Faculty of Medicine - Information on Clinical Rotations

Faculty of Medicine

Internal Medicine MD 4

General Information on Conducting Clinical Rotations

Requirements: For 16 weeks the students are expected to be in the wards Monday-Friday from 8:30AM - 1:00 PM.

Clerking: During this time they are required to clerk at least 2 patients a day.
This clerking should include full history of presenting illness, past medical history, social and family history, review of systems, and complete physical exam. These clerkings should be written, and submitted every Friday to one of the faculty staff of Internal Medicine. The student will keep a list as outlined below that the faculty member will sign weekly.

Required ward skills: The student should:
1. Set up 4 intravenous lines e.g. 1/v prip administration with competence in calculating the DROP RATE.
2. Insert 4 urinary catheters in male and female patients.
3. Draw 4 i.v blood specimens for investigations.
4. Administer 4 i.m. and i.v injections (therapeutic).
5. Administer at least 2 subcutaneous therapeutic injections.

These procedures must be supervised. A record should be signed by the authorized senior ward nurse or a member of the department of internal medicine.

Laboratory Skills:
1. Stain and read correctly at least 4 thick and 4 thin smears for Malaria.
2. Stain and read 4 specimens of sputum positive for AFB.
3. Stain and read 5 blood slides with abnormal RBC morphology.
4. Examine 4 or 5 stool samples for ova and parasites.

Other Skills:
1. Performing a scratch test (allergy).
2. Performing intradermal test (allergy).
3. Patch test (to discover cause of contact dermatitis).

Afternoon seminars: Attendance is required for Ifternoon sessions 2 - 3 times per week. Students ill be taught basic ECG interpretation. They will also be asked to give presentations on common clinical problems.

Record of activities and procedures: This record sheet of paper has to be returned to the coordinator at the end of the rotation.

Assessment and Evaluation:
Clerkings shall be graded and handed back to students within 3 - 4 days, so as to provide feedback. Students shall give presentations daily at the bedside to the group of his/her fellow students and internal medicine lecturer. Lecturers are required to be present in the wards at the time of clerking, so as to give feedback and supervise the physical examinations.

The final grade is determined by:
Clerkings 15%, Attendance 5% (Attitude and Ward procedures), and Mid-term written Examination 20%, which makes 40% in total. The Final Exam will constitute 60% that is; 30% for the Written Examination, and 30% for the Clinical Examination. Students must pass this part of the examination as per the University examination regulations No. 16.3.6.

Requirements:
Students should have required tools for full physical exam, such as: stethoscope, blood pressure machine, thermometer, reflex hammer, tuning fork, measuring tape and patellar hammer.

Reading List:
A. Clinical Methods
1. Macleod’s CLINICAL EXAMINATION (e.g. 11th edition) 2006. Elsevier, Edinburgh, Ed .Graham Douglas.
2. Introduction to Clinical Examination (8th edition)2006.Ed.Michael Ford, et al.
3. HUTCHISON’S CLINICAL METHODS An integrated approach to clinical practice (2nd, edition, edited by Micheal Swash and Micheal Glynn.(c)2007) Saunders. London.
4. Bate’s physical examination.

B.Text Books
1.DAVIDSON’S PRINCIPLES & PRACTICE OF MEDICINE 20th edition 2006.Churchill, Elsevier, Edinburgh.
2.CECIL TEXTBOOK OF MEDICINE, 1987.Saunders publishers. Philadelphia, USA.
3.Harrison’s PRINCIPLES OF INTERNAL MEDICINE.1996.Saunders co.Philadephia.
4.OXFORD TEXT BOOK OF MEDICINE e.g 2nd Edition, 1987 Ed.D.J.Weatherall.OUP London.
5.CLINICAL PROCEDURES Glencoe/Mc Graw-Hill.1999.New york,U.S.A.Ed.Barbara pricket-Ramutkowski, et al.

Date

Activity or Procedure

Consultant or   Technician



Name

Signature

- Students must try to clerk across a variety of systems.

System / Area

Number

  1. CVS

  1. RS

  1. GIS

  1. Met/Endocrine    

  1. Neurology

  1. Musculoskeletal

  1. Renal

  1. Infectious

  1. Reticuloendothelial

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