, you must request an extension.
This request must be addressed to the University Registrar.

USMLE STEP 2 CS AND STEP 2 CK

A student is eligible to be certified to take the Step 2 CS/Step 2 CK exams

after the following requirements have been met:

            USMLE STEP 2 CS – must complete a minimum of 20 weeks of

clinical training

USMLE STEP 2 CK – must complete all 48 weeks of core clinical

training and be within 12 months of graduation

Any exceptions to this rule must be approved by the office of the Clinical Dean.

Students are allowed three attempts to pass USMLE 2 CS and USMLE 2 CK. 
Students that are unsuccessful will be Academically Withdrawn.

Enrollment Status

Once you complete fifth semester your enrollment status will change to a Vacation
for up to 15 weeks in which students remain fully enrolled. If you do not begin
clinical rotations within the 15 weeks you may apply for an Academic Leave of
Absence up to 180 days as long as you have not had one within the previous 12
months. The ALOA begins on the last day of the 5th semester NOT the end of the
vacation period. You must complete an ALOA form available from the Office
of the Registrar before the end of the vacation period. If you are registered for
Step 1 and have failed to apply for an ALOA you will be placed on a temporary
withdrawal. If you do not register for Step 1 you will be Administratively
Withdrawn. You will need to contact the Financial Aid department for information
on how this will affect your loans.

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Detailed information regarding clinical rotation registration and grading,
registration for Step 2 CK, 2CS and preparing for the NRMP Match will be
distributed at a later date. If you have any questions, please contact Linda Everett,
University Registrar, or the Office of the Registrar at (212) 868-4720.

Professional Conduct

Your clerkship experience is perhaps the most rewarding of all your training.
However, this assignment carries not only opportunity but responsibility. You not
only represent UMHS, you represent the discipline of medicine. With this comes a
most serious responsibility and you are expected to maintain a professional
appearance and demeanor at all times. At UMHS, we have always emphasized
the importance of professionalism and ethical conduct.

We expect that you will bring a sense of pride in UMHS to your clinical experience,
and bear in mind that you not only represent yourself, but the University and the
student body.

In the event you experience any significant problems during the course of your
rotations, please contact the clinical staff at UMHS. .We expect you to resolve
them in an ethical and professional manner; the Clinical Dean and his staff will be
available, if it is warranted.

Conduct Requirements and Dress Code

You are expected to dress in a professional manner. Appearance is most

important not only to patients but to the clinical supervisors. The dress code for
clinical rotations is:

All Students: A clean white finger length-lab coat

Men........... Dress slacks with shirt and tie
Women...... Dress slacks, dress (knee length), or skirt (knee length) and
dress shirt or blouse

Your conduct will be under constant review. You must develop and demonstrate a
caring and kind attitude toward all colleagues, supervisors, patients, and patients’
families. Deference to supervisors, residents, and all physicians is required.

Clinical Attendance Policy

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You are expected to be in attendance 100% of the time. It is important that you
attend every class, every round, and be fully prepared for every assignment. You
are required to be totally familiar with all your patients’ medical and social history.
It is imperative that you know your patient as a person, not merely as a number
and/or diagnosis. In addition, you will be assigned readings and administered tests
during your clinical rotations. You must maintain your assigned readings and it is
critical that you set up a schedule for evening study. You must take the
responsibility of learning clinical medicine through patient contacts and through in-
depth reading. It is mandatory that a written record of daily clinical activities is
recorded in your Daily Log.

You are expected to show significant interest in work and to be readily available
for consultations and learning opportunities. Failure to attend rotations may result
in dismissal from the rotation and/or course failure. You are required to be present
at all work related activities. You are to show up on time, remain for the duration
of the shift, and leave only when all work has been completed. Students can
expect to work a full day Monday through Friday and all on-call days and nights,
and weekends as assigned. Unless unusual circumstances prevail, the work day
and call should end by 10:00 p.m.

Absences

Should you be absent for more than the acceptable amount of rotation
experiences, you will be withdrawn from that rotation and denied credit for the
clerkship. If the absences are excused and approved by the Dean, a grade of
“WP” will be recorded; if the absences are unexcused and without approval of the
Clinical Dean, a grade of “WF” will be recorded. Absences from clinical
experiences are limited as follows:
4-week rotations – two (2) days
6-week rotations – three (3) days
12-week rotations – six (6) days

You are also required to abide by the standards of the policies, procedures, rules
and regulations as outlined by the host hospital. You must present yourself to
your preceptor each day to ensure that you are in attendance.

Sick Leave

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If a student becomes ill and unable to participate in the daily rotation assignments,
the student may be able to make up the time at the discretion of the Clinical Dean.
If the sickness extends beyond the permitted number of absences (described
above) the student must provide substantiation from the physician. It remains the
prerogative of the Clinical Dean to permit make-up work. If the Dean determines
that the time lost to sickness exceeds the permitted absences by policy, he may
deny the make-up work and request the student withdraw from the rotation. With
evidence from a physician as to the nature and extent of a health condition which
led to the absence, the Dean may assign a grade of Incomplete (I) for the course
and provide a time at a later date for the student to make up the incomplete
portion of the course. All such documentation must be provided to the Clinical
Dean.

If a student has to withdraw from a clinical rotation any tuition refund will follow the
Universities tuition refund policy set out in the University catalog.

Daily Log

You are required to maintain a Daily Log of time and activity of every clerkship
experience. The Daily Log must contain a complete log of all the patients
assigned to you (including age, sex, and diagnoses) and all procedures performed
by you. Log entries must conform to HIPAA regulations regarding privacy rights of
the patient. The Daily Log attests to the attendance and successful involvement in
rotation experiences for the required number of weeks. At the end of each
rotation, you must submit the completed and signed Daily Log to the Office of the
Clinical Dean. Failure to submit the Daily Log within two (2) weeks of clerkship
completion can result in credit being denied for the clerkship. Before submitting
the Daily Log to the Dean, a copy should be retained for your personal records.

Clinical Rotation Health Requirements

UMHS requires all students, including those in clinical rotations, to have health
insurance coverage while enrolled at the University. To that end, the University
offers a basic health insurance plan to its students. Students must either avail
themselves of University sponsored medical plan or prove coverage under another
plan.

Please note: Students in clinical rotations may receive separate bills for insurance
throughout the year. Health insurance billing follows the academic year, whereas
tuition billing for clinical semesters may not be based on the academic school
year.

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Our health insurance coverage year is from September 1st of the current year to
August 31st the following year. The coverage year is broken into three parts for
the purpose of billing and to allow new enrollment and requests to waive
coverage. The billing periods are as follows:

 September - Coverage for September 1st through December 31st

 January - Coverage for January 1st through April 30th
 May - Coverage for May 1st through August 31st

Additionally, should you plan to do any rotations in the United Kingdom you must
comply with the following:

If you are in the U.K. undertaking exposure-prone procedures you will be required
to have testing for HIV, Hepatitis B and Hepatitis C, prior to being granted
clearance. You must contact their local physician or Health Department for the lab
work. The results must be on file with the Clinical Department at UMHS prior to
your leaving for a U.K. rotation. You should also take copies of those laboratory
results with you to the U.K. The samples must be taken by an independent
laboratory or physician who must document that the sample was drawn from the
specified individual based on having seen reliable photo identification.

For all clinical assignments, the New York Clinical Department will provide you
with a list of the specific health tests that you must complete and submit as a
prerequisite to your hospital placement.

Supervision of Students

You will be supervised at all times by a physician. This physician will be a resident
or an attending physician. There may be multiple physicians participating in your
education, but one physician will be designated at the start of the clerkship as the
principal supervisor. It will be this physician who will oversee your day-to-day
activities and assignments and who will be responsible for completing the
Clerkship Evaluation Form and signing your Log Book.

Evaluation of Faculty

Clinical faculty will be evaluated by the on-site Course Director. Course Directors
will be evaluated by the Chief of the appropriate department and the Chief will be
14
evaluated by the Clinical Dean. Criteria used will include direct observation,
interviews, student performance, and student evaluations. The results of the
evaluations will be made available to the faculty and the Directors and will be used
for continuous performance improvement. You must complete a rotation
evaluation form at the end of each rotation.

Patient Care

Upon arriving at the hospital you will be assigned patient care responsibilities. An
adequate number and variety of cases will be assigned during each clerkship
rotation. You will perform histories and physicals, write progress notes, present
cases, and assist on procedures. The written notes may be incorporated into the
medical record only if they are countersigned by the supervising physician.

Lectures

You will be required to attend lectures and grand rounds during each clerkship
rotation. There will be regularly scheduled conferences for students, residents,
and attending physicians, covering general and subspecialty topics.

Enrollment Status

Immediately following the completion of your fifth semester you will be placed on
Vacation status for 15 weeks. Students remain fully enrolled during this period of
time. To be eligible for this status you must be registered for the USMLE Step 1.
You will be administratively withdrawn if you do not register for the USMLE
Step 1 immediately after successful completion of the fifth semester. You are
expected to sit for the USMLE Step 1 and receive your score report within this 15
week period.

If you are unsuccessful at passing the USMLE Step 1 or have not received your
scores by the end of the fifteenth week you may apply for an Academic Leave of
Absence (ALOA). To be eligible for the ALOA you must not have had one within
the previous 12 months. In addition, an ALOA form must be completed and
approved by the Clinical Dean prior to the end of the Vacation status. An ALOA
may be taken for up to 180 days, however, the start date of the ALOA will
commence from the first day following the completion of fifth semester.

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If you are unsuccessful at passing the USMLE Step 1 a second time, or have not
received your scores by the end of the 180-day ALOA date, your status will be
changed to a Temporary Withdrawal status. The Temporary Withdrawal status
will commence from the first day following the fifth semester. For student loan
purposes you will be considered withdrawn as of your last day of attendance from
fifth semester; however, we will still be able to certify you to take the USMLE.

You may remain on a Temporary Withdrawal status for one year from the date that
you became eligible to take the USMLE. If you have not passed the USMLE within
this one year time limit you will be Academically Withdrawn.

You will then need to contact the Financial Aid department for information
concerning how this status will affect your loan.

During the clinical years you will be eligible to take up to a total of two Academic
Leaves of Absence to study and take the USMLE Step 2. An ALOA form must be
completed and approved by the Clinical Dean. The Academic Leave of Absence
should not exceed 8 weeks in length and you are not eligible if you have taken
one within the past 12 months.

If you have any questions, please contact the Office of the Registrar at (212) 868-
4720.

Fifth Semester

A student who does not qualify at the end of the MICM 1020 Biological Basis of
Clinical Medicine will be allowed three additional attempts to pass that
Qualification exam. If a student fails to obtain a passing score on the MICM
1020 Biological Basis of Clinical Medicine Post-test in two attempts, he/she
will have a choice of either retaking the MICM 1020 course OR completing an
external board review program found to be acceptable by Dr. Pringle. The
student will then have one final opportunity to re-take and obtain a passing
score on the MICM 1020 Post-test.

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Registration

Students who pass Step 1 of the USMLE must provide the official USMLE Score
Report and Performance Profile to the Registrar’s Office as evidence thereof.
Upon receipt of this documentation, a clinical registration form will be sent to you.
You will be required to sign and return this form as an acceptance of your clinical
rotations. Registration will not be final until the student has met all administrative
and financial responsibilities.

This is a critically important process and any failure to promptly comply with these
registration procedures will result in the following consequences - non acceptance
of credit for a core or elective and non-release of financial aid funds. As a
reminder, students who have passed Step 1 and do not contact the clinical
department within ten (10) business days to schedule clinical rotations will be
subject to administrative withdrawal.

If you fail to appear on time for the start of an appointed clerkship, that clerkship
shall be deemed forfeited. Appointment to a different clerkship shall be at the
discretion of the Clinical Dean and you may be required to wait out for the next
available rotation.

Assignment Policy

By obtaining a passing score on the USMLE Step 1, you are eligible to begin your
clinical core clerkships subject to availability and specific hospital requirements,
such as start dates and a minimum Step 1 score.

To become eligible for a core clinical clerkship, you first must:

a. Successfully complete all basic science courses.

b. Pass the ICM portion of the fifth semester.
c. Be in good standing, with all tuition, fees and financial obligations paid no
later than fourteen (14) days prior to the beginning of the clerkship.
d. Have submitted all required documents from the information found in the
Clinical Welcome Packet.
e. Present a passing score on the USMLE Step 1 to the Registrar and Clinical
Coordinator in the New York office.
f. Contact your Clinical Coordinator and request an assignment.

Although the clinical department will attempt to accommodate your preferences,

you are not guaranteed an assignment to any specific hospital.
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And once you are scheduled to commence your rotations at a specified hospital,
you must attend. If you do not attend, you will forfeit your tuition for that semester.
If you leave the clerkship early, your tuition will be forfeited and this could damage
your academic record and your chance for future rotations.

Clerkship Tuition

Tuition is billed on a clinical semester cycle, regardless of how many weeks of

rotations you complete within a year. In addition to tuition, students in clinical
rotations may receive separate bills for insurance throughout the year.

Please note that any balance due must be paid upon receipt. Any portion of tuition
covered by approved financial aid is deferred until the semester begins.

Financial Aid

The UMHS Financial Aid Office is located in the administrative offices in New York
City.  Counselors are available by phone and email weekdays from 7a.m. to 6
p.m.    Private educational loans are generally approved for three semesters at a
time and require adequate credit worthiness by the borrower.  At times, in lieu of
good credit, a cosigner is acceptable.  Students with questions should request
assistance by writing finaid@umhs.net or calling 212-868-0855 or 888-686-0380.

Clinical Curriculum

There are seventy-eight (78) weeks of third and fourth year of clinical clerkships.
You are required to complete your third year core training in teaching hospitals. In
the United States, they must be ACGME (Accreditation Council for Graduate
Medical Education) accredited. Third year consists of forty-eight (48) weeks of
core clerkships, and thirty (30) weeks of elective courses in the fourth year. There
are two subtypes of teaching hospitals. One is where all core departments are
separately ACGME accredited as either a sponsor or participating with a sponsor
for a residency program. The second is where the hospital is an ACGME
accredited teaching hospital for Family Medicine and all cores are taken under the
umbrella of the Family Medicine residency program.

In order for clerkship experiences to count toward the third and fourth year, all
clinical activities must be performed under the direct supervision of a physician.
Under no circumstances can you begin any clerkship, either core or elective,
without prior written approval from the office of the Clinical Department

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Clinical Clerkships

The third year mandatory core rotations are:

Surgery ………………. Twelve (12) weeks

Internal Medicine……..Twelve (12) weeks

Pediatrics………………Six (6) weeks

Ob/Gyn…………………Six (6) weeks
Psychiatry……………...Six (6) weeks
Family Medicine……… Six (6) weeks

Total Core Rotations: 48 weeks

The order of these will be decided based upon availability of the rotation at the
start date requested. After you have been assigned to a rotation site, an
orientation will be provided. You will be evaluated by the preceptor to whom you
are assigned.

If there are more requests for a specific hospital site than are spaces available, the
preference will go first to the student with the higher USMLE Step 1 score.

Students generally complete the forty-eight weeks of core rotations without

interruptions. If you are granted an Academic Leave of Absence during a core
clerkship rotation, you will not be guaranteed placement back at the same rotation
site. In most circumstances, you may have to repeat the entire core. At times,
interruptions due to the start date of specific rotations are created by “scheduling
gaps” or a student’s leave of absence.  During short scheduling gap periods and
academic leave of absences, students are considered enrolled and in the case of
ALOA may reenter the clinical program where they left off. 

Fourth Year Electives

The Clinical Dean must approve all elective rotations in writing. The fourth year
clinical elective rotations provide you with more flexibility and responsibility in
working within the hospital setting. The students who have opted to take their third
year rotations within the United Kingdom will profit from conducting their fourth
year in the United States.

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You may request your elective rotations in a hospital where you have taken third
year clinical rotations. However, you may schedule your own fourth year elective
rotations. This affords you the opportunity to explore specialty areas of interest.
Additionally, hospitals other than those affiliated with UMHS require that you apply
directly for these rotations.

Finding hospitals for fourth year rotations really is not difficult if you have the right
resources. The most useful resource is the Graduate Medical Education Directory
(commonly referred to as “The Green Book”), published by the American Medical
Association. This book lists every ACGME-accredited program and teaching
hospital in the United States. It will tell you which hospital has what program and
the affiliated schools, but do not let that deter you. Many will accept fourth year
students from other medical schools, both United States and International. The
Graduate Medical Education Directory can be accessed online at www.acgme.org

Many hospitals offer applications online for their fourth year rotations. This will
save you tremendous time and expense. The websites provide contact
information that you enable you to obtain details regarding the programs offered
as well as information on the geographical area to facilitate your housing search.

The most valuable resource is your own networking. Attending professional

conferences during your third year (and earlier years) is an excellent way to meet
doctors who may be willing to accept you into their program (and for them to meet
you). Word-of-mouth from friends can also be very important. They may have
had a great clerkship somewhere and know the right person for you to contact.

Be aware that when you schedule rotations, many hospitals have a specific time
requirement between receipt of application and start of rotations. It would be
prudent to apply approximately four (4) months before you finish your third year
rotations. It is also important to note if the hospital books all the fourth year
rotations at a specific time of the year for the entire year. Many create yearly
schedules in July for the coming academic year.

Remember that affiliate hospitals may provide you an opportunity, not a

guarantee, that you are accepted there for rotations. If you secure a hospital not
on the list, call the Clinical Dean’s office to request approval. Some hospitals have
waiting lists for senior electives; therefore, it is essential that you send all
documentation as early and as completely as possible to avoid unnecessary
delays in your placement.

In order to apply for a rotation at a hospital, request an application for visiting

senior electives. Complete the student portion and forward to the Clinical Dean for
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approval. You should also ensure that the U.S. office has a current copy of
immunizations and health certificates, liability/malpractice insurance, health
insurance, curriculum vitae and personal data information (including email) on file.
The Clinical Dean’s office will forward the appropriate documents and the
application to the hospital. Applications will not be approved if we do not have all
documents on file. If applying online, the hospital may require that you submit a
letter of good standing from the school; you will only need to contact the office of
the Clinical Dean with the appropriate information for this to be done.

The ECFMG (Education Commission for Foreign Medical Graduates) permits

elective rotations to be attended at non-ACGME accredited or non-teaching
hospitals. Such rotations must be approved in writing by the Clinical Dean.

Clinical Evaluations and Rotation Conclusion

You will be evaluated by your preceptor at the conclusion of each rotation. It is

advisable that you present copies of the UMHS Evaluation Form to the preceptor
and request copies of your record of the weeks you have worked at each hospital
site. If there are discrepancies in the weeks credited, it will be your responsibility
to work this out with the education office at the hospital. No changes on the
permanent record will take place without authorization directly from the hospital.

You will be evaluated for every clerkship rotation. To receive a passing grade for
a clinical clerkship, you must:

a. Submit within two (2) weeks of clerkship completion the completed and
signed Daily Log of clinical performance.
b. Receive from the DME’s office of the hospital a passing evaluation from the
preceptor.

Grades are based upon a weighted average of the combined grade on the
clerkship written examination, and preceptor evaluation.

Your conduct will be under constant review. Preceptors will evaluate your work
and conduct in the clinical setting. You will be judged on your professional attitude
toward colleagues, supervisors, patients, and patients’ families. Deference to
supervisors, residents, and physicians is expected and you will remain ethical in
all activities. You will maintain patient confidentiality and discuss sensitive case
information only with doctors, appropriate medical personnel, or students in a
private setting according to standards established by the U. S. Department of
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Health and Human Services in their disclosure/privacy of information act, HIPAA
(Health Insurance Portability and Accountability Act). Failure to follow these
regulations may result in an unsatisfactory evaluation from the preceptor.

If you receive an unsatisfactory evaluation on your clinical performance you will be

required to repeat the clerkship at your additional expense.

Core Clerkship Exams

The core clerkship examinations are administered as reasonably soon as possible

at the end of the rotation. You will receive an email notification from the Clinical
Dean’s office as to when and where the exams will be administered. The Core
Clerkship Examination must be taken at the first opportunity it is offered. If you
have completed a rotation and moved to a new site – or are awaiting your next
assignment, contact the Clinical Dean’s office to arrange your testing center.

You will not receive credit for a core rotation until you have documented proof of
completion of the required number of weeks, the hospital has provided evidence of
a satisfactory evaluation from the preceptor, a Daily Log has been received by the
Clinical Dean’s office within two (2) weeks of clerkship conclusion and completion
of on the core clerkship written examination. You will not be permitted to take an
exam until the end of the core rotation.

An examination will be administered for each of the six core clinical clerkships. All
questions will be multiple-choice, matching, and/or multiple matching. Case
histories are also included. The exams are administered in ninety minute sessions,
separated by a ten (10)-minute break. The maximum time for each core exam is
ninety minutes. Total time for each test site is three hours.

These examinations are administered at all sites at exactly the same time. You will
be required to stay in the examination room during the entire ninety minute
session. You will not be allowed to leave the test room during the exam without a
chaperone. At the beginning of a test, you will be issued only one exam at a time.
You will not be issued the second exam until the next exam period begins. You
must turn in the first exam before receiving the second.

Any action perceived by the proctor as cheating will result in your being removed
and a failing grade being assigned. The preceptor will then file a report of the
incident with the Clinical Dean to be placed in your file.

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Your final grade will be the average of the preceptor’s evaluation (80%), and the
clinical core examination (20%). However, all three [including the Daily Log for
that clerkship] are required to be submitted, and no final grade will be assigned
until all three have been submitted.

Information Requests During Senior Year and Residency

Requests for transcripts, clerkship evaluations, degrees, etc. to support an

application for residency must be accompanied by the fee listed in the published
UMHS Student Catalog. All letters of reference and similar supporting
documentation will be provided for senior electives.

When you request the documentation, please do so in writing, addressed to the

Registrar’s office. Be sure to allow sufficient time to complete the request. All
requests for documents should be made through the Registrar’s office.

State Board Regulation Restrictions

Currently you will not be allowed to engage in clinical core rotations in New
Jersey, Pennsylvania, Kansas, Florida, and California due to the individual state
boards’ regulations. It is always best to research the state board in the state
where you wish to practice.

Graduation

To be eligible to graduate you must:

 successfully complete all required coursework;
 successfully passed Step 1 and Step 2 [both parts] of the USMLE
 meet all financial obligations of the medical school; and
 have all required administrative documents on file.

Formal commencement exercises are held each year in May. Additional completion dates
include August and December, which administratively acknowledge graduation.

Residency Placement

You will be eligible to apply for a residency in the United States only after you
have earned the following:

 Doctor of Medicine degree from UMHS.

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  Successful completion of the USMLE Step 1
 Successful completion of the USMLE Step 2CK (the knowledge component)
and 2CS (the clinical skills component).
 Completion of TOEFL (Test of English As A Foreign Language, via ECFMG,
if applicable)
 ECFMG Certificate

You may improve your chances for a residency by engaging in a clerkship rotation
in the hospital in which you seek a residency. This will enable the staff of the
hospital to become familiar with your skills and personality. It is also helpful to
consider a residency specialty that is generally underserved in the United States.
Residencies in primary care areas, e.g., family practice, geriatrics and pediatrics
are generally more readily available as are rural and inner-city locations.

The most frequently used approach for residency selection is participation in the
National Residency Match Program (NRMP). You may apply for this by submitting
your application no later than the end of October. Before July you must have
completed all required coursework and obtained an ECFMG certificate. Send your
application to: National Residency Match Program, Section for Student Services,
2450 N Street North West, Washington, D.C. 20037-1127. As a senior, you can
apply for the Match even though you may not know your USMLE Step 2CK score.
The results of the Match are released in March.

In order to be eligible to participate in the NRMP, you must have passed USMLE
Steps 1 and 2 [both parts], by February of the year you wish to enter residency.
Additionally, you must be scheduled to graduate medical school on or before June
30. Most residencies begin on July 1.

The second approach for obtaining a residency position is to apply to specific

hospitals either before or after the Match. Many wait until after the Match and
apply to those hospitals whose residencies were not filled. For information
regarding residencies that use the Electronic Residency Application Service
[ERAS], contact the ECFMG.

Student’s Statement of Understanding and Compliance

I have read, understand, and will comply with all policies and procedures set forth
in the clinical handbook of which I have been given a copy. Any questions I have
on this policy or any other subject regarding clinical rotations will be directed to the
Office of the Clinical Dean.
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I will provide all documents and all updates, and will provide a copy of the policy,
along with any other necessary documents, to the Clinical Dean’s Office as well as
the particular clinical site.

I am aware that I will not be eligible to graduate until it can be demonstrated that I
am in good standing (academic, financial and behavioral) with UMHS.

Readmission Policy

If you have been withdrawn from UMHS and wish to be readmitted you should
anticipate doing so six (6) weeks prior to the start of the upcoming semester. The
reasons for this are:

1. To ensure Financial Aid application procedures are in place, if applicable.

2. That you must be aware that rotations will commence in the semester
following re-admission.

3. To allow for scheduling rotations/malpractice insurance application

processing/Letter of Good Standing, etc. to rotation site.

4. To ensure time for processing of the clinical registration and rotation

assignment forms as well as application for malpractice insurance.

5. To allow time for Student Accounts invoicing and receipt of any

payments.

______________________________________________________________
Date

________________________________________________________________
Signature

_____________________________________________________________
Printed Name

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