Clinical Guide Section 6: Fourth Year & Residency Applications Table of Contents Fourth-Year Requirements / Advanced Studies I. Twenty-four advanced clinical weeks All advanced rotations have these general requirements: · Rigor and substance · Clinical content · Explicit learning objectives · Learning plan · Appropriate assessment of student mastery · Core as prerequisite · Significant role in preparing students for graduation as well-rounded physicians and prepared interns    Tier 1: Advanced patient care rotations (16 weeks minimum):    · Characterized by responsibility for patient management    · Done under the supervision of UCSF faculty, therefore not "away"    · At least 8 weeks of "A" rotations; additional "A" rotations can replace "B"    "A" rotations must be done on services that have interns (or clear role for fourth-year students managing patients directly); fourth-year students work side-by-side with house staff with a similar level of responsibility. All "A" rotations must be four weeks long. All students are required to take Medicine 140.01 _ inpatient medicine (which cannot be taken at the same site that you took your core medicine clerkship) or FCM 140.40. Students' first two "A" rotations must be done in two different departments, although emergency room rotations with a Medicine course number are acceptable as a second "A" rotation. At least one "A" rotation must be completed by the end of Fall 1 block.    "B" rotations must include responsibility for patient management, as a member of the primary team or as a consultant, for 40 hours or more per week. These rotations can be two or four weeks long. Students' first two "B" rotations must be done in two different departments.    Tier 2: Advanced clinical rotations:    · If tier 1 "A" and "B" rotations have met the requirement for 24 advanced clinical weeks, then no other tier 2 rotations are required.    · Must meet general requirements above    · Clinical content, but not necessarily patient care responsibility    ·May be done "away," but must be signed off on by the UCSF analog department as conforming to general requirements. II. Twenty-seven discretionary weeks    At least 19* weeks must be taken for credit - includes:    · Area of Concentration work    · Additional clinical electives    · Independent study/international work not through AoC - up to one month    · 8* weeks available for vacation and/or internship interviews    (* assumes 4 weeks of vacation scheduled during the Clinical Core with either anes 110 or ids 110 remaining in 4th year) Note that clinical electives must be distributed over multiple disciplines. "Coda" course co•da n. Mus. A passage of more or less independent character introduced after the completion of the essential parts of a movement, so as to form a more definite and satisfactory conclusion. (Oxford English Dictionary, Third Edition) All students are required to take this course in the spring of their fourth year, immediately prior to graduation. The course structure will be modeled upon Intersessions, and includes a series of lectures, as well as large and small group sessions. The course focuses on several components of "preparation for internship" and conclusion to medical school: reviewing the presentation, pathophysiology, and management of common, critical diseases and clinical situations; learning technical and teaching skills; and exploring advanced aspects of professional development, ethics, and healthcare systems. Participation in the small groups and attendance at lectures are course requirements. All students will be expected to attend lectures for the didactic component of the advanced cardiac life support course. However, the practicum session and ACLS certification are optional, requiring individual sign-up and payment. The course is coordinated by Dr. Elizabeth Harleman and Dr. Ken McQuaid.   United States Medical Licensing Examination, Step 2 All UCSF medical students are required to take the Clinical Knowledge (CK) portion of the United States Medical Licensing Examination (USMLE) by December 31. "The Clinical Skills (CS) component of Step 2 supplements the (CK) component and must be taken by April 1. Step 2 CK uses the multiple-choice examination format to test clinical knowledge. Step 2 CS uses standardized patients to test medical students and graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues." Both examinations should be scheduled at www.nbme.org and you will need to bring your completed USMLE application form, photograph, and proof of payment to the Office of Curricular Affairs for processing and mailing. The CK component can be scheduled at any authorized Prometric testing center. However, the CS component is currently administered at only five sites: Atlanta, Chicago, Houston, Los Angeles, and Philadelphia. Again, CK must be completed by December 31 and CK by April 1. For more information and updates, please speak to Kathy Healy or Mario Mercurio.