FAMILY MEDICINE

In order to receive a Letter of Distinction in the Family Medicine Clerkship, the student
must meet the following criteria:

1. At least one faculty member must nominate the student for a Letter of Distinction
on the medical student evaluation form.

2. The marks on the medical student evaluation forms must be all "outstanding"
3. The final exam grade must be 80% or above.
4. The group participation must be excellent during the Friday sessions.
5. The final case presentation must receive a grade 9 or above.

INTERNAL MEDICINE

Students who perform in a particularly outstanding manner throughout the Required Internal Medicine Clerkship will be awarded a Letter of Distinction. The criteria needed to earn a Letter of Distinction include:

1. An outstanding performance throughout the clerkship
2. A score of greater than 77 (approximately the 80th percentile) on the Internal Medicine Subject Exam.

To understand what demonstrates an outstanding clinical performance, please see the descriptors listed below.

Letters of Distinction are awarded by unanimous vote of the Junior Medicine Clerkship Committee at its bi-monthly meeting.

History taking: Precise, logical, through, reliable, purposeful, and focused. Includes all pertinent positives and negatives.

Physical examinations: Very complete, accurately done, directed toward patient's problem(s), and elicits subtle findings.

Case Presentations: Extremely clear, organized, complete, accurate, and polished presentation appropriate in length to the situation. Uses precise, accurate terminology.

Write ups: Outstanding, conscientious and accurate in recording patients' histories and physical exams. Differential diagnoses are extensive. Outstanding analysis of patient problems. Therapeutic plans are thorough.

Medical Knowledge: Extensive, well-applied knowledge of disease, pathophysiology, diagnosis, and therapy. Consistently up to date. Familiar with relevant current journal articles. Judicious in selection of www materials.

Clinical Judgment: regularly integrates medical facts and clinical data, weights alternatives, costs, risks and benefits. Understands limitations of knowledge. Wise use of diagnostic and therapeutic procedures. Regularly applies evidence-based medicine.

Physician Patient Interactions: Does not use jargon, communication with patients and families reflects clarity and empathy. Effective communicator with teams, staff et al.

Professional Attitude and Behavior: Enthusiastic, responsive, reliable. Committed, cooperative and respectful. Establishes trust. Displays initiative.

NEUROLOGY

The student must meet the following to be considered:

1. They must be nominated by one faculty member on the evaluation form.
   The criteria that will be given to faculty to consider are: A) Precise, reliable history taking, with problem oriented focus. B) Physical examination is complete and accurate. 3) Case presentations are polished. 4) Differential diagnosis is comprehensive and appropriate. 5) Good clinical judgment. 6) Effective communication with patients, families and housestaff. 7) Overall attitude reflects commitment, trustworthiness and respect.
2. Remarks on the Medical Student Evaluation forms from all three reviewers should be outstanding. The evaluations must also demonstrate that the Attending and Resident physicians on the team feel that the student has outstanding clinical and interpersonal skills, as well as applicable fund of knowledge.
3. The final exam grade must be the 80th percentile or above.
4. They must attend all Monday lecture sections and group discussion sections.
5. All evaluations and clerkship requirements must be submitted on time.

OBSTETRICS & GYNECOLOGY

90th percentile or above on the written examination judged to have truly exemplary clinical activities.

PEDIATRICS

You will be evaluated by housestaff and attending staff during your pediatric clerkship. At the conclusion of the rotation, a summative evaluation will be completed by the clerkship site director rotation and will include evaluations of your clinical work in all settings as well as your score on a written examination.

"Pass with Letter of Distinction" will be given to those students who achieve a score on the written examination above the mean, whose evaluation is in the outstanding range for all assessed categories and who excel in ALL of the following areas:

1. Demonstrated ability to apply basic medical knowledge to clinical scenarios
2. Demonstrated skill in performing, presenting and documenting history and physical examinations.
3. Demonstrated ability to critically evaluate and integrate data in seeking solutions to identified problems.
4. Demonstration of interest and responsibility in participating in patient care.
5. Demonstrated ability to work as a team and communicate effectively with other staff, including nursing, attending and house staff.
6. Demonstrated ability to establish rapport with patients and families.
7. Active and consistent participation in conferences and other teaching sessions.
8. Evidence of general inquisitiveness, consistency and responsibility.
9. Presence of a positive general attitude during the clerkship.

PSYCHIATRY

To obtain a Letter of Disctinction in the Psychiatry clerkship a student must

1. demonstrate to the attending and resident physicians on the clinical units the student's superlative clinical and interpersonal skills in caring for psychiatric patients and working with the interdisciplinary team.
2. demonstrate and excellent understanding of the basic content material of the clerkship on a written examination.
3. be an active and informed participant small group learning.

RADIOLOGY

Letters of distinction are not given because of the limited contact of faculty with the students.

SURGERY

1. The student must demonstrate a superior performance of the written examination.
2. The student must demonstrate a superior performance on the oral examination.
3. The student must demonstrate superior performance on their clinical evaluations.
4. The group consideration is given to students who receive a nomination or letter of recommendations for a Letter of Distinction from a faculty member.