General Responsibilities

1. Attend all scheduled rounds and teaching conferences offered at the various sites. A list of required conferences will be provided at each site. Policies regarding student attendance on weekends and holidays will be set by each site.
2. Core lectures will be held on Monday afternoons from 2-4 pm in Room 225 of the UND Medical Education Center. Bismarck and Grand Forks campus students attend via teleconferencing. These lectures will consist of problem-based learning conferences with Dr. William Newman, Dr. John Hagan, Dr. Jennifer Raum, as well as several UND faculty physicians.
3. Bismarck students meet with Dr. John Hagan each Monday at 4:30 pm. Dr. Hagan will hold open office hours on Thursdays beginning at 4:30 pm.
4. Notify your attending physician/preceptor and the Clerkship Office if you are absent. In Bismarck, call 751-9581 (Evie Hudson). In Fargo, call 293-4134 (Barb Swann). In Grand Forks, call 777-3406 (Phyllis Tweton).
5. A total of two (2) learning issues and two (2) patient writeups are required by the end of Week 8. Before the end of Week 4, submit one patient writeup to the clerkship administrator on your campus. It will be reviewed during your mid-clerkship feedback session for formative feedback. You will have the opportunity to revise the document and submit for grading after the feedback session.
6. Complete a mid-clerkship feedback meeting with the campus coordinator (Dr. Hagan in Bismarck, Dr. Newman or Dr. Raum in Fargo, Dr. Hargreaves in Grand Forks) as scheduled by the clerkship administrator.
7. Complete the Physical Diagnosis exam given the last Monday afternoon of the rotation.
   
8. Complete the Internal Medicine shelf exam given the last week of the rotation.
9. Complete 15 EKG cases which will be given to you by your campus clerkship administrator.
10. Access the web site:  https://survey.med.nodak.edu/ome/Clerk/preceptor_eval.asp  to complete your preceptor/attending evaluations.
    
11. Access the web site:  https://survey.med.nodak.edu/ome/Clerk/clerkship_eval.asp to evaluate the overall clerkship.
    
12. Complete patient database on Personal Data Assistant (PDA) and enter on the school’s web site.

Teaching Service Responsibilities

1. Perform an initial History and Physical Examination on at least two new patients each week as assigned by the attending physician or preceptor. A larger number of patients may provide a better learning experience.
   
2. Submit at least one patient write-up per week to your attending physician. Complete a concise, but thorough and accurate, patient write-up. The write-up must include a database, problem list, discussion of a learning issue, and patient management plan (see the section of this manual on write-ups for guidelines). This should represent your own independent thinking. A copy should be provided to the attending physician or preceptor within 24 hours of patient assignment for review and comments.
   
3. Present each patient orally to the attending physician or preceptor for review and comments (see appendices for specific guidelines).
   
4. Participate fully in the daily care of your patients (those on whom the student has completed a work-up). See each of your patients and complete follow-up assessments each day. Write daily progress notes on these patients (to be reviewed by the resident or attending). Be up to date on the clinical status and test results of each of your patients (be prepared to update your attending when asked), be present for procedures and participate when possible, and learn/perform minor procedures such as venipuncture and arterial blood gases. Attend any autopsies performed on patients who die while under your care.
   
5. Obtain the co-signature of the resident or attending on all notes and orders placed in the patient's permanent chart. This is entirely the student's responsibility. No orders may be carried out prior to being co-signed by a licensed physician. All student signatures in the medical record should indicate status, e.g., John Doe, MS-3.
   
6. Students will be expected to assist the residents on call and to work up a new patient when possible.  Any changes in the call schedule must be approved by the attending physician.
   
7. Additional duties may be required during rotations at specific sites. Information will be provided when you begin these rotations.

Preceptorship

1. If inpatient duties are assigned by your preceptor, see inpatient responsibilities above.
   
2. Complete a focused History and Physical Examination on approximately two patients per half-day in clinic as assigned by the preceptor.
   
3. Your preceptor may direct you to write or dictate a note for the patient's permanent chart. If so, your preceptor will give you explicit directions on how this should be done.
   
4. Present each patient orally, if requested to do so, to the preceptor for review and comments (see appendices for specific guidelines).
   
5. Identify learning issues for each patient you see. It is a good idea to write them down in a notebook or on index cards. Identify learning resources and research learning issues as soon as possible. We suggest researching learning issues immediately after seeing each patient. Some preceptor-student pairs may decide that it works better to save all learning issues for a block of time during the day. Review your learning issues with your preceptor as time permits.
   
6. Participate in all aspects of the preceptor's practice as directed by the preceptor, e.g., hospital rounds, consultations, nursing home visits, call, etc.
   
7. Take call as specified by your preceptor.
   
8. Additional duties may be required during rotations at specific sites. Information will be provided when you begin these rotations.