Clinical clerkships are essential for equipping medical students with the knowledge, skills, and experience needed to provide safe and effective care. These hands-on learning opportunities, typically undertaken during the third and fourth years of medical school, immerse students in real-world healthcare environments under the guidance of physician preceptors and other healthcare professionals.
“Clinical clerkships are an exciting time for our students as it provides the opportunity to gain hands-on experience in the healthcare field,” said Jay S. Feldstein, DO ‘81, president and chief executive officer of Philadelphia College of Osteopathic Medicine (PCOM), during a recent episode of the PCOM Perspectives podcast.
Joining Feldstein were Michael Becker, DO, MS, FACOFP, associate dean of clinical education for PCOM, and Marla Golden, DO, MS, FACEP, associate dean of clinical education for PCOM Georgia and PCOM South Georgia.Together, they discussed the importance of clinical clerkships in medical education and shared advice to help students prepare for and thrive in these critical learning experiences.
Success in clinical clerkships begins with a strong foundation in the basic sciences and core clinical skills. According to Becker, the preclinical years are critical for mastering the science of pathology and physiology. This groundwork enables students to effectively apply their knowledge when diagnosing and treating patients during rotations.
Becker emphasized clerkships allow medical students the opportunity to develop several key skills:
Golden agreed.
“Establishing a strong fund of knowledge in the basic sciences is critical, as is mastering the history and physical because that's truly how they will communicate with their colleagues about patients for the rest of their careers,” she said.
Developing a solid grasp of osteopathic practices and principles is also important, she added.
“If they do this and they move into their clinical years, they'll be able to apply this comprehensive frame of reference and approach to every patient they treat,” she explained.
Beyond these preparations, Becker shared some advice given to him by his predecessor, Dr. Joseph Kaczmarczyk.
“He always recommended to students that they need to learn to be comfortable with ambiguity, uncertainty and change,” Becker said. This adaptability is essential as students transition from textbook scenarios to the complexities of real-world patient care.
Clinical clerkships mark the transition from classroom learning to hands-on patient care. Students hone their skills by working directly with patients, conducting examinations, and managing cases under supervision. These experiences also help shape their professional identity as physicians.
Networking is another key benefit. Clerkships provide opportunities for students to connect with program directors, clinicians, and peers. Becker underscored the importance of fostering these relationships, noting that the medical profession thrives on mutual support and collaboration—ultimately benefiting patient outcomes.
As critical as clinical clerkships are to medical education, securing clerkships has become increasingly difficult over the past decade
“It's a very competitive environment with more and more osteopathic schools, larger allopathic classes, and competing for white coat space with other clinical programs, whether it be physician's assistant programs, nurse practitioner programs. It's just very, very competitive,” Feldstein said. “We could have a great relationship with a hospital, and tomorrow it gets sold, or two years from now, it closes. And as more and more care goes outpatient, we've got to adapt.”
The increased competition for placements, the shift to outpatient care, and the integration of technology are reshaping how students learn.
Adjusting to the growth of outpatient care does present challenges, Becker said. In years past, patients were often in the hospital longer giving students more time to interact and learn with a patient. Now, Becker explained, discharge discussions begin almost as soon as a patient is admitted.
“Certainly more and more of medicine is in the outpatient environment, and we have to learn to be more and more comfortable with having our students get outpatient medical education,” he said.
Technological advances in medicine are also impacting clinical clerkships.
“They've changed the way we do things,” Golden said. “We have electronic medical records now. We have information at our fingertips. And so that puts us in a place where the pace is much higher, much faster, and the time to diagnosis is shorter.”
What that means, Golden explained, is that expectations have changed. Basic clinical skills that were once learned during clerkships are now expected to be mastered before the clerkship even begins.
Clerkship rotations now emphasize specialized training to better prepare students for residency programs.
“In the past we were happy to follow our preceptor around and learn everything about anybody who walked in the door,” she said. “Now, we try to expose our students to as much of a specialty as we can in each core rotation.”
These challenges, Golden added, are part of the evolution of medicine.
PCOM is responding to these challenges with innovative, online blended learning for all the core rotations with online preceptors.
“Because hospital business is so fast-paced, there isn't that time where an attending or a resident could stop for a half hour and give a lecture,” Becker said.
Online blended learning is designed to help students better prepare for exams, Becker explained. Improved performance on the end of the clerkship exams (COMAT), as well as the COMLEX Level 2CE Board exams, could enhance a student's chances of being selected for residency interviews.
Feldstein encourages students to take ownership of their education during clinical clerkships.
“You will get as much out of it as you put into it,” he said. “It's really your commitment to it that's going to determine the success of your clinical education”
Feldstein also encourages students to find a way to actively participate in clinical care—not just watch a fourth-year ahead of them or an intern or a fellow. Choosing a rotation in a small community hospital, he said, can provide a great hands-on opportunity and a better overall clinical clerkship experience.
“Being out in the clerkships is the ultimate active learning experience,” Becker added. “I always recommend students remember, it's not about you. It's about the patient. It's always about the patient.”
Above all, students should remember that their efforts during clerkships reflect not only on themselves but also on their institution.
“We can't overemphasize that when students go out on rotations, they are representing PCOM, not just themselves, but our institution, which is why I think we put so much energy and effort into making sure they're well-prepared and well-trained,” Feldstein said.
PCOM’s dedication to preparing its students for clinical clerkships is reflected in its robust training programs and supportive community. With access to a vast network of alumni and a reputation for excellence, PCOM students enter clerkships with confidence, ready to excel and contribute meaningfully to patient care.
“I think that our brand is extremely powerful and it helps our students get opportunities that other medical schools might not have,” Becker said.
Those opportunities include a vast alumni network of physicians ready to help those who are following in their footsteps.
“We tell our residents when they come for orientation, don't forget what it's like to be a student,” Feldstein said. “So when you're a fourth-year student, don't forget what it's like to be a third-year student. Be there to help that person, because we're all trying to do the same thing and that's take care of patients the best way we can.”
Visit PCOM Perspectives on Soundcloud to listen to the podcast in its entirety.
Disclaimer: The video featured in this article was produced using an AI-powered tool to transform text into visual content, including AI-generated voiceovers.
© 2024 Philadelphia College of Osteopathic Medicine