8470 - Acting Internship: Internal Medicine - Beaumont Dearborn

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Henry Ford Health Service

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Additional Locations: Main Campus on W. Grand Blvd.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: EPIC

8470 - Acting Internship: Internal Medicine - St John Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - St Joseph Pontiac

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Preceptor(s): Geetha Krishnamoorthi, MD

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: EPIC

8470 - Acting Internship: Internal Medicine - St Mary Mercy Hospital/Livonia

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: EPIC

8470 - Acting Internship: Internal Medicine - Barbara A Karmanos Cancer Inst

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Sinai Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Harper Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Detroit Receiving Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes. Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one.  New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts.  Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship.  This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students.  Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades.  In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: CPRS