Clerkship Descriptions

Anesthesiology
Medicine
MCY Foundations

Neurological Surgery
Neurology
Obstetrics and Gynecology
Ophthalmology
Orthopedic Surgery
Otolaryngology/Head & Neck Surgery
Pediatrics
Primary Care

Psychiatry
Urology
Surgery
Mechanisms and Practice
Clinical Assessment Program/Cornell University Clinical Skills Center

 

Anesthesiology
The Anesthesiology clerkship is a one-week rotation. Students obtain clinical experience in the operating room under supervision, reinforced with didactic teaching sessions. The primary goals of the clerkship are to:

  • Increase capability of initiating appropriate therapy in acute problems which lead to respiratory and circulatory arrest
  • Become familiar with the role of the anesthesiologist in the operating room, the intensive care unit, as the respiratory therapy consultant, and in pain management
  • Help students learn fundamental anesthetic technique, procedures. and preanesthetic patient evaluation and preparation
  • Acquire techniques of IV placement and airway management
  • Review pharmacology of vasoactive drugs and their physiologic effects

Saundra Curry, M.D.
Course Director
Office: PH 5-517
Email: sc42@columbia.edu

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Medicine
The Medicine clerkship is a ten-week rotation, five weeks of which are spent at New York Presbyterian Hospital, Milstein Building and a second five weeks at one of the following: Harlem Hospital, Stamford Hospital, or the Allen Pavilion. This course emphasizes the integration and application of pathophysiology to the diagnosis and management of patients in addition to the skills of history-taking, physical examination, and case presentation. The course is an apprenticeship focusing on the bedside care of patients. Students work closely with house staff members and ward attendings - making daily rounds, admitting new patients, and caring for them with the team.  Students also participate in Preceptor groups - small case-based seminar sessions which meet regularly throughout each of the five-week segments of the ten-week clerkship.

Katherine G. Nickerson, M.D.
Course Director
Office: PH8E-105
Email: kgn1@columbia.edu

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Neurological Surgery
The week of Neurological Surgery will acquaint the student with neurosurgical problems and their management, including CNS and spinal cord trauma, spinal herniated disc and degenerative conditions, subarachnoid hemorrhage, extracranial carotid vascular disease, brain tumors, and hydrocephalus. Students observe and/or assist in neurosurgical operations, meet with their attending preceptor for discussion of various neurosurgical topics, evaluate outpatients, and attend educational conferences.

Guy McKhann, M.D.
Course Director
Office: NI 4-428
Email: gm317@columbia.edu

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Neurology
The Neurology Clerkship is a five-week introduction to clinical neurology, the specialty of medicine devoted to patients with diseases of the nervous system. The essential tools for the evaluation of neurological disease are the neurological history, the neurological exam, and specialized diagnostic testing, including neuroimaging.

The clerkship emphasizes the basic clinical methods of bedside neurology: based on the history and examination, students develop skills at neuroanatomical localization and clinical reasoning. Students learn to interpret clinical findings, develop a differential diagnosis, and formulate a plan of evaluation.

Over the course of five weeks, students develop a basic understanding and management approach for the major neurological problems:  stroke, headache, epilepsy, dementia, parkinsonism, multiple sclerosis, coma, brain and spinal cord injury, diseases of the spinal cord, tumors of the nervous system, back pain and sciatica, peripheral neuropathy, infections of the nervous system, including AIDS, and neurological emergencies.

Students participate directly in the care of patients on the Neurology Services and ambulatory clinics at Columbia University Medical Center and Harlem Hospital Center. Additional learning experiences include general and subspecialty conferences, daily Teaching Attending rounds, weekly core didactic sessions to review the neurological examination in adults and children,  neuroimaging interpretation, neurological problem-solving, and the Clinical Practice 3 session, focusing on communication, hope and empathy.

Goals of the rotation are congruent with Accreditation Council of Graduate Medical Education (ACGME) guidelines and the 6 domains of medical education:  patient care, medical knowledge, communication skills, professionalism and humanism, practice-based learning, and systems-based practice.  All of these elements form key parts of the educational experience in the neurology clerkship, as well as the feedback and evaluation process.

Students undergo an observed neurological history and examination, and feedback is provided at the mid-point of the rotation. Students are encouraged to take advantage of the many conferences and educational resources of the Department of Neurology. Evaluation is based on all aspects of clinical performance, oral presentations, patient write-ups, a neurology portfolio assignment, and the NBME clerkship shelf exam.

James Noble, M.D.
Course Director
Office: NI 308
Email: jnoble@neuro.columbia.edu

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Obstetrics and Gynecology
The Obstetrics and Gynecology clerkship is a five-week rotation which is spent either at the Presbyterian Hospital or Stamford Hospital (Stamford, CT). The main objective is to familiarize students with the signs and symptoms of normal and abnormal reproductive function and to teach the basic examinations in Obstetrics and Gynecology. The course will emphasize and reinforce skills of taking an appropriate history, performing a physical and pelvic examination, formulating a differential diagnosis as well as a treatment plan, and properly managing patients.

The student may gain exposure to the medical-surgical aspects in the subspecialty areas of gynecologic oncology, reproductive endocrinology, and perinatology.

The primary didactic vehicles will consist of formal lectures with assigned readings. Small group preceptor sessions along with conferences will supplement the core.

Rini Ratan, M.D.
Course Director
Office: PH16-62
Email: rr2172@columbia.edu

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Ophthalmology
The program consists of eleven hours of clinically-oriented lectures, twenty five hours of closely supervised instruction in clinical history-taking and ophthalmic examination, two hours in laser photocoagulation, two hours in ultrasonography, and twelve hours in the operating theatre. In small groups, students spend three hours in the private offices of attendings. The clinical experience is amplified by student attendance in a variety of subspecialty clinics including laser, retina, neuro-ophthalmology, uveitis, orbit and plastics, glaucoma, and pediatric ophthalmology. Students are encouraged to attend seminars and Grand Rounds and an on-call schedule has been devised to enhance clinical exposure. A multiple-choice examination is given based upon formal lectures and assigned readings.

Bryan Winn, M.D.
Course Director
Office: EI 3rd Floor
Email: bjw15@columbia.edu

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Orthopedic Surgery
Medical students spend a didactic two-week rotation on Orthopedic Surgery. The primary teacher is an attending, with some lectures and demonstrations by the resident staff. Students attend subspecialty conferences, rounds and patient clinics, and participate in some surgical procedures.

At the end of the rotation, the student should be able to:

  • Take an orthopedic history and perform an orthopedic physical examination
  • Understand the pathophysiology of the more common orthopedic disorders
  • Identify the basic diagnostic and therapeutic approaches to common musculoskeletal disorders (both medical and surgical)
  • Leave with a sense of how an orthopedic service is administered and its relationship to other medical disciplines

Joshua E. Hyman, M.D.
Course Director
Office: PH 11‑1124
Email: jh736@columbia.edu

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Otolaryngology/Head & Neck Surgery
Students spend one week on the service being introduced to the various aspects of the specialty, including Otology/Neurotology, Head and Neck Surgery, Facial Plastic and Reconstructive Surgery, and Pediatric Otolaryngology. Emphasis is placed on developing basic knowledge in the specialty and in acquiring the skills of the otolaryngologic examination. This is achieved through active participation in patient care in the ENT Clinic and offices, the Speech and Hearing Department, and in the operating room.

Joseph Haddad, Jr., M.D.
Course Director
Office: BHN 5-501
Email: jh56@columbia.edu

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Pediatrics
Students spend five weeks on Pediatrics either at Children’s Hospital of New York or Harlem Hospital. The rotation is divided between inpatient and outpatient experiences. The emphasis is on learning to care for children and families in a variety of patient care settings and developing the clinical skills, diagnostic reasoning, and basic management strategies core to the practice of pediatrics. Attendings and house officers emphasize normal child development as well as the role illness plays in the lives of children and families. Patient care experience is supplemented with daily rounds, conferences, lectures, and case-based seminars.

Andrew Mutnick, M.D.
Course Director
Office: BHN 517
Email: am312@columbia.edu

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Primary Care
This five-week clinical clerkship provides an exciting opportunity for students to have clinical experiences in ambulatory practices in rural, suburban, and urban settings. Students will learn the core skills and knowledge essential to the practice of Primary Care: diagnosis and treatment of common outpatient complaints, management of chronic medical conditions, and strategies for health promotion and disease prevention. Students will be precepted by faculty in Family Medicine, General Medicine, and/or General Pediatrics.

The teaching sites for the five-week clerkship are: Bassett HealthCare (Cooperstown, NY), Stamford Family Medicine Residency Program (Stamford, CT), Stamford Hospital General Medicine Residency Program (Stamford, CT), Harlem Hospital Center General Medicine Residency Program (Harlem, NY), Bronx Veteran’s Administration (Bronx, NY), NYP Columbia University Medical Center Family Medicine Residency Program (Washington Heights, NY), Dartmouth Family Medicine Residency Program (Concord, NH), Heritage House New York (NY, NY), Scarsdale Medical Group, Columbia Medical Group-White Plains (White Plains, NY), or the Indian Health Service sites - Whiteriver Family Medicine IHS (Whiteriver, AZ); Zuni Family Medicine IHS (Zuni, NM); Shiprock Internal Medicine/Pediatrics IHS (Shiprock, NM); or Shiprock Family Medicine IHS (Shiprock, NM).

The clinical experience is augmented by an online curriculum covering common outpatient conditions and basic principles in preventive medicine.

Deborah Jones, M.D.
Course Director
Office: P&S 3-401
 
Carmen Dominguez-Rafer, M.D.
Assistant Clerkship Director

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Psychiatry
Students spend their five-week Psychiatry clerkship assigned to one of the following clinical sites: Presbyterian Hospital/Psychiatric Institute or Creedmoor Psychiatric Center/Presbyterian Hospital. All students evaluate and follow patients on inpatient and outpatient services, child psychiatry, and the psychiatric emergency room, participating in their patients' care with close attending and resident supervision. The acquisition of clinical skills is emphasized: conducting an interview to obtain a psychiatric history and mental status examination; organizing, recording, and presenting the findings to generate a differential diagnosis; and formulating a treatment plan in accordance with the biopsychosocial model. Seminars complement the clinical experience by enhancing the knowledge base necessary to master these skills.

Janis Cutler, M.D.
Course Director
Office: PI 1st Floor, 1303-E
Email: cutlerj@pi.cpmc.columbia.edu

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Urology
The Urology Clerkship is a two week experience. Common urologic problems will be discussed during lectures and at bedside clinical teaching seminars, in clinics, and in the operating rooms. Emphasis will be placed on recognizing, diagnosing, and teaching common diseases of the genito-urinary system. All students will be assigned patients for individual evaluation. Each student will be required to write a short paper during the rotation.

James McKiernan, M.D.
Course Director
Office: 11-1101 Atchley Pavilion
Email: jmm23@columbia.edu

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Surgery
The clerkship in General Surgery is offered at four clinical sites: New York Presbyterian Hospital, Columbia Campus where students are assigned to teams at the Milstein Hospital Building, CHONY, or the Allen Pavilion; and off-site at Stamford Hospital in Connecticut, or Bassett in Cooperstown, NY. Doris Leddy is the clerkship coordinator.

At all sites students work closely with faculty preceptors as well as with the resident physician teams. The course is designed to provide clinical experience to improve skills in overall patient care as students apply their knowledge of the basic sciences and expand their knowledge base through exposure to the wide variety of patients and procedures that fall into the realm of General Surgery. Students become a valued member of the team as they assume responsibility for the overall care of their patients pre-operatively and post-operatively and assist in the operating room. There are team specific conferences, out-patient visits, emergency room consultations, and night calls (one night in four) to supplement inpatient "floor" learning. Students improve their clinical skills as they get appropriate feedback throughout the rotation and they will demonstrate their increased knowledge on the written "shelf exam" as well as their clinical skills on the oral examination at the completion of the clerkship. We hope that the rotation proves to be an enriching experience that at least matches our enthusiasm as we greet each new group of students.

Roman Nowygrod, M.D.
Course Director
Office: 651 Athcley Paviliion
Email: rn5@columbia.edu

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Mechanisms and Practice 
Mechanisms and Practice is an Integrative "back to classroom" experience that takes place during two one-week periods in the spring and fall of the major clinical year.  During these weeks, all students return to campus.  Sessions are designed to promote analysis of clinical cases on levels ranging from the molecular to the population, to foster reflection and teamwork, to enhance procedural and communication skills, and to build medical decision making capacity.  Time is allotted for exploration of scholarly projects, meetings with advisory deans and other mentors, preparation for upcoming clerkships, and individual commitments.

Mike J. Devlin, M.D.
Course Director
Office: 1051 Riverside Drive, Unit 116
Email: mjd5@columbia.edu

 

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Clinical Assessment Program/Cornell University Clinical Skills Center

All Major Clinical Year students participate in a day-long Clinical Assessment Program designed to evaluate their mastery of the skills of the clinical transaction. Students are excused from their clerkships for one day during the Spring when they are assigned to attend the Clinical Assessment (held at the Clinical Skills Center at Weill/Cornell School of Medicine). Using standardized patient methods, each student performs a focused medical evaluation on ten patients. The patients present with symptoms of medical, psychiatric, pediatric, surgical, gynecological, or neurological diseases, as seen in ambulatory settings. In fact, to achieve standardization, all patients are actors who have been coached to portray reliably the clinical aspects of each case.

After the interaction, the student writes a progress note including a history of present illness, physical exam, and differential diagnosis, and orders follow-up diagnostic tests. Meanwhile, the patient fills out information about the student’s history-taking skill, performance of the physical examination, and communication skills. The entire proceedings are videotaped for review later by the student and a faculty member. On the basis of patient ratings and students' written progress note, assessment scores are generated throughout the day on the individual cases as well as the individual skills assessed.  

Since the installment of the NBME Clinical Skills Exam in the required Board exams in 2004, this exercise has taken on more importance for P&S students. This is the only practice students will receive in taking formal standardized patient examinations, and it should be regarded as valuable preparation for the Step 2 CS exam. We know this assessment, performed at Cornell, is predictive of performance on the Step 2 Clinical Skills.  The format, timing, written note, and clinical situations are fashioned to mimic the conditions at the Clinical Skills Board exam. Students who do poorly on the Cornell assessment are at higher risk for poor performance on the boards.  Hence, this assessment functions as a valuable screen to identify students who may have difficulties on the Step 2 CS exam.  As a result, students who score two standard deviations below the mean of the class are required to meet with a faculty member (Dr. Low, Dr. Bakar or Dr. Baron) to review his/her performance videos in order to formulate a remediation plan and further prepare him/her to pass Step 2 CS.  In addition, video review sessions are offered in small group sessions for every student to have the unique opportunity to receive both peer and faculty feedback on your clinical performance.  All students are expected to sign up for at least one session as it is very useful in both preparation for Step 2 CS as well as providing you with feedback regarding clinical skills that should be helpful for your current practice.

The results of this assessment are not used as a pass/fail exam (as they are in other schools), nor are the results part of the student academic record in the Dean’s Office or the Dean’s Letter or transcript. The results are, as outlined above, used as a screen to predict performance on the Boards Clinical Skills exam. This will help all P&S students pass their CS boards on the first try. In addition, and perhaps more enduringly, the chief dividend of this exercise is obtained when the student reviews his or her videotape to learn what kind of doctor he or she is becoming, and to receive guided feedback about ways in which to improve clinical performance.

Participation in the Clinical Assessment Program is a requirement for promotion to the fourth year, and all Clerkship Directors release students from their clerkship duties on their assigned day. Students who fail to attend the Clinical Assessment on their scheduled day will be required to attend at a later date and to pay the not inconsiderable cost of the assessment themselves.

Academic Year 2013-2014 Regulations/Guidelines:

  • Participation is required by all 3rd year P&S students (including MD/PhD students) for graduation (No grade)
  • You may NOT switch your assigned day with other students without specified permission from Joy Bailey (jb13@columbia.edu)
  • If you miss your assigned day, you must be rescheduled AND pay Columbia University the cost of your open space which is approximately $400

Faculty Contact Information:

Melissa Bakar, MD mb3178@columbia.edu

Beth Barron, MD  - bab2113@columba.edu

Cari Low, MD  - cl2745@columbia.edu

212-932-5218

 

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MCY Foundations 
The goal of MCY Foundations is to foster the continuing practice of individual and group reflection on patient-physician relationships in the context of the clinical rotations. Discussion sessions co-led by an FCM preceptor and senior student co-leaders, focus on the transition to clinical clerkships, emerging concept of the doctor-patient relationship (Medicine clerkship), professional values and the “culture” of the operating room (Anesthesiology clerkship), sociocultural assessment (Primary Care clerkship), working with pain and suffering (Obstetrics & Gynecology clerkship), the appreciation of multiple perspectives in situations of conflict (Pediatrics clerkship), intense emotional responses in clinical work (Psychiatry clerkship), balancing hope and realism in serious illness (Neurology clerkship), and managing uncertainty and unexpected outcomes (Surgery clerkship). Students are asked to prepare brief written reflections prior to the shared group reflection.
 
Mike J. Devlin, M.D.
Course Director
Office: 1051 Riverside Drive, Unit 116
Email: mjd5@columbia.edu